Fentanyl: use, abuse, addiction and harm

ABC’s Background Briefing have recently looked critically at the rise in prescription of fentanyl and associated addiction, harm and fatal overdose.

A national emergency Pt. 1 (May 20th, 2018) reviews issues covered in Prescription killer: Australia’s imminent fentanyl epidemic (November 2017).

The programme summary from Pt. 1 of A national emergency follows;

Alarming numbers of Australians are dying from fentanyl overdoses at increasing rates and undercover recordings show just how easy it is to get it.

A NSW coronial inquest into the deaths of six people has just found double the amount of people die from prescription opioids than they do from heroin.

In the first of a two part investigation, reporter Hagar Cohen revisits a story first broadcast last year, she speaks to people whose lives have been torn apart by fentanyl abuse.

You can also listen to the programme below. (33.5 MB) © ABC Background Briefing;

Or download the mp3 file here.

 

On May 27th, 2018 Background Briefing presented A national emergency Pt. 2. The programme summary follows (bold mine);

Paramedics across Australia are stealing lethal opioids to cope with workplace trauma.

Freedom of Information documents reveal nearly 100 investigations into the misappropriation of addictive drugs by ambulance workers since 2010.

In this co-production with the 730 program, reporter Hagar Cohen asks why paramedics have stolen fentanyl for personal use.

A warning, this episode deals extensively with suicide. It might not be suitable for everyone and if it brings up any issues at all for you please contact Lifeline on 13 11 14.

You can access the audio above or use the player below. (35.8 MB) © ABC Background Briefing;

Or download the mp3 file here.

 

The opening summary from last year’s Prescription killer: Australia’s imminent fentanyl epidemic is as follows;

Fentanyl is the prescription opioid so deadly a dose the size of ten grains of sand can kill you.

In the US it’s fuelling a national emergency, making up a third of all drug overdoses there.

New exclusive figures show alarming numbers of Australians are dying from fentanyl overdoses at increasing rate.

Undercover recordings show just how easy it is to get. Hagar Cohen investigates. [November 26th, 2017]

You can access the audio above or use the player below. (34.6 MB) © ABC Background Briefing;

Or download the mp3 file here.

 

NB: Transcripts are made available at ABC Background Briefing past programmes shortly after the programme airs.

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The fight against anti-vaxxers continues despite Andrew Wakefield’s ongoing deceit

In early August last year the Australian Vaccination-skeptics Network held one of many Australian screenings of the fraudulent, debunked anti-vaccine film Vaxxed at Hawthorn town hall in Melbourne Victoria. The director of this nonsense is disgraced former gastroenterologist and persistent enemy of public vaccination, Andrew Wakefield.

At this event the AVN hosted a rogue Melbourne GP who, using bogus claims, was helping parents circumvent No Jab No Play legislation. With video of the GP published online, the outcome was immediate revelation of his identity. Three weeks later Dr. John Piesse faced suspension by the Australian Health Practitioner Regulation Agency (AHPRA). At that time it was reported he “vowed” to continue placing innocent children and the community at risk until he was indeed suspended. Not long after he agreed to stop practising while AHPRA investigated his conduct.

By mid September he had his licence suspended. The ABC reported;

A Melbourne doctor who has been under investigation for his anti-vaccination stance has had his licence to practise suspended.

Dr John Piesse’s practice in Mitcham was raided by the Australian Health Practitioner Regulation Agency (AHPRA) and police officers last week following allegations he had helped families avoid compulsory childhood vaccinations.

He had agreed to stop practising temporarily while AHPRA investigated the matter.

But the Medical Board of Australia’s Immediate Action Committee met on Thursday and decided to suspend his registration while the investigation into his practice continued.

An excellent and comprehensive summary of Dr. John Piesse may be found at Diluted Thinking.

Because of the danger posed by Piesse and an unknown number of other GP’s who may be engaging in similar conduct, new No Jab No Play laws were recently announced by Victoria’s Minister for Health, The Hon Jill Hennessy MP. [PDF]

The damage done by the anti-vaccination lobby across the developed and developing world continues. Their lies cost lives and quality of life. In addition they promote angst for innocent parents and attack hard working advocates – who may be grieving parents themselves – with relish.

It is now 20 years since Wakefield published his fraudulent paper in The Lancet contending a link between the MMR vaccine, bowel disease and autism. It was ultimately described by The Lancet’s editor-in-chief as “utterly false”. A 2004 investigation by Brian Deer of Britain’s Sunday Times uncovered enormous financial conflicts of interest. Wakefield was exposed as a liar and fraud and struck off the UK medical register. Astonishingly three dozen charges were found proved. Almost all of his fellow authors withdrew their names and support from the fraudulent paper.

With thunderous arrogance Wakefield “rejects” all of the findings against him.

Years of research failed to reproduce or uncover phenomena similar to his claims. Wakefield continues to push his fraud from the USA, profiting now from the global Conspiracy Theory movement, destroying public health and what is left of his callous character as he goes.

One understands Vaxxed is simply his most recent project. If and when more follow, as has been suggested, they too will be debunked.

Recently BBC 4 produced an excellent review of the anti-vaccine movement titled, In the Wake of Wakefield (BBC).

Twenty years ago, in February 1998, one of the most serious public health scandals of the 20th century was born, when researcher, Andrew Wakefield and his co-authors published a paper in the medical journal The Lancet.

  • You can access the audio below, © BBC 4;

Fake News serves conspiracy theorists well

A recent article posted by Orac examined the fallacious story of FBI raids on the USA Centre for Disease Control.

What’s concerning here is that such stories aren’t just bogus claims or cherry picking from evidence or misrepresenting of reports and announcements from authoritative sources. Nope, these stories are utter nonsense with no basis at all in verifiable events.

They aim to advance malignant and anti-social agendas. In the case of the above lie that the FBI raided CDC offices, it’s clear purpose was to exploit the drooling anticipation of the anti-vaccination lobby. Mainly that with “vaccine/autism/tweeting” Trump having been inaugurated the evil masters behind mass poisoning-by-vaccine would get theirs.

A second very useful purpose is that very few people check the source of the material. Within 24 hours the fake news story may have been read by tens to hundreds of thousands. Even if the piece is refuted with evidence and thoroughly debunked, it is unlikely readers drawn to the key message will invest the time and intellectual discipline to ascertain a. the facts and b. how readers were deceived.

There’s an interesting article here examining Trump’s grab bag of lies.

Do read Orac’s piece. It focuses on the FBI/CDC issue nicely. Not only was this fake news story published but was followed up with further fake news boasting articles with headlines proclaiming “Confirmed”.

Fake news isn’t new to those dealing with anti-vaccination lies. The anti-vaccine lobby has been publishing deceitful articles and “announcements” for years.

It seems in the present climate it is likely we will see more fake news from a range of anti-science, far right wing, bigoted groups that are finding a damaging voice to Western democracy.

Andrew Denton on Assisted Dying

Earlier this month Andrew Denton presented what might be called his findings on the need for assisted dying, or voluntary euthanasia in Australia. Without this legislation one Victorian per week suicides to escape pain. Just one state. These mainly “elderly violent suicides” are composed in the book Denton released on August 10th titled The Damage Done.

Denton has travelled to Belgian, The Netherlands and Oregon where assisted dying legislation exists in law. Whilst there are differences and similarities in these laws it was what such legislation is not that is most striking to the Australian situation at present. There is no sign that the many horrors organised opponents insist will accompany such legislation exist.

No slippery slope. No sanctioned killing of the disabled, the elderly, the sick or the frail. No sign of greedy family members metaphorically marching a family member to an early unwanted demise. The legislation itself presents this from happening by ensuring the decision is that of the individual in question.

An individual must be of sound mind, enduring intolerable suffering, aware of the consequences of their decision and checked and double checked by separate, independent physicians. There are many reasons why the fear conjured by self-appointed moral guardians is simply fallacious. Not least, in their own words, organised planning to distort facts and feed the public and legislators unrealistic images as to what assisted dying would mean.

Denton presents the primary four “myths” that sustain opposition to the much needed and compassionate legislation that would see assisted dying a right in Australia. These are demolished with more than enough hard evidence gleaned from where assisted dying is legal. Furthermore these points and many more are embellished. Australians it seems, are fed deception. With over 80% in favour and under 10% in opposition to assisted dying the orchestrated abuse of power denying public will is thunderously immoral.

It’s important Australians understand that we were once world leaders in such legislation. Assisted dying existed in N.T. under the Rights of the Terminally Ill Act 1995. The Liberal Party’s Kevin Andrews (“a leading member of the conservative Lyons Forum, dubbed by some ‘The God Squad'”) and Labor’s Tony Burke, assisted by powerful fellow Catholic busnessmen undermined the will of the N.T. public, ultimately having the law repealed. Their harmful work continues today. 28 attempts have been made in the last 20 years to pass assisted dying legislation.

Denton argues the two politicians have “engineered” a denial of evidence. He covers this dynamic, the reality of assisted dying legislation and the importance of palliative care. A significant number of patients who meet eligibility requirements and whose cases satisfy safeguards for assisted dying ultimately do not take life-ending medication. In Oregon this figure is 40%. What this tells us is that the peace of mind that comes with knowing one has control over their end is powerful indeed.

What we often call euthanasia is not “killing”. It is assisted dying. It is dying with dignity. I do urge finding the time to listen to Denton’s material.

 – Andrew Denton: The Damage Done. The price our community pays without a law for assisted dying

© National Press Club of Australia, 10 August 2016

© ABC Lateline, 10 August 2016


Andrew Denton investigates the stories, moral arguments and individuals woven into discussions about why good people are dying bad deaths in Australia – because there is no law to help them.

So-called “research” in anti No Jab, No Pay submissions

A casual review of anti-vaccine submissions pertaining to the Social Services Legislation Amendment (No Jab, No Pay) Bill 2015, reveals a striking repetition of unsubstantiated or demonstrably false claims, mixed with more of the misguided beliefs that have brought Australia to this point in the first place.

The most prominent theme backed by deceptive pseudoscience or distortion of genuine science is that vaccines are harmful. More so they are either not needed due to the wonders of modern snake oil or have never had the dramatic impact on the scourge of vaccine preventable diseases, that they have indeed irrefutably had. Vaccines are however, capable of causing the diseases the public is deceived into believing they prevent, and go on to enable their spread.

A while back I touched on the triumphant antivaccinationist claim of “having done my research”. I suggested a lack of critical thinking and cognitive bias left a great deal of these “researchers” incapable of discerning reputable source material from nonsense. That the unwary reader is presented with huge volumes of championed material, yet lacks the rather vital tools of cognition to identify and trust the genuine expert. This is a fast track to accepting opinion (or worse) as fact.

Tim Harding tackles this problem in more depth and with far more care than I, in his article How Dr Google spawned a new breed of health ‘experts’. Harding identifies key elements contributing to this phenomenon. Under the heading Misunderstanding democracy, he writes;

Reducing the influence of experts is sometimes mistakenly described as “the democratisation of ideas”. Democracy is a system of government — it is not an equality of opinions.

While the right of free speech prevents governments from suppressing opinions, it does not require citizens to treat all opinions equally or even take them into account. Equal rights do not result in equal knowledge and skills.

[…]

Deakin University philosopher Dr Patrick Stokes has argued the problem with “I’m entitled to my opinion” is that it has become shorthand for “I can say or think whatever I like” without justification; and that disagreement is somehow disrespectful.

Dr Stokes suggests that this attitude feeds into the false equivalence between experts and non-experts that is an increasingly pernicious feature of our public discourse.

The truth and import of Dr. Stokes’ observation of false equivalence between experts and non-experts is a reality I feel we should readily accept. Skeptics and science advocates have experienced and will continue to experience such when it comes to the anti-vaccination lobby.

In recent weeks this lobby has accused its critics of being worse than Nazis. They have launched a concerted attack against the families and grieving parents of infants lost to pertussis. They have produced memes likening vaccination to rape – and defended criticism of this. Whilst less insulting but no less ludicrous they’ve insisted democracy in Australia is dead.

Yet they never doubted their democratic right to swamp the No Jab, No Pay Social Services Amendment process with submissions accommodating a host of patently ridiculous, fallacious and time wasting material.

Some don’t know they are parroting nonsense. Meryl Dorey’s old trick attacking pertussis vaccine efficacy pops up here and there. 1991 was the first year for compulsory notification of pertussis cases, which were recorded by the National Notifiable Surveillance Diseases System. 1991 was a different time. Not all health professionals were logistically prepared to diagnose, much less report pertussis cases. Sensitivity of diagnostic equipment was magnitudes less than today. This was five years prior to the Immunise Australia campaign, launched by Michael Wooldridge.

So the deception runs that in 1991 with only around 71% of 0-6 year olds vaccinated, there were only (according to one submission) 347 cases. In fact there were only that many cases reported. NNSDS pertussis figures for 1991 still creep up at about five per year. 1991 notifications in 2012 are 332. This year to date: 345. The same submission goes on to report that in 2011 with a 95% pertussis vaccine uptake in 0-6 year olds, “there were 38,725 cases of whooping cough”.

Notice the age of vaccination is the 0-6 years cohort, but the pertussis notification figure is Australia wide. This includes overseas visitors, workers and new arrivals who brought the infection with them.

And of course by 2011 it’s not that PCR testing can detect Bordetella pertussis in samples hundreds or thousands of times smaller. And days older. Or that practitioners are constantly on the lookout for signs, or that documentation of notification is meticulous. Or sciencing in this field is better and faster.

Or that it is therefore significant that last year’s total of 11,866 (approx. 700 more than 2005) is comparatively low, and the high figures collated for 2009 – 2011 reflect the national outbreak that is reported as beginning in Meryl Dorey’s backyard. NB: article uses a number of media sources.

Nay. It’s the vaccine whatdunnit, dear reader, and Meryl Dorey has been peddling that lie and tripping up people who “do their research” for years. She never has replied to my January 2012 email wherein I step by step showed her how she pulled off this trick.

Vaccines it is argued, still cause autism. One may read that “autism-like symptoms” are in fact autism. That the US Vaccine Injury Compensation Program has compensated cases of autism arising from vaccination. This is most certainly untrue. The VICP continue to deny ever having compensated any individual for autism caused by vaccination.

Whilst terms such as “autism-like symptoms” are used the Compensation Program at no time refers to anything like “autism arising from vaccination” or “autism as a result of vaccination”. The Pace Law School scandal is deconstructed here. Meryl Dorey’s fraudulent addition of the word “[Autism]” to the US Court of Federal Claims case file dealing with the case of Bailey Banks is documented here. Sadly it is not realistic to think these claims have not influenced opinion in some.

Across the internet the false tale of 83 vaccine induced autism cases, compensated by the US Vaccine Injury Compensation Program will pop up. It refers to a paper written by Pace Law School Students entitled, Unanswered Questions from the Vaccine Injury Compensation Program: A review of compensated cases of vaccine induced brain injury.

I wrote in 2011;

Reading the document reveals ample use of terms such as “settled cases suggesting autism”, “language that strongly suggests autistic features”, “published decisions that used terms related to autism”, “payment of vaccine injured children with autism”, and not – as Seth Mnookin pointed out – “because of their autism”. More so, the authors spend some time arguing why there should be no distinction between autism and autism-like symptoms. This is a major concession they award themselves.

The paper includes caregiver opinion, parental opinion, phrases from doctors who gave evidence at hearings and provides a case table of “Language suggesting autism or autistic-like symptoms”. A notable concern is referencing The Age of Autism: Mercury, Medicine and a Manmade Epidemic [2010] by Dan Olmsted and Mark Blaxill.

This issue of insisting “autism-like symptoms” should be accepted as autism may have an intuitive feel to it but would ultimately reap an injustice on individuals involved. If we consider patients who have experienced brain injury from head trauma, stroke, near drowning or drug overdose, each may present with near identical symptoms. However the mechanism of brain injury is different and demands specificity of treatment.

So it is with autism. Diagnosis, treatment and prognosis are not opinions one can choose. Other erroneous opinions we find as a result of anti-vaccine research lean towards the legislative change being an abuse of rights and freedoms. It is an abuse of our constitution. Vaccines, being poisonous and responsible for chronic disease in children will reap harm because natural is best whilst chemicals and toxins are bad.

In fact the submissions rejecting No Jab, No Pay appear to be a cornucopia of all anti-vaccine misinformation. The authors have indeed “done their research”.