Naltrexone implants backed by zealotry but not evidence

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

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

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

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

DFAposition_statement_sigs1

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

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

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

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

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

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

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

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

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

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

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

Indeed we do.

Naltrexone implants backed by zealotry but not evidence


Psych ‘n’ Soul Naltrexone Deaths Inquest Findings

Complementary medicines’ problem with evidence

Evidence aplenty for complementary medicines-by ex-head of the AMA-Take THAT Friends of Science-enemies of truth!

Anti-vaccine lobbyist Meryl Dorey seizing legitimacy from Dr. Kerryn Phelps

Last week Dr. Kerryn Phelps wrote an article for The Australian defending the view that alternatives to medicine are in fact, a type of medicine.

The article’s heading, Evidence aplenty for complementary medicines itself touched on a unique feature of the massive Wellness Industry. Semantics. We have witnessed natural medicine become alternative medicine become complementary medicine become integrative medicine or more frequently complementary and integrative medicine. These are semantic costume changes designed to market integrity. To divert attention away from the fact that evidence for the efficacy of alternatives to medicine is lacking. Simply put, this is not medicine.

Dr. Phelps criticised Friends Of Science In Medicine [FSM], suggesting their “agenda was a declaration of war”. Yet I would conclude FSM are providing a long overdue and organised response to the rise of demonstrably non efficacious and potentially dangerous practices gaining undeserved academic credence. These have always shared a hostility toward evidence based medicine and science itself.

FSM president Professor John Dwyer writes:

We strongly support sound research to determine the effectiveness or otherwise of any biologically plausible areas of ‘alternative’ interventions. We do not seek to prevent consumers from making informed choices about alternative interventions, but wish to see the public better informed and therefore protected from false claims.

I do not doubt for a moment that Dr. Phelps and many other GPs who support alternatives to medicine are above reproach. Nor am I suggesting that all naturopaths and chiropractors (for example) are incapable of establishing a meaningful patient-focused reciprocal relationship with conventional medicine. What I am suggesting is that they are a minority and it is thus in error to suggest alternatives to medicine are generally based on evidence. Dr. Phelps’ insistence that these practices “compliment” or effectively “integrate” with conventional medicine is simply wishful thinking.

I strongly agree with Kerryn Phelps in that individuals taking more responsibility for their health is positive. I support and defend the right of patients to have more choice in managing their health. What I find deeply troubling is that once these two conditions are met, patients and wellness consumers are faced with bogus claims, unnecessary expense and a cornucopia of charlatans. That this is in no small part due to paper tiger regulation reflects that the system itself is broken and failing Australians.

That 19 of Australia’s 39 universities offer courses in scientifically implausible practices is alarming. The role of FSM in highlighting the perils of affording academic credibility to these practices is vital. It can be argued, as Dr. Phelps has previously, that universities will ensure rigid standards are met. Or as now, that FSM should support “an increase in university-based education for practitioners”. Sound reasoning to be sure. Until one considers that these very practices depend upon denial of the scientific method and graduates often emerge highly defensive of an ideology.

There is also an inescapable convolution of practice, integrity and accountability. A belief system associated with one modality may open the way for increasingly absurd practices. The anti-science, anti-medicine, post modernist culture so crucial to new age chiropractic is conducive to opposition, not integration.

This convolution raises the question of where the line is drawn. Few understand what constitute homeopathic principles beyond assuming they provide a “natural” therapy. Yet I would be surprised and disappointed if Dr. Phelps agued it had a role in medicine beyond placebo. Basic chemistry confirms there is no ingredient at all in homeopathic products, beyond expensive sugar. For those who seek to understand more about this “informed choice” there await increasingly bizarre claims most often concluding quantum physics will one day reveal all. This is the same mechanism behind theta healing – even remote theta healing.

For the purposes of this post it’s important to focus primarily on Dr. Phelps’ defence of chiropractic. But what type of chiropractor? John Reggars is past president of the Chiropractors Registration Board of Victoria and present vice president of the Chiropractic and Osteopathic College of Australasia. Focused on science, he is concerned by the rise of “ideological dogma” and the anti-scientific fundamentalist training that FSM have identified as problematic. In a paper by Reggars published in May 2011 he notes that in Australia the 1990s saw a resurgence of “chiropractic philosophy” and with it the belief in VSC, or Vertebral Subluxation Complex.

Reggars is highly critical of such chiropractic pseudoscience, pointing out misuse of diagnostic treatment, schemes to “double your income”, selling the notion of lifelong chiropractic care “to an ignorant public” and locking patients into contract plans. He also writes:

For the true believer, the naive practitioner or undergraduate chiropractic student who accepts in good faith the propaganda and pseudoscience peddled by the VSC teachers, mentors and professional organisations, the result is the same, a sense of belonging and an unshakable and unwavering faith in their ideology.

Belief in the unseen VSC is accompanied by the insistence all disease – including infectious disease – has its origin or cure in the spine. Chiropractic is the invention of 19th century magnetic healer Daniel David Palmer. Perhaps nothing reinforces the value of Friends Of Science In Medicine better than this modern scam of chiropractic. Represented in Australia by the Chiropractor’s Association of Australia [CAA] its aim is:

To achieve a fundamental paradigm shift in healthcare direction where chiropractic is recognised as the most cost efficient and effective health regime of first choice that is readily accessible to all people.

In other words they seek to displace the GP as the primary care physician. It is impossible to broach the many areas of medicine or do the same with the many pseudosciences chiropractic endorses to elaborate on this. Yet from vitamin therapy to homeopathy new age chiropractors have a positive word. Efficacy matters not. The CAA seem to instill fear and confusion about conventional medicine as a key mechanism in their “fundamental paradigm shift in healthcare direction”.

When we understand what seeking to usurp the family doctor entails, we can see that FSM can scarcely be accused of declaring war. The article Recent Controversies in Chiropractic and RMIT courses/clinic provides exceptional insight into the very concerns FSM seek to address with quackery in universities. Palmer argued humans have “a god-given energy flow” which when disrupted leads to illness. Exhuming such nonsense and contending that the doctrine is “evidence-based education and practice”, as suggested by Dr. Ray Myers, head of RMIT University’s School of Health Sciences is shameful.

One area the CAA has chosen to immerse itself in is the anti-vaccine movement. Many graduates emerge convinced that vaccination is a toxic medical trick. As one put it, raging on Meryl Dorey’s anti-vaccine Facebook page; “Of course we don’t support vaccination, it’s the biggest medical sham since bloodletting!”. The reason for his outburst was the article Doctors accuse chiropractors of selling anti-vaccination message.

To better understand why we must travel back over 100 years. In 1909 D.D. Palmer’s son, Bartlett Joshua (or B.J.) Palmer wrote (Ref; 2003), (Ref; 2014):

If we had one hundred cases of small-pox, I can prove to you where, in one, you will find a subluxation and you will find the same conditions in the other ninety-nine. I adjust one and return his functions to normal… . There is no contagious disease… . There is no infection… . ♠

Herein lies a major problem for Dr. Phelps who is under no such illusions about vaccination. As seen above Meryl Dorey has hitched a ride on Dr. Phelps’ reputation. On another email list Dorey simply copied the entire article and sent it off with the opening line, “If only we could get her to look at the vaccination issue as well… <sigh>”.

As well?! Dr. Phelps opined in The Australian about the “us and them” attitude. Yet these two words reflect just how rusted on and integral to many who entertain alternatives to medicine the “us and them” mindset is.

Some months back Dorey was also using Phelps’ prior role as AMA president, in the AVN attack on all conventional medicine. I wondered if Dr. Phelps knew of her unofficial patronage.

Past president of the CAA, Simon Floreani, has promoted homeoprophylaxis, showcasing Isaac Golden. Anti-vaccine activist and “paediatric chiropractor” Warren Sipser went as far as testifying in the family court against the immunisation of a five year old girl. Sipser informed reporters at the time “there is credible evidence they [vaccines] may do more harm than good”. Nimrod Weiner of Newtown Chiropractic ran anti-vaccine workshops using information garnered from the same AVN to whom Dr. Phelps is “diametrically opposed”.

Weiner informed pregnant mothers at a public talk that homeopathic immunisation (water) was superior to regular immunisation. That Andrew Wakefield’s fraudulent paper attempting to causally link MMR to autism was “scientifically good”. Last July Dr. Phelps tweeted:

WIN News Wollongong recently aired a comment from Meryl Dorey claiming that “all vaccines” are linked to autism in the medical literature. This is complete opportunistic nonsense and is now quite properly the subject of a complaint to ACMA. As Jonathon Holmes observed on Media Watch “there’s evidence and there’s bulldust” and that “Dorey’s claim about the medical literature linking vaccination and autism is pure, unadulterated baloney.”

Quite right. Which raises my point on convolution again. Where do we draw the line? Of the 222 listed professional members of Dorey’s anti-vaccine group over 60%, or 135 are chiropractors. The next largest is homeopaths with 16 members, or a comparatively small 7%. Naturopaths number 15 members. Then kinesiologists, then acupuncturists with 5 and 4 members respectively. Aside from one physiotherapist and one occupational therapist, all “professional members” sell alternatives to medicine of some description.

A US study published in Vaccine showed that parents who deny their children vaccination are four times more likely to see a chiropractor as the primary care physician. When Floreani was CAA president his chiropractor wife wrote of their newborn son’s pertussis. Including [bold hers]:

We performed chiropractic checks on our baby daily and utilised a whooping cough homeopathic. I dosed myself with an array of vitamins to boost his immunity via breast milk and kept him hydrated with constant breastfeeding. Whooping cough is often slow to develop and may respond well to conservative management, including chiropractic, osteopathy, homeopathy, herbs, acupuncture or acupressure.

Magically, it resolved within two weeks. Which means it wasn’t pertussis but a self limiting infection and all that woo did nothing but correlate to the illness. But I am sure Dr. Phelps would be the first to agree herbs, acupressure, homeopathy and so on would do nothing to manage pertussis. It is very dangerous misinformation with potentially fatal consequences.

So not only are unvaccinated children more likely to see a chiropractor and be subject to such abuse, but by not seeing a GP they are unlikely to become a recorded notification. Officially whilst only 5% of 0-4 year olds in Australia are not fully vaccinated for pertussis they make up 27% of cases. Thus, this figure may well be conservative. Dr. Phelps must ask herself; If vaccine deniers will choose chiropractors, might chiropractors influence parents to reject vaccination? The above rubbish is by Dr Jennifer Barham-Floreani – B.App.Clin.Sci, B.Chiropractic after all.

Australian Doctor wrote in part about the study in Vaccine:

Are naturopathic and complementary healthcare providers reinforcing parental concerns and ‘anti-vaccine’ opinions or promoting exemptions, or are they providing healthcare without emphasizing vaccinations?

I hope Dr. Phelps is asking herself that question also. As I stress above I’m sure Dr. Phelps and her colleagues are above reproach. But that’s not the point. The larger message being advanced here is that alternatives to medicine not only complement but “integrate” with conventional medicine. Not only does available evidence show this is not true but to generalise is to lend credence to dangerous charlatans.

This post has focused primarily on chiropractors, because they not only serve as a hub for health focused pseudosciences, but also seek to replace the family GP. I will contend that my point on convoluted overlap is valid. Once a patient is referred to one pseudoscience how does the referring GP control for pollution as it were? More material on the dubious ethics of new age chiropractic, including catastrophic neck injury and paediatric “improvement” by parental proxy can be found here.

St. John’s Wort seems to be trotted out in almost every article claiming alternatives to medicine have an evidence base. What is forgotten is that hyperforin, the antidepressant extract of St. John’s Wort, and other extracts are both inducers and inhibitors of P450 cytochrome enzymes. These liver cytochromes are involved in the metabolism of over 50% of marketed medication.

In the case of opioid pain relief studies have demonstrated a decrease of blood plasma levels of oxycodone of up to 50% and reduced half life of 27%. In the case of alprazolzm (a benzodiazapine), prescribed for anxiety and panic attacks a doubling of clearance rate has been documented.

Chronic pain is associated with depression and depression with anxiety. Opioids and benzodiazapines are causally linked to respiratory depression overdose death. Hence the clinical significance of any “integration” of serious pain management with a herbal choice for the depression it may cause is likely to be anything but “complementary” for the patient. Many patients choose not to inform their GP of herbal supplements.

Proper diagnosis following treatment with medication will be hampered by St. John’s Wort. Excessive doses of actual medication may be prescribed. Should a patient cease St. John’s Wort whilst on opioid, benzodiazapine or both medication regimes a spike in blood plasma of the active metabolites will ensue. More likely, as St. John’s Wort is improperly regulated and dose concentration varies widely a patient may unwittingly expose themselves to respiratory depression and possibly death with no change in their daily medication/St. John’s Wort routine.

In short whilst the concentration (dose) of actual medication is stable, the drug interaction outcome due to St. John’s Wort mimics an unstable medication dose. Patients may easily find themselves unsuitable to drive, work, operate machinery, bathe or sleep without potential for disaster. Consequently many medication regimes may be deleteriously effected by St. John’s Wort.

Thus the wider picture of evidence pertaining to St. John’s Wort is not quite the basis for “integration” proponents of alternatives to medicine would have us believe.

My response to the ongoing insistence that placebo effects derived from acupuncture constitute evidence is likely to be here in Acupuncture: essential facts about a major scam. Over and again it emerges that subjects who think they are receiving acupuncture, whether they are or not, demonstrate a response.

Findings aside, how would Dr. Phelps explain meridians, invisible forces, chakra or vital energies? It is too easy to point to apparently positive findings when the mechanism by which they arise is implausible, unknown or assumed to be related to endorphin release. The technology to manufacture acupuncture needles did not exist until the 1600s and the only nation to seriously try to ban acupuncture was China under the Chinese Nationalist Government. Western marketing has done much for this “traditional” Chinese medicine.

What of naturopaths who insist on Black Salve [2]? Or who use herbal balls from China with high levels of elemental mercury, arsenic and lead? What of poor hygiene and bacterial infection from acupuncturists or masseurs? The astonishing story of Monika Milka and non-sterile syringes used in biomesotherapy, leaving her patients seriously infected with mycobacterium chelonae?

Tragic cases like Penelope Dingle and Isabella Denley indicate that the notion of integration or proper supervision is seriously flawed. One point raised repeatedly by FSM is that whilst ill patients waste time being exploited by pseudoscience acting as a health choice, the chance of genuine care, full recovery or even survival is lost.

These are the real issues Dr. Phelps could constructively help Aussies understand before raging at FSM. How is it that so many various practices have come to exist that are beholden to ideology, not evidence? How is it they can convince parents to withhold treatment from their children and in doing so undermine the health of our entire community?

FSM exists to address an unacceptable situation in our educational institutions. They have taken a stand because those in a position to defend academia seemingly chose to act unethically. When it comes to “informed choice” there is an excess of non evidence based, expensive pseudoscience. It is pervaded by a combative, arrogant anti-science and anti-medicine mindset. It is amply equipped with scams.

This madness must stop and Dr. Kerryn Phelps is most welcome to clearly state just what aspects of non conventional medicine are high risk ideology and what is safe, effective and backed by evidence. Real evidence that can be trusted alone.

Presently, there appears to be a scarcity.

♠ This quote has been attributed to D.D. Palmer. However in 2013 the Journal of the Canadian Chiropractic Association, cited the author as B.J. Palmer.

A fact sheet should have facts

There are only two organs in the human body where we know the cause of cancers that effect them.

One is the liver, which has shown a definite link between the hepatitis B [HBV] virus and liver cancer. The other is the cervix with an irrefutable link between human papillomavirus [HPV] and cervical cancer. As we have vaccines to prevent infection with these viruses, HBV derived liver cancer and cervical cancer may thus be considered “preventable cancers”.

In the case of the HPV vaccine, anti-vaccine lobbyist and University of Wollongong student Judy Wilyman continues to deny its success. A cervical cancer “fact sheet” on her web site contains irrelevant or misleading snippets of misinformation. Designed to create a fiction, the item is anything but a “fact sheet”.

It begins with the confusing claim that the HPV vaccine Gardasil was not trialled against cervical cancer. Rather it was trialled in 16-26 year old women against pre-cancerous lesions. Wilyman criticises the age group because women therein rarely present with cervical cancer. She criticises the focus on pre-cancerous lesions because most do not lead to cervical cancer.

Later Wilyman observes that cervical cancer takes 8-25 years to develop answering her own concern about lower rates of cervical cancer in the sample group. With respect to pre-cancerous lesions her thinking is disturbing. Cervical cancer develops from these lesions and the trial demonstrated a reduction in development by almost half.  Unsurprisingly Wilyman then notes the death rate is 1.9/100,000 – “a very low risk to Australian women”.

We’re informed, “there are more than 15 high risk strains associated with cancer not covered by the vaccine”. Strange. Now Judy has a sudden concern for cancers caused by HPV? No. She’s omitted that 70% of cancers are caused by HPV strains 16 and 18 and that Gardasil also targets HPV 6 and 11, responsible for 90% of genital warts. The vaccine is almost 100% effective against these strains.

We read that, “the duration of this vaccine is unknown as it has only been tested in adults for 3-4 years”. I’m sure Judy means the duration of immunity. Perhaps she overlooked the role of antibody response and concentration in predicting immunity. The reality is that whilst research is ongoing, close to 100% protection remained after five years. Protection shows no signs of weakening. Whilst the need for a booster has not yet been established it appears to be unlikely that it will.

  • “We don’t know how long vaccine protection will last”, is regarded as a Myth by the Australian Cancer Council.

Further criticism of trials include the observation that, “in young women pre-cancerous lesions have a high clearance rate and do not always lead to cancer”. This completely ignores the necessity to vaccinate before the onset of sexual activity and exposure to wild HPV. Vaccines are preventative, not curative. It is a most strange complaint from a “PhD candidate”, failing to understand the very aim of the trial.

Five separate references to trials being conducted and funded by drug companies are listed. This assumed conspiracy is frequently cited by Wilyman in regard to all vaccines without making any links to, or cogent arguments about, inefficacy or unsound trials. Conflict of interest and the influence of drug companies should be, and is, taken very seriously by relevant sections of the scientific community. But accusatory assumption without evidence is unacceptable.

Wilyman seems to deliberately mislead by documenting as a “concern” that 94 deaths and 21,635 adverse reactions are associated with Gardasil. Citing anti-vaccine lobby group S.A.N.E. she then notes that only 10% of reactions are picked up by the passive surveillance systems that produced those figures. What does this mean?

When authorities talk of under-reporting in passive surveillance they refer to minor events – soreness, redness, swelling, a bit queasy post influenza jab etc. These are so minor as to be inconsequential to the recipient, thus never reach the vaccine provider for reporting to the system. Her intent is to insinuate close to 950 deaths and well over 200,000 adverse reactions are possibly/probably associated with or causally linked to Gardasil.

Of reactions that are reported there is no evidence of any link. Great efforts are made to convey causality has not been demonstrated. All that’s known is that the event occurred sometime after vaccination. Also, reports remain on the database no matter how unlikely or ridiculous. Despite easy access on how to avoid the trap Judy Wilyman has set, she has chosen to obfuscate the reality.

These reporting systems exist to highlight trends from which likely adverse reactions are chosen for follow up study. It’s the findings of these studies that provide any evidence backed conclusions on adverse reactions. When links are shown to not exist the reports still remain on the database.

We may confidently dismiss her figures of 94 deaths and 21,635 adverse reactions. Conclusions cannot be drawn from unverified reports.

The “fact sheet” also includes claims that the aluminium adjuvant is, “known to cause allergies/anaphylaxis and auto-immune reactions in humans”. This claim has been criticised with regard to many vaccines. With 65 million doses of HPV vaccine given safely in over 100 countries, rates of serious allergic reactions are being recorded at about three per one million doses.

Nonetheless a paper cited by Wilyman does speculate on a possible role of adjuvants in auto-immune disorders. It must be stressed that in this review vaccine adjuvants alone have not been identified, nor is there any robust research behind the proposition. Possibly, Wilyman has not read the material.

Certainly, Judy Wilyman selectively cites trial methodology. Ignoring use of saline placebo in safety trials [page 4], she zeros in on AAHS because it’s “not a true placebo used to test safety”:

The manufacturer funded clinical trials used the adjuvant, aluminium hydroxyphosphate sulphate as the placebo in the unvaccinated group: a chemical known to be linked to adverse events including autoimmune diseases

One cannot stress enough that aluminium hydroxyphosphate sulphate is not “known to be linked” to ADRs or autoimmune disease. Five months later the authors write in The Rheumatologist:

Taking it all together, it seems that enigmatic but nevertheless common and often disabling complaints can coincide in many individuals diagnosed with siliconosis, MMF, GWS, or postvaccination events […]

Moreover, genetic links observed in animal models, and in the human disease MMF, bring about the notion that the adjuvant effect promotes the appearance of an adjuvant disease in subjects who are genetically susceptible or in those who encounter an additional trigger…

At best this is speculation. At worst the authors are attempting to coin a new syndrome based on review and suggest it be used to label challenging diagnoses. Examining their contention nonetheless, it’s clear they refer to a rare and individualised pathology.

Wilyman also cites anti-vaccine lobby group Immunisation Awareness Society, N.Z. in claiming that juvenile, rheumatoid and osteoarthritis are caused by Gardasil. As recently as January this year another study found no evidence of this.

  • “The vaccine has serious side effects that aren’t being reported” is considered a Myth by the Australian Cancer Council.

No attempt is made to mention the Australian HPV Register and its role in ongoing assessment. A large portion of Wilyman’s so-called fact sheet seeks to demote the risk of HPV infection, relegating it to developing nations or to a small promiscuous section of our community.

The rest seeks to spook readers into feeling that 200 cervical cancer deaths annually and unnecessary genital warts is acceptable collateral damage.

It is a biased and misleading document.

Dealing with the Brian Martin dilemma

Recently Brian Martin a Professor of Social Sciences at the University of Wollongong, published an article in Health Promotion International.

Dealing with dilemmas in health campaigning appears to be a bipartisan analysis of social dynamics and some areas of public health. However whilst Martin relies upon science and methods employed by the scientific community to sustain his argument he demonstrates his signature ignorance of the scientific method and the import of evidence.

In short Martin has continued his campaign to elevate supporters and perpetrators of scientific fraud, pseudoscience, censorship, personal vitriol, calculated deception and dangerous scams to the status of legitimacy. Rather than admit his role in supporting and coaching Australia’s premier anti-vaccination lobby, Martin hides this affiliation behind:

I give a few examples, especially from the vaccination controversy in Australia.

I selected the dilemmas discussed here based on my studies of a large number of public controversies, including informal conversations with prominent as well as lower-profile campaigners. […]

A key aim of this paper is to make these dilemmas explicit so they can be given the scrutiny they deserve.

Health campaigners today face intractable ideological devotion manifesting as evidence denial. The resistance of certain scientifically durable realities that play important roles in the maintenance of public health, is commonly presented as “the other side”. In fact cursory examination reveals malignant intent, bogus information, illegal pursuits, frequent monetary scams and outright fraud.

Certain areas have become key targets of a persistent opposition that uses pseudoscience, conspiracy theory, evocation of public fear and the exploitation of scientific ignorance in an attempt to mask ideological persuasion as legitimate science. Whilst the intellectual paucity of these proposals are immediately apparent to scientists, and consequently dismissed out of hand, the mechanisms behind why this is so are not apparent to the lay reader.

As such, scientists face a dilemma in managing, preventing or containing what may be a disproportionately negative effect on public confidence in crucial areas of health policy. The problem with engaging vested interests that promote pseudoscience and scientific denial is that the risk of lending legitimacy to demonstrably false contention, is significantly heightened when recognised scientists (or health authorities) respond.

On the one hand the public have a right to expect reputable authorities address falsehoods in a transparent manner. On the other hand, notions such as the scientific method, scientific consensus, the impact of evidence and abuse of statistics is poorly understood by the general public. Understanding risk-benefit is a skill the largely scientific illiterate public in developed nations lack. Poor, and at times, irresponsible reporting by media outlets compounds this problem.

Recently a bogus claim by Natasha Bita of The Australian drew immediate condemnation from Australia’s Therapeutic Goods Administration. Influenza vaccination has been conclusively linked to no deaths in Australia. However Bita misused information from the Database of Adverse Event Notifications, to insinuate ten deaths were “linked to anti-flu vaccine”. Meryl Dorey, president of the anti-vaccination group Martin is a member of has been continually pushing the falsehood launched by Bita.

Interestingly in another of his articles, Suppressing Research Data: Methods, Context, Accountability, and Responses Brian Martin offers an excellent account of Dorey’s conduct:

Censorship, fraud, and publication biases are ways in which the availability of research data can be distorted. A different process is distortion of the perception of research data rather than distortion of the data itself. In other words, data is openly available, but efforts are made to shape people’s perception of it.

Although he’s referring to publishers, the above paragraph adequately describes how Dorey conducts herself. In Dealing with dilemmas in health campaigning, Martin raises the prospect that not engaging anti-science proponents such as anti-vaccination lobbyists may have a negative effect on public perception. Yet the complex reality of how adverse reactions are reported, accepted, documented and how they must be interpreted would be lost on the bulk of the public. The catchy, but false, ten deaths linked to anti-flu vaccine would have an impact.

More so, placing a callous, dishonest, unqualified opportunist such as Dorey alongside a genuine health authority creates the illusion that there actually is a debate to be had. Worse is that the individual lies and tricks of the anti-science identity by extension gain credibility. As I note below new research reinforces that opponents to public health and even the myths they create are best ignored when seeking to address they mess they’ve created.

Consequently, engaging such extreme minority views can be detrimental to public confidence and rather than removing respect for ideological falsehoods may well create an impression of legitimacy. Given his affiliations it is almost certain Brian Martin seeks to do exactly this in his article.

In fact the above quote splendidly describes Martin’s own generalised distortion of data. A suitable example follows. Rather than tackle the disparity between anti-vaccination propaganda and say, the risk of flying, driving, overseas travel or any day to day task he writes:

Supporters of vaccination emphasize the large benefits from being vaccinated, notably a reduction in disease, including associated deaths and disabilities. They also emphasize the social benefits, due to herd immunity, from high levels of vaccination (Andre et al., 2008). That is straightforward. But is it wise to mention that a small number of individuals will have adverse reactions, including death and permanent disability?

The advantage of sticking to positives and not admitting shortcomings is that the message is much more powerful. ‘Vaccines are safe’ is far more reassuring than ‘Vaccines are nearly always safe’. ‘Vaccines are safe’ is also clear and uncomplicated and hence far easier to sell. Furthermore, any admission of weakness is likely to be seized upon by opponents and trumpeted far and wide.

Unsurprisingly the second paragraph is without citation. What Martin is doing is constructing a faux dilemma that resonates with poor appreciation of risk-benefit. The fact is vaccines are safe. They are monumentally safe and to use such a vague term as “nearly always safe” conveys a risk-benefit somewhat more dangerous than riding high speed motorcycles on city streets.

To then suggest without breaking stride the proper description of vaccine safety makes them “far easier to sell”, is simply outrageous. This is exactly the sort of bogus information I mentioned above. It is the perpetuation of the malignant untruth that vaccines need a market and supporters of vaccines will pursue this. At one point we read an equally outrageous slur on scientists:

The most common way to deal with vested interests on one’s own side is not to mention them, relying on the belief held by scientists that they are objective, so it does not matter if corporations offer research funding and perks.

Recent research into debunking myths has underscored the perils of not only engaging proponents of evidence denial, but of simply repeating the myth itself. This material may help explain why, on the topic of scientific dissent, Brian Martin continues to give unjustified credence not only to soundly scientifically refuted notions (fluoride in drinking water, vaccination, conspiracy theory put forward as “vested interests” and even HIV/AIDS denialism), but also to the view that a “debate” may be legitimate.

Indeed not only are terms such as “debate” entirely inaccurate in a scientific sense, they at once distract from the true dynamics at play and arguably with tragic consequences, lend even more false legitimacy to what is essentially pseudoscience, abuse of science and denial of evidence.

Martin continues to place anti-science lobby groups on equal footing with public health authorities or refer to unqualified saboteurs of public confidence as “citizen campaigners” seemingly simply raising legitimate concerns. This fails to acknowledge scientific consensus, its import and value to community health, and its dependence upon the rigours of the scientific method.

In short Martin demonstrates an alarming ignorance of the scientific method and its ability to expunge in totality such ill conceived ideas that “debate” rightly applies to numerous areas of outright denial of evidence. Martin is a financial member and published supporter of Meryl Dorey’s anti-vaccination group and the PhD supervisor of radical anti-vaccine conspiracy theorist, Judy Wilyman. Yet again he has labelled volunteers who deconstruct the harmful messages of Meryl Dorey to suit himself.

Thus it is right and just to call into question Brian Martin’s acceptance or not of moral responsibility. Prior to this article he was furnished with ample facts that he’s chosen to ignore despite claiming to have been in discussion with participants. Clear demonstration of the bogus claims of the AVN that impact heavily on his subject material have been omitted. Impartiality is clearly irrelevant if not inconvenient to Brian Martin.

Amusingly he again raises the silliness of Dorey’s obsession with global conspiracies as an apparent fiction invented by her critics. After a frustrating exchange of emails over a year ago I demonstrated that yes, in their own words the AVN do believe in vaccine delivered microchips and global culling. I’m quite surprised he saw fit to republish such a ridiculously irrelevant aspect to this ongoing saga.

More seriously, the scientific community would quite rightly be justified to review reference to the bulk of scientific methodology and accepted consensus as “the dominant paradigm” or “the dominant epistemological position” in dismissive terms. Whilst it is true that scientific findings remain always open to further inquiry and challenge, this process cannot be jump-started by suggesting evidence denial constitutes scientific “debate” or that the very methods and practices that led to The Enlightenment constitute a “paradigm”.

It can be far more adequately argued that proponents of pseudoscientific beliefs and evidence denial have not, over the entire course of their existence, altered scientific consensus as it pertains to their chosen ideology. This is especially true of anti-vaccination, anti-fluoridation, alternatives to medicine and the denial of HIV/AIDS.

In this light we can see such groups as disempowered and effectively divorced from scientific and genuine skeptical inquiry. With no evidence to further their belief structure or force their ideology into reality we witness a constant recycling of well documented falsehood. This is backed by predictable contrariness that is more and more prone to argue their evidence is not flawed, but suppressed or censored by a covert conspiracy. Needless to say this has never been demonstrated.

Alienated, irrelevant and left to defend overwhelmingly debunked and thoroughly refuted notions, those incapable of accepting this reality predictably lash out and attack conventional science in an increasingly extremist fashion. Clearly these groups crave acceptance by the scientific community as they continue to use scientific terminology and mimic scientific research, discussion and reasoning.

However since their inception they have never once produced material that is accepted as genuine research or conclusive evidence. Their modus operandi is to shirk genuine research and produce bogus reviews they falsely label as “critiques”. These are carefully produced selections of cherry picked data presented with a false argument.

In addition they rely overwhelmingly on the alarmist and pseudoscientific work of a small number of faux professionals, whose greatest skill is the abuse of science – not its application.

This impasse has been manifestly apparent for many years. Thus far from accepting these groups have any legitimate contribution to make it should be stressed that the areas they continue to challenge are indeed settled scientifically. Yet Martin writes:

Supporters of the dominant position often say that the existing research base is more than sufficient to conclusively support their stand. Sticking with this claim has the advantage of not admitting weakness. It also can have an economic justification: unnecessary research is avoided.

The disadvantage of rejecting calls for more research is that the critics have a continual source of complaint. When critics have little capacity to undertake their own research—at least research requiring substantial funding—they can portray the defenders of orthodoxy as stonewalling in the face of legitimate doubt.

Again this is manufacturing a dilemma. With respect to vaccination health authorities have gone to extreme lengths researching, and continue to research, every possible adverse reaction or problem with vaccines. The research called for is today unethical and methodologically impossible. Other research demanded has already been conducted. Yet the goal posts are continually moved.

Consequently it is regrettable that certain authors appear to go to extreme lengths to cast denial as genuine dissent whilst insinuating that science has, and will, progress from those who consistently attack the process that does not produce the results they seek.

It should be noted Martin’s article has clearly been firmly edited away from his usual obvious slant in praise of scientific dissent. Its overall tone is seemingly reasonable. Nonetheless that’s not the real point.

Brian Martin has again shown he will be deceptive in the pursuit of his own interests.

Pseudoscience and Christian bigotry

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

US Republican Senator Todd Akin, August 19th 2012

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

Sydney Anglican Archbishop Peter Jensen, September 10th 2012

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

They open with this paragraph:

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

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

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

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

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

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

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

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

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

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

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

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