For Carlton L. Murray and Don Jones, the easy money comes in tablet form and at the prick of a needle. And it can be habit-forming.
This time out, the two men are holed up on the second floor of a West Fayette Street building, confined with 14 other healthy men, each assigned a number in a research test of generic form of high-blood-pressure medicine. For seven consecutive days, they pop pills, give blood -- as many as 12 syringe-sucking draws a day -- eat what's on their plate, refrain from exercise, put up with "stinky feet" and other niceties of dormitory life. Then, they do it again for another seven days. The payoff -- $ $ $ -- one thousand of them.
"We know a sweet study when we hear one," says Mr. Murray, a cheerful 36-year-old from Washington and a regular in PharmaKinetics Laboratories Inc.'s stable of participants in such tests.
"I seen how easy it is to make a little bit of money, and I've been coming every time," says Mr. Jones, 34, of Baltimore, who earned his first dollar at the private drug-testing company in 1989. "I'm laid off right now. . . . As far as I'm concerned, this is a savior."
And it's an offer many people can't refuse.
From Lincoln, Neb., to Miami, hundreds of volunteers across the country are participating in scores of studies at private contract research firms, pharmaceutical companies, universities and medical institutions.
They test everything from nasal sprays to new AIDS vaccines, drugs to relieve the numbness in a diabetic's toes or aches in arthritic joints. The pay can range from $300 to $3,000.
"Hopkins needs you," says an announcement in a Johns Hopkins Medical Institutions publication. The notice lists at least 20 different studies, searching for tension headache sufferers, healthy men, diabetics ages 18 to 59, marijuana users and others. Not all test drugs on their participants. Many, nonetheless, do offer cash to compliant research subjects.
In a billion-dollar industry that relies on healthy volunteers for the initial phase of a clinical drug trial ("first in humans"), competition for participants can be stiff.
It's a mostly male club; test subjects rarely include women because of concerns that a drug may affect their ability to have children. But grandmothers (post-menopausal women) have joined novice filmmakers, retired machinists and the unemployed test drugs that have previously been administered to animals. There are even a few young men -- known to some as "professionals" -- who hop from state to state, study to study, to earn a living.
Pharmaco-LSR of Austin, Texas, billed as the largest clinical research testing firm in the country, draws retirees and college students alike with offers of "Shoot Pool . . . Get Paid," "Watch Movies . . . Get Paid." The newspaper advertisements play off the leisure time afforded a drug tester who may be confined for 24 hours or a month at its 198-bed unit. Last year, the company paid out $2.6 million to 2,903 test subjects.
"We've never hesitated to use humor as a way of capturing people's attention," says Ellen Buckmaster, a company spokeswoman. "Our aim in advertising has always been to try to be real and human . . . and to reassure."
Stephen M. Hale of Austin has been so reassured by the "Camp Pharmaco" staff that he's volunteered for more than a dozen studies.
"I stopped counting at 15," says Mr. Hale, who joined what he once referred to as "Laboratory Rats Inc." to make extra cash. "I know one year I made $7,000 and it put me in the next tax bracket. I would recommend it to anyone who needs quick, easy cash legally."
Plus, "you're doing something for mankind," says Mr. Hale, the 45-year-old father of two and a program director of a vocational rehabilitation center in Austin.
At PharmaKinetics in Baltimore, where (in the words of one ad copywriter) "helping others always pays," Carlton Murray, Don Jones and the others have traded in their street clothes, money and other belongings for lab scrubs, thermal underwear, numbered T-shirts and slippers embossed with a smile. Physical exams and blood work completed, they have tested negatively for drugs or alcohol, a must to enter the study.
After signing the consent forms, they know what to expect from the generic drug they will test -- a calcium blocker used to treat high blood pressure and heart disease. Headaches, stomach cramps, dizziness, "a hot flushed feeling" -- the possible side effects associated with the drug -- can be treated by friendly staff nurses.
When friends call him "a guinea pig," Mr. Murray explains that he's usually taking a generic form of a brand-name drug that already is on the market. And, he notes, the test is measuring how well the body absorbs the drug -- "how fast it goes in, how fast it goes out."
For 156 hours, these so-called "temporary employees" are locked in a second-floor wing of the West Fayette Street building that includes a game room, a television lounge, dining area and dormitory cubicles. They rise at 5:30 a.m., are in bed by 11. The day's monotony is broken by blood draws, telephone calls to their families, the taking of vital signs, a pool game, the numbing, nonstop showing of thriller, killer, sci-fi video fillers such as "Under Siege," "The Godfather" (1-2-3) and "Rapid Fire."
Through two sets of windows, they watch the world, a cornflower blue sky and gritty cityscape circumscribed by rooftops, alleyways, building lines and an occasional passing woman.
"The key to a long stay like this is to keep the peace and not hurt anyone's feelings," says Mr. Murray, who sets his own bedtime challenge, a million score on the pinball machine.
By Day Six, however, even a veteran like Mr. Murray seems rattled. A buddy, among a crew of four who decided to do the study together, has twice snapped at him. "Robot Jock," his movie selection, has been panned by its captive audience. His 2-year-old daughter won't talk to him when he phones. And for some reason, he is the only one in the group whose daily change of clothes includes a maroon, instead of a red, T-shirt. And no one will let him forget it.
"I know now how animals feel in the zoo," says Mr. Murray, who works in a banquet department at a Washington hotel.
Over the past three decades, the U.S. Food and Drug Administration has adopted a series of regulations to protect participants in drug trials. Biomedical ethicists and others cite as grounds for the safeguards the infamous examples of abuse that predate them, like the 1932 Tuskegee syphilis study in which several hundred Alabama black men who had syphilis were never told of it nor treated for it. Federal public health officials conducting the study wanted to see how untreated syphilis would affect the human body.
Today's regulations govern drug-trial advertising, payments to test subjects, and the information that must be revealed to participants, both the benefits and risks associated with taking a drug. Before a study can proceed, an institutional review board, made up of experts and lay people, evaluates the protocol as it pertains to participant safety and approves it.
Dr. Robert Temple, director of an FDA drug evaluation office, knows of no deaths related to drug testing of healthy volunteer subjects. But he adds: "That doesn't mean one couldn't happen. The people are healthy. They are given modest doses, and they are being watched very closely. On the whole the history is these are quite safe procedures."
New York sociologist Bernard Barber, who has written on issues affecting research subjects since the 1960s, says there has been much improvement in the industry.
"A potential subject has to ask questions," adds Dr. Timothy J. Keay, co-director of the Center for Biomedical Ethics at University of Maryland at Baltimore.
On the evening the PharmaKinetics group departs, the only ailment members appear to be suffering from is cabin fever.
"This is the longest hour of this day," says Mr. Murray, as the first phase of the trial ends with one last "stick," the test jargon for a blood sample.
Group members leave with $150 in cash in their pockets and plans for the week. To claim the remainder of the $1,000 booty, they must complete the second, seven-day pill-popping, blood-drawing, movie-watching stay.
"Once I leave, I leave the study behind," says Mr. Jones, a laid-off hotel worker whose family has moved to Dundalk while he's been in the program.
"It's like leading two lives," says Mr. Jones, who has used earnings from past studies to buy Christmas presents, pay outstanding child-support debts and treat his family to a Kings Dominion outing.
"You're living with the guys, eating together, sleeping together, joking around. You go home, you're a father to your children, a husband to your wife. You come back here and you're one of the boys again. You're not a lab rat. You're a human being."