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

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”.

Chase before (left) and after his parents ceased prescribed nutrition

  • Updates added to text on June 1st 2017
Advertisements

AVSN president Tasha David misleads ‘We Are Vaxxed’ audience

Current president of the Australian Vaccination Skeptics Network, Tasha David, visited Atlanta Georgia in the USA to attend the so-called “CDC Truth rally”.

This caper was a big deal for antivaccinationists obsessed with the dishonest, deceptive film Vaxxed. In forming a view about the push to promote Vaxxed and the individuals involved it is important to understand how utterly false and potentially harmful it is. Like most outspoken antivaccinationists Tasha David keeps reminding us of her own dishonesty.

Whilst in the US, on the weekend of October 15-16, David joined the parade of vaccine victims appearing as video subjects for We Are Vaxxed. Although dishonest throughout her stint it is the first lies she offers that are so patently absurd. Initially David offers:

The government made us change our own name because we’re not allowed to choose our own name in Australia, so that’s basically one of the reasons why we’re here because in Australia we don’t have a Bill of rights we don’t have guaranteed freedom of speech, so we’re not allowed to speak on a lot of things.

Freedom of speech? Bill of Rights? Not allowed to choose our own name in Australia? Oh my. The government had “made us change our own name”? Balderdash and Blubberblurt. The Australian Vaccination-Skeptics Network are obsessed with manipulating discourse and social media to keep their prior name – the Australian Vaccination Network (AVN) – alive.

The AVN was formed in 1994. Twenty years later Tasha David became president. Clearly the AVN had a long run with the name they had chosen. It was however a confusing name and always intended to deceive. Regrettably the official sounding name was successful in fooling members of the public, and a legitimate midwifery organisation listed the AVN as reputable. The NSW Department of Fair Trading received complaints to this effect.

In December 2012 they ordered the AVN to change its name within two months or be deregistered. Minister for Fair Trading at the time, Anthony Roberts, said the group’s name “is confusing and has misled the public as to its operational intention”. The order was a huge blow to the twisted morale of the group which thrived on whenever possible snubbing regulators and mocking the vital purpose of regulation. They unsuccessfully challenged the order and by March 2014 changed their name to the Australian Vaccination-Skeptics Network.

By the time of the name change the Fair Trading Minister was Stuart Ayers. The ABC reported:

Fair Trading Minister Stuart Ayres says the association’s original name was misleading.

“The title wasn’t reflecting their strong anti-vaccination stance and so we after receiving numerous complaints requested them to change their name,” he said.

“They’ve now complied with that request and the new title reflects their anti-vaccination stance.”

The Australian Medical Association (AMA) says it hopes the name change makes sure the organisation is not mistaken for a government agency.

It would appear that David’s intellectually contorted statement suggesting government strong arm tactics and suppression of free speech is a calculated lie crafted to gain sympathy. In reality it is the health of Australian democracy and Fair Trading legislation that led to the order to change their deceptive name.

  • Listen to the first 2 min of David’s interview. NB: I edited out the confusion around live video streaming but have not altered the commentary in any way.

Tasha David continues:

I see that you guys are up in arms about that new CDC um, rule we’ve been talking about – forced vaccinating um, children, or people basically in the US. But I’m really sad to say that they’ve already passed that law in Australia. It’s called the Biosecurity Act 2015 so basically, um, they can force vaccinate you if you have a disease or um, some kind of illness that is a risk to human health.

Now that could be anything. Could be a cold you know, so we’ve already got the legislation in place. I haven’t seen it be used yet but the fact that it’s even in place is scary to me, you know, so…

Here, David is contending that forced vaccination is a reality in Australia if circumstances meet conditions outlined in the Biosecurity Act 2015. She further contends that the Act permits forced vaccination of an individual suffering “some kind of illness that is a risk to human health… that could be anything… could be a cold”. Putting aside David’s alarming lack of understanding the role of vaccination we should look closer at the Biosecurity Act 2015.

The Act is headed, An Act relating to diseases and pests that may cause harm to human, animal or plant health or the environment, and for related purposes.

The HTML version I’ve linked to has 681 pages, including endnotes. The word “vaccination” appears eleven times, the majority of these being in subsections or related sections. That is to say this vast document does not present a number of novel reasons for vaccination. Rather parts of the Act describe when vaccination is relevant to interpretation and application of the Act.

David is in error when claiming the Biosecurity Act 2015 deals with “anything” or “a cold”. The diseases this Act is designed to manage are in fact far removed from such a dismissive notion. Chapter 2 – Managing biosecurity risks: human health includes Listing Human Diseases:

(1)  The Director of Human Biosecurity may, in writing, determine that a human disease is a listed human disease if the Director considers that the disease may:
(a)  be communicable; and
(b)  cause significant harm to human health.
(2)  Before making a determination under this section, the Director of Human Biosecurity must consult with:
(a)  the chief health officer (however described) for each State and Territory; and
(b)  the Director of Biosecurity.
(3)  A determination made under this section is a legislative instrument, but section 42 (disallowance) of the Legislative Instruments Act 2003 does not apply to the instrument.

With regard to Human Biosecurity Control Orders it should be noted that these are not applied frivolously and when an individual objects to the application of such measures the Director of Human Biosecurity “must take into account any factors that may affect the health of the individual”. Thus an established risk to an individual of an adverse reaction from vaccination would prevent administration of a vaccine.

With respect to imposing biosecurity measures the Act includes, in Chapter 2:

[Protections] aim to ensure that a power is exercised, or biosecurity measure imposed, only when circumstances are sufficiently serious to justify it, and only if it would be effective, it is appropriate and adapted for its purpose, and it is no more restrictive or intrusive than is required. [Protection] also ensures that the requirements of this Chapter do not interfere with an individual’s urgent or life‑threatening medical needs.

It’s important to realise with respect to disease a great deal of this Act and the application of biosecurity measures involve individuals entering Australian territory and the operation of aircraft or vessels entering or leaving Australia. Managing risks to human health include human biosecurity control orders. Section 59 of the Act includes:

A human biosecurity control order that is in force in relation to an individual may require the individual to comply with certain biosecurity measures. [Those measures] include vaccination, restricting the individual’s behaviour and ordering the individual to remain isolated.

In Division 2 of the Act it states under Entry Requirements (bold mine):

The Health Minister may determine one or more requirements for individuals who are entering Australian territory at a landing place or port.

for an individual to provide either:
(i)  a declaration as to whether the individual has received a specified vaccination or other prophylaxis within a specified previous period; or
(ii)  evidence that the individual has received a specified vaccination or other prophylaxis within a specified previous period

With respect to vaccination identical requirements exist under Exit Requirements.

Unvaccinated Australians are freely travelling to and from the country without being vaccinated against potential disease. Despite the Biosecurity Act travellers have brought measles to Australia, resulting in a sixteen year diagnostic high in 2014. Tasha David may claim that under this Act a simple cold could lead to forced vaccination, but there was no evidence of Human Biosecurity Control Orders in the wake of a recent measles outbreak in Melbourne. David would benefit from understanding just why she hasn’t seen this Act used to force vaccination for trivial reasons.

Section 74 of the Act notes when an individual is expected to comply with a biosecurity measure. Subsection (2) reads:

The individual is required to comply with the measure only if:
(a)  the individual consents to the measure; or
(b)  the Director of Human Biosecurity has given a direction for the individual to comply with the measure…

Section 92: Receiving a vaccination or treatment:

An individual may be required by a human biosecurity control order to receive, at a specified medical facility:
(a)  a specified vaccination; or
(b)  a specified form of treatment;
in order to manage the listed human disease specified in the order, and any other listed human disease.

With respect to the use of force one notes Section 95: No use of force to require compliance with certain biosecurity measures:

Force must not be used against an individual to require the individual to comply with a biosecurity measure imposed under any of sections 85 to 93.

Note: Force may be used in preventing an individual leaving Australian territory in contravention of a traveller movement measure (see section 101) or in detaining a person who fails to comply with an isolation measure (see section 104).

Thus contrary to Tasha David’s claim that, “they can force vaccinate you” under implementation of the Biosecurity Act 2015, we can see in this case that the Act itself prevents forced vaccination. It’s clear that no force can be used for the imposition of biosecurity measures under Sections 85 to 93. Vaccination, being Section 92, falls within this range.

No doubt antivaccinationists will disagree with any legislation that involves vaccination to protect the public from serious disease. What is important however is to underscore how this group will continually mislead the public without compunction. The Biosecurity Act 2015 is not used for just “anything” or simple “colds”. Nor does it permit forced vaccination.

David continues with considerable more nonsense. Offensive, crude dishonesty. Her next target is No Jab No Pay but it is the impact she claims to have observed that is quite sickening.

So these people that are single parents that don’t have that money to pay, you know that need that money just to survive… they can’t work, they can’t afford child care. So they’re basically on the street. We have so many stories on our web site of people living in cars, that are having abortions because they can’t afford to have a child in Australia now because of these laws.

Typically there is no evidence for these claims. If they were true the right thing for Tasha David to do would be to advise these individuals to have their children vaccinated and thus be eligible for the payments in question. Or perhaps the AVSN could help with some of that donated cash instead of spending it on trips to the USA.

Either way I doubt the AVSN will change their deceptive habits.

Cannabis misinformation and the anti-drug lobby

The most dangerous aspect of drug use is that the chemical becomes the centre of life, leads to physical debilitation after tolerance is reached, and no amount of drug produces the necessary euphoria – only coma or suicide are left

– Herschel Mills Baker (Drug Free Australia)

“Suicide/Schizophrenia: Consequences of acute and chronic cannabis use”

A recent thread on Facebook gave me cause to reflect upon the impact that the anti-drug lobby has had upon community perception of evidence specific to cannabis, its use, abuse and potential.

This perception of course can be traced in part to sensational media headlines following the release of research into the effects of chronic cannabis abuse. Yet the anti-drug lobby has been willingly involved in the perpetuation of self serving and frequently egregious falsehoods that have left inhumane policy sabotage and damaged individuals in their wake. Worse, the very real and well understood problems associated with cannabis abuse have been scattered by the gale of “cannabis psychosis”.

I should stress this is not a pro-drug nor pro-cannabis post. If anything it is a pro-evidence post and I would hope readers can reflect upon the value of evidence in a human rights manner, much as we do in a consumer rights manner. As I suggest under my “About” tab, skeptics make excellent agents of morality because they are agents of evidence. This isn’t to suggest one is endowed with superior morale. Rather, one is bound to reject subjective and predisposed constraints in favour of evidence.

An effective informed policy on cannabis use should not slant only toward the harms caused by its use but also by the harms caused by the social measures/existing policies designed to control or prevent its use. Cannabis is not a hard drug. Cannabis is not a soft drug. Cannabis is a drug, and as such deserves the respect that science and apolitical critiques can bring.

The nonsense above was originally written in 1988 and has been continually polished and rephrased over the years. Its most recent incarnation was Cannabis – suicide, schizophrenia and other ill effects, uproariously tagged “First Edition, March 2009”. Subtitled A research paper on the effects of acute and chronic cannabis use, it is in fact a biased selection of literature. Not research, nor literature review.

Cannabis “potency” is a key driver of fear and a launch pad for ongoing misinformation. This area is fraught with notable disrespect for variables involved. Is “potency” THC content per volume? If so, what strains grown under what conditions provide conclusive answers? Or does one compare the hashish and hash oil of the 1970s and 1980s (at around 20% THC content) with todays plants? If so, what of the famed sinsemilla grown for decades?

DFA choose to refute Australia’s peak illicit drug body, the ANCD, and their “Evidence-based answers to cannabis questions: a review of the literature” (2006), which concluded no significant increase in THC content had occurred. This was challenged by the unqualified lobbyists with a preposterous figure of 30% THC content from an apparent – and unsourced – 1993 Australian Bureau of Criminal Intelligence claim. Readers were to be very afraid as the equally preposterous and unsourced joint potency from the 1960s was 0.5%

Could this even be true?

In THC content of cannabis in Australia: evidence and implications, Wayne Hall and Wendy Swift reported in 1999:

The major obstacle to testing these claims is that the THC content of cannabis products has not been systematically tested by any Australian police force over the period in which average THC content has been claimed to have increased.

Well, no, it appears to be fiction.

So why are DFA misleading the public this way? A primary area of community confusion and angst is the poorly reported association between psychosis and cannabis. The most fallacious is the “puff-puff, go mad” claim. It terrifies parents and this fear can persist in the absence of evidence. I must stress that negative experiences associated with ingesting THC can certainly be exacerbated by ingesting a volume of cannabis that contains more THC than a user is accustomed to. I’m not attempting to refute this possibility. I would add however, that user titration gives control to the cannabis user over the amount ingested. In this light a number of claims pushed by DFA demand criticism.

Primary is that DFA claim that the introduction of hydroponic cannabis (itself a spin-off of prohibition’s failure) brings with it [page 11]:

…a well demonstrated dose-response relationship between cannabis and its related drug-induced psychosis, where the greater amount of cannabis consumed correlates to a higher degree of risk of psychosis any three to fourfold increase is absolutely critical in any assessment of cannabis harms. When it is further considered that changed usage patterns, whereby users smoke only the multiple potent heads of the cannabis plant… the ANCD paper’s approach to potency is of concern.

Again, as we shall see below, this is not backed by evidence. What is drug-induced psychosis in this context? Sure, hydroponic production has provided the equivalent of sinsemilla-type product to users. Yet DFA then go on to cite the ANCD paper which confirms a tripling of THC figures in the USA. Quite correctly there is no reason to suggest this hasn’t occurred here, yet as the paper notes:

…the majority of THC levels in studies of [USA] cannabis seizures have remained under 5%.

So the ANCD conclusion that no evidence exists for huge THC increases in recent decades is valid. If anything users have more of the THC rich component of the plant, and less of the THC poor component. Hydroponics ensures rapid maturation and more flowering (head). Per plant there is more THC rich matter. But that matter is not notably more THC potent.

I hate to excessively mull this over, so to speak, but once again prohibition has placed better drugs for the same price into the hands of Aussie kids.

Let’s consider DFA’s claim that, “users smoke only the multiple potent heads of the cannabis plant”. They are challenging figures from 1970 to 1997. Returning again to Hall and Swift 1999, we see on page 8:

HallandSwift_type of cannabis smoked

So consumption of “skunk” or “super-skunk” that DFA claim is driving kids insane increased as much as leaf in the 14-19 year old group, from 1995-1998. Yet head seems to be the main product. Nonetheless users are not “smoking only multiple potent heads”. Which sounds more scary than just “heads”, one presumes.

Under Changing Patterns of Cannabis Use, Hall and Swift write on page 7:

The media preoccupation with the THC content of cannabis has distracted attention from other causes for concern about changing patterns of cannabis use among Australian adolescents and young adults. These patterns of cannabis use, which may encourage younger users to use more potent forms of cannabis, may also increase their chances of developing problems as a consequence of their cannabis use.

This is of course, exactly the point. By pursuing sensationalism, co-morbid health problems and negative lifestyle changes are frequently ignored. That this has been willingly and eagerly encouraged by groups such as DFA as part of their agenda to encourage blanket illicit drug zero tolerance and the public health damage this brings, is deeply concerning.

In 2009 this manuscript of misinformation was used to lobby independent conservative QLD MP, Peter Wellington to push for the old DFA staple of School Drug Testing. Such tactics are typical of the evangelical crusade waged by this conservative Christian group. The Australian National Council on Drugs concluded in 2007 that SDT was technically unreliable, cost prohibitive, morally and legally problematic, prone to exacerbate problems faced by at-risk children, designed to normalise punitive measures and fraught with false positives.

You can read more here about Drug Free Australia and their campaign against evidence. Or just marvel at a school kid’s drawing of God espousing “be drug free and you’ll be with me”. It isn’t just punitive policies DFA seek but a quite inhumane roll back of Harm Minimisation strategies, particularly those involving harm reduction. Whilst it is unacceptable for young Aussies to be under the impression cannabis is entirely safe, we can see without much effort how a spike in reports on cannabis and psychological harm has been exploited.

Claims that cannabis is supposedly endowed with benign or even beneficial properties because it is “natural” are equally concerning. The notion that if something comes from the earth it’s therefore by default superior to a manufactured pharmaceutical analogue is certainly not backed by evidence.

In fact this point is ripe for confusion about the role of evidence, its import and what might be termed insults from intuitive reasoning. Cannabis use as a recreational drug is defended at times with argument from antiquity. Combined with the “mother earth” line it may sound quite compelling. Like many alternatives to medicine (such as TCM), cannabis is also subject to further defence with argument from antiquity. According to The Mayo Clinic medicinal use can be traced back 5,000 years. Yet a crucial distinction is made here.

Research into the medicinal benefit of cannabinoids or their application as medication is quite different from inhaling cannabis smoke and expecting better health. There is quite a lot of rot about cannabis being medicinally magical. Whilst there is some potential for a rather large range of symptoms and side effects, grasping impact on actual pathologies demands extensive investment in research.

As abundantly hinted at above, perhaps the most alarming and challenging theme I’ve faced in recent years is the media construct that cannabis “causes” psychosis or schizophrenia. The primary reason this created so much angst in the illicit drug policy and discourse deconstruction fields was the immediate negative impact on management of the many known psychological issues. The 2007 meta-analysis by Moore et al published in The Lancet was seized upon as conclusive evidence.

It remains an excellent review, and fortunately drew much needed explanation about the nature of meta-analyses and in particular that of Moore et al. Amidst the frustrating and very disappointing bad science reporting to follow (including one of the worst by Australia’s own Jonica Newby on ABC’s Catalyst), were calmer voices such as that found on Storied Conduct: Resources and News in Psychology.

Correlation, as our basic research theories tell us, can never prove causation. All of the studies examined by Moore et al. (2007) were correlational in nature. Further, the additional use of meta-analytic grouping techniques cannot turn correlational data into experimental data no matter how sophisticated the statistics. This means that, while the trends and the thrust of the data seems to make marijuana a very promising explanatory causal factor in the development of some of the psychoses that these research participants developed, such a link has not been conclusively demonstrated. And, while the gross odds ratio speaks of a 41% increased risk, the authors themselves acknowledge the impact of confounding and other variables in lowering the risk percentage in the studies they examined. Hence, we are left without a good estimate of what the actual increased risk might be.

The number of media articles poorly reporting findings grew steadily over three to four years. Diligently a steady number of D&A workers, bloggers and independent media contributors used a dual method of exposing predetermined agendas and explaining the results in proper context. Generically speaking – and I stress generically – the headline “Cannabis induced psychosis increases 300% in two years scientists find”, might pop up. On examination it reflects that a sample with 0.2% predisposition to psychotic episodes had two years later, under different methodology, been found to present a 0.6% prediction to experience the transient psychosis they are genetically predisposed to, had they continued to smoke cannabis heavily for another decade.

One of the sadder developments was the establishment in 2008 of the National Cannabis Prevention and Information Centre. The NCPIC. Coined the National Cannabis Propaganda and Infotainment Centre by a contributor to a professional e-list, it regretfully offers themes well documented as not being efficacious in reducing cannabis abuse. In 2009 NCPIC head Jan Copeland was pulled up by the same publication for dodging the need to publish bipartisan research.

The NCPIC is in the habit of presenting the style of faux science we see above from DFA and also using alarming distortion of facts in their supposed quest to “prevent”. The public is seemingly deemed at risk from balanced information which is substituted with bias and deception. In view of the documented harm this approach leads to it is not good enough for a tax payer funded organisation.

One of the best papers I’ve read is Continued cannabis use and the risk of incidence and persistence of psychotic symptoms: 10 year follow up cohort study, by Kuepper et al. This paper controlled very well for baseline incidence (Eg: self medication of psychosis/schizophrenia, supplementation of low cerebral anandamide [thus proposed alleviation of psychotic symptoms] via cannabis, cumulative effect of CBD’s anti-psychotic properties, other drugs, unstable lifestyle, etc.

In doing so, they thus also controlled for the host of suspected [exact cause remains unknown] causes of psychosis (stress, genetic predisposition, changes at puberty, assault, major life changes, biological causes, neuroses etc). This was itself arguably misused by Professor Jan Copeland who we’ve just met.

Wayne Hall and Louisa Degenhardt contributed an excellent review [BMJ 2011;342:d719] at the time. They noted the superior methodology and also that:

In the light of these findings and those of earlier studies, it is likely that cannabis use precipitates schizophrenia in people who are vulnerable because of a personal or family history of schizophrenia… A modelling study suggests that we would need to prevent 2018-4530 young people in the United Kingdom from becoming regular cannabis users to prevent one case of schizophrenia, or to prevent four to five times as many (10,000-23,000) from light cannabis use to achieve the same result.

Of course schizophrenia is a disease with a clear diagnosis. Psychosis is a transient symptom with a much less clear delineation. What’s certain is that the term is misused and frequently in the manner suggesting cannabis use/abuse leads to a permanent state of psychosis.

Copeland is quoted in an article for The Drum by Quentin Dempster:

Professor Jan Copeland, director of the NCPIC  a government-backed preventative agency, told 7.30 NSW that if cannabis was taken out of the picture the incidence of schizophrenia in Australia could be reduced by 8 to 14 per cent. She could not be more specific. That guesstimate was based on overseas studies. There have been no studies in Australia. This is revealing.

I had seen the report and was stunned. Copeland had failed to grasp the import of incident cannabis use to incident psychotic symptoms. More so she had failed to appreciate the basics of the different time periods. What she had messed up re 8% and 14% from the Kuepper et al study came from this line in the Abstract under Results:

The incidence rate of [sub threshold] psychotic symptoms over the period from baseline to T2 was 31% (152) in exposed individuals versus 20% (284) in non-exposed individuals; over the period from T2 to T3 these rates were 14% (108) and 8% (49), respectively.

The paper cited mentions “schizophrenia” twice. Once in describing instruments used to collate data and again under “methodological issues”.

I wrote to Jan and rather comprehensively outlined the incident specific nature of the results, to seek clarification. I received no reply. For the record here is the conclusion from this sterling study.

Cannabis use is a risk factor for the development of incident psychotic symptoms. Continued cannabis use might increase the risk for psychotic disorder by impacting on the persistence of symptoms.

It’s important to realise that this association is emerging as a very small but very significant issue for individuals predisposed to psychotic episodes. “Cannabis induced psychosis” is thus better viewed as schizophrenia. To date new trends and good research has been seized or sabotaged for political gain. There are areas in need of research dollars wherein we should despise bad science or exploitation of good science. Illicit drug policy is one of them.

As I mentioned way above this is not a pro-cannabis post. There are a host of reasons including psychological, physical and social to not use cannabis. Although I note it is Australia’s most popular illicit drug.

Which reminds me. There are no reasons to not use and respect evidence.

Global Commission on Drug Policy: HIV Report

FULL REPORT HERE

On Tuesday June 26th the report’s release was streamed live

Drug War tactics driving up HIV/AIDS

The Global Commission on Drug Policy recently released yet another report condemning illicit drug prohibition and the War on Drugs.

Entitled The War on Drugs and HIV/AIDS – how the criminalisation of drug use fuels the global pandemic the report lists 6 key dynamics behind the trend.

1.) Fear of arrest drives persons who use drugs underground, away from HIV testing and HIV prevention services and into high risk environments. 2.) Restrictions on provision of sterile syringes to drug users result in increased syringe sharing. 3.) Prohibitions or restrictions on opioid substitution therapy or other evidence based treatment result in untreated addiction and avoidable HIV risk behaviour. 4.) Conditions and lack of HIV prevention measures in prison lead to HIV outbreaks in incarcerated drug users. 5.) Disruptions of HIV antiretroviral therapy result in elevated HIV viral load and subsequent HIV transmission and increased antiretroviral resistance. 6.) Limited public funds are wasted on harmful and ineffective drug law enforcement efforts instead of being invested in proven HIV prevention strategies.

Let’s forget “drug war” and call this problem what it is. Treating drug use as a criminal offence. Now, just by raising that image we’re into different waters entirely. Pointing to problems with the criminal model immediately evokes suspicion of compulsory promotion of illicit drug use. We’re conditioned to assume if we don’t punish drug use, it will be everywhere and bring about a host of nasty outcomes.

Mostly, we’re well conditioned to associate drug use with crime and to see it as criminal. Stitched on to this is the pop culture image from which we draw stereotypes. My favourite is one I often refer to as Quinn Martin. Quinn Martin Productions brought us Streets Of San Francisco and a host of other unrealistic 1970’s TV Cop shows. If you wanted a crime – it was drug related. A bad guy or a weak willed loser? Toss in a druggie.

Of course, I’m not suggesting we imagine this. The reality is criminals are made from associating in criminal circles and from being incarcerated, regardless of the reason. How this fits in with the drug-crime punishment model was addressed recently by eminent Australians who authored the Australia 21 Report. They state:

The prohibition of illicit drugs is killing and criminalising our children, and we are all letting it happen

Rather than legalisation alone, that report discussed regulation, decriminalisation and de-penalisation. Far from being an open slather free ride these measures involve control, certain losses of freedom, the need to demonstrate responsibility and a major focus on rehabilitation back to a productive and useful lifestyle. What they don’t involve is the destruction of lives and sustaining criminal enterprise at huge cost to the community.

Yet in Australia we do very well managing HIV/AIDS in injection drug users [IDU]. 16 million use IV drugs globally. Almost 20% live with HIV. Fortunately, Australia managed to keep that level at 3%, and a significant number of that sample were at higher risk statistically from acquiring HIV from another high risk behaviour. This level remained stable for decades.

So the question does arise. Apart from acknowledging shocking human rights abuses, tragedy in many nations and an ongoing source of disease and corruption, what policy aspects need we mull over?

Since the Howard years Tough On Drugs initiative and emergence of groups like Drug Free Australia lobbying against expanded protective measures, the level of HIV in IDU jumped to 4%. It remains an exquisite example of how just a few years of delayed and abandoned Harm Reduction responses, increased punishment and disinformation about Harm Reduction efficacy has an immediately devastating impact on HIV control in Aussie IDU.

The fact that this collective undermining of Harm Minimisation occurred during a period when Harm Reduction services, research and supporting evidence expanded rapidly in Australia is testimony to how effective disinformation and intuitively themed attacks on evidence can actually be.

Still, as of April this year we remain extremely fortunate thanks to Harm Reduction:

HIV in IV Drug Users matched to Harm Reduction

The single greatest sabotage of Harm Reduction initiatives under the auspices of John Howard, was the suppression of a heroin on prescription trial in 1997. This had strong bipartisan support and the Federal Health Minister, four States and the ACT were excited about the decision to go ahead. Under instructions from then ANCD head Major Brian Watters – later to become a Board member of Drug Free Australia – Howard immediately vetoed the decision.

Exactly how many HIV cases, ruined lives and deaths this led to is impossible to estimate, and I would err toward a minimal estimate. Still, 15 years later we can assume the body pile is now somewhat impressive. In what is unique insight into how Howard in turn manipulated the zealots who tried to manipulate him, he never flinched on needle exchange.

To his credit he continued to fund over a thousand outlets across Australia, with some specialising in bulk dispensing, others in hard core risk management. Abandoning these programmes was insanity, despite conservative lobbyists being convinced he might do so. Yet to Howard, being seen to usher in heroin prescription – “free heroin” – as shock jocks called it was political suicide.

Despite strong support for our official policy of Harm Minimisation, which accommodated extreme spending against smuggling (Supply Reduction), this is how he presented his thoughts in 1998:

The policy of zero tolerance of drug taking in this country is a wholly credible policy and policy that ought to be pursued more vigorously by government and by people who are concerned about the problem.

Of all the lies he told, this remains one of my favourites. There was no such policy beyond words. He seemed to despise everyone equally. Which was essential for the politician he became. All that mattered to Howard was Howard, and securing votes. Manipulating drug workers, users, science advisers, policy experts and voters over what was a social crisis at the time was pure business.

British Columbia did introduce heroin on prescription in 2005. 5 years later the effects of the combined measures on HIV were compelling:

British Columbia: HIV infection matched to Harm Reduction initiatives

Similar success from heroin on prescription is found in every nation to usher in trials and programmes. Sadly, Australia was ready before the Howard years. We were in fact, world leaders. Now it’s a different story. We have one Medically Supervised Injecting Facility that ran as a successful trial for 11 years.

Seven of those 11 years were due to disinformation and sabotage from conservatives. In October 2010 the Kenaelly NSW State government passed a Drug Misuse and Trafficking Amendment bill to ensure the Centre became permanent. 11 years of moral panic was, at least legislatively, silenced.

Whilst actually attacking Harm Reduction initiatives, confusing methadone and buprenorphine with illicit drugs and muddling the lot in with AFL drug policy, Alan Jones delighted us with his wisdom on “Harm Minimisation”, in mid 2007 [MP3 here]. Obnoxious, offensive and completely ignorant of facts it is also somewhat representative of Aussie views today:

So today Australia has a long, long way to go before we do, if ever, fully recover from the rise of anti-drug conservatives under John Howard. They did far more damage than just raise HIV infection by 1% in injection drug users. Our fluency with progressive policy and public maturity has been undermined. Australia waits, on pause.

33 million people live with HIV today. Outside sub-Sahran Africa IV drug use accounts for 1/3 of new infections. For almost 15 years annual HIV infections have been falling on a global scale. Except for seven countries wherein HIV infections increased by about 25% primarily due to IV drug use.

The “drug war” is full on in Eastern Europe and Central Asia and unsurprisingly 5 of these 7 countries are in these boundaries. In the last decade people living with HIV in these areas has close to tripled. Russia has resisted Harm Reduction measures keeping methadone illegal and charging users for needle possession. As this demographic is actively abused by law enforcers the motivation to use needles based on access convenience and minimal time is heightened. The results are clear:

HIV infections – Russian Federation

Thailand has impressively cut HIV infection in workers in the famous tourist attracting sex industry from 40% in the mid 1990’s to around 5% today. This pulled male clientele infection rates down in parallel. At the same time fierce drug war tactics led to 2,500 “death squad” murders in 2003 and HIV is up to 1 in 2 IDU in some regions. A comparison of different demographics for HIV infection is compelling:

THAILAND: HIV infections per demographic

In a splendid example of stupidity the USA reinstated it’s 21 year ban on federal funding for needle exchange programmes only 2 years after ending it. A stark lesson for Australia, constantly under the assault of disinformation from anti-drug group Drug Free Australia, can be found on page 9 of the GCDP Report.

Recently in reviewing the history of Harm Reduction and HIV, I noted the stark difference between not just nations, but regions within nations favouring HR as a powerful controller of HIV spread. Similarly today it can be seen that in nations with extreme law enforcement, and regions within the USA with the most intense law enforcement that HIV levels are higher than those with low law enforcement.

For instance, a study of the 96 largest US metropolitan areas found that measures of anti-drug “legal repressiveness” were associated with higher HIV prevalence among injectors and concluded: “This may be because fear of arrest and/or punishment leads drug injectors to avoid using syringe exchanges, or to inject hurriedly or to inject in shooting galleries or other multiperson injection settings to escape detection.”

DFA fallaciously – and skillfully – report the exact opposite. Similarly DFA urge for dedicated Harm Prevention measures, described already on this blog as crude behaviour modification. Whether through blind or biblical force the aim is to do just that: force drug users to stop by changing behaviour. Forget the addiction and crush the symptom.

The easiest way to do this is control the environment. Enter compulsory detention. What DFA have called “compassionate detention”. The models they are considering are terrifying. Not only is HIV infection spread through these centres, they fail to offer any addiction treatment. Forced abstinence is associated with high fatality relapse.

Once infected with HIV criminal and punitive approaches act as a disincentive to testing and treatment. Requirements to be drug-free in order to receive treatment (as in Sweden) and denial of certain rights like child custody and employment correlate directly to higher HIV/AIDS fatalities. Confidentiality breaches and stigma impact frequently due to law enforcement regardless of country.

This leads to higher circulation of HIV in the community as treatment has been shown to reduce HIV transmitted via blood and body fluids. As such it is vital all demographics in all communities can be reached through treatment which ultimately leads to prevention.

Incarceration also increases HIV infection and Australia is heading toward a USA type model which has 25% of prisoners listed as HIV positive. Fortunately our initial lower levels in the IDU population will protect us significantly from such a nightmare. Unusually, prison needle exchange is resisted strongly. DFA play the key lobby role nationally and prison guard unions seem intent to deny evidence in favour of their health.

Australian prison guards profit enormously from selling syringes to prisoners. Secondary to money is the control of prison dynamics, control of prisoner behaviour and the essential control of these transactions in corruption entire. A syringe is power in the prison setting. The sooner we remove this tool from guards and protect prisoner health with clean exchanges, the better.

Resources spent on law enforcement are resources not spent on health initiatives generally, on a global scale. With drug crime and infection encouraged by the former and lessened by the latter, it is clear we face a major global challenge. Public health is the first principle of drug control.

Settings where HIV prevention measures have been curtailed as a result of economic concerns have been particularly vulnerable to increases in HIV risk among injection drug users. For instance, a greater than 10-fold increase in newly diagnosed HIV infections among injecting drug users has recently been reported from Greece during the first seven months of 2011.

Australia remains incredibly lucky and indeed most fortunate in this global picture. What cannot be ignored and what must be cautioned against is our slow morphing into a landing pad for USA styled conservative disasters. DFA is an arm of Drug Free America Foundation and act at their bidding. DFAF have their “division”, the Institute on Global Drug Policy who fund the Journal of Global Drug Policy and Practice.

This is no journal but a vehicle for lobbying against progressive drug policy primarily that which targets HIV control. All get together and play at the Swedish based World Federation Against Drugs which similarly is nothing like a “world federation”. What they strive for is patently out of this world.

As today’s most brilliant minds accept the evidence condemning prohibition, the global Drug Free Whomever groups seek to defend the UN Drug Conventions that originated in 1961.

Fortunate we may be, but complacent we cannot afford to become.