Palikot’s intentions of lighting a joint in the Polish Parliament in late January drew a flurry of media attention to his campaign to decriminalize possession of cannabis. Having realized that lighting up could land him in jail and potentially oust him from parliament, he resorted to burning a hemp incense stick instead.
Palikot’s stance on decriminalization is commendable. Absent from the coverage of his press conference at parliament was his support for the recommendations of the
Global Commission on Drug Policy and the
Letter of 44, a group of Polish public figures supporting the liberalization of drug laws. Both campaigns advocate for evidence-based drug policies that protect the human rights of drug users, investment in harm reduction and treatment, and the avoidance of costly and counterproductive incarceration for minor drug offences.
It is questionable whether Palikot’s symbolic gesture was a sensible stunt as it played into the hands of a media that is eager to
demonize the decriminalization campaign. The symbol overshadowed a more complex debate around the decriminalization of cannabis and other illicit drugs.
Drug laws in Poland remain punitive, despite a recent small step towards liberalization. A new law introduced in December 2011empowers public prosecutors to avoid bringing people to court on drug possession charges in three circumstances: if the quantity is small, if it is a first-time drug offense, or if the person has a drug dependency. In practice however, leniency is rarely applied. The law also raised the maximum penalty for possessing a large quantity of illicit drugs from 10 to 12 years.
Having embraced harm reduction measures in the 1990s in response to the prevalence of HIV amongst injecting drug users, in 2000 the Polish Government resorted to applying punitive sanctions to drug users under considerable public pressure. Following these changes, drug possession cases rose by 1,500% over a ten-year period, but the number of convictions decreased. Around 80 million Polish zloty (20 million euro has been spent each year on criminalizing drug possession. Meanwhile, many social, health, and education services remain seriously underfunded.
Is it therefore the media that is at fault by failing to pay enough attention to the broader, substantive issues?
Take neighboring Czech Republic for example. A forthcoming report from the Open Society Foundations praises Czech drug policies, which are based on scientific evidence, and the results of thorough evaluation and monitoring. Possession of small quantities of drugs is decriminalized and health professionals, police and non-governmental organizations are all involved in the policymaking process. Police prioritize large–scale trafficking over small drug offences, which is cost-effective. Harm reduction measures, such as needle exchange programs and access to medication-assisted therapy, have kept HIV transmission rates low amongst injecting drug users.
Unsurprisingly, the Polish media reactions to Czech drug policies have been simplistic and moralized. But so much could be learnt from its southern neighbor. The potential success of decriminalization and a public health-based approach to drug use is story that is not being told. In this instance, it was overshadowed by the frenzied media reaction to Palikot’s stunt and it remains to be seen whether this will prompt a broader debate around the benefits of decriminalization in Poland.
By Alex Wayne
Feb. 13 (Bloomberg -- Drugmakers led by Pfizer Inc. would have to provide $156 billion in discounts over the next decade for medicines sold to low-income senior citizens under President Barack Obama’s proposed fiscal 2013 budget.
The administration’s budget request, released today, contains a package of changes to Medicare, the U.S. health insurance program for the elderly and disabled, and Medicaid, the health plan for the poor. The policies combined would help save $362 billion over a decade to slow medical spending.
Brand-name drug manufacturers already provide rebates worth at least 15 percent the price of their medicines to Medicaid. The administration is proposing to extend that policy to cover so-called “dual eligibles,” about 9 million senior citizens who qualify for both Medicare and Medicaid.
Because Medicare and Medicaid have different payment programs, Medicare is “receiving significantly lower rebates and paying higher prices than Medicaid” for drugs, the administration said in budget documents.
The drug industry agreed to provide $80 billion in discounts and rebates to help cover the cost of expanded insurance coverage under the 2010 health-care law. The rebates proposed in the budget documents today would come on top of those commitments.
(CNN -- Scientists say they "serendipitously" discovered that a drug used to treat a type of cancer quickly reversed Alzheimer's disease in mice.
"It's really exciting," said Maria Carrillo, senior director for medical and scientific relations for the Alzheimer's Association. "They saw very positive and robust behavior effects in the mice."
In the study, researchers at Case Western Reserve University School of Medicine gave mice mega-doses of bexarotene, a drug used to treat a type of skin cancer called cutaneous T-cell lymphoma. Within 72 hours, the mice showed dramatic improvements in memory and more than 50% of amyloid plaque -- a hallmark of Alzheimer's disease -- had been removed from the brain.
The study was published Thursday in the journal Science.
Gary Landreth, the lead researcher at Case Western, cautioned that even though his results were impressive in mice, it may turn out not to work in people.
"I want to say as loudly and clearly as possible that this was a study in mice, not in humans," he said. "We've fixed Alzheimer's in mice lots of times, so we need to move forward expeditiously but cautiously."
Mice -- and humans -- with Alzheimer's have high levels of a substance called amyloid beta in their brain. Pathology tests on the mice showed bexarotene lowered the levels of amyloid beta and raised the levels of apolipoprotein E, which helps keep amyloid beta levels low.
Landreth said he hopes to try the drug out in healthy humans within two months, to see if it has the same effect.
Those participating in the trial would be given the standard dose that cancer patients are usually given.
Researchers tested the memories of mice with Alzheimer's both before and after giving them bexarotene. For example, the Alzheimer's mice walked right into a cage where they'd previously been given a painful electrical shock, but after treatment with bexarotene, the mice remembered the shock and refused to enter the cage.
In another test, the scientists put tissue paper in a cage. Normal mice instinctively use tissues in their cage to make a nest, but mice with Alzheimer's can't figure out what to do with the tissues. After treatment with the drug, the Alzheimer's mice made a nest with the paper.
Carrillo said one of the major advantages of bexarotene is that it's already been approved by the Food and Drug Administration for use in humans, which means the researchers can move into human trials sooner than if it were a completely new drug.
The Alzheimer's Association is funding Case Western's next phase of research, which will involve using bexarotene at the levels used on cancer patients, Landreth said. Since the drug does have some side effects -- it can increase cholesterol, for example -- he hopes to use it in even lower levels as the study goes on.
Landreth said his lab had been working on other drugs for Alzheimer's for 10 years when a graduate student, Paige Cramer, decided to try bexarotene, which works on a receptor involved in amyloid beta clearance. Some other drugs that worked in mice were too toxic to use in humans.
"We're really lucky that bexarotene is a great drug with an acceptable safety profile," he said. "This doesn't happen very many times in life'"
Low official wages created a temptation for physicians, who would attract fee-paying patients by falsely categorising them as pregnant women who are exempt from the normal requirement to help pay for their drugs.
Corruption remains widespread, according to doctors, pharmacists and medical suppliers, with direct bribing by suppliers.
“The
fakellaki
system [envelopes containing cash bribes] is still operating at big hospitals in Athens, run by the heads of procurement,” says one Greek executive working for a foreign medical supplier.
Another executive says pharmacists sometimes seek reimbursement by falsely claiming medicines for fictitious or dead patients. Health insurance funds do not require verification that costly medicines are essential, resulting in fraud estimated at up to ˆ1bn a year.
Patent-protected drugs have been sold to the Greek health system in high volumes at prices which are relatively low by EU standards. One consequence was more than ˆ850m last year in “parallel exports” of medicines bought cheaply by Greek pharmacists and resold abroad. The government responded in recent months by banning foreign sales of some medicines after domestic supplies ran out.
Once patents have expired, the lack of any requirement for Greek doctors to prescribe cheaper, generic versions means patented drugs still represent nearly 80 per cent of total prescriptions in Greece, compared with less than 30 per cent in Germany. Yet generics were traditionally sold at relatively high prices, with very low discounts to patented drugs. Even after recent reforms, they are typically only a third cheaper, compared with lower rates of nearly 90 per cent less in the UK.
Vassili Kontozamanis, a former Greek drug regulator, calls for greater efforts to boost generic prescribing at lower prices, but he cautions that such moves are meeting resistance from the country’s powerful generic drug industry, which employs more than 15,000 people.
Recent government reforms have included non-binding prescription guidelines, and cuts in drug prices amounting to ˆ1bn, with the aim of reducing the state’s medicines bill to 1 per cent of GDP by the end of this year. But reforms at state hospitals are making only modest progress amid strong opposition from medical staff.
If regional governments keep failing to pay their pharmaceutical bills, "the supply could be cut off," Humberto Arnes, head of the Farmaindustria association, warned on Friday.
His deputy, Javier Urzay, said there are already small pharmaceutical companies that avoid selling drugs to certain regions because of the risk of not getting paid for more than two years. Urzay mentioned Valencia and Andalusia as being among the culprits. For now, though, he insisted, there is no risk for patients because these suppliers are replaced by others.
In the Valencia region, pharmacies went on strike recently to protest the fact that they were not getting paid by health authorities for subsidized prescription drugs. Meanwhile, Catalonia has announced a one-euro charge for patients who get prescriptions from the public health service; the fee will be introduced in May as part of a slew of cost-cutting measures affecting the health sector in the northeastern region.
Spain has already been warned by the Swiss laboratory Roche, which has stopped servicing some Greek health centers. At one point, the company began charging a Castellon hospital for each antitumoral drug it supplied, rather than charging it to the account as before. Another lab, Novartis, included Spain in a warning about the risk of certain countries defaulting on their drug bills.
Regions owe pharmaceutical labs over 6.7 billion euros for medicines sold to public hospitals. Arnes warned that if public spending on health continues to be slashed, things could reach the point where authorities will have to choose which treatments to stop subsidizing to focus on the truly serious diseases.
Continue reading "Clueless Anti-Drug Agencies Oppose Medical Marijuana In Ohio" >
12-FEB-2012
INDORE : In yet another complaint against the unethicaldrug trials that took place in the city, a local resident lodged a complaint with the Drug Controller General of India (DCGI , Medical Council of India (MCI and National Human Rights Commission on Saturday accusing some city-based doctors with a clinic of making his son a trial subject after keeping him in the dark.
Om Prakash Agrawal, a resident of Rajmohalla here, alleged that the people involved in the controversial drug trials kept him in the dark. He alleged that the drug had severe side-effects and the health condition of his son, Nitin, continued deteriorating. "After my son failed in examination, his mental health became unstable. He was not a healthy volunteer. Then, how could the doctors conduct trial on him," asked Agrawal.
The complainant stated that a medical store owner referred him to Dr Abhay Paliwal at his clinic in Geeta Bhawan. "Nitin was admitted in May 2010 and we were told that he would be alright in a few days. They asked me to sign on some forms, which were in English. Though I could not understand the content, I signed on it trusting the doctors. My son was admitted to the hospital for 10 days," stated Agrawal in his complaint.
Informing that the 'treatment' did not yield any result as per the promise, Agrawal complained that the doctors used to take blood samples 8-10 times a day.
"We even opposed when doctors collected blood samples frequently but no one listened," alleged Agrawal.
The complaint alleged that an Ahmedabad-based company, Intas, sponsored the trial for which approval was taken from city-based Naitik independent ethics committee and ethics committee of CHL-Apollo Hospital.
Nitin was also not insured against clinical trial liability and is still taking the medicines for his ailment. He was not given patient information sheet and a copy of informed consent form, the complainant added.
However, the doctor involved in the particular case clarified that no trial was conducted without informing patient or family member. "I do not remember the case. I have to check the records. However, no trial was conducted without taking consent of the patient or family members," added Dr Paliwal.
After my son failed in examination, his mental health became unstable. Then, how could the doctors conduct trial on him.
http://timesofindia.indiatimes.com/articleshow/11855229.cms
Three weeks ago, the National Institutes of Health announced new rules to govern federally-funded researchers and their financial conflicts of interest. Three years in the making, the policy will affect
over 38,000 scientists at 2000 organizations as the NIH attempts to ensure that biomedical research, paid with taxpayer dollars, remains objective.
But none of these changes might have happened were it not for Dr. Charles Nemeroff.
A renowned chairman of psychiatry at Emory University, Nemeroff was a proponent for drugs sold by GlaxoSmithKline, such as the antidepressant Paxil. While earning hundreds of thousands of dollars jetting around the country and giving talks about Paxil to doctors at fancy restaurants, Nemeroff also managed a multi-million dollar grant from the NIH to research drugs under development by Glaxo.
The ensuing scandal became central to an investigation by Senator Charles Grassley into undisclosed payments from companies to prominent physicians—a practice that puts patients at risk and drives up healthcare costs. As Grassley’s lead investigator on the matter, I had a ringside seat as arguably the most powerful psychiatrist in the country was forced from prominence, eventually leaving Emory.
In This Story:
Intro |
Ghosts From The Past |
A History Of Conflict|
Welcome To The Sunshine State|
Mistakes Were Made|
“Couldn’t Be Better“
At my new job with the Project On Government Oversight (POGO , a government watchdog, I have continued to study the cozy relationships between physicians and corporations. I also observed as Nemeroff left Emory for a new job at the University of Miami which has a medical school operating under financial strain. But why would this school snatch up a physician with such a history?
According to new emails and other materials shown to me, UM officials had serious concerns about Nemeroff’s history of ethical blunders. However, these emails suggest that Nemeroff’s perceived ability to raise money trumped those concerns. At one point while negotiating with UM for a job, Nemeroff even dangled the possibility of a new funder for the school if he was hired. These emails imply that, despite new federal rules, the public must remain vigilant to ensure that medicine is practiced with the highest regard for ethics and patient safety.
Officials at UM did not respond to detailed and repeated questions about the emails, which include communications by UM President Donna Shalala, who is now facing public scrutiny over a separate ethics scandal involving UM’s football program.
By Paul Thacker.
Most people are now aware how the academic literature on medications is undermined, (perhaps fatally for some drug classes such as antidepressants [1] , by publication bias and selective reporting. To these, we must now add citation distortion or “unfounded authority”. Unfortunately, much consensus in psychopharmacology is based on unfounded authority.
Citation distortion [2,3] is the process whereby, in a field with ambiguous primary data, studies showing the desired outcome are preferentially cited. Over years and generations of reviews, this distortion is amplified with exponential increases in supportive citation, facilitated by increased citation of papers that do not contain primary data (ie, one review cites another . At the same time, there is no parallel increase in citation of critical reviews.
Errors accumulate in this process of reiterative citation; for example what is acknowledged as hypothesis in cited articles is misrepresented as fact in reviews.
An example from this week’s academic literature is an article from Australia’s MJA [4]. Amongst the numerous self-citations (count them , note the disingenuous citation of the discredited Gibbons et al paper (see David’s blog at
http://davidhealy.org/coincidence-a-fine-thing as though it supported ‘The importance of managing anxiety and depression in young people to minimise functional, medical and psychological complications’.
[1] Ioannidis JP. Effectiveness of antidepressants: an evidence myth constructed
from a thousand randomized trials? Philos Ethics Humanit Med. 2008 May
27;3:14.
http://peh-med.com/content/pdf/1747-5341-3-14.pdf.
[2] Greenberg S. How citation distortions create unfounded authority: analysis of a citation network. BMJ2009;339doi: 10.1136/bmj.b2680 (Published 21 July 2009
http://www.bmj.com/content/339/bmj.b2680.full
[3] Slawson DC, Shaughnessy AF. Obtaining useful information from expert based sources. BMJ. 1997;314(7085 :947-9.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2126390/pdf/9099121.pdf
[4] Scott EM et al. Targeted primary care-based mental health services for young Australians. MJA 2012; 196: 136-140
http://www.mja.com.au/public/issues/196_02_060212/sco10481_fm.html
Amyloid beta deposits in brain of Alzheimer’s patient.
What’s the News: A drug used to cure skin cancer is also a possible treatment for Alzheimer’s, according to a
new study in
Science
.
The drug not only reduced levels of
amyloid beta—a protein whose elevated levels are a hallmark of the disease—but also reversed cognitive decline. In mice, dramatic effects were evident after just 72 hours.
How the Heck:
bexarotene could enhance expression of a gene called
apoE
.
apoE
activates the immune system to break down amyloid beta, and mutations in the apoE gene are a major risk factor for Alzheimer’s. Turns out the researchers were right. Mice with genetic mutations that make them prone to the disease are the standard model for Alzheimer’s research. When these mice were treated with bexarotene,
macrophages in their brain gobbled up amyloid beta, and the levels of amyloid beta fell by 40% in just 72 hours. Molecular changes are good and all, but an effective drug for Alzheimer’s also has to treat the behavioral symptoms. Bexarotene actually reversed cognitive deficits. The team put treated mice through standard memory tests, including ...
Durgesh Nandan Jha
9-FEB-2012
NEW DELHI : May 28, 2009: Caught in a compromising position, daughter kills mother in Paschim Vihar.
June 8, 2011: Man stabs his 70-year-old father in Bhogal after an argument over selling land and not supporting him against his wife, who was allegedly having an affair.
July 8, 2011: Man murders his father in Zamrudpur area of Greater Kailash because he was spending a fortune on a woman with whom he allegedly had a relationship.
Feb 7, 2012: Man batters his father to death, injures mother in Krishna Nagar.
Domestic violence is no more limited to marital discord and torture of women at the hands of their husbands and in-laws. Violence is now permeating into relationships as varied as between father and son, mother and daughter.
Psychiatrists say Tuesday's case where a man battered his 58-year-old father to death at their Krishna Nagar home, caring little even for his mother's intervention, should be taken as a wake-up call. Frequent misbehaviour, physical abuse, tendency to inflict injuries on oneself and substance abuse must not be tolerated and one should contact a psychiatrist or the family physician to explore possibilities of an underlying mental illness or behavioral disorder, which are treatable, they said.
"Violence against family members, including parents is increasing. We get two to three such cases every day. Most often, it is triggered by an untreated mental illness or stress which manifests in aggression against close members of the family," said Dr Nimesh Desai, director, Institute of Human Behaviour and Allied Sciences (IHBAS . He said fall in family values has added to the problem.
Dr Jitendra Nagpal, another psychiatrist, said, "Mental illness and issues related to it need to be taken seriously. One must consult a doctor if a person is facing relationship woes or work-related stress, a common problem particularly in big cities, which is causing depression or aggression. Mental disorders are a growing health concern which affect more than 7% of the total population in the country. Such disorders are present in many more people in the form of sub-clinical emotional and behavioral health issues which can manifest as aggressive behaviour if ignored for too long," Nagpal said. He said the stigma attached to mental illness must be done away with.
Dr Nand Kumar, additional professor of psychiatry at All India Institute of Medical Sciences ( AIIMS , said treatment is available for most mental health issues. "Many people cannot control their impulses. It is a kind of mental disorder and is treated with mood stabilizers. We give anti-psychotic drugs to patients, who complain about abnormal belief, for instance, someone who thinks his father doesn't love him as much as he loves his other children," he said.
He said that in children deviant behaviour, frustration and depression have been observed. "With proper counselling it can be treated. But if ignored, it can turn into a major health issue," Kumar said.
http://articles.timesofindia.indiatimes.com/2012-02-09/delhi/31041232_1_mental-illness-man-batters-kind-of-mental-disorder
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