Dr. Albert Stuart Reece again restricted by medical authorities

Posted in Anti-Drug Lobby, Drug Free Australia, Drug Free Australia, Health, Human Rights, Illicit Drug Policy by Paul Gallagher

The Medical Board of Australia has placed fifteen limitations on the practice of Dr. Stuart Reece of Highgate Hill QLD. The conditions, enforced on 21 December 2022, have resulted in the temporary closure of the Southcity Medical Centre where Reece practices.

Reece (pictured) is a controversial figure in addiction medicine and a vocal critic of Australia’s successful policy of harm minimisation. He holds no formal qualifications in addiction medicine, but has authored or coauthored extensively on the subject, presently as an adjunct professor at UWA. Almost exclusively, his writings link illicit drug use, methadone and medical cannabis to death and disease.

Experts have refuted certain works as “reefer madness”. Reece has long associated his Christian faith with treating addiction. His book, titled “Let My People Go: A Theology of Addiction”, was published in 2016. His work is favoured by extreme anti-drug pressure group, Drug Free Australia, and frequently cited by them in lobbyist material, media replies and parliamentary submissions.

This is not the first time regulators have acted to ensure the safety of his patients. An article published on this blog in December 2011 examined his use of unapproved naltrexone implants and the deaths of 25 patients who had undergone the treatment. In 2009 Reece was suspended from practice for supplying morphine to opiate dependent patients and falsifying records to disguise the fact. This was because of his ideological opposition to evidence backed methadone maintenance therapy. That suspension was in turn suspended for three years.

The Medical Board of QLD, Health Practitioners Tribunal observed at the time that Reece:

… has a somewhat evangelical approach to this area of medicine and because of that he does appear to lack a degree of insight and objectivity in relation to the treatment of his patients. Furthermore, he seems to feel that the ends justify the means in terms of treatment of patients.

Today, the catalyst for intervention includes the number of patients being bulk billed per hour and quality of care. This is reflected in the limitations on practice (complete list in slideshow below).

1. The Practitioner must not exceed four (4) of patient consultations in any one hour (60 minutes). […]

5. The Practitioner must only practise as a general practitioner when supervised by another registered medical practitioner with knowledge and experience in addiction medicine (the supervisor).
For the purposes of this condition, ‘supervised’ is defined as:
The Practitioner must consult with the supervisor who is always physically present in the workplace and available to observe and discuss the management of patients and/or performance of the Practitioner when necessary and otherwise at weekly intervals. […]

7. In the event that no approved supervisor is willing or able to provide the supervision required the Practitioner must cease practice immediately and must not resume practice until a new supervisor has been nominated by the Practitioner and approved by the Board.

A search for general practitioners providing services in addiction medicine in the Brisbane area yields modest results. There just isn’t enough practitioners providing these select services across Australia. If one adds the fact that such providers have often taken on all the patients they can, it isn’t beyond comprehension that Dr. Reece is unable to find a supervisor. Reece has loyal supporters amongst his patients, who have a Facebook page here. They have argued in a petition that finding a supervisor is “an impossibility”. The petition, “Reinstate Dr. Stuart Reece Immediately”, contends that the predictable lack of a supervisor indicates that the action taken is about the control of services offered under bulk billing.

AHPRA is also advising that Dr Reece must have another Doctor with him for consultations into the future to oversee his work to their satisfaction. This requirement is an impossibility. AHPRA and Dr Reece both know that this doctor does not exist. There is not a ‘spare doctor’ lying around that is available for this. […]

THIS IS NOT ABOUT PATIENT CARE OR BETTER HEALTH OUTCOMES. THIS APPEARS TO BE ABOUT CONTROL OF THE TYPE OF SERVICES OFFERED TO PATIENTS WHO NEED BULK BILLED DOCTORS.

The petition is a long heartfelt plea seeking to justify the way Reece operates his practice. It makes the point that certain appointments, particularly prescription refills, may require only five minutes. The petition also notes that Reece would be forced to close his doors in part because, “his practice would be limited dramatically by the immediate reduction of the number of patients he is able to see daily…”. Whilst I empathise greatly with these patients and find removal of any addiction treatment services troubling, one cannot escape the fact that such a huge patient load should never have eventuated. Health Practitioner Regulations state, “A Practitioner must NOT exceed four (4) patient consultations in any one hour (60 minutes)”.

There’s no doubt that Medicare is not meeting the needs of Australian General Practitioners. The patient rebate is beyond inadequate, being markedly out of step with the Consumer Price Index (CPI). This manifests in significantly fewer consultations being bulk billed, and in many practices fees now apply to concession card holders. For Australians surviving on the aged or disability support pensions a visit to their GP is now financially prohibitive. The end result is a health system under strain. However there comes a point where increased patient quantity, means decreased quality of care. Let’s remember that the Health Practitioners Tribunal observed in 2009 that when it came to treating patients Reece lacked insight and objectivity, and felt the ends justified the means. The same document notes (point 22):

He does provide care to a large number of detoxifying and drug dependent patients. In June 2009, alone, he had 409 Subutex patients in Queensland and I understand the numbers are larger at the moment. From 2001 to 2007 he was responsible for 8681 registrations of opiate withdrawal registrations in Queensland.

Arguably, Reece is the architect of his own professional distress. As noted above, in November 2009 the practice suspension applied to Reece was itself suspended for three years. Yet less than two years later there was no tone of contrition for falsifying medical records to supply opioid dependent patients with morphine. The occasion was a Senate Inquiry into the Professional Services Review (PSR) Scheme, to which Reece, representing the now defunct Australian Doctors Union, made a submission. Bear in mind Reece has today been saddled with limitations to prevent excessive bulk billing at the expense of Medicare. The PSR “aims to protect the Australian public from the risks and costs associated with inappropriate practice within Medicare…”. Reece began his submission:

Prof. Reece: The Australian Doctors Union is a nascent union which has come together to support each other through the nightmare experience of PSR’s incompetence, lies, intimidation and bullying. In addition to doctors damaged by—

CHAIR: Hang on please. That is making accusations and it is not the way that we take evidence. If you could please refrain from using that sort of language, that would be appreciated.

Reece continued for a full five minutes explaining why he believes the PSR “has been shown to be waging a very successful war against general practice in this country”. He blamed the PSR for doctor suicides, marriage breakdowns, a lowered bulk billing rate, marginalisation of women, being racist, sexist and for damaging “many excellent doctors”. One of these was his ideological colleague, “Dr George O’Neil of naltrexone implant and detox fame”. Despite the fact naltrexone implants are not TGA approved Reece felt O’Neil should have been assisted by Medicare. Perhaps most alarming was when Reece included himself as one of those excellent doctors. Referring to himself in the third person, he humbly submitted:

Associate Professor Stuart Reece, one of the foremost detox doctors in the nation and a world authority on the long-term effects of opiate addiction.

This dear reader, is the crux of the matter. Stuart Reece is not a world authority on the long term effects of opiate addiction. In 2007 he opposed needle-syringe programmes, methadone maintenance therapy and the policy of harm minimisation in general. He informed a parliamentary inquiry that condom use was linked to AIDS deaths. Yet in June 2009 Reece was managing 409 Subutex patients. Buprenorphine is the opioid in Subutex and today it is distributed in combination with naloxone under the brand name Suboxone. It is a successful mainstay of substitution therapy for opioid dependent patients seeking to manage addiction and eventually cease opioid use. It is a key element of harm minimisation.

Exactly how a strident opponent of harm minimisation has today found himself with so many opioid substitution patients that Ahpra require supervision and auditing of him, is baffling. It may however have something to do with the attitude toward Medicare and the PSR Scheme reflected in his 2009 submission. Or his 2012 comment, What is wrong with medicare? (p. 170) bemoaning the PSR and Medicare audits. It may also have something to do with the disdain Reece has for evidence based health policy and genuine, original research. Reece has spent a career convinced he simply knows better. Better than the bulk of his colleagues, better than global research trends and better than health authorities. In short, Stuart Reece is the cause of the dilemma faced by so many of his patients.

Having said that, one cannot deny that Reece and Southcity Medical Centre have been accomodating the needs of a great many patients. An excessive number of patients. However accounts such as this on reddit aren’t isolated. They suggest the practice is busy, waiting times are high but Reece is attentive and compassionate. Google reviews are more varied. According to the petition there are 1100 patients in need of treatment. Over the last 18 days, 224 people have signed. The goal is presently 500.

Ultimately this situation doesn’t bode well for these patients. It is doubly sad that many are not able to see that the cause of their problem is Stuart Reece himself and not Ahpra. Funnelling high numbers of vulnerable in-need, at-risk patients through the surgery is far from acceptable. The only way forward is to abide by the limitations. Anything less is to abandon his patients.

Stuart Reece must accept that the ends do not justify the means. It is time to place patients first.

Medical Board of Australia restrictions imposed on Dr. Stuart Reece

♠︎ ♠︎ ♠︎ ♠︎

Latest update: 3 January 2023

30Aug2019

International Overdose Awareness Day – August 31st

Posted in Anti-Drug Lobby, Drug Free Australia, General, Health, Human Rights, Illicit Drug Policy, Science by Paul Gallagher

Time To Remember Time To Act

August 31st is International Overdose Awareness Day.

Access the IOAD link above to find an activity, get resources or make a donation. On the main page just under a couple of videos, we read;

International Overdose Awareness Day is a global event held on 31 August each year and aims to raise awareness of overdose and reduce the stigma of a drug-related death. It also acknowledges the grief felt by families and friends remembering those who have died or had a permanent injury as a result of drug overdose.

International Overdose Awareness Day spreads the message that the tragedy of overdose death is preventable.

Thousands of people die each year from drug overdose. They come from all walks of life.

Do you recognise the signs and symptoms of overdose? What is the impact of drug use and overdose on family, friends and those experiencing it?

These videos include people affected by the impact of drugs use and overdose who share some of their stories.

Australia’s Alcohol and Drug Foundation have a comprehensive site set up for IOAD. There’s helpful information here such as Signs and Symptoms of an Overdose, Harm Minimisation, How to Help in an Emergency, along with references and resources.

This morning on ABC Melbourne Jon Faine ran a great interview. The info’ paragraphs run as follows;

Cherie Short’s son Aaron died of a drug overdose in 2015. She tells Jon Faine we need to change drug policy and “make humane decisions” to stop others from dying.
“This tragedy is preventable, I believe overdose is preventable,” she said.

Ms Short is joined by Kayla Caccaviello, who dated Aaron and has overcome her own addiction to drugs to become a drug and alcohol counsellor.

The interview is titled “Humane drug policy could have saved my son”: Mum

You can download the 8 minute mp3 file here.

Activities for this year globally and across every state in Australia can be accessed on this page. Fortunately Australia is second from the top and easy to access. But of course please use the drop down menu for fast access to the area of your choice. Australia has 79 activities with 48 in Victoria, 11 in NSW, 7 in WA, 4 in QLD and TAS, 3 in NT and 2 in ACT.

Activities are varied ranging from O.D. prevention training, to art display, to group naloxone (opioid antidote) training, to afternoon tea – followed by naloxone training and a free kit, remembrance events to de-stigmatise overdose, etc.

Australia has only two supervised injecting centres. One, the MSIC in Kings Cross Sydney opened in May 2001 and after more than 11 years of successful trial moved to permanent basis. The MSIC in Richmond, Melbourne commenced on a trial basis at the beginning of 2018. Whilst it is running successfully and saving lives daily the entire concept is a punching bag for conservative politicians.

Regrettably whilst it is easy to manufacture the illusion of government funded drug induced harm and negative community appearances the peer reviewed evidence, globally, supports the health benefits of Safe Injecting Facilities. Always be aware of the myth of a Drug Free Australia.

This notion is pushed on the back of pseudoscience, the rejection of peer reviewed evidence and moral panic. You can read up on the antics of Drug Free Australia Ltd via their tag here.

Evidence backed themes that are often presented on IOAD support the fact that prohibition and the “war on drugs” waste money, ruin and cost lives. Harm minimisation practices such as harm reduction approaches like needle exchange and injecting facilities, prevent overdose, the spread of blood borne diseases and community dysfunction.

Evidence supports harm minimisation and particularly harm reduction.

Prescription Drug Overdose

One area to receive increasing attention again this year is that of prescription opioids. According to this ABC article OD fatalities have risen almost 40% in the last decade.

A constant concern for those who need adequate pain management via prescription, is that the “war on drugs” mentality may permeate policy modification under the belief it is a sensible solution. Once again the political conservative gravitates to this mode of moral dictation.

Overseas activity suggests that those who are denied prescription medication for prolonged pain management may find their way to illicit opioid abuse and inherit all the problems of crime, disease, socioeconomic stress and violence that come with such abuse.

We must yet again be careful that in managing this emerging problem we do not allow the denial of rights and an ignorance of incumbent facts such that we see punishment and manipulation of those in need.

31May2017

A Little Boy Lost and the Goat in the Sheep’s paddock

Posted in Alternative "medicine" scams, Anti-Vaccination Lobby, Anti-Vaccination Lobby, Health, Human Rights, Illicit Drug Policy, Legal, Meryl Dorey, Scam by Paul Gallagher

A few days ago Australia’s Seven Network screened Saving Chase as the subject of their Sunday Night programme.

The general plight of Chase can be gleaned from watching the programme. However this hasn’t just happened in the last few weeks. More so in no way, as Melissa Doyle tells viewers during the introduction, is this “a classic case of what would you do?”. Indeed Doyle confirms this in her next statement.

A child just four years old suffering from a serious disability. He is distressed, in constant pain and gripped by violent, uncontrollable seizures. Understandably his parents want him to be well and happy like other little boys. In desperation they abandoned traditional style medicine and turned to a bizarre hippy-style church for help.

The question rather, is “How can any parent subject their innocent, vulnerable, high needs child to the unverified guesswork pushed upon him by a reckless, dangerous and deregistered doctor who had caused “catastrophic” injuries through administering cannabis oil to prior patients?“

https://youtu.be/xs4bhovdfG0

Arrogant, unrepentant and angry with the demands of genuine medical science, Andrew Katelaris, the so-called Dr. Pot is the last person who should be anywhere near a fragile child like Chase. Presently as a result of his disdain for medicine and accountability Katelaris is “permanently prohibited from supplying or administering cannabis or any of its derivatives to any person for the treatment or purported treatment of cancer”.

It appears to be a very thin line that he is walking on.

Despite being deregistered for breaking the law in 2005, Katelaris last year managed to break the law for non-registered health practitioners. He injected cannabis oil into two women suffering from ovarian cancer, in what was described as “a hasty, ill-conceived and unsafe clinical trial of injected cannabis oil as a treatment for malignant ascites”.

The ABC reported in part;

The NSW Health Care Complaints Commission concluded Dr Katelaris put his own interest in self-protection and self-promotion ahead of the health and safety of two vulnerable women suffering from ovarian cancer.

It found he posed a risk to the health and safety of members of the public, prompting him to be permanently prohibited from supplying or administering cannabis or any of its derivatives, to any person for the treatment or purported treatment of cancer.

The full HCCC finding published on October 25 2016 may be found here.

As is plain in the video Katelaris deems himself right and everyone else wrong when it comes to his use, or rather abuse, of cannabis. It’s impossible to call his guesswork the “medicinal” use of cannabis. Katelaris conducts no trials, keeps no clinical notes, takes no measurements and lacks the use of basic statistical models. As the HCCC noted last year in describing his bogus “trial” it lacked credibility, authorisation, scientific legitimacy or ethics approval. The best he could offer reporter Alex Cullen with regards to efficacy was that he sees results. However he admits his work is “experimental”.

Problems began with Katelaris at least as far back as 1986. The NSW Medical Board record that in this year he “self-administered morphine”. The 2006 NSW Medical Board Annual Report includes a compelling paragraph on page 24;

Andrew John Katelaris

In 1991 Andrew Katelaris was suspended for 12 months from the practice of medicine because of his opiate use. However on return to practice Mr Katelaris continued to indulge in use of restricted or illegal substances, including morphine, pethidine, cannabis and ketamine.

In December 2005 the Medical Tribunal found Mr Katelaris guilty of professional misconduct conduct and ordered his de-registration with no review period for three years. The Tribunal found Mr Katelaris had inappropriately prescribed schedule 8 narcotics, a schedule 4D drugs and cannabis to friends, family and to himself not in accordance with therapeutic standards. It was also alleged he breached his registration conditions. The Tribunal considered that the flagrant disregard by Mr Katelaris of the conditions on the his registration was conduct that portrayed indifference and an abuse of the privileges which accompany registration as a medical practitioner.

The full NSW Medical Tribunal Determination, December 15 2005 may be found here. Katelaris could not apply for re-registration for a period of three years. It is clear from reading this document that Katelaris struggled with his opioid addiction and this was compounded by surgery in March 1992 for a spinal disc lesion. His Schedule 8 authority was restored in August 1992 with restrictions that he could not take possession of Schedule 8 drugs, only prescribing for patients at the hospital where he worked. In October 1993 his authority was fully restored.

On 14 January 2002 the Pharmaceutical Services Branch of NSW Health Department received a report of an empty packet of ketamine at the home of Katelaris labelled with a name other than his. On 19 January 2002, Katelaris was admitted to a hospital Emergency Department. Records note he stated he had been self administering ketamine since September 2001. His struggle with addiction continued with appropriate restrictions being applied when necessary. Regrettably for him it has destroyed his medical career.

Nonetheless his problems with self medication are not the problem for Chase. The danger is his reckless use of cannabis on vulnerable patients combined with the conviction he is doing what is right and what is safe. With a history of obtaining opiates for “friends and family” it is clear his provision of cannabis could be dangerously reckless.

In 2009 he sought to “review an order that his name be removed from the register of Medical Practitioners”. You can read the full NSW Medical Tribunal determination here. It is noted that in addition to the 1986 use of morphine he used both morphine and cocaine in 1988. No conviction was recorded and he was placed on a good behaviour recognizance for two years. He again self-administered morphine and at his own request his right to prescribe Schedule 8 drugs was withdrawn.

It was 1989 when Katelaris initially sought for the prescribing restrictions to be lifted. Restrictions on Schedule 8 remained but the Medical Board, after interviewing Katelaris decided some restrictions could be lifted. This depended on undergoing urinalysis and informing his employer “of the undertakings”. Katelaris refused thus the application was unsuccessful. The determination continues on describing his addiction to and use of morphine, Pethidine, Ketamine, cocaine and Fortral.

The Goat in the Sheep’s paddock

In describing his poor insight Katelaris said;

Poor insight, really that I was prepared to stand outside of a majority opinion. I must admit I considered myself very much…like a goat in a sheep’s paddock where a lot of people were content to walk one way but I felt free and quite unconstrained to exercise my own independence of thought and action. I still in many ways feel it is the right of every sovereign being to exercise independence of thought and action but being part of a profession which has considerable responsibility and access to technologies and pharmaceuticals of considerable strength and power, they have to be constrained so whilst maintaining an independence of thought I now accept that one does have to, to a greater or lesser degree, fall in with the herd, certainly in regard to accepted behaviour such as self- administration I have very little problem with saying that without equivocation.

He went on to say he was “testing the law” and was “impatient to bring forward progress in Australia”. When it came to not being able to supply cannabis to others in pain he added;

…but the insight was that I failed to appreciate the authoritarian stance and lack of compassion in the legal system

The application was dismissed and the applicant had to pay the respondent’s costs. The April 2010 NSW Medical Board News included on page 8;

Application for restoration to Register – irregular prescribing, own use of cannabis and breach of conditions

Issue

Mr Andrew Katelaris (MBBS (Syd) 1982) was deregistered in 2005 by the Medical Tribunal which set a non-review period of 3 years following a finding of professional misconduct for irregular prescribing of Schedule 8 and 4D drugs to family and friends, his own use of cannabis and breach of conditions on his registration. In his application for restoration, Dr Katelaris argued that he had developed insight and was a changed man.

Findings

The 2009 Tribunal did not accept that Mr Katelaris was a changed man, referring to his conviction for 4 criminal offences since 2005 and his inability to accept the 2005 decision; the application was dismissed.

As we can see today with respect to reckless administration of cannabis Katelaris remains very much a goat in a sheep’s paddock, unable to accept his responsibility to evidence based science. Despite his penchant for obtaining opioids for “friends and family” it is Katelaris’ reckless pseudoscientific use of cannabis that has raised complaints relating to the Drug Misuse and Traffiking Act 1985. Katelaris admitted his supply of cannabis for individuals between October 2002 and September 2004 was in contravention of the Act.

It was reported today that Katelaris was arrested yesterday and will;

…appear in court today charged with possession and supply of illegal drugs and also having cash suspected of being from the proceeds of crime. Police raided the St Ives home of Andrew Katelaris yesterday morning where they allegedly seized cash and cannabis found in the Luton Place resident of the former doctor. The 62-year-old was taken to Hornsby Police Station and charged and spent the night in the cells after being refused bail. As a doctor Mr Katelaris was an outspoken supporter of the use of cannabis oil for cancer sufferers.

Although it is almost certain that Chase’s condition is not a “vaccine injury” his parents have been convinced not only of this, but that he will die if fed and medicated properly by qualified medical staff. Under the “care” of Katelaris and others he has lost 50% of his body weight and is notably emaciated [See below].

Tragically last month his parents fled with Chase to prevent him being admitted to hospital for proper care, sparking an amber alert across QLD and NSW. In disturbing insight into how the rights of Chase are unappreciated by his mother, Cini Walker she posted a video at the time asking;

“My son is … Do I even own him anymore? Who’s going to help our family? When is this nightmare going to stop?”

Ownership of another human being? Whilst it is likely incorrect to suggest Cini thinks she owns Chase as she might a piece of property, it does yield significant insight into how incapable she is of accepting the role of Child Services, the necessity of medical care and the harm caused in snatching him from hospital to flee across state lines.

They stayed at the NSW Church of Ubuntu [Facebook] until FACS authorities under the protection of police came and removed Chase due to “medical neglect”. Indeed his life had become a perverse sideshow for a number of self-serving anti-science conspiracy theorists. The so-called church was raided on December 1st last year.

Presently Chase is safe in hospital for at least another week, despite the abuse and harassment of hospital staff by his “supporters”.

Unfortunately regardless of where he is or whom he is with Chase will continue to be used as a proxy for the antivaccinationist conspiracy theorists. A poster boy for the proposed magic of cannabis.

His parents are blind to the abuse and suffering they have allowed to be forced upon him. They have been manipulated into believing Chase must not be treated by reliable medical means and are blind to the towering immorality of what they have allowed; ongoing, sustained and life threatening medical neglect.

Only the strictest of conditions and ongoing monitoring will suffice when he is released into his mother’s “care”.