Naltrexone implants backed by zealotry but not evidence

Less than a month after Sydney coroner Mary Jerrum referred a provider of naltrexone implants to the NSW Health Care Complaints Commission, the Christian Democrats’ Reverend Fred Nile revealed he wants them used as compulsory treatment for opioid addicts.

Naltrexone implants are not backed by any convincing evidence but the rapid opioid detoxification [ROD], opioid blocking properties they offer appeal greatly to anti-drug crusading Christian evangelists. Long opposed to harm reduction measures and evidence based treatment of addiction, such as methadone maintenance, far right Christians and conservatives see naltrexone implants as a moral masterstroke. Muscling into the action in recent years are the profit-focused, such as Sydney’s Ross Colquhoun, director of Psych ‘n’ Soul.

I’ve previously written about Dr. Stuart Reece, who features in the video below with the same title as this post. His abuse of patients with naltrexone and Jesus saw 25 of them die in 20 months. His career is the epitome of callous faith based pseudoscience which uniquely targets evidence based harm reduction measures. When I posted on a faux “research” paper he had co-authored with other members of Drug Free Australia, I referred to an exchange on an email list hosted by the Alcohol and Drug Council of Australia. It was on this list years ago that I first read Ross Colquhoun defend naltrexone implants as “common sense”. Indeed his evidence free defence of implants led me to conclude that his “common sense” was the equivalent of the religious zealots’ “belief”.

Both individuals are signatories to Drug Free Australia’s so-called position statement which includes funding of naltrexone implants as an “urgent pro-active change to our illicit drug policies”.

DFAposition_statement_sigs1

Handing down scathing findings into three deaths, the coroner recommended that the HCCC consider proceedings against a doctor working at Colquhoun’s Pysch ‘n’ Soul, Dr. Jassim Daood. According to the ABC she noted, “a number of disciplinary cases have already been completed about some of the clinic’s other staff”. The scale of potential problems becomes clear when one considers the implants have never been approved for use, eager staff have little or no training and post-implant support regimes are entirely absent. For over a decade these implants have been available via the TGA’s Special Access Scheme, which is designed to allow patients access to otherwise unavailable drugs to treat conditions deemed potentially fatal in the absence of that drug.

In this case the Scheme is being exploited as a loophole whilst the implant option itself has left in it’s wake a litany of failure and fatalities. Colquhoun is unlicenced to perform ROD but ignored requests from the NSW Health Department in mid 2010. SMH wrote on October 20:

Despite this direction, Colquhoun resumed the treatments while still unlicensed between July and September of that year, only desisting when Grace Yates, a 23-year-old with a five-month-old baby, was given ROD and naltrexone at the clinic on September 29, 2010. She suffered a heart attack and died two months later, having never regained consciousness.

It’s worth considering this failed treatment option is likely to be expanded under a coalition government. As health minister in the Howard Government, Tony Abbott provided the funding for the launch of the evangelical Drug Free Australia from the Tough on Drugs/Assets of Crime kitty. Describing themselves as “Australia’s Peak Drugs Body” they failed to meet the conditions of the funding, choosing instead to sabotage related health policy basics. Without doubt they have proven to be to addiction treatment what the Australian (anti) Vaccination Network is to the management of vaccine preventable disease.

Abbott also sent $50,000 they way of Psych ‘n’ Soul in the same year, showing exceptionally poor judgement. There is little doubt with enemies of Harm Minimisation such as Bronwyn Bishop, Sophie Mirabella and Christopher Pyne on his proposed front bench, Australia’s strong evidence based approach to addiction management would suffer. As the coroner noted:

It appears that a patient only had to present at the clinic to be enthusiastically recommended for rapid opioid detoxification, no matter what their history or situation, without alternatives being discussed or considered or any information given out of the risks involved.

Another death related to the attempts at ROD Psych ‘n’ Soul is now infamous for, involved Michael Poole, 48. He was described as “delirious and delusional” after ROD and died at the Prince of Wales Hospital in Sydney two days later. The third death involved James Unicomb, 23 who died from drug toxicity following a poly-drug overdose, which followed the ROD and occurred whilst an implant remained active. This lack of appropriate follow up of patients is perhaps the most appalling failure related to the practice of ROD and implants.

Rapid detox’ doesn’t treat addiction. It removes cravings and leaves patients open to the possibility of overdose. Often they are dependent upon high doses of benzodiazapines which raises the risk of opioid induced respiratory depression. As addiction is not treated, behaviour cannot be expected to change. It is for this reason follow up should form the most important aspect of rapid detoxification. It is for the same reason that implants have such a high failure rate in “curing” addiction.

One can only imagine the profit made and moral crusading accomplished from treating now dead addicts who were essentially exploited, not treated. Of course, testimonials abound. Whether it’s those who adore Reece for showing them the way to Jesus or Colquhoun’s (third time lucky) performer in the below video, let’s not kid ourselves. The dead cannot speak.

Alex Wodak, director of Sydney’s St. Vincents Hospital Alcohol and Drug Service observed:

How they are allowed to be used for routine purposes in several states in this country beats me. It goes against all the normal regulations and I think the only explanation I can understand is that this is allowed in this case because they’re only drug addicts. […] We really need a national independent inquiry into the regulatory failure, the serious regulatory failure that’s gone on with Naltrexone implants for over a decade.

Indeed we do.

Naltrexone implants backed by zealotry but not evidence


Psych ‘n’ Soul Naltrexone Deaths Inquest Findings

Pseudoscience and Christian bigotry

First of all, from what I understand from doctors, that’s [pregnancy] really rare. If it’s a legitimate rape, the female body has ways to try to shut that whole thing down.

US Republican Senator Todd Akin, August 19th 2012

Some doctors have told me that health outcomes are worse for gay and lesbian people, and gay activists themselves point to health problems. I mean this in the widest sense, not just HIV-AIDS but rates of cancer, alcoholism and other disease.

Sydney Anglican Archbishop Peter Jensen, September 10th 2012

An interesting article headed When did it become okay to bag Christianity? was published in Mamamia recently.

The author recounts hearing what appears to be a fairly unjustified anti-theistic rant directed at Christians, then poses some queries as to why such criticism is common. Common in various media and comedy sketches. Of course this applies also to drama, casual discourse, public debate and genuine lobbying for equal rights.

Perhaps the question should have been phrased differently, or presented as an observation. Christianity particularly, has practitioners adhering to many different practices, beliefs and intention. Regrettably there are those who ignore the privacy of faith and wield their version of Christianity as if it were authoritative. Or worse, an absolute truth or blueprint for life. Everyone’s life.

It is this constant song of demand that the only life we know be discarded in servitude or demoted to a test run that sustains a deep and painful wound in the Australian psyche. The strange mix of fundamentalism and patronising insistence that others must live by an unwelcome moral code is at once offensive and utterly absurd. The intellectual paucity upon which it rides is truly astonishing.

Yet it is the message of Christianity as put forward by those in a position to command media attention, those who lobby or horrifically as revealed in recent years, those who seek to indoctrinate our children at public schools. The scale of material wealth enjoyed by the institutions that protect and nurture this archaic message and sadly defend those known to have abused so many children is not lost on Australians.

That religious institutions based on Christianity and the faith of Christianity are not one and the same, is not always clear. This may explain why it’s seemingly “okay to bag Christianity”. On the most recent episode of Q&A on Australia’s ABC, Aussies were treated to some splendid bigotry and misogyny from Anglican Archbishop Peter Jensen. Such views would and do disgust many Christians. He also spoke of the message of Jesus Christ and the positives associated with this. This view would be celebrated by all Christians.

Therein lies much confusion and the source for criticism of Christianity. It may not be Christianity in it’s entirety or individual Christians that are intended to be “bagged”. Yet the inordinate wealth, control and unwanted influence afforded truly unpleasant individuals based upon what is essentially a belief in magical beings, does not sit well with the progressive 21st century mind. Christianity remains a most irritating influence and/or manifestly detrimental force for so many that “bagging” or mocking, is not surprising.

The divisive and deceptive nature of many messages pushed out by Christian identities is reflected in the above comments. In both instances we see an appeal to authority. Toss in the claim some doctors have said this or that and apparently one has the opportunity to trot out whatever bigoted opinions one would like to be fact. In both cases it backfires because “doctors” in general say nothing of the sort.

Hence no proper research was attempted but the faux impression of having sought informed consensus is bravely put forth. Worse, these are smart men so this author will assume they knowingly lied. I hasten to add Jensen followed with, “I do not know whether there is sound evidence for this or not”. Which far from saving him should rightly raise questions about his access to Google or who on earth advises him. At the time, the claim had already been in the headlines for five days.

Hiding behind dodgy “research” is nothing new for Christian bigotry. The myth that homosexuality and paedophilia are linked has been the topic of bogus, offensive, pseudoscientific and at times bizarre reporting. Quite benign findings are breathlessly reported as evidence of children in danger from gay men. For example, one source from the US Family Research Council (Advancing faith, family and freedom) is cited:

In The Gay Report, by homosexual researchers Karla Jay and Allen Young, the authors report data showing that 73 percent of homosexuals surveyed had at some time had sex with boys sixteen to nineteen years of age or younger.

The wording seeks to convey that gay men have overwhelmingly had sex with teens, whereas “at some time” conveniently distorts consensual legal sex. Exactly the type of findings we’d expect with heterosexuals.

An in depth article by Mark E. Pietrzyk, Homosexuality and child sexual abuse: science, religion and the slippery slope, followed the 2006 resignation of US Congressman Mark Foley. We read in part in the conclusion:

A number of recent studies and articles have attempted to discredit the gay rights movement by linking homosexuality to pedophilia.  These writings have either cited articles in the scientific literature alleging to show that homosexual males are more inclined to molest children than heterosexual males, or they have attempted to demonstrate an inevitable trend toward toleration of pedophilia by employing the “slippery slope” argument.

However, the very scientists that are cited in support of the contention that gays are more likely to be molesters explicitly reject the idea that homosexuals pose a disproportionate threat to children.  […]

In fact, the Judeo-Christian tradition and many other religious traditions tolerated and even affirmed pedophilic relationships for centuries.  The contemporary taboo against such relationships developed only a little over one hundred years ago…

On Q&A Jensen was lending credence to Australian Christian Lobby head Jim Wallace’s argument that the “gay lifestyle” leads to death 20 years earlier than heterosexual estimates. Perhaps relying on Modelling the impact of HIV disease on mortality in gay and bisexual men, published in 1997, Wallace certainly chose to ignore the important follow up paper, Gay life expectancy revisited, by the same authors.

They open with this paragraph:

Over the past few months we have learnt of a number of reports regarding a paper we published in the International Journal of Epidemiology on the gay and bisexual life expectancy in Vancouver in the late 1980s and early 1990s. From these reports it appears that our research is being used by select groups in US and Finland to suggest that gay and bisexual men live an unhealthy lifestyle that is destructive to themselves and to others. These homophobic groups appear more interested in restricting the human rights of gay and bisexuals rather than promoting their health and well being.

Wallace might like to buttress his bigotry with the solidly debunked “gay obituary study” published by the head of Family Research Council (a documented Hate Group) Paul Cameron, with Playfair and Wellum. Choosing only obituaries these guys “concluded” gay men die at 43. I’m sure this came as quite a shock to all the living gay men from the same generation over 43 years of age. Especially as the sample had no living subjects and further skewed it’s results by sampling only urban openly gay men.

Today, with antiretroviral drugs mean life expectancy from the time of diagnosis with HIV is over 40 years. So, these chaps had to zero in on a particular time period and ignore living subjects. Average age of death from AIDS was around 40 years. 20% of gay men would die of AIDS in the period before drug treatment. According to Steven Ross, even if we crank that up to 50% Cameron’s mean lifespan of 43 years requires healthy gay men to die at 46. Said differently, if healthy gay men died at 70 those with AIDS would need to die at 16.

Then there’s the group of bigoted evangelicals I personally enjoy catching out in their abuse of science. The conservative anti-drug lobby continues to produce junk science arguing measures to control blood borne virus spread have failed. They remain at the forefront of efforts to undermine the methodology of expert panels who conclude illicit drug prohibition tactics in present form are quite damaging. An assorted group of Christian fundamentalists bent on faith based practices, it is quite sad to see them attack Christian run faith based charities.

When Drug Free Australia published an attack on research supporting Vancouver’s safe injecting site under the guise of science, Mark Wainberg, professor of medicine and director of the McGill University AIDS Centre 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 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.

Thus in all three examples the demonstrable abuse of existing science or presentation of pseudoscience to justify or defend outright discrimination is clearly demonstrated. The quest for abstinence – forced if need be – in all it’s forms certainly leads to bigotry.

Clearly the discrimination and abuse levelled at members of the LGBTI community has a demonstrable impact on health and lifestyle. For gay Christians or those raised in Christian families the effects of bigotry can be negatively life changing. If Wallace was honest he would admit that his identified lifestyle problems of drug abuse, self harm and suicide would reduce without his bigotry.

If HIV is of genuine concern he would accept stable, monogamous relationships and of course marriage, reduce the risk of not knowing the HIV status of a partner. Instead he prefers to cite a Danish study that found brief relationships of around 18 months. He might not let on this was a sample of young men aged 18-21 years. In fact same sex civil unions are rather boringly unlikely to differ from the general population.

Wallace’s claims are surely demonstrably false. What is more shocking than Jim’s predictable bigotry is his attempt to link choice to sexual orientation. In arguing that smoking reduces lifespan by up to a decade and we educate children not to smoke, he’s suggesting we should similarly educate about the dangers of the “gay lifestyle”.

Of course as Jim tells it he was misrepresented by “gay activists”. Just as his anti-Islamic, homophobic ANZAC Day tweet was a misrepresentation by “twitter activists”. In both cases Aussie Christians vocally distanced themselves from him and his mess. His knack for denial is almost impressive.

Fortunately this debacle will have a notably positive outcome. More children being educated not to listen to Jim Wallace and the outmoded Australian Christian Lobby.

Reject that and you belong in hell

In God We Teach follows the story of a high school student who recorded his history teacher proselytising for Jesus.

In Kearny New Jersey, student Matthew LaClair recorded teacher David Paszkiewicz preaching about Jesus. An avowed “anti-Darwinist”, who places god before all and concludes academic freedom includes the freedom to preach and not teach, at one time Paszkiewicz informs his history students:

He (Jesus) did everything in his power to make sure you could go to heaven. So much so that he put your sins on his own body, suffered your pains for you and is saying ‘please accept me, believe’.

You reject that and you belong in hell.

During a high school christian club meeting Paszkiewicz allows students to articulate the fundamentalist view that immorality thrives through “endorsing” evolution. One student suggests that people would, “… grow cold and empty. You grow cold to people with disabilities. You grow cold to an after life. There is no after life. Why not do what you want? Why not steal? Why not assault people?”.

Paszkiewicz calmly tells the student attendees;

The world doesn’t understand this but believers do. Teaching Darwinism, is something that’s going to take peoples eyes off of god, especially Jesus Christ. […]

It may be against the law to teach Creationism as fact, but that doesn’t mean it’s wrong.

With the town backing the wayward teacher, Matthew LaClair does what clearly had to be done to defend the right to public education and the separation of church and state.

An excellent documentary by vic Losick. Read more at In God We Teach or visit Vimeo.

Australian Skeptics National Convention 2012

The Australian Skeptics National Convention for 2012 is set to run from Friday November 30th to Sunday December 2nd.

You can check out the ticketing situation here, and digest evolving details on a great line up of presenters. There’s a run down on a bunch of events and a look at the awesome Spot Theatre. So, it’s just as well that’s also where the Convention will be I guess.

Head over to Facebook, do the Like thing and keep up to date. The theme is Active Skepticism. So if you’ve an interest in how reason and evidence makes a positive dent from prophylaxis to progressive politics this may just be your gig.

Follow @auskepcon on Twitter.

According to the Victorian Skeptics promotion page speakers include, James “The Amazing” Randi, DJ Grothe (President of the James Randi Foundation), Brian Thompson (Outreach Coordinator of JREF), Rebecca Watson (SGU blogger), Lawrence “Unbelievable” Leung (as seen on TV!), Dr. Rachael Dunlop, Richard Saunders, Lynne Kelly, Dr. Krissy Wilson, Dr. Ken Harvey (Choice Magazine Consumer of the Year Award), Adam vanLangenberg, Dr Cameron Martin (from Friends of Science in Medicine), Meredith Doig, Stephen Mayne (media commentator and shareholder activist), plus many others.

Sounds like there will be some impressive appearances and the opportunity to meet interesting people.

Of course, if you don’t come you can make do with this video.