Category Archives: Denialism

Meryl Dorey’s ABC of immunisation incentive lies

Posted in Denialism, Health, Legal by

On Friday November 25th after Nicola Roxon and Jenny Macklin announced the Stronger Immunisation Incentives reform, Meryl Dorey went on a lying frenzy.

First up was ABC 612 Mornings programme with Terri Begley. You can listen in the player below or download the audio here.

Let’s deal with Dorey’s second lie first. That Nicola Roxon’s media release makes no mention of Conscientious Objectors. This is also being propagated on the AVN’s Yahoo! email list as “despicable” on the part of Nicola Roxon. There’s “no mention” of it cries another AVN member whilst yet another writes authoritatively:

That exemption is rendered effectively unavailable to all those parents who hear, officially or semi-officially, only that there is no exemption, as is implicit in Dr Roxon’s media release, which is therefore highly deceptive.

Highly deceptive? Implicit in Dr. Roxon’s media release? [R]endered effectively unavailable? What planet are these people on? You can read the release in my prior post in PDF (on page 2) or visit the Health Ministers web page here. And what do we read smack bang in the middle of this “highly deceptive… despicable” media release?

Existing exemptions will continue to be available for people who register as conscientious objectors to immunisation.

Oh.

Would that stop Meryl Dorey from lying on air? Surely our self styled guru would at least read the media release. Search for the words “conscientious objector”?  As Meryl told Terri Begley:

I have not seen anywhere in this information that’s coming out today to say that you are entitled to be a conscientious objector and still get the money. If the money is being given out it should be given out to all, whether you vaccinate or not, um, otherwise it becomes a matter of discrimination and I don’t think the Government wants to be discriminating against people, that is the wrong thing to do.

Frankly, that’s just not good enough. There are a lot of implicit accusations there, all wrong and all based on ignorance at best or Dorey’s own deception at worst. This is perhaps Roxon’s mistake here. She has failed to see that such a move will give the antivaccination lobby a soap box from which to embellish their misinformation and promote Conscientious Objection. Dumping the Maternity Immunisation Allowance and linking Family Tax Benefits as an “incentive” to complete vaccination schedules, may well become an incentive toward Conscientious Objection.

Earlier Dorey tries to make a link between pertussis vaccination of very young children in the ACT and the notification levels of pertussis in all age groups. National Notifiable Diseases Surveillance System data do not provide notification for each state and territory by age. I’ll get onto that again after we visit Dorey’s second ABC interview.

You may remember Dorey’s reply to the HCCC over complaints made. In September 2009 she wrote [bold mine]:

… the current increase in the incidence of pertussis has nothing to do with any purported decline in the rate of vaccination. Instead, we are seeing an outbreak of pertussis despite a substantial increase in vaccination against it – an experience which is being duplicated in every country for which mass vaccination against this illness exists.

She cited articles with the opposite argument to hers and even went as far as plagiarising a WHO graph. Despite the HCCC finding against her Dorey has made this claim often only last July blaming the vaccine for an increasing death rate. She makes this claim again on air except this time implicates the USA claiming [bold mine]:

…they are actually blaming the use of the whooping cough vaccine for this outbreak that’s occurring in the countries where the vaccine is being used.

This has also been picked up over at Thinking is Real which includes a terrific piece by piece breakdown of Meryl’s earlier distortion of an article she’d posted to Facebook. Dorey claimed it as proof that the pertussis vaccine is “ineffective”, where it says no such thing. It’s essential reading for those interested in Dorey’s tactics. Indeed the article reinforces all we know about pertussis immunity and the newer acellular vaccine.

Then it’s on to Louise Maher for Drivetime on ABC 666. Again you can listen below or download the audio here.

By this time Meryl has discovered CO still applies but is arguing government flyers and media reports aren’t stressing this fact loudly enough. Dorey’s risk to public health is borne out again as she raises the need for parents “who have done their research” to be able to avoid vaccination, get CO forms signed and still be able to collect FBT, way above the vital need to have their children vaccinated.

Nicola Roxon’s intent to raise the profile of vaccination schedules as essential to public health is being outdone by a conspiracy theorist arguing that the vaccines we’re using are not even known to “be safe and effective”, yet parents are being “bribed” to comply. Instead the government should be testing these perhaps unsafe and ineffective vaccines and comparing the health of vaccinated vs unvaccinated children, Dorey suggests with a straight face.

Then the distortion about pertussis again [bold mine]:

… we’re finding in the United States and in all other countries that use the mass whooping cough vaccination that the vaccination is not leading to a decrease in disease.

No doubt Dorey would be aware that the ACT Government’s alert on pertussis includes informing the population about a targeted adult vaccination program and states under “What else can you do to protect your baby?”:

  • Ensure your baby is vaccinated on time, this can be done from 6 weeks of age.
  • Ensure everyone in your household is up to date with their vaccinations.

The efficacy of pertussis vaccination is beyond doubt. It’s role in saving infant lives is irrefutable. Whilst vaccinated children may contract pertussis they receive a much milder infection and experience non life threatening symptoms. All pertussis fatalities in Australia have occurred in unvaccinated children. It is quite outrageous on the part of the ABC that Dorey was given uninterrupted air time to spread her rapid fire calculated untruth designed to malign an essential vaccination for infant health and presently, infant survival.

Asked about pertussis Ms. Dorey answered in dissonance to government advice and claimed vaccination “doesn’t seem to be the answer”, then proceeded to present a statistically implausible correlation between the rate of vaccination of babies in the ACT and the notification level of pertussis across all age groups in the ACT. It’s simply the same old trick Dorey has been using now for years. Comparison of unrelated data sets.

The Dept. of Health and Ageing National Notifiable Diseases Surveillance System represents the prevalence of legally notifiable diseases. It carries no information on the vaccination status, active immunity or lack thereof in the cases counted. Vaccine induced immunity for pertussis is temporary. It wanes and this is the primary concern in combating spread of pertussis. Of the 18 age groups covered, 16 are outside the age at which immunity can be said to wane. Of course, Dorey did not give age group specifics nor qualify her claim in the context of an epidemic.

Notification simply does not reflect the efficacy of pertussis vaccine induced immunity in vulnerable newborns. Notification does not reflect the origin of infection, but rather the location of diagnosis and compliance with the requirement to notify. This is further complicated by tourism, immigration, business travel, diplomatic and political visitors to our nation’s capital, potentially impacting on infection of the ACT populace.

Adults rarely experience the debilitating symptoms and as such represent a silent reservoir of infection. Around 11.3% of adults can be considered to have pertussis vaccine immunity. For this reason the ACT is offering free pertussis boosters. Authorities state:

Infants too young to be fully vaccinated are most at risk of catching the disease and suffering serious complications from pertussis. Most infants catch pertussis from their parent or carers.

Dorey claimed pertussis infection rates in the ACT were “seven times that of Tasmania and more than twice the level of most states and territories”. The second claim is false. No other state or territory is “more than twice” that of the ACT.

According to the National Notifiable Diseases Surveillance System on pertussis notification, the rates per 100,000 citizens at present for 2011 are: ACT – 217.3,  NSW – 157.1, N.T. – 127.6, QLD – 167.7, S.A. – 128.1, Tasmania – 31.9, Victoria – 137.7, W.A. – 112.5.

Dorey also said:

…even though we’ve had a huge increase in vaccination rates over 20 years it has not correlated with any decline in whooping cough, in fact we have more cases of whooping cough now than we’ve ever had on record and that is despite an over 95% rate of vaccination amongst children.

Again the irrelevance of quoting unrelated data sets is borne out. This statement falsely assumes pertussis vaccination that provides temporary immunity in small children should also be contributing to the eradication of pertussis in the entire community.

There are other very good reasons documented by the National Centre for Immunisation Research and Surveillance. In their November 2009 Pertussis Fact Sheet on page 2 we find:

In recent years, there have been periodic epidemics which have occurred at intervals of 3–4 years (1997–98, 2001, 2005–06, 2008– 09), set against a background of endemic circulation. However, increasing immunisation coverage has been associated with reductions in disease among immunised children and adolescents. Between 1998 and 2008, there were 84,758 notifications of pertussis nationally, ranging from 5,670 in 1998 to 14,347 in 2008. However, the increase in notification rates over time could also be due, in part, to better case ascertainment through the increased availability of serological testing and more sensitive tests (e.g. polymerase chain reaction).

Of the last 20 years only the last three show childhood infection rates that compete with adulthood rates. This is due to an epidemic, not a failure of vaccine efficacy. Pertussis vaccine induced immunity does not offer 100% protection against contraction of pertussis in all children. However it does provide sound immunity in the majority, and renders infections far milder than those that strike unvaccinated children saving the lives of those vaccinated.

The reason we have “more cases of whooping cough now…” is due to excellent reporting which shows up in Notification data and a present epidemic of pertussis. One contributing factor is the prevalence of misinformation such as that peddled by Ms. Dorey leading to a drop in infant vaccination. Ms. Dorey omitted to include a fall in immunisation rates predicates a rise in infection in both vaccinated and unvaccinated children. In fact her deception can be further borne out if we quote from the article posted on her Facebook page. The one in which she claimed Californian pertussis vaccination was “ineffective”.

Under Waning Pertussis Immunity Comes as No Surprise Dr. Carol Baker writes in part:

The California epidemic was caused by underimmunization of some children, and by waning immunity in fully vaccinated children. It showed that we are not where we need to be to have herd immunity. The 2010 California outbreak caught everyone’s attention.

In June 2009 the Journal Paediatrics published an article on the fall out from parents refusing pertussis vaccination for their child – Parental refusal of pertussis vaccination is associated with an increased risk of pertussis infection in children. The authors concluded in part [bold mine]:

Vaccine refusers had a 23-fold increased risk for pertussis when compared with vaccine acceptors, and 11% of pertussis cases in the entire study population were attributed to vaccine refusal.

Ms. Dorey’s statement of a “huge increase” in vaccination in the past 20 years is misleading. In 1989-90 71% of children were immunised. In 1995 61% of children were immunised. In 2001 71.6% of children were immunised. By March 2006 95.1% of children were immunised. There has been no steady increase in pertussis infection to match the increase in vaccination. This epidemic began in 2008. 2007 notifications were the third lowest on record since data collection began in 1991.

Pertussis infections rise and fall dramatically and until 2007-2008 the bulk of infections occurred in adults. In 2001 there were 48.5 cases per 100,000. In 2002 there were 28.0 cases per 100,000. In 2003 – 25.3, in 2004 – 42.9…. by 2007 there were 22.6 cases per 100,000. As mentioned this makes 2007 the third lowest year since records began. It is higher than only the first two years, 1991 and 1992 (1.9 and 4.5 per 100,000 respectively) when the notification of pertussis was still new to health practitioners. More so, Dorey has this very information in front of her but simply chooses to cite selectively. Consider the variation in Australian pertussis totals in the far right column. This does not show a steady increase:

Click to Embiggen

Little wonder the NSW Health Care Complaints Commission investigation established that the AVN:

  • provides information that is solely anti-vaccination
  • contains information that is incorrect and misleading
  • quotes selectively from research to suggest that vaccination may be dangerous.

The HCCC also stated that the AVN refusal to comply with requests may “…result in members of the public making improperly informed decisions about whether or not to vaccinate, and therefore poses a risk to public health and safety.”

Most frustrating is that this manipulation of unrelated data sets by Ms. Dorey has already been the subject of an upheld complaint, published on November 11th, 2009. Dorey’s obfuscation of her intent to mislead listeners and the failure of the ABC to properly disclose her biased agenda as an anti-vaccination lobbyist has also been the subject of an upheld complaint, published June 29th, 2010.

There can be no doubt that yet again Dorey has misled listeners in a most egregious manner that, in the context of the present epidemic, places the lives of Australian newborns at risk. The ABC has shown extremely poor judgement in putting Dorey to air as very few if any commentators can deal with the speed and volume of her misconception.

Dorey has absolutely no qualifications and as such should not be providing any on air information. She did not cite any scientific material, nor – for good reason – the source of her figures. Nor is her argument supported by any peer reviewed literature. Indeed quite the contrary.

In short the ABC has recklessly given Dorey a platform from which to seize control and misrepresent the Immunisation incentive, sway uncertain parents toward not vaccinating and repackage her lies on failing pertussis immunisation. In this light they have completely failed listening audiences.

Won’t they ever learn?

Acupuncture: Essential Facts About A Major Scam

Posted in Alternative "medicine" scams, Big Placebo, Health, Scam by

Back in May 1998 a systematic review of published results from clinical trials and the country they are published in was, well… published.

Two studies were conducted. In one, trials in which the outcome of acupuncture was compared to placebo, no treatment or a non acupuncture intervention were studied. In the second study randomised, controlled trials (RCT) of non acupuncture interventions in China, Japan, Russia/USSR, or Taiwan were compared to those published in England. Regarding the study of acupuncture:

Research conducted in certain countries was uniformly favorable to acupuncture; all trials originating in China, Japan, Hong Kong, and Taiwan were positive, as were 10 out of 11 of those published in Russia/USSR.

It was also found that trials in the second group were skewed to produce favourable results in China [99%], Japan [89%], Russia/USSR [97%], and Taiwan [95%]. In England, “75% gave the test treatment as superior to control”.

No trial published in China or Russia/USSR found a test treatment to be ineffective.

Conclusion: Some countries publish unusually high proportions of positive results. Publication bias is a possible explanation. Researchers undertaking systematic reviews should consider carefully how to manage data from these countries.

In 2010 a systematic review of systematic reviews of acupuncture for depression stated in part:

Acupuncture is often advocated as a treatment for depression, and several trials have tested its effectiveness. Their results are contradictory and even systematic reviews of these data do not arrive at uniform conclusions. The aim of this review is to critically evaluate all systematic reviews of the subject with a view of assisting clinical decisions. […]

All the positive reviews and most of the positive primary studies originated from China. There are reasons to believe that these reviews are less than reliable. In conclusion, the effectiveness of acupuncture as a treatment of depression remains unproven and the authors’ findings are consistent with acupuncture effects in depression being indistinguishable from placebo effects.

So on top of favouritism to acupuncture in certain countries, notably China, there is also an overlay of unusually high results. Indeed as shown in many studies and reviews initial study design and publication bias in Asian countries favours acupuncture efficacy. A few minutes searching will confirm this over and again. Thus, we can confidently be skeptical about studies raised in defence of acupuncture and stand firm that it’s “success” stems from study design and publication bias.

Yet, there’s also the issue of mythology and outright fallacies presented time and again regarding acupuncture’s origins. Appeal to antiquity is a major thought stopper when it comes to how acupuncture works and the other hanky panky around “forces” and “energy flows”. Consider:

Acupuncture is a traditional technique developed over two thousand years ago based on the insertion of needles or more recently electrical stimulation, based on the Chinese medical theory that diseases are caused by blockages in the flow of energy within the body.

We can rather swiftly expose that story as a patently modern day fake. Some scam artists know that acupuncture as we know it, is only a few decades old. In reputable organisations or conventional medical service providers where it is offered, a cleverly worded non committal pitch, seems to please legal advisers whilst keeping the mystique alive. I particularly like this one from Arthritis M.D.:

Acupuncture is one of the key components of the traditional Chinese medicine system.  Chinese medicine was documented in China in the 3rd century B.C.  This system views the body… Traditional acupuncturists also believe… According to Chinese medicine… As acupuncture has evolved and spread across countries and continents, different acupuncture points have been reported.  Chinese theory…

It’s one of the very few that acknowledge (but do not admit) the fallacious creation of the vast majority of the more than 2,000 acupuncture points, or acupoints. There was originally 365 to correspond to days of the year. But thanks to Western marketing, bogus diploma courses, bad science and general unaccountability manifesting in mock up journals things got more convoluted and sciency. So what are the problems with the story of a 2,500 year old therapy? Fortunately other sciences can explain.

We’re asked to believe that the technology to make needles far thinner that hypodermic needles existed around 500 BCE. Just on that, Reflexologists claim a history of up to 5,000 years in their appeal to antiquity. Historiologically this is absurdity on steroids, even out-dating Moses by 1,600 years.

Earliest Chinese texts are from 3rd century BCE, and no mention of any needling is in evidence. By 90 BCE needling of infected wounds and bloodletting was reported. Archeological and anthropological evidence is robust and unambiguous. Needles used were huge. It was not until the 1600s that the technology to manufacture acupuncture needles existed. So, immediately we’re down to a generous 400 years.

In 1680 the first Western accounts of Chinese medicine [TCM was introduced by Mao in the 1960s] by Wilhelm Rhijn did not mention acupuncture points,”qi” or energy flow. Needles were shoved into wombs and skulls for “thirty respirations”.The USA did try this technique for drowning victims from 1826, reporting 100% failure and that they “gave up in disgust”. Western reports of “acupuncture” from around the early 1900’s mention not one word of the practice we’re today told is 2,500 years old. Most tellingly there are no points, qi or meridians in these reports.

In fact, it mirrored mechanical nociceptor stimulation and endorphin release, with needles jabbed into sites of pain. By the 1900s, “Qi” is still “vapour emitted by, or arising from food”. Meridians are still inert vessels/channels with no bodily association. So, we’re down to a few decades – but how few?

Enter… The French. Georges Soulie de Morant coined the usage of “meridian” to justify his belief that energy or “qi” moved throughout the body. He is the first properly documented human being to make that link. It was 1939. However, we had to wait until 1957 until another Frenchman, Paul Nogier, invented auricular acupuncture. Note this is not today’s acupuncture, nor the claimed ancient method. It is the notion of unseen energies. Similarly, today we hear much of non existent “toxins” where once we heard of disease carrying “Miasmas”. Some others in France accept this concept. Most French doctors claim this is “resurrecting an absurd doctrine from well deserved oblivion”.

So in respect of this practice supposedly a part of Chinese history, we’re down to 53 years, have no scientific or medical community support and seem to be nowhere near China. Also the Traditional Chinese Medicine [TCM] phrase is yet to exist also. Why? Interestingly enough, the only nation to strive to ban the acupuncture (of large needles jabbed into wounds, skulls and wombs) was China, between 1822 and WWII, under the Chinese Nationalist Government. Post Communist Revolution, Mao was faced with the reality of infection and disease as the few remaining Western or Soviet trained doctors worked in cities in a nation where 80% of the population was rural. An immediate problem for Mao was wide spread schistosomiasis. Vikki Valentine writes:

One of the Party’s first steps in medical reform called for massive campaigns against infectious disease. Thousands of workers were trained and sent out into the countryside to examine and treat peasants, and organize sanitation campaigns.


Enter his “Barefoot Doctors” who provided cheap and dangerous “alternative medicine”, and demonstrated the power of the Peoples Party when ordered to physically catch all fresh water dwelling snails capable of passing on the schistosoma parasite responsible for schistosomiasis. Ten million residents suffered from this and peasants called it “Big Belly”.

The schistosoma parasite when infectious swims about happily until it encounters a human. Then it burrows into the skin and becomes a schistosomula. It then sets up camp in the lungs or liver to mature.

Adults then infect the lungs and liver and also set off to invade the bladder, rectum, intestines, the portal venous system which carry blood from the intestines to liver, spleen, and lungs. Symptoms include seizures and the swollen belly.

A major platform of the Communist Party was a revolution in agriculture. A “Great Leap Forward” was needed in China. But Party leaders, including Chairman Mao Zedong, knew that improving the health of peasants was integral to increasing agricultural production.

What followed was a backlash against Western-style “elite” medicine. The “bourgeois” policies of “self-interested” physicians who only treated rare and difficult diseases were denounced as “disregarding the masses.”

Mao was pleased with reports that the disease was wiped out in up to 95% of areas where it had been endemic. He claimed his party could “cure what the powers above have failed to do”.

Mao’s government coined the term “traditional Chinese medicine” – TCM – including herbal medicine, crude acupuncture, moxibustion and more in the 1960’s. Mao himself despised the notion, never using any “TCM”. Vested interests had little trouble manufacturing an entire fake history which – ironically – we in the West could access with ease, from a nation practically able to suppress the flow of air, much less information.

Chinese do not use the TCM we have invented here in The West. In 1995 a group of visiting American medico’s were informed between 15-20% of Chinese use herbal medicine. Almost no Chinese medicine is used in and of itself but with mainstream medicine. It is considered a sign of poor class and ignorance by the Chinese in general to use any “TCM”.

The Australian Acupuncture and Chinese Medicine Association offer a celebration of meaningless “qualifications”, codes of ethics and standards, all carefully crafted by themselves. So, what’s happening within this multi-billion dollar industry that need face no medical tribunals, provide data nor adhere to Australian Medical Standards?

Today it is a Western marketing success that grew following Communist Dictator Mao’s smirking at – then – superior economies. Unable to apply widespread Western medicine, alternatives were used. The West was assured this was successful and superior. We were scammed via our own gullibility about the far East and The Orient, still are by the Wellness Industry and China has indeed had the last laugh. Acupuncture produces a documented placebo effect. If you think youʼre getting it, it works, whether you are, or not. Itʼs you, the recipient who does this “mystical thing”. Harriet Hall writes in Science Based Medicine:

In the best controlled studies, only one thing mattered: whether the patients believed they were getting acupuncture. If they believed they got the real thing, they got better pain relief – whether they actually got acupuncture or not! If they got acupuncture but believed they didnʼt, it was less likely to work. If they didnʼt get it but believed they did, it was more likely to work.

Acupuncturists can rationalize with great ingenuity. In a recent study using sham acupuncture as a control, both the sham placebo acupuncture and the true acupuncture worked equally well and were better than no treatment. The obvious conclusion was that acupuncture was no better than placebo. Their conclusion was that acupuncture worked and the placebo acupuncture worked too!

Certainly there are ancient practices involved in the modern TCM plaguing the growing hokus pokus that constitutes the “Wellness Industry” yet acupuncture is not one of them. What we have today is not a 2,500 year old practice but a relatively modern expression of bad science derived from archaic ignorance that’s been very recently polished and refined to seem like genuine therapeutic intervention. At it’s very best acupuncture may well be responsible for releasing endorphins. It is a placebo and thus as a reliable mode of treatment is utterly and absolutely useless.

Of course many herbs can have demonstrable effects. In truth those that do are few and regulation is poor. Contamination with mercury, arsenic and lead is common whilst interaction with genuine drugs can lead to serious adverse reactions. All TCM must be regarded as harmful in that it delays access to efficacious evidence based treatment and is buoyed by the deceptions or well meaning but erroneous beliefs of practitioners. Proponents are welcome to subject their “medicine” for clinical trials, yet time and again they emerge as alternatives to medicine.

To argue there has been an unbroken chronology of superior “natural” therapies is simply false. It’s a common myth proffered by the Wellness Industry. Archaeology is absolute in producing evidence that humans have for many thousands of years died much, much younger and from painful chronic diseases that were quite simply beyond treatment. Diseases we today do not encounter in developed nations. Like any alternative to medicine acupuncture cannot survive RCT except to emerge time and again as placebo.

Australia would do well to review how much we spend on education and insurance for this slick ritual.

With friends like these… Meryl Dorey’s exploitation of Saba Button

Posted in Anti-Vaccination Lobby, AVN, Denialism, Health, Judy Wilyman, Legal, Meryl Dorey by

Over the past few months I’ve come to accept that there is one Australian absolutely delighted with the fact that (then) 12 month old Saba Button suffered organ and brain damage following febrile convulsions brought on by Fluvax.

Meryl Dorey of the AVN has enveloped herself in the tragedy of the Button family, declaring long and loud she is their unofficial antivaccination representative. She claims to have twice met with them and had been, “in contact by both telephone and email many times over the intervening period…”. Finally, after 18 years of fabrication, untraceable images, offensive claims and being a danger to public health the woman who likens vaccination to “rape with full penetration” has landed her fish.

She writes in a conspiracy piece on her blog:

I can also tell you that this reaction was entirely preventable because neither they nor any other parent who gave permission for their precious child to be vaccinated in this campaign was informed that their babies were being used as guinea pigs in a trial that was paid for by the drug companies involved. Neither were they aware that those payments going to people who ostensibly worked for the government (both state and federal) and who were considered to be – but actually were not – independent.

All of this is a complete fabrication. No trials are conducted surreptitiously. Ethics requirements aside exactly what data could those conducting Meryl’s pretend trial hope to collate? By who, how and when would subjects be monitored, what tests would be carried out and for how long? Indeed Dorey is suggesting this “trial” was simply a stab in the dark to see what happened. No such trial took place and thus was not paid for by drug companies. Worse, this is knowingly exploitative of the Button family and reduces their personal tragedy and grief to yet another of the thousands of tactics Meryl Dorey has used to mislead Australians.

Morally it is no different to her claim yesterday that infants who die in a co-sleeping arrangement are likely vaccine induced fatalities. Why? Because GP’s point out the danger of this arrangement, so it must be an abuse of “natural instinct” and thus a conspiracy is in order. Or her ACTION ALERT! announcement that supporters of vaccines were mobilising to harass the author of Virus in the system – an article that recounted Saba’s experience.

CSL does carry out yearly trials following strict protocols on an informed, compliant sample, the results of which are published in peer reviewed literature. This is mentioned below. Yet I’m not here to make excuses for CSL whose conduct surrounding Fluvax, their economic handling of certain legitimate trial results and adherence to Good Manufacturing Practice leaves a great deal to be desired. Nor am I by any stretch of the imagination a fan of Dr. Rohan Hammett, head of Australia’s Therapeutic Goods Administration. One cannot however make conclusions without evidence. Unless of course, one fabricates.

As an update, one commenter below has pointed out there was a trial to gauge the epidemiological impact of the present schedule, in response to infant fatalities from influenza the year before.  I’m perhaps duty bound to note that infant fatality from flu was mentioned by Judy Wilyman at the AVN’s first Perth trip on June 30th 2010 at the State Library, W.A. Judy informed the audience that the media report such fatalities as scare campaigns to “coerce us into vaccination”. This is because, “We’re being educated by the media who have pharmaceutical interests”. I should also point out that W.A. was the only state to use seasonal influenza and H1N1 together for children under five, which can be regarded as novel and thus raise concerns about earlier trials, particularly on sample size. Yet there were no guinea pigs, or state sanctioned, profit driven guesswork.

Regarding “those payments going to people who ostensibly worked for the government…”, that too is fallacious. TGA national manager Dr Rohan Hammett was before a Senate estimates committee on October 19th, being quizzed over the very nature of Fluvax, CSL, trial results, the febrile convulsions in W.A. and payments from drug companies.

Liberal senator Concetta Fierravanti-Wells, quizzes Dr. Hammett beginning with justified concerns that the TGA knew of high fevers in 2009. Yet more disturbing is that 2005 trial data yielded fever rates of 22.5%. The 2006 fever rates were 39.5%. Despite this, CSL advised the TGA in 2009 of the 2005 figure [pp.42-43]:

Senator FIERRAVANTI-WELLS: Are you demanding an explanation? You should be.
Dr Hammett: We are. We have written to CSL.
Senator FIERRAVANTI-WELLS: It emerged that the company knew two years ago about research suggesting a sharp rise in feeders linked to its seasonal flu vaccine but omitted this from information given to doctors. We have canvassed this in these estimates. My question is: when did you and when did the government first know about this? Is this the first you have heard of it? That is really what I would like to know.
Dr Hammett: No, it is not, Senator. In 2009 a study was published which related to clinical trials undertaken in 2005 and 2006. That study was published in peer-reviewed scientific literature. We were advised by CSL of its publication at about the same time as it was actually published. You will recall that that in the years before the Fluvax incident with febrile convulsions—and, indeed, for the last four decades—seasonal flu vaccine has been regarded as an incredibly safe vaccine. In 2009, 2008, 2007, 2006 and 2005 there was no suggestion of safety problems with the flu vaccine.
In retrospect, knowing now what we know in 2010, that there was a problem with the 2010 vaccine, people are going back through clinical trials and saying, ‘With the aid of the ‘retrospector scope’, could we have picked anything?’ Indeed, in those earlier clinical trials there were rates of fever for the Fluvax vaccine that were higher than some other comparable vaccines. However, as noted in yesterday’s article, most of those fevers were mild or moderate and there was no sign of a febrile convulsion signal. Febrile convulsions were not occurring in those studies that were done.
As I have said, we have written to CSL and made inquiries as to whether there was any delay in notification of us of these issues and have sought to gain a greater understanding of what they knew when. We have not yet received a response, but we are awaiting that.
Senator FIERRAVANTI-WELLS: Can I ask you to take on notice how much money has been paid to CSL? It is an enormous amount of money that you pay them. You obviously must have a very close relationship with CSL—and I mean that simply because of the nature of the work that they do and how much they provide in terms of products to the Commonwealth. Surely, Dr Hammett, you must have been aware of what this company was doing and certainly known about its research in relation to these fevers.
Ms Halton: Let’s just back up a second. There are a couple of things. Dr Hammett is the regulator. He does not pay the CSL anything. He has a very clear role, which is as a regulator. He takes that role very responsibly and very seriously. There is a separate part of the government which purchases vaccine, including from CSL. So I think we need to make a distinction here about who is paying what for whom and what the nature of the relationship is, because I do think it is—
Senator FIERRAVANTI-WELLS: I am happy for that to happen, Ms Halton, but the point that I am getting to is, given the close relationship—whether it is on the side of the purchasing arm or on the side of the TGA—this is a serious issue. Two years ago, at a period much earlier than has been previously canvassed in these estimates, there was an issue about fever. My question is: when did the government first become aware of this?

Senator Nick Xenophon later cuts to the chase addressing Hammett [p.44]:

Because time is so limited, I will put some questions on notice for you. First, can you provide details of when the TGA first became aware of the peer-reviewed article? Second, at what point was action taken? Third, did the TGA embark on other inquiries as a result of that peer-reviewed article? Fourth, do you agree with Professor Peter Collignon’s view? It is:
The TGA should be ensuring companies do update their data—it should be compulsory that the TGA should be informed of any new information, and the TGA should ensure the product information is updated to reflect that.

What really stinks coming from CSL is that the 2010 product information did not include the already documented 2009 higher fever rates. It is true these fevers are usually mild to moderate and of short duration – a factor which influenced the TGA to take no action.

It is here – and only here – that Meryl Dorey is more than welcome to raise concerns and recount poor practice or lack of insight and follow up on the part of either CSL or the TGA. However perhaps the greatest damage done by CSL is to public confidence in the safety of influenza vaccination, particularly for at risk children.

So what of actual febrile convulsion? Dorey variously claims hundreds of hospitalisations or hundreds of cases. The ABC reported “hundreds of reactions” on April 18th, 2010 with 47 taken to hospital reported on April 23. The West Australian on the same day reports 23 admissions. This led to the suspension nationwide by Commonwealth chief health officer Professor Jim Bishop.

Fluvax was given to W.A. babies resulting in a seizure rate of 3.3 per 1000. On this point MJA Insight write:

This rate of febrile convulsions [noted in 2006 trial data] (1 per 272) is similar to the estimate for the 2010 season (3.3 per 1000) which led to the unprecedented decision by Australia’s chief medical officer to suspend the use of paediatric flu vaccines.

A TGA spokeswoman told MJA InSight that a single adverse reaction report within a clinical study was not usually regarded as an adequate signal of a major safety problem. Lead author of the clinical study, Professor Terry Nolan, also told MJA InSight that the small sample size of the study meant the rates of febrile convulsions were not comparable with those seen in the community in 2010.

“We did a clinical study. It was published in a peer-reviewed journal. The serious adverse events were notified to the sponsor [CSL]”, said Professor Nolan, who is also head of the school of population health at Melbourne University.

It is not Professor Nolan’s role to inform the TGA. Nor do other members of the ATAGI receive special bonuses or payments from drug companies to influence perception of vaccines. Nevertheless Dorey manufactured a letter from a supposed “whistleblower”. A sordid tale about another W.A. based ATAGI member being handsomely rewarded by evil drug companies led her to wind up her article with:

In fact, we are told that all of our medical advisors must be paid by the drug companies because it seems to be impossible to find qualified people who haven’t been tainted by drug company cash.

This is why the AVN says that we can’t trust our government when it comes to their assessment of the safety or effectiveness of drugs and vaccines. There is a holy trinity comprised of the government, the drug companies and the doctors. This triad is protected by self-regulation (via the TGA which is completely funded by pharmaceutical licensing fees) and a complicit media which is beholden to drug company advertising.

Sounds conspiratorial? Well I’m sorry, but these are the facts.

No Meryl, that is simply fantastic conspiracy twaddle wasting good space on your blog when the real facts are far more convincing and indeed far more concerning.

But Meryl wasn’t finished with that simple post-W.A. trip tantrum, presumably to let off steam after her enormous W.A. tour flop. Last Wednesday November 16th she posted:

We read fiction:

I personally know of one 70 year old woman and a 19 year old man who were hospitalised within hours of getting the shot and who died within 7 and 2 days of that (respectively) Those deaths were never reported as being related to the vaccine.

More accusations are made about the TGA “knowing” and the CDC not buying Fluvax for this reason. No sources are cited. Then most offensively:

I will check and see how donations can be made to Saba’s fund. I know there is one that was set up for her when she was first injured. Her parents could not possibly be taking care of her in this way if it weren’t for that fund. Here’s hoping that compensation will be swift and generous for this poor victim of vaccines.

So far there is no word and I imagine no feedback will be forthcoming. In all the press surrounding Saba Button Meryl Dorey and the AVN is totally absent. Dorey has never breathed a word of the lawyer acting for the Buttons. History shows exactly what will happen to any money she would have gleefully collected and pocketed before the OLGR revoked her charitable fund raising licence for exactly that reason. Members of Stop the AVN can be proud they have this time stopped her stealing money from another family in need.

Those familiar with Dorey know if this was a death from a vaccine preventable disease her accusations would be of earlier vaccines – especially HBV leading to the death, possible antibiotic induced fatality, a lack of breast feeding or a simple media fabrication designed to scare people into vaccinating. Without sighting the medical records Dorey might well deny any disease at all. “You didn’t die from [measles or whooping cough] thirty years ago and you’re not going to die from it today”, she announced on national TV. All that’s needed is homeopathy, fresh air and clean water. Avoid doctors and hospitals.

Let’s face it. Dorey cares little for children, vaccine injured or maimed by the diseases she has helped bring back to dangerous levels. On either side they are tools to help her to offend, mislead and to cultivate fear. Snaring an innocent family with a very rational view of the world in her web of deceit can only be a negative for them. There are ample facts that assist their case. Facts Dorey is largely ignorant of. I fail utterly to see how lies and conspiracy theories manufactured by a proven threat to public health can be welcome.

Saba Button is in need of constant care via conventional medicine. Dorey is an out and proud enemy of conventional medicine. Despite the catalyst for her injuries Saba will forever be an at risk patient and need vaccination and conventional prophylactic measures to protect her from future viral threats. She will be surrounded by doctors, specialists and hospital staff perhaps for most of her life. The very people and places Dorey insists keep people sick – for profit.

It’s time Meryl Dorey did at least one morally correct thing and just left the Button family alone.

Legal synthetic drugs leading to arms race of prohibition

Posted in Anti-Drug Lobby, Health, Human Rights, Illicit Drug Policy, Legal, Science by

Few things underscore the failure of the war on drugs quite like the, well… failure of the war on drugs.

Two mornings ago I read in the press Synthetic drugs banned ahead of schoolies.

Attorney-General Paul Lucas said a further 19 cannabinoids, which are used to make fake illicit drugs such as the synthetic cannabis Kronic, have been outlawed. Mr Lucas said anyone caught selling them now risked between 15 and 20 years in jail.

Ten hours later I read Synthetic drugs seized ahead of schoolies, as police raided business across the Gold Coast to remove the obvious supply of, but not the demand for, synthetic drugs. No problems. Kids can go back to buying regular pot supporting organised crime in the time honored fashion. Perhaps amphetamine type stimulants (ATS) like ecstasy (or their safer legal cousins) will soon be managed identically, literally placing kids lives at risk.

Trying to terrify a nation Detective Superintendent Steve Holahan lies, “They’ve contained pesticides, crushed glass – extremely dangerous for human consumption.” Then, even though kids will now buy from organised crime figures with corrupt connections, zero accountability, no business to legally maintain and nothing in mind but an easy quick dollar we get Poe’s Law:

“Anything that you don’t know what it contains, should sound alarm bells straight away,” he said. “I really can’t emphasise enough, don’t ingest something that you don’t know what it contains.

“People need to understand they’re taking a very real risk both for their personal health…”.

In this 60 Minutes clip examining the status of “legal highs” – synthetic drugs that do not fall under the various misuse of drugs, or drug misuse and trafficking acts – vision of police savaging illegal cannabis growers struck me like never before. The recognition of futility, posturing and wasted public money was there. Yet more and more the anger I used to feel has given way to vague annoyance toward these pitiful people dressed up in action costumes to engage in what is a demonstrably futile endeavour.

Perhaps my annoyance peaked when NSW Drug Squad Chief, Nick Bingham angled to plead tough on “legal” drugs. He first admits to the difficulty of policing drugs that are not illegal then offers:

We have enough legal drugs on the market. We have tobacco, we have alcohol, we have your benzodiazapines. Why do we want to open up an avenue of all these synthetic substances to make them legal as well?

Er, firstly benzodiazapines area a prescription medication. Why not just rattle off the entire edition of MIMS there Nick? Next, there is no safe level of tobacco consumption. Which leaves alcohol – the most abused mind altering drug in the developed world clocking up a cost to public health that is approximately 15 times that of illicit drugs and once again wasting public money in policing violence. Lastly, regarding drugs that can’t be legally seized without legislative change there is no evidence anywhere of “opening up an avenue… to make them legal as well”.

Readers may remember back in June I covered the inaccurate “anecdotal” claims made by Steve Fielding on June 22nd in Questions without notice as he hassled Attorney-General Representative, Senator Joe Ludwig over what he intended to do nationally about Kronic. Fielding’s hysteria aside we still have no evidence to back his horror stories about what NSW health minister, Kevin Humphries told ABC Lateline was a “synthetic psychotic drug”. Indeed, despite years of sensational press and conservative panic the risk of chronic psychosis in people genetically predisposed to schizophrenia is roughly around one in 15,000 of regular smokers of illegal cannabis.

Of course, Fielding’s frown and Ludwig’s lament did nothing. It turns out Kronic derivatives remain legal and misunderstood. Colin Barnett, perhaps Australia’s most daring and dashing politician on the topic of illicit drugs banned Kronic in June promising maximum sentences of 25 years. Rather than understand the drugs and manage any issues we have simply enforced ignorance and expanded the supposed problem.

Surely now is the time for education and sensible regulation. In all the hype essential facts are lost and urban myths begin to emerge. “Synthetic cannabinoids” aren’t in many cases, cannabinoids. The European Monitoring Centre for Drugs and Drug Addiction notes:

Although often referred to simply as synthetic cannabinoids, many of the substances are not structurally related to the so-called ‘classical’ cannabinoids, i.e. compounds, like THC, based on dibenzopyran. The cannabinoid receptor agonists form a diverse group, but most are lipid soluble and non-polar, and consist of 22 to 26 carbon atoms; they would therefore be expected to volatilize readily when smoked. A common structural feature is a side-chain, where optimal activity requires more than four and up to nine saturated carbon atoms. The first figure shows the structure of THC, while the others show examples of synthetic cannabinoid receptor agonists, all of which have been found in ‘Spice’ or other smoking mixtures. The synthetic cannabinoids fall into seven major structural groups…

This clip spends ample time allowing Matt Bowden, NZ’s incredibly successful legal drug producer to chat with Liz Hayes. With ATS we all know the status of mephedrone as illegal in Australia. Yet smart chemists have enough formulas for both ATS and cannabinoids to keep the production-ban-production-ban arms race going for some time. Slowly the rhetoric is changing. Less and less are we terrified with stories of mashed neurons, instant madness and blokes who ripped off their scrotum. It’s pretty simple. Impairment. Drugs, like alcohol, cause impairment. And no, we don’t want those we care about going about their business impaired.

We need open and honest discourse. Proper scientific understanding and advice strikes me as the only sensible, critical next step. Users do not deserve to be scared witless to the point of hiding and lying about what is in essence simple human behaviour. More to the point the action to ban synthetic cannabinoids announced the presence of such legal drugs to Australians sending sales to unprecedented levels.

The history of banning previously legal substances is one of failure. Perhaps we might like to not repeat this particular aspect.

Drug Free Australia manipulate, misrepresent data to discredit Insite

Posted in Anti-Drug Lobby, Denialism, Drug Free Australia, Health, Illicit Drug Policy by

In April 2011 the Lancet published an article written by authors from the British Columbia Centre for Excellence in HIV/AIDS, the UBC Faculty of Medicine, the UBC School of Population and Public Health and Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA.

The title was Reduction in overdose mortality after the opening of North America’s first medically supervised safer injecting facility: a retrospective population-based study, by Brandon D L Marshall, M-J Milloy, Evan Wood, Julio S G Montaner, Thomas Kerr was followed by a media release from The University of British Columbia which included:

Researchers compared nearly 300 case reports from the British Columbia Coroners Service documenting all illicit drug overdose deaths in Vancouver between January 1, 2001 and December 31, 2005.

Compared to the 35 per cent reduction in overdose deaths in the immediate vicinity of Insite following its opening in September 2003, overdose deaths in the rest of Vancouver declined only nine per cent over the same period. No overdose deaths have been recorded at Insite since the facility’s opening. The researchers also noted that there was no evidence of significant changes in drug supply or purity during the study period.

“This study provides the first unequivocal scientific evidence of the benefits of supervised injection facilities, and clearly demonstrates that facilities such as Insite are saving lives and playing a vital role in reducing the harms associated with illicit drug use,” says co-author Dr. Julio Montaner, director of the BC-CfE and Chair of AIDS Research at the UBC Faculty of Medicine.

The Abstract can be read here. Insite which opened in September 2003 has also been the subject of more than 30 studies in 15 peer reviewed journals. These have cited a number of benefits including increased access to rehabilitation services, detoxification, reduced syringe litter, reduced public injecting and most importantly reduced needle sharing which serves to reduce blood borne virus spread.

Background

In 2006 the new Conservative government which did not support the initiative threatened to let the site’s legal exemption lapse before the project was complete. On September 1st 2006, Health Minister Tony Clement cited a need for more research as he deferred his decision to extend the site’s legal exemption. On the same day the Government cut all funding for future research. In August 2007 two addicts and the Portland Hotel Society filed suit in the B.C. Supreme Court arguing violation of rights – “security to the person”. What followed was from a legal and human rights perspective remarkable including the May 2008 strike down of sections of the Canadian criminal code on drug trafficking and possession as a breach of the Canadian Charter of Rights and Freedoms.

The struggle between progression and conservatism continued with the federal government appealing this legal advance in human rights. The B.C. Court of Appeal dismissed this in a 2-1 ruling. The government announced a further appeal to the Supreme Court of Canada. There were nine interveners in the Supreme Court Case. Only one supported the stance of the conservative government to close Insite. That group was the socially conservative, anti-women’s rights lobby group REAL Women of Canada.

National vice president of REAL Women…, Gwen Landolt, argued against the Canadian Medical Association and other supporters. She claimed that Insite would allow users to get “worse and worse until they die” and that such facilities “are assisting in the suicide of drug addicts.” The government had to admit it had no credible research to show Insite was not working. There were no valid data to show Insite was not reducing drug related harm. In essence the government and REAL Women of Canada were mounting non evidence based claims.

The Supreme Court of Canada ruled unanimously on September 29th, 2011 to uphold Insite’s exemption from the Controlled Drugs and Substances Act. This allowed the site to stay open indefinitely. The ruling was highly critical of Health Minister Tony Clement’s application of the CDSA to Insite stating it was grossly disproportionate and undermined “the very purposes of the CDSA, which include public health and safety”.

Drug Free Australia’s Bogus Critique

Drug Free Australia (DFA) is a conservative right wing prohibitionist lobby group of loosely affiliated extremists masquerading as a quasi-official body critical of Australia’s illicit drug policy. Regarding Injecting Facilities they have a discredited history (indeed presence) in maintaining the highly flawed opinion piece Case For Closure attacking Sydney’s Medically Supervised Injecting Centre. The Drug Misuse and Trafficking Amendment (MSIC Bill) was passed in October 2010 with considerable support from then Premier Kristina Keneally, The Australia Medical Association and the Royal Australasian College of Physicians. All three along with countless other individuals, MPs and organisations rejected the efforts of Drug Free Australia under the auspices of Secretary Mr. Gary Christian to sabotage over a decade of trial success.

On September 17th 2011, perhaps in a final effort to sway the Supreme Court of Canada (at that time yet to hand down it’s decision) DFA presented a media release claiming to have “exposed major, inexcusable errors” alleging “research fraud and professional misconduct” in the Lancet paper by Marshall et al. They cited an article headed Analysis of the 2010 Lancet study on deaths from overdose in the vicinity of Vancouver’s Insite Supervised Injection Facility published in the Journal of Global Drug Policy and Practice (JGDPP).

The authors were familiar names. Dr. Greg Pike co-author of the Case for Closure, and already profiled here. Dr. Stuart Reece and Dr. Joe Santamaria, also both co-authors of the Case for Closure of the Sydney MSIC. Prohibitionist Robert DuPont, former “White House Drug War Czar” under Richard Nixon and present board member of Drug Free America Foundation and finally Dr Colin Mangham, Director of Research, Drug Prevention Network of Canada. Their coordinator was anti-Harm Reduction campaigner Gary Christian.

In a comprehensive response the Lancet authors note their methodology and data was subjected to extensive scientific peer review and that this independent process “confirmed the appropriateness of the data and methods that we employed”. They further note Mr. Christian’s source has not been subject to peer review nor published in any scientific journal.

Nevertheless this formed the basis of a complaint by “research coordinator”, DFA Secretary Mr. Gary Christian to the University of British Columbia. The media release included:

The international team’s analysis has been sent by the Drug Prevention Network of Canada to the Ethics Committee of the agency which funded the Lancet study with questions regarding research fraud and professional misconduct.

Mark Wainberg, professor of medicine and director of the McGill University AIDS Centre was called upon to independently review the matter. Wainberg reviewed DFA’s analysis, the Lancet paper and the author’s response. He concluded in part:

In my view, the allegations that have been made by ‘Drug Free Australia’ are without merit and are not based on scientific fact. In contrast, it is my view that the work that has been carried out by the team of Thomas Kerr et al is scientifically well-founded and has contributed to reducing the extent of mortality and morbidity in association with the existence of the safer injection facility. . . . The University of British Columbia should be proud of the contributions of its faculty members to the important goal of diminishing deaths due to intravenous drug abuse.

The JGDPP analysis and complaint were found to be entirely without merit and the complaint was dismissed.

Drug Free Dishonesty

Along with the Lancet author’s response and the independent review there are a number of elements which render this amateurish attack particularly offensive. As noted above the “analysis” is not peer reviewed nor published in any recognised scientific journal. It was published in the JGDPP which is a collection of non peer reviewed articles and opinion pieces. Described as a “glorified blog” by The Media Awareness Project, the JGDPP is run by DFA’s parent body Drug Free America Foundation (on whose board sits DuPont). It was initially funded by the US Department of Justice which is presently under investigation for corruption. It has an international reputation for hosting articles seeking to sabotage human rights oriented policy initiatives successful in controlling the spread of blood borne viruses. Many authors hold extreme and archaic religious and/or anti-science views.

Essentially the JGDPP piece argues that the 35% reduction in overdose deaths in a delineated area following the opening of Insite and documented in the Lancet by Marshall et al. is flawed. Tactics by which this is done obfuscate context and manipulate the import of data in such a way as to misrepresent it to the reader. By using flawed population analysis and failing to state the nature of deaths across a much larger area it seeks to claim overdose deaths increased. The JGDPP team also suggest the Lancet authors should have dismissed an entire year as irrelevant because doing so decreases the overall decline in mortality. Thus it was, in their minds, only included by Marshall et al. to skew results.

The Lancet authors note the JGDPP report:

[U]ses crude Vital Statistics data, which included all accidental poisonings to define its estimate of overdose deaths, and it did not exclude deaths unlikely to be affected by a supervised injecting facility (e.g., suicides, adverse effects of drugs in therapeutic use). We note that the REAL Women/DPNC (JGDPP) critique seeks to call into question the Lancet paper’s findings using these crude data, and then goes on to argue that the Lancet paper’s findings cannot be relied upon because they use similarly unrefined death counts. We would argue that you cannot have it both ways.

The JGDPP article also fails to admit it used crude death counts and not population-adjusted mortality rates. This fails to account the relevance of death rates in a changing population. The Lancet study used annual population estimates from Statistics Canada to conclude on overdose mortality. Most shocking however was the increase by the JGDPP authors in area consulted by around a factor of 10. The Lancet studied mortality in 41 city blocks. The JGDPP article refers to mortality in a 400 block area. This further obscures the fact that the greatest reduction in overdose is within 4 blocks of Insite and significantly decreases outside that area.

The area in green is that studied by the Lancet authors showing a 35% reduction in overdose mortality. The area in red is that used by the JGDPP authors to misrepresent the Lancet finding.

The JGDPP article was written as an analysis for REAL Women of Canada and the Drug Prevention Network of Canada (DPNC). It is demonstrably a collation of highly selective, misleading, out of context and academically discredited material. The “analysis” relies time and again on a 2007 “critique of [the Insite] parent philosophy” written by co-author Dr. Colin Mangham of the DPNC. The DPNC holds a highly partisan irrational anti Harm Reduction position claiming it “leads to terror, degradation and the eventual death of the addict”, refers to supporters of HR as “enablers” and presents a grossly distorted misrepresentation of HR on it’s website.

They are dedicated to:

…advance abstinence-based drug and alcohol treatment and recovery programs, to promoting a healthy lifestyle free of drugs and to opposing legalization of drugs in Canada.

Their Mission Statement freely includes, Lobbying in the media, at the community level and in government for the support of our stated principles. At no point does the DPNC propose to hold to an evidence based approach or accommodate advances in scientific consensus. Not surprisingly the previous 2007 article by Mangham is critical of research which supports harm reduction and Insite. Even less surprisingly it too is published in Journal of Global Drug Policy and Practice.

Along with accusations of fraud, professional misconduct and research errors directed at the Lancet authors, the media release From Gary Christian also expanded on the supposed impact of the work of Marshall et al:

The article was influential in the Canadian Supreme Court hearings of May 12 this year, where the court reserved its decision on whether the Canadian Government is rightfully able to close the facility. The Canadian government has been trying to close Insite since 2006, but has been hampered by court action by harm reduction activists.

This is extraordinary. The JGDPP analysis that has so emboldened Mr. Christian was written for REAL Women of Canada and the DPNC. REAL Women of Canada were interveners in the Supreme Court in favour of the Canadian Government. The JGDPP analysis relied significantly upon material critical of Insite produced by the DPNC in 2007. The same DPNC with a mission statement to lobby community and government. Surely the time for accusations and presentation of evidence was in the Supreme Court itself. Yet the reasons why the government could produce none of this flawed “evidence” are manifestly clear.

The JGDPP piece cites the 2007 critique of Mangham in formulating the claim that changes in policing, “could account for any possible shift in overdose deaths from the vicinity of Insite”, arguing this was intentionally ignored by Marshall et al. Mangham is also cited as refuting Insite as having any impact on public crime or public disorder. Yet the Royal Canadian Mounted Police who had commissioned Mangham’s 2007 report claimed it, “did not meet conventional academic standards”.

Although every injection within Insite is sterile and safe from contraction of blood borne viruses, Christian’s JGDPP analysis further cites Mangham 2007 in arguing:

Added to this [the impact of policing] are the spurious claims by Insite researchers that the facility has impacted HIV and HCV transmission, despite the claim being possible only if ALL injections by those HIV or HCV positive are hosted by Insite, which has rarely been the case.

Unsurprisingly Mangham’s 2007 report was ignored by Canada’s Expert Advisory Committee on Injecting Site in formulating their own report. This doesn’t stop the JGDPP piece from citing data from Canada’s Expert Advisory Committee on Injecting Site that Insite statistically saves only one life per year. It’s argued that “this would not be detectable at the population level. This estimate is backed by the European Monitoring Centre’s methodology and avoids the error of naively assuming overdose rates in the facility match overdose rates in the community.”

At first blush this sounds compelling but is in fact a rogue construct manipulating entirely different methodologies, which yield entirely unrelated data sets, to imply naivety on behalf on Marshall et al. Regardless of what is “detectable at the population level”, neither study is relevant to the other. Citing the European Monitoring Centre’s methodology is simple weasel wording applied to distract the reader from the straw man of “one life per year”.

In truth the “one life per year” comes from person to person intervention in a clinical facility. It actually underscores the safety of the Insite environment in averting dynamics which may predicate a potentially fatal overdose. Community overdose rates considered by Marshall et al. cover 41 blocks surrounding Insite. The Lancet authors seek to quantify the impact of Insite’s presence on these rates.

Canada’s Expert Advisory Committee on Injecting Site is in no way at all dismissive of the “one life per year”. They write plainly [bold mine]:

INSITE staff have successfully intervened in over 336 overdose events since 2006 and no overdose deaths have occurred at the service. Mathematical modelling (see caution about validity below) suggests that INSITE saves about one life a year as a result of intervening in overdose events.

Marshall et al. write in their abstract [bold mine]:

We examined population-based overdose mortality rates for the period before (Jan 1, 2001, to Sept 20, 2003) and after (Sept 21, 2003, to Dec 31, 2005) the opening of the Vancouver SIF. The location of death was determined from provincial coroner records. We compared overdose fatality rates within an a priori specified 500 m radius of the SIF and for the rest of the city.

Furthermore it is interesting that the EMCDDA 2004 report notes such rooms can be expected to reduce high-risk behaviour beyond the consumption room setting itself and reduce exposure to and transmission of drug-related infectious diseases [p.25]. On public order and crime the same report lists two main objectives of 1.) to reduce public drug use and associated nuisance and 2.) to avoid increases in crime in and around the rooms [p. 61].

It should be noted each of these four points is in dissonance to the position of the JGDPP authors and every point they cite from Mangham 2007. More so, as noted during the Supreme Court Case the Canadian Government and the government’s only supporting intervener REAL Women of Canada, chose not to produce Dr. Mangham’s 2007 report. They effectively admitted they had no evidence to support their case to close Insite. As such it is remarkable Mr. Christian relied so heavily on Mangham to argue there were, “questions regarding research fraud and professional misconduct.”

Mr. Christian’s problem is not that the Canadian Government, “has been hampered by court action by harm reduction activists” since 2006. It is the simple reality that despite having had five years in which to produce convincing evidence in a court of law to close Insite, the Canadian Government has been unable to do so all the way to the Supreme Court of Canada. Apart from criticising Clement for undermining the purpose of the Controlled Drugs and Substances Act the ruling also acknowledged the dysfunctional nature of the prohibitionist mindset, stating:

…the potential denial of health services and the correlative increase in the risk of death and disease to injection drug users outweigh any benefit that might be derived from maintaining an absolute prohibition on possession of illegal drugs on Insite’s premises.

Other shonky tactics employed by Christian’s team include intentionally misrepresenting the findings and recommendations of other research. In attacking cost effectiveness of sterile injecting the JGDPP report states:

The 2009 Andresen and Boyd cost-benefit study calculated savings to government from 35 supposed HIV/AIDS transmissions averted by Insite annually, despite the most authoritative international review to date not finding any demonstrated effectiveness of clean needle provision reducing HIV transmission via needle exchanges.

This is a misrepresentation of the cited IOM review. Preventing HIV Infection among Injecting Drug Users in High Risk Countries: An Assessment of the Evidence, states:

The report provides evidence-based recommendations regarding drug dependence treatment, sterile needle and syringe access, and outreach and education. The report urges high-risk countries to take immediate steps to make effective HIV prevention strategies widely available.

Page 2 of the report brief includes [bold mine]:

Avenues for making clean injecting equipment more widely available—and thus reducing drug-related HIV risk—include needle and syringe exchange; the legal and economical sale of needles and syringes through pharmacies, voucher schemes, physician prescription programs, and vending machines; supervised injecting facilities; and disinfection programs….. Multi-component HIV prevention programs that include sterile needle and syringe access are effective in reducing drug related HIV risks such as the sharing of needles and syringes.

Gary Christian also claimed in his media release as part of the allusion that policing, not Insite had caused a reduction in mortality:

These researchers cannot truthfully claim they knew of no policing changes in the immediate area around Insite when some of their number produced an indignant study condemning the changed policing.

Yet in their response the authors indicate that the police initiative referred to ended “within weeks” of Insite opening. It was not ongoing during the study – which is what Christian’s team had falsely suggested. More so if the crackdown was the cause of a reduction in mortality after Insite opened then it was the cause of an increase in overdose deaths in the area prior to Insite opening. Even more crushing for Gary Christian, is that this means the decline in drug related overdose clearly demonstrated in the Lancet occurred because the policing initiative ended.

Perhaps most scurrilous as mentioned above is the suggestion by Gary Christian’s JGDPP team that the Lancet authors included 2001 in their methodology in order to skew results in favour of overdose reductions. The JGDPP report suggests a review from 2002 onwards would show an increase. Yet the Lancet authors had written an earlier report in 2009 showing stable use from 2001 to 2005:

As shown in a figure from that report (below), although the proportion of IDU reporting daily heroin use declined from 1998 to 2001, the proportion of IDU reporting daily heroin injecting remained stable from 2001 to 2005 (i.e., the period considered in our Lancet study).

Figure showing that daily heroin use from 2001 to 2005 remained stable

Whilst this is a look at the most prominent manipulations and misrepresentations authored by Gary Christian’s team a quick reading of the Lancet author’s response – below – reveals a more comprehensive overview. Accusations of careless assessment are put to rest and a read of the original paper shows the lengths gone to in the Discussion to acknowledge other factors that may contribute to a reduction in drug induced mortality. There are also many other absurdities presented in the JGDPP article (such as “recommended reading” and citing a speech by “Christian voice in politics”, Gordon Moyes) that must condemn Christian and his team even further.

Of course like an antivaccination lobbyist Christian has not budged an inch, still insisting he is completely correct and that peer review and science itself is flawed. Now, in the shadow of their complete demolition we can review the hypocrisy and misplaced confidence of Mr. Christian in his ability to scam the public and academics alike.

 Activists are never likely to provide objective science and there are dozens of other Insite studies that must now be under a cloud as a result.

Drug Free Australia has never produced any science and peer reviewed research. This shows their inhumane prohibitionist world view as without merit, and data supporting Insite as entirely safe.