Kanye West allegedly addicted to laughing gas

Your “Stigma in the News” lead story for August 15, 2024

Special note: I’m creating a new series called “Stigma in the News,” with I will find interesting stories about stigmatized diseases and share them in short newsletters. But before we dive in, I have a panel shortlisted for the South by Southwest (SXSW) film festival, titled "Leveraging Social Media for Health Education and Advocacy." Could you take a minute to click on this link — panelpicker.sxsw.com/vote/155127 — and upvote our panel? It would make a world of difference!

Item #1: Kanye West’s ex-chief of staff says the rapper is addicted to laughing gas

In its simplest form, addiction is the tipping point at which compulsion turns into dependency, when a person’s behavior or drug use spirals out of control despite harmful consequences. Everyone’s heard of nicotine and cocaine, but nitrous oxide, commonly known as laughing gas or whippets, can also be abused — due to its euphoric and hallucinogenic properties.

American rapper Kanye West is addicted to laughing gas, according to a recent affidavit submitted to the California Dental Board by his former chief of staff. The story goes that, allegedly, West’s dentist provided him the nitrous oxide for cash—over $50,000 per month—even after West experienced distressing symptoms, including “erratic behavior, mood swings, paranoia and violence.” The affidavit goes on to say that this dentist provided four canisters of nitrous gas to West’s home and “knowingly encouraged their use in the absence of a qualified anesthesia or medical professional by a person with history of mental illness and addiction.” Yikes.

West, who is no stranger to controversy (or antisemitism), has not responded to these claims, as far as I can tell, but his dentist has denied them, with his spokesperson saying this story is “not only factually incorrect but also intentionally misleading.”

For now, this is just a tabloid tale, so who knows what’s true or what’s not. But I wanted to share it because addiction (medically known as substance use disorder) rarely breaks through to the public. So what can this story teach us about it?

American rapper Kanye West (David Shankbone)

First, addiction isn’t just about the substance but about patterns of use that can take over a person’s life, regardless of the consequences. While the opioid use disorder narrative has long been dominated by “deaths of despair,” centered on working-class white Americans, we shouldn’t forget that addiction can affect anyone, no matter their wealth, fame, or status. (Anyway, the deaths of despair narrative is out-of-date, since more Black and Native Americans are dying of suicide, drug overdose, and alcoholic liver disease nowadays, per a JAMA Psychiatry study.)

Second, this incident underscores the stigma around addiction. With West’s fame and controversial history, including his struggles with bipolar disorder, there’s a risk that the alleged substance use may be trivialized or even stoke some schadenfreude. Let’s remember that addiction is a serious health condition, one that requires compassion and understanding, rather than judgment. When famous people face these struggles, the public often conflates their personal flaws with their illness, reinforcing harmful stereotypes and making it harder for the public at large to speak openly about substance use and recovery.

Finally, addiction isn't just an individual struggle but can involve systems and people who, either intentionally or out of negligence, contribute to the problem. Our solutions, in turn, must include accountability across all levels—individuals, healthcare providers, and the government. STAT News, for instance, has an incredible series called the “War on Recovery,” where it delved into how almost every part of American society is sabotaging our best tools to treat opioid addiction.

Addiction is a chronic disease and a public health crisis. We need to treat it as such.

Item #2: FDA rejects ecstasy as PTSD treatment

Imagine you’re a veteran suffering from PTSD. One day, you could take Molly to help.

But that day isn’t today. On Friday, the Food and Drug Administration (FDA) rejected MDMA, commonly known as ecstasy or Molly, as a treatment for PTSD. Two clinical trials, published in Nature Medicine had shown this treatment worked, reducing PTSD symptoms and functional impairment while also being safe and well-tolerated by patients. More granularly, they showed that two-thirds of participants no longer met the diagnosis criteria for PTSD, thanks to talk therapy and MDMA, compared to only about 40% of the placebo group who got talk therapy alone.

Recent Phase III clinical trial that showed MDMA may be a breakthrough treatment for PTSD

But the FDA had an issue with this trial design since it wasn’t blinded, meaning participants in the MDMA and placebo groups knew what they were getting (and so did the researchers). There’s a bit of a no-shit-Sherlock element here, since obviously there’s no placebo “trip,” but the worry is that this lack of blinding made the results biased. According to STAT News and the Institute for Clinical and Economic Review, there have also been some allegations that patients with severe negative outcomes were excluded from the trials. Other issues included the drug regimen not being standardized across trial sites and the risk of misconduct, given a report about an unlicensed therapist sexually assaulting a participant in one of the older MDMA trials.

I don’t know enough to say whether the FDA made the right or wrong decision, but it’s understandable how veterans groups and psychiatrists might be disappointed, given that there are no good therapies for the 13 million Americans with PTSD and ecstasy seems to offer real hope.

The basic science also checks out: ecstasy induces the release of serotonin, the “happiness hormone,” which could help people with PTSD eliminate fearful memories and promote social behavior. When some Johns Hopkins researchers gave MDMA to octopuses, these traditionally solitary creatures became more social and extremely hug-friendly.

What I wonder about this FDA controversy is how much did the stigma around psychedelics, known for their recreational drug use, impact the decision. After all, this stigma can reinforce outdated notions of mental illness as being untreatable, as well as perpetuate the notion that mental health issues must be handled with extreme caution, even when patients are desperate for new solutions. But I also wonder, and worry, about how patients’ excitement for a “magic bullet” — to the point of cult-like enthusiasm — might have put hype over evidence.  

That’s all for this week! If you enjoyed reading this first edition of “Stigma in the News,” please consider liking this post and restacking it.