Saturday, March 1, 2014

The Lab Rat Chronicles: Everything You Wanted to Know But Likely Just Assumed the Worst Instead

So you wanna know what it means to be a lab rat?

Consider this your condensed summary:

Various medical research companies worldwide recruit healthy participants to take a low -- often an incredibly low -- dose of a new (and, yes, experimental) medicine in order to ensure that there are no serious side effects. These companies recruit healthy (and drug-free) subjects because they need to know for certain that any particular side effects -- if there are any at all -- were caused solely by the drug and not any additional chemical or environmental factors. More importantly, they want to see how fast the compound metabolizes in the body, or how it interacts with another drug already approved by the FDA. (For instance, people with high cholesterol often take blood thinners, so if one were to test a new cholesterol medicine, it would be beneficial to see how it interacts with Coumadin, the most popular blood thinner on the market.) In order to gather the most accurate research and to best monitor the health of those who have been dosed, it is required that the subjects remain on-site in a controlled environment for the duration of the study. This means not only living in the equivalent of a giant dorm with labs attached but also maintaining a set schedule and diet.

There are further restrictions: no medicine, no herbal supplements or vitamins, no caffeine, no alcohol, no smoking, no drugs, no vigorous exercise leading up to the study. (Grapefruit and Seville oranges are generally a big no-no as well.). Also, no contraband (pornography, weapons, candy, gum) and no hanky panky with your fellow participants once you're on the inside. Subjects are usually allowed outside once a day, but unless the clinic has an enclosed patio and a liberal policy on staying outdoors, you will spend most of the time stuck inside. That's why the compensation is lucrative and meals, wi-fi and full-service laundry are included. Of course, one can choose to leave a study at any time -- subjects are here of their own free will -- but then you'll only be paid for the days completed (and will probably miss out on the bonus that comes with completing the study).

That said, there are several particulars worth pointing out:

The risks really are minimal: Before anyone can enroll in a study, they have to screen for it first to ensure that they meet all physical, mental and schedule requirements. It is then that the coordinators hand over a fat packet of information and carefully walk you through the study procedures: what the drug is for, how large the dose will be, the number of doses throughout the study and how they'll be administered, how many subjects have already been dosed, known and possible side effects from previous trials, total number of blood draws. Essentially, you know everything that they know about the drug in question as well as what will be required of you as a study participant. Some drugs are already on the market (or about to go to market) but have shown promise as a treatment for another ailment. A most illustrious example of this would be sildenafil citrate, which was originally created for hypertension but also turned out to cure erectile dysfunction -- and that's how Pfizer wound up raking in untold billions with Viagra. (Can you imagine what the first clinical trial for that must've been like?!)

Easy money, plenty of perks: Because you're volunteering both your body and your time, medical research facilities generally offer anywhere between $200-$300 per day for these studies. If you're eligible, it is quite possible to make $10,000 in one month's time -- and all for something as simple as taking one pill a day. I was unemployed during a big stretch of the Great Recession before finally landing a worthwhile 9-to-5 job in early 2012. I worked 50 hours a week for 18 months, and although my debts stopped going up, they wouldn't really go down either. Then suddenly HR canceled my contract despite the protests of my supervisors, leaving me to scramble for new work. I stumbled upon clinical trials by sheer accident, and now I'm on a fast track to paying off my debts once and for all and saving up a nest egg so that I can gain a skill and move on to better things. Rest assured, I don't plan on making this a career, but I do travel all the time now -- for both pleasure and in pursuit of work -- and I'm healthier than I've ever been because I basically get a comprehensive check-up and physical every month. And, yes, it certainly is an odd way to make money, but I think it's a far better use of my time and energy than scraping by at a minimum-wage gig. Also, there are plenty of fascinating and worthwhile people to befriend at these places. (Never, ever underestimate the incentive of camaraderie.)

It's certainly NOT for everyone: With the exception of opiates -- never sign up for an opiate study as they absolutely will come with strange and discomfiting side effects -- the drug is actually the smallest hurdle of these trials.* People hate needles more than they hate new medicine, and these studies require A LOT of blood draws. For example, on an average "dose day" a subject usually endures 12-15 blood draws over a 24-hour period. They don't take a lot of blood overall, but that's still a lot of vein sticks. Worse, because subjects must live in a controlled environment, you're choosing to give up most of your personal freedoms. Want to go on a date with that hot crush who's suddenly interested? Nope. Best friend you haven't seen in three years passing through town for the weekend? Sorry, you've got a job to do. Did your kid just take his first steps? Well, I hope someone got that on video and e-mailed it to you. It sucks not having the freedom to go wherever and do whatever you please! And living in a dorm isn't the end of the world, but it's a lot to ask of someone who cherishes their privacy. (Living arrangements vary from facility to facility. I've been lucky enough to get my own room, or room with a good friend. I've also had to live for two weeks in an open-dorm layout that could accommodate up to 80 people at any given time; of course, I just had to be stationed right next to the most annoying and argumentative study participant I've ever encountered as well.) Worst of all, the sheer boredom of it can drive you crazy. Sure, you might plan on reading all these books you've been meaning to get around to, or catch up with all these critically-acclaimed movies and TV shows stored on your laptop hard drive, or write that great American novel about people who -- what else? -- donate their bodies to science, but you still need FOCUS to accomplish these things. That's not always easy when 50+ strangers are milling about in your immediate vicinity, shuffling, scratching, coughing, snorting, wheezing and talking shit far louder than necessary. If you're not diligent about using your time wisely, it's easy to squander all of it in the slowest and least productive manner possible -- and that's maddening.

Nothing is guaranteed (until you dose): Clinical trials are a fantastic way to make money, but it's not much of a career. Securing this kind of work full-time requires that you consistently remain healthy and drug-free. Obviously, if you get sick, you won't be eligible for a study. But look out 'cause even if you're finally over a cold, your antibodies could still be too high during screening, which will disqualify you from a study. Iron too low? Ineligible. Creatine levels too high? Pass. It can be incredibly difficult to match the study parameters, and a lot of times you won't know if you're truly eligible until you arrive for the screening. (For instance, I've seen several participants get rejected in a row after a lightning-fast sight inspection of their arms proved that their veins weren't ideal for IV doses. Imagine driving 2-5 hours to screen for a study and being told to go home before you have a chance to fill out the initial paperwork.) Even more exasperating is the fact that tracking down the most lucrative studies might mean driving or flying thousands of miles with the hope that a.) you meet the study requirements and b.) your lab results are better than the dozens, possibly hundreds, of others who are also screening for it. Finally, in order to secure enough eligible participants, these facilities recruit more subjects than actually needed for every. single. study. What makes this especially frustrating is that one-third(!) of the subjects checking in must be sent home before the end of the first day with little compensation for their time -- and you very well could be one of them. Even if you might be in the best shape of your life, if there are too many eligible participants available to choose from, it's still possible that you could be randomly selected to go home.** (If this happens, just remember: It's not personal, and there's always another study.)

So that's pretty much everything you need to know about what it takes to make a living as a lab rat. As you can see, it's no more glorious or depraved than most jobs where you work on-site for weeks or months at a time. It can be terribly lonely or terminally boring at times, but there's also the possibility of accomplishing any number of goals and making the most of your days if you really set your mind to it -- and then walk away with a big check for all your troubles! Essentially, it's easy money in exchange for some not-too-hard time.

Think you got what it takes?

*An incredibly assuring study coordinator put it into perspective: "The human body is quite resilient and more than capable of filtering or outright rejecting a vast array of chemical influences. Even if we were to give you something toxic -- and we most certainly would not -- the doses we administer are so low that you'd likely overcome it in a matter of hours. And worst case scenario, we have nurses and paramedics here 24/7 to ensure your safety."

**This is why there's a common-sense rule among lab rats that you don't count yourself as officially enrolled into a study until you actually dose. Anything could happen before then -- the sponsor could cancel the study at the literal last minute; the doctor overseeing the study might decide that they want more female participants than they currently have on hand; your blood pressure might be too high the morning of the dose -- anything -- and until you take that drug, you have zero claim to that big payout at the end. In fact, it's recommended that you don't even unpack your bags until you dose. In essence, "Don't chill 'til you take the pill."

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