Category Archives: General debate

Australasian Science takes on Homeopathy

Hard to argue with a lot of the press release reproduced below, although there’s always the risk of generalisations killing off what may be some avenues worth exploring:

The Real Cost of Homeopathy

There is no evidence that homeopathy is more effective than a placebo yet medical insurance companies – subsidised by the government – are extending their cover due to client demand, while health authorities lack the power to act on misleading claims that can have lethal consequences.

Dr Ken Harvey of La Trobe University’s School of Public Health says health insurance premiums are being driven “higher than they need to be because the insurers involved fund alternative therapies that lack an evidence base, such as homeopathy, reflexology and iridology”.

Writing in the June edition of Australasian Science, published today, Dr Harvey says the practice is occurring at a time “when premiums are consistently rising faster than the consumer price index. As a result many people, especially those retired on fixed incomes, have great difficulty maintaining their private health insurance cover.

“As the government substantially subsidises private health insurance, this means that all taxpayers are contributing to therapies that lack evidence of their effectiveness.

Dr Harvey explains that homeopathic preparations contain little or no active ingredient. While this means “they are unlikely to directly cause harm,” he warns that “the results can be deadly… Earlier this year, a homeopath and his wife were found guilty of manslaughter after their baby daughter died when they treated her severe eczema with homeopathic remedies rather than conventional medicines.“

Dr Harvey says that “the World Health Organisation does not recommend homeopathy for the treatment of serious diseases”, while the UK’s House of Commons Science and Technology Committee “recently concluded that the UK health service should cease funding homeopathy because ‘homeopathic products perform no better than placebos’.”

In Australia, claims made for homeopathic medicines are subject to the Therapeutic Goods Advertising Code, but Dr Harvey says that “the Complaints Resolution Panel that administers the Code has no power to enforce its determinations. The end result is that around one-third of those found to breach the rules fail to publish retractions or withdraw misleading material.”

Dr Harvey describes a case where “an Australian homeopath claimed that homeopathic immunisation was effective against polio, meningococcal disease, cholera, whooping cough and other serious diseases… These claims breached numerous sections of the Therapeutic Goods Advertising Code, including promotion of a treatment for which there was no evidence of efficacy. The homeopath was asked to publish a retraction and withdraw misleading information but she refused.”

Dr Harvey concludes: “The Rudd government needs to stand up to the alt-med lobby and give the TGA real teeth”.

Harm reduction and law enforcement CAN be friends

This has to be a positive development yes?

It is with great pleasure that I can inform you that the Law Enforcement And Harm Reduction Network (LEAHRN) website is now live.

The website can be accessed through: www.leahrn.org/

LEAHRN is about bringing law enforcement and harm reduction closer together.

LEAHRN aims to connect people who want to know more about how police and harm reduction services can work together more effectively.

LEAHRN seeks to promote harmony and a better understanding between police and health service providers so that more programs involving clean needles and syringes, methadone, condoms and supervised injecting facilities can be successfully delivered.

The website is still in its formative stages and will undergo further development over the next few weeks, including additional resources and updated information being added regularly.

You can access the LEAHRN Blog – ‘COPS HR’ to write an opinion, make a comment, post news items, ask questions etc etc about issues related to policing and harm reduction. I encourage you to forward the LEAHRN link to others, particularly police, to facilitate connections/discussions between those representing law enforcement and harm reduction agencies.

Australian Government’s new illicit drug strategy: more of the same?

The Federal Health Minister has launched an Illicit Drug Campign to go along with its Tobacco and Alcohol campaigns. It’s a campaign that involves lots of information around the dangers of illicit drug use, that aims to “decrease motivation” of young people to commence use.

I’m all for education and knowledge, but I just get the feel this is just more of the same. There doesn’t seem to be any real differentiation from the decades of previous information and it just doesn’t seem that engaging. Again, campaigns like this probably do help but I’m interested in your thoughts: if you had the same budget, what would you do to ensure an effective and engaging campaign for young people and illicit drugs?

Here’s the text of the full press release:

Ad Campaign launched to confront Illicit Drug Use

The Rudd Government today launched the next stage of its hard-hitting $17 million advertising campaign to combat illicit drug use in Australia.

The campaign presents the ugly facts of illicit substance use including confronting and graphic images of young people addicted to drugs and the reality of underground production
labs.

This campaign aims to tackle drug use by presenting the physical and psychological impacts of illicit drug use.

It urges young people to decide against drug use and directs users to support, counselling and treatment services.

This campaign is about young people understanding the consequences of illicit drug use, asking them to ‘face facts’ and emphasising the damaging effects drugs have.

Too many young Australians don’t understand the very real and dangerous impacts of taking or using illegal drugs.

Ecstasy is made in filthy, makeshift labs, using toxic ingredients like battery acid and bleach. The toxicity of each pill varies and the potential for overdose is in every single pill.
There is no ‘quality control’ over the manufacture of drugs such as ecstasy.

In 2007 more than one third of the people aged over 14 had used an illicit drug at least once in their lifetime.

The proportion of recent regular ecstasy users who use weekly or more often has risen from 0.8 per cent in 1998 to 17.3 per cent in 2007. There is also a disturbing trend in the
increased ecstasy use by young females aged between 14-19 which is up from 4.7 per cent in 2004 to 6 per cent in 2007.

The campaign features print, outdoor, radio and in-venue advertisements depict real-life situations.

The advertisements, which will appear from this Sunday, were developed with the advice of clinicians, law enforcement officers and young people.

Further information, fact sheets and advice is available at www.australia.gov.au/drugs or by calling the free national hotline: 1800 250 015.

Needle exchange, prevention and return on investment

It’s been a substantive week for the ATOD sector from a government policy viewpoint, with the release of the Return on investment 2: evaluating the cost-effectiveness of needle and syringe programs in Australia 2009 report by the Commonwealth Department of Health and Aging and the steady progress towards realisation of a nationwide Preventative Health Agency.

For those working at the NSEP coalface the Commonwealth report doesn’t contain any great surprises: the program has saved hundreds of millions of dollars overs its lifetime (Alex Wodak has a спалниnice piece over at Crikey on the report). The challenge now falls to both the Commonwealth and State governments to follow-through and further entrench the validity of NSEP. Hell, they could even expand its reach. There’s a chance for some governmental innovation.

The Health Minister Nicola Roxon is enthused by the passage of the legislation supporting the formation of a preventative health agency. Not surprisingly, the pressure is already being applied to Senators in regards to its passage through that chamber. The press release in full:

Australia’s first ever Preventive Health Agency will soon be established following the passage of important legislation in the House of Representatives today. The Agency is a key part of the Rudd Government’s decision to invest more in preventative health measures than any other government in Australia’s history.

The legislation is now with the Senate for consideration. It is essential that this Bill be passed without delay so that the agency can commence work on 1 January 2010.

The creation of this agency responds to calls from health professionals for Australia to establish – as many other countries have done – a dedicated agency to focus exclusively on driving the prevention agenda and combat the complex challenges of preventable chronic disease.

The agency will guide health ministers in their task of curbing the growth of lifestyle risks driving chronic disease. It is a role requiring national leadership, capacity to work across sectors and portfolios, and an oversight role for surveillance and monitoring.

The agency will bring together the best expertise in the country and play a key role in gathering, analysing and disseminating the best available evidence and evidence-based programs.

Its prevention activities will engage all Australian governments as well as employers, businesses and other sectors, to benefit every community in the nation.

The new preventive health agency will concentrate on reducing the burden that preventable health problems are already placing on the workforce, and ensure Australia’s productive capacity is maintained.

The agency will receive $133 million over four years, from the Government’s record $872 million COAG Prevention Partnership funding.

Strong support for the agency has been expressed by key players in the preventive health field such as the Public Health Association of Australia, and this is important in ensuring the agency’s success in forging cohesiveness in national preventive health efforts.

The preventative health agency legislation holds some promise and it’ll be interesting to see how much ideology enters the debate. You can expect the AMA to go in hard on the issue of medical funding not beign sacrificed on the altar of prevention. There may also be some argy bargy over the taskforce being another incremental step toward Commonwealth takeover of health. Beyond that, it’s really hard to see any Senator taking a strong stand unless it’s to claim the model is wrong or that there’s not enough funding for it to work effectively.

Over to you: are you encouraged by the NSEP report and the taskforce legislation? Do you see it as a positive step toward better health services delivery?

Fetal Alcohol Spectrum Disorders

I couldn’t think of a more worthy piece to pass on, from Australia’s FASD advocacy body:

Today 9/9/09 is the 10th Anniversary of International FASD Awareness Day – The 9/9 was first choosen because 9 is the number of months of pregnancy when alcohol consumption can cause permanent brian damage. .

Fetal Alcohol Spectrum Disorders is an umbrella term used to describe a range of adverse effects caused by prenatal exposure to alcohol, including Fetal Alcohol Syndrome (FAS), Partial FAS (PFAS), Alcohol-Related Neurodevelopmental Disorders (ARND) or Alcohol Related Birth Defects (ARBD)

FASD is not a label – it is a medical condition and a serious lifelong disability. Prevention, diagnosis and intervention are critical public health issues that require a high degree of planned action at a policy and service delivery level in order to reduce harm.

While International Fetal Alcohol Spectrum Disorders Awareness Day is recognised throughout the world NOFASARD would like to reflect on the current situation in Australia:

– Children, adolescents and adults with FASD have multiple and complex needs that are currently not being met and this is resulting in poor life outcomes including social exclusion
– FASD rarely appears in Australian research or policy documents where it should be receiving attention.
– FASD does not appear on the government list of registered disabilities?
– There are no Australian Clinical Guidelines for diagnosing FASD and there are no Government funded specially trained interdisciplinary diagnostic teams.
– There is no Medicare number for rebate for the diagnosis of FASD
– Despite having very similar needs, individuals with FASD do not receive the same level of care and funding as those with Autism Spectrum Disorders.
– Individuals with FASD will be over-represented amongst those with drug and alcohol dependency issues yet most treatment programmes offered by service providers are not appropriate for this population.
– There is no national standard of care for individuals of any age with FASD – they are seldom treated effectively or fairly and they are seldom connected to service dollars.
– FASD is NOT just an Indigenous issue – FASD will be find wherever alcohol is part of the culture and exists across all social groups – the majority of individuals with FASD who are on NOFASARD’S data base are non-Indigenous.

Families with affected children have waited long enough – they are desperate and their children are suffering. Families are tired of their pleas falling on deaf ears and they are tired – they need action and they need it now.

– At a minimum there needs to be at least one specially trained interdisciplinary diagnostic team in each state of Australia
– Families want to see collaboration and a greater understanding of FASD in the education, disability, drug and alcohol, health, mental health and justice systems and they want these systems to work with them, instead of against them or separate from them.
– Families who have FASD want to be consulted – they have the benefit of the wisdom that comes from practice and they are the experts when it comes to knowing what are the current gaps and inadequacies in the systems and so if we are to have any chance of addressing the best interests of those who are directly impacted, there needs to be a government sponsored forum that enables wide consultation at the grass roots level.
– Families need policy makers to understand that their children with FASD don’t grow out of their disability as they get older – they grow up to be adults with FASD who will need targeted integrated support services throughout their whole life if they are to achieve any level of sustained function.
– Families need an immediate commitment from government to provide the same level of funding as has already been provided to support children with Autism Spectrum Disorder to enable children, adolescents and adults with FASD to have access to specifically targeted service delivery.
– FASD must be included under the Commonwealth list of registered disabilities so that families don’t have to continually fight for services from the education, health, disability, social service and justice sectors.

Why medical marijuana could be a good thing

I saw the piece reproduced below on the ADCA Update list, and it’s quite a comprehensive look at the opportunities medical marijuana provdes and deconstructs some of the misconceptions around the use of medical cannabis in the USA. It was originally published at the excellent MAPINC:

THE CASE FOR MEDICAL MARIJUANA

In a piece published [1] here last week, Rachel Ehrenfeld reports with dismay that the National Institute on Drug Abuse is presently soliciting proposals from contractors to grow marijuana for research and other purposes. Unfortunately, Ehrenfeld’s misunderstanding of this request for proposals is so monumental that one doesn’t know whether to laugh or cry.

Ehrenfeld suggests that this is some sinister part of “ObamaCare.” “For the first time,” she writes, “the government is soliciting organizations that can grow marijuana on a ‘large scale,’ with the capability to ‘prepare marijuana cigarettes and related products … distribute marijuana, marijuana cigarettes and cannabinoids, and other related products’ not only for research, but also for ‘other government programs.'”

Ehrenfeld spends several paragraphs explaining how this is all the evil brainchild of George Soros, the pet villain of prohibitionists. After all, “Since when is the U.S. government in the business of distributing marijuana cigarettes?”

Since 1978, actually. The federal government has been distributing medical marijuana to a small group of patients for more than [2] three decades via a program known as an IND (for “investigational new drug”). This program has been covered in the media from [3] time to time, and still exists, although it was closed to new enrolment by President George H.W. Bush in 1992. It’s not exactly a state secret.

In addition, under present (thoroughly dysfunctional) rules, scientists doing clinical research on marijuana must obtain the marijuana for testing [4] from NIDA. Since the 1970s, the government has contracted with the University of Mississippi to produce marijuana for this purpose, and all expectations are that the university will get the contract again. In other words, there is nothing new here.

Having completely misconstrued NIDA’s request for proposals as something new and sinister, Ehrenfeld proceeds with a selective, wildly distorted description of research on medical marijuana, claiming, “The evidence about the harm caused by marijuana to the individual user and society is overwhelming.”

In fact, there is a wealth of research that documents marijuana’s medical [5] efficacy and safety, and a vast array of medical and public health organizations that have recognized marijuana’s [6] medical potential.

For the record, let’s consider a bit of what’s been said about medical marijuana by organizations that are presumably not part of the Evil Soros Conspiracy. Bear in mind that this is just a tiny sampling of the material that’s available from respected medical organizations.

. From the 124,000-member [7] American College of Physicians:

“Given marijuana’s proven efficacy at treating certain symptoms and its relatively low toxicity, reclassification [out of Schedule I of the federal Controlled Substances Act] would reduce barriers to research and increase availability of cannabinoid drugs to patients who have failed to respond to other treatments. …

“Evidence not only supports the use of medical marijuana in certain conditions but also suggests numerous indications for cannabinoids.”

. From the [8] American Nurses Association:

“There is a growing body of evidence that marijuana has a significant margin of safety when used under a practitioner’s supervision when all of the patient’s medications can be considered in the therapeutic regimen. …

“There is significant research that demonstrates a connection between therapeutic use of marijuana/cannabis and symptom relief. The American Nurses Association actively supports patients’ rights to legally and safely access marijuana/cannabis for symptom management and to promote quality of life for patients needing such an alternative to conventional therapy.”

. From the Lymphoma Foundation of America, HIV Medicine Association of the Infectious Diseases Society of America and others (in a [9] brief filed with the U.S. Supreme Court):

“For certain persons the medical use of marijuana can literally mean the difference between life and death. At a minimum, marijuana provides some seriously ill patients the gift of relative health and the ability to function as productive members of society.”

And finally, from a study of smoked marijuana as a treatment for HIV-related nerve pain, published in the February 13, 2007, issue of the journal [10] Neurology:

“The first cannabis cigarette reduced chronic pain by a median of 72% vs. 15% with placebo … No serious adverse events were reported. Conclusion: Smoked cannabis was well tolerated and effectively relieved chronic neuropathic pain from HIV-associated sensory neuropathy.”

Marijuana has been used as a medicine for some 5,000 years–maybe longer, actually, but written records only go back that far. In the world of scientific reality–not to be confused with the BizarroWorld inhabited by certain prohibition ideologues–it is both effective at treating a number of troubling symptoms and safer than the pharmaceuticals taken by millions of patients every day. Indeed, as a “recreational” substance it’s vastly safer than booze. But it’s much easier to imagine conspiracies run by billionaires with foreign-sounding names than it is to read and understand the actual research.

This article first appeared at forbes.com. Bruce Mirken, a longtime health writer, serves as director of communications for the [11] Marijuana Policy Project.

REFERENCES

1. http://drugsense.org/url/hrqFXWxS

2. http://drugsense.org/url/EmG1kbx7

3. http://drugsense.org/url/HE4Hi7XI

4. http://www.maps.org/sys/nq.pl?id=1921

5. http://www.mpp.org/assets/pdfs/library/MedConditionsHandout.pdf

6. http://www.mpp.org/library/medical-marijuana-overview.html

7. http://drugsense.org/url/RTJp0V7l

8. http://drugsense.org/url/sPuJf8tI

9. http://drugsense.org/url/bplTeMy6

10. http://www.neurology.org/cgi/content/abstract/68/7/515

11. http://www.mpp.org/

What are your thoughts? It seems a fairly straight down the line treatise to me. It’s a shame this level of defense still needs to be put up against misinformation.

Poll Results: Drug Free Australia’s role in ATOD professional discussion

Back in February, we started a poll on the role of Drug Free Australia in regard to professional email lists such as the ADCA Update list.

dfa_poll2
The final results in and show that there’s some mixed views on the role of non-government lobby groups promoting their objectives in professional forums. Specifically, three quarters of those surveys prefer no such mixing of messages. Let’s start a discussion on this: do scientific and moral approaches work, and if so, when?

UNODC Parody: guerilla warfare or legitimate debate?

An Australian ATOD professional pointed me to a fake UNODC site, which looks nearly identical to the real one. The main difference is that the lead story on the fake site states:

unodc

If the ‘read more’ or any other link is clicked on the fake site, it leads to a page with the following text:

JOBS AND POLITICS BEFORE HEALTH?
In fact Costa has not made a statement supporting these life-saving measures and it is likely that the Political Declaration, which will shape global drug policy for the next ten years will have no reference to harm reduction.
This website is part of a campaign to expose the damage caused by misguided United Nations drugs policy. It is in no way endorsed by the United Nations.
Ten years after the UN based their strategy on the slogan “A drug free world: we can do it!” cocaine production has increased by 20% and opium production by 120%. Despite restrictive drug laws and extraordinary levels of incarceration, drugs remain completely out of control. Efforts to reduce the harm caused by drugs are repeatedly undermined by the UN’s refusal to pursue harm-reduction policies.

Cheap public health measures are easy to deliver and extremely effective in reducing the spread of blood born viruses – particularly HIV – among injecting drug users. What can possibly be wrong with taking practical measures to reduce the harms associated with drug use? The results of denying access to these proven public health measures can no longer be termed ‘unintended consequences’.

During the second week of March 2009 the UN will hold a meeting in Vienna for high-ranking government officials to review the past ten years of global drug control efforts and to adopt a new Political Declaration for the next ten years. We think it is time for:

No more stupid slogans
Replacing dogma with science
A UNODC commitment to save lives through harm reduction
A real improvement in the control of drugs
Dear Mr Costa
It would be nothing less than criminal if all proven public health measures to reduce HIV among injecting drug users were not featured uppermost in the Political Declaration that will arise out of the forthcoming High Level Meeting on drugs to be held in Vienna in March.

If you agree with the above please click here to email Antonio Maria Costa, the Executive Director of the UN Office on Drugs and Crime and copy in his boss Secretary General of the UN Ban Ki Moon.

This is a protest that has had a lot of thought put into it and I imagine technically its been a feat in itself. What are your thoughts – is this a legitimate form of protest?

I tend to believe it is, if no laws are being breached. I imagine some are in this case, as far as use of the UN’s intellectual property. That said, I tend toward supporting actions like this as it’s a way of putting an opposing viewpoint to behemoths like the UN.

Poll: Drug Free Australia on professional email lists

There are a number of email lists for ATOD professionals in Australia. The preeminent one is arguably the ADCA Update list. Over the past year or two, Drug Free Australia has been active in posting articles emphasising an abstinence approach, something that’s riled a number of prominent ATOD professionals on the list.

The issue has escalated to the point that I though it worth posting a poll to see how widespread the objections are to Drug Free Australia’s approach on the email list. Whether ADCA take any notice of the results is up to them – I sympathise with the difficulties in balancing varied debate with claims of overt propaganda. Onto the poll:

As always, feel free to make any further comments below, no matter which side of the fence you are on the issue. If you can’t see the poll above, use this link to vote.