The FDA Guerillas of Wonky DrugWonks - Part II
http://www.opednews.com/articles/The-FDA-Guerillas-of-Wonky-by-Evelyn-Pringle-080811-726.html
by Evelyn Pringle
11 August 2008
Brain will be battlefield of future, warns US intelligence report
The human brain could become a battlefield in future wars, a new report predicts, including 'pharmacological land mines' and drones directed by mind control
http://www.guardian.co.uk/science/2008/aug/13/military.neuroscience
Ian Sample
Wednesday August 13 2008 17:23 BST
Rapid advances in neuroscience could have a dramatic impact on national security and the way in which future wars are fought, US intelligence officials have been told.
In a report commissioned by the Defense Intelligence Agency, leading scientists were asked to examine how a greater understanding of the brain over the next 20 years is likely to drive the development of new medicines and technologies.
They found several areas in which progress could have a profound impact, including behaviour-altering drugs, scanners that can interpret a person's state of mind and devices capable of boosting senses such as hearing and vision.
On the battlefield, bullets may be replaced with "pharmacological land mines" that release drugs to incapacitate soldiers on contact, while scanners and other electronic devices could be developed to identify suspects from their brain activity and even disrupt their ability to tell lies when questioned, the report says.
"The concept of torture could also be altered by products in this market. It is possible that some day there could be a technique developed to extract information from a prisoner that does not have any lasting side effects," the report states.
The report highlights one electronic technique, called transcranial direct current stimulation, which involves using electrical pulses to interfere with the firing of neurons in the brain and has been shown to delay a person's ability to tell a lie.
Drugs could also be used to enhance the performance of military personnel. There is already anecdotal evidence of troops using the narcolepsy drug modafinil, and ritalin, which is prescribed for attention deficit disorder, to boost their performance. Future drugs, developed to boost the cognitive faculties of people with dementia, are likely to be used in a similar way, the report adds.
Greater understanding of the brain's workings is also expected to usher in new devices that link directly to the brain, either to allow operators to control machinery with their minds, such as flying unmanned reconnaissance drones, or to boost their natural senses.
For example, video from a person's glasses, or audio recorded from a headset, could be processed by a computer to help search for relevant information. "Experiments indicate that the advantages of these devices are such that human operators will be greatly enhanced for things like photo reconnaissance and so on," Kit Green, who chaired the report committee, said.
The report warns that while the US and other western nations might now consider themselves at the forefront of neuroscience, that is likely to change as other countries ramp up their computing capabilities. Unless security services can monitor progress internationally, they risk "major, even catastrophic, intelligence failures in the years ahead", the report warns.
"In the intelligence community, there is an extremely small number of people who understand the science and without that it's going to be impossible to predict surprises. This is a black hole that needs to be filled with light," Green told the Guardian.
The technologies will one day have applications in counter-terrorism and crime-fighting. The report says brain imaging will not improve sufficiently in the next 20 years to read peoples' intentions from afar and spot criminals before they act, but it might be good enough to help identify people at a checkpoint or counter who are afraid or anxious.
"We're not going to be reading minds at a distance, but that doesn't mean we can't detect gross changes in anxiety or fear, and then subsequently talk to those individuals to see what's upsetting them," Green said.
The development of advanced surveillance techniques, such as cameras that can spot fearful expressions on people's faces, could lead to some inventive ways to fool them, the report adds, such as Botox injections to relax facial muscles.
From The Sunday Times
May 4, 2008
Doctors 'fail in prescribing'
An Edinburgh clinician is calling for a GMC review after finding junior doctors blame lax training for their poor prescription writing
Mark Macaskill
http://www.timesonline.co.uk/tol/news/uk/scotland/article3868558.ece
THREE-QUARTERS of junior doctors say they are putting the safety of patients at risk because they have not been trained to prescribe drugs properly, says a new report.
In a survey of 2,400 junior doctors by scientists at Edinburgh University, 74% said the teaching of drug prescription was inadequate and more than half said their training failed to test their knowledge and skills.
More than 40% said they were not confident they would achieve minimum prescribing competencies set out by the General Medical Council (GMC).
Almost two-thirds said they were not confident about prescription writing and barely a third had filled in a hospital prescription chart more than three times during training.
“Our study suggests that a large proportion of medical students and recent graduates from UK medical schools who responded believe that their teaching and assessment in this area was inadequate,” said Dr Simon Maxwell, a clinical pharmacologist at Edinburgh University and co-author of the study.
The report, to be published in the British Journal of Clinical Pharmacology, has prompted calls for the GMC to conduct an urgent review of undergraduate training.
It is believed that mistakes in prescribing, most of which are avoidable, kill dozens of patients every year.
A study published in The Lancet in 2002 found that, of 88 serious medication errors in a UK hospital, deficits in “skills and knowledge” were a factor in 60% of cases.
An Audit Commission report suggested that adverse medication events were responsible for the deaths of 1,100 hospital patients in 2001 in the UK, a fivefold rise on the previous 10 years.
Across the UK, adverse reactions to medicines are estimated to account for one in 15 hospital admissions at a cost of about £470m a year.
The National Patient Safety Agency database receives 40,000 reports annually of medication incidents from acute and general hospitals.
“The medical curriculum as far as pharmacology is concerned is substandard,” said Robert Cumming, chairman of the Scottish Health Campaign Network.
“This problem has been around for a while and it still hasn't been solved. This requires students to be taught pharmacology in a rigorous fashion. There are significant problems and complaints being raised by patients.”
Last week, the GMC insisted that there were no proven links between patient deaths and the standard of medical training.
However, it is carrying out a £100,000 study to investigate the prevalence and causes of errors in doctors' prescribing
Yours magazine, February 26 2008
'GPs turned us into drug addicts’
Guidelines state benzodiazepine tranquillisers should not be routinely prescribed for more than four weeks. Yet thousands of older women have been on them for up to 35 years and are now addicted
Kathleen Dunion doesn't make it out of her bedroom much most days. It was October 2007 when she last left the house and that was the first time for a year. Tears roll down her cheeks as she lays in bed thinking about how lonely her life has become.
Like an estimated 1.1 million people in the UK-the majority, women over 50 - Kathleen is hooked on anti-anxiety drugs prescribed by her GP. At 70 she's battling to come off the medication her GP prescribed when she was a young woman of 35. The withdrawal symptoms are crippling. Kathleen can't watch television with her husband Hugh (72), because of the constant ringing in her ears and noise sensitivity. She can't concentrate and is struggling to cope with muscle pains and exhaustion.
Turn the clock back 35 years and Kathleen was a jolly, outgoing silver service waitress with a busy family life. Kathleen says: "My doctor prescribed Valium after I had panic attacks. My daughter had married at i9 and nine weeks later her husband was killed in an accident; it was hell watching what she went through. One night I went to bed and just started to shake uncontrollably. My doctor said Valium would `pick me up'.
Kathleen has been on benzodiazepines ever since but has vowed to wean herself off. She has halved her dosage and hopes to be off them completely by autumn: "They've robbed me of my life. At times I've been suicidal. Last time I felt like ending it. I saw the faces of my two great grandsons and knew I had to go on for their sakes.”
Benzodiazepines-more familiar to the public as Valium (diazepam), temazepam, Xanax and Ativan, among others -were introduced in the Seventies as a `safer' replacement for barbiturates, a treatment for anxiety and insomnia which had been implicated in accidental suicides.
Back then, the drugs were said to be non-addictive. By 1979 there were 31 million prescriptions for benzodiazepines prescribed in the UK alone. But by 1988 the UK's Committee for Safety of Medicines was urging caution. It advised GPs that benzodiazepines should be prescribed for no more than two to four weeks and only for severe anxiety and not for depression, because they can increase the risk of suicide.
Although benzodiazepine prescribing has declined, there were still 10,768,910 prescriptions for the drugs in England in 2006. The All Party Parliamentary Drug Misuse Group is so concerned about the scale of benzodiazepine and other prescription drug misuse that a public inquiry is underway. Dr Brian Iddon. MP for Bolton South East and inquiry chairman, told Yours: "This problem should have gone away by now, but in fact it's worse. GPs are still not following the prescribing guidelines on this. I'm not disputing these drugs can be useful in certain circumstances... but in some areas they are still giving them out like Smarties."
Anne* (54) is one of the few UK benzodiazapine addicts who has received compensation. She was first prescribed Valium in 1978 when she was 24 and struggling to cope with three young children: " I was finding it hard to sleep. Whenever I asked my GP if I could come off them, he'd say, `Don't worry, they're helping you'."
For 26 years, Anne obediently took a tablet every day. It was a chance telephone conversation with the surgery receptionist that alerted her something was wrong: "I'd rung to get antibiotics and was told I couldn't get a prescription over the phone. I asked, `Why not? I've had tranquillisers over the phone for years'. The receptionist went quiet and said I needed to talk to the doctor."
Anne confronted her GP: "At first he told me he'd forgotten I was still being prescribed the drugs. Later he backtracked and told me I'd been given the best medical help I could get."
Horrified and ashamed, Anne kept her addiction secret - even from her husband: " I worried about what people would think. But I also felt angry and badly let down so I changed my GP and consulted a solicitor."
Anne's solicitor Caroline Moore says: "Although her doctors tried to say they had advised her of the addictive nature of the drugs, there were no notes to prove it. GPs know they have to keep proper notes and they hadn't. They'd never referred her for counselling and they just continued to make the repeat prescriptions. That amounted to gross negligence."
After three years of legal wrangling Anne's doctor finally offered her £5,000 compensation in an out-of court settlement but she remains disappointed because she never had an explanation: "I'm angry and I may still take this further."
Like Anne, Tess Higham (78), a former head teacher from Lancashire, has managed to conquer her addiction. She was first prescribed benzodiazepines when she was widowed in her 30s with four children aged between two and seven: "I went back to work but ended up being totally burnt-out. I was tired, irritable and couldn't sleep. My GP prescribed benzodiazepines. As my body got used to them the tablets began to depress my ability to cope and concentrate. It was like all my nerves were deadened."
In 1987 Tess told her GP she wanted to come off them and was admitted for a two-week hospital withdrawal programme: "The symptoms were terrible. My body tensed up and it was as if I had a vice around my head. But in other ways it was like a magic wand had been waved over me - I could concentrate for the first time in 21 years and was soon reading 12 books a week. I got to know my children all over again. On Mother's Day they sent me a card saying `We're so glad we've got our real mum back'."
Heather Ashton, professor emeritus of clinical psychopharmacology at Newcastle University, conducted a survey of GP practices in Newcastle in 2004. She found that each had around 180 long term users of benzodiazepines: "I suspect that 70 to 80 per cent are women over 50."
Despite the scale of the problem there is only one NHS-funded benzodiazepine withdrawal project, set up in 2005 by the Oldham Drug and Alcohol Service. It receives £55,000 a year compared to £1.67m for dealing with illegal drug users in the area. Barry Haslam (64), a former benzodiazapine addict who set up the Oldham project, says: "It's unfair that illegal drug users get more help than those trying to come off prescription drugs. There should be a levy on the drug industry to fund withdrawal projects like ours in every town."
Jim Dobbin, MP chairman of the parliamentary All Party Action Group on Involuntary Tranquilliser Addiction, agrees: "The Department of Health should look at the Oldham project for benzodiazepine withdrawal and every Primary Care Trust should have a facility or support system in place. People think this was sorted out 20 years ago but nothing could be further from the truth."
*Name changed.
HOW TO GET HELP
Dr Jim Kennedy, chairman of the Royal College of General Practitioner's prescribing committee says: "I'd advise patients considering coming off benzos to go to their GP and ask for help in reducing their dosage. If they refuse, that could be considered unacceptable practice and I'd advise patients to find another GP and contact the Primary Care Trust."
For information go to www.benzos.org.uk or call the Council for Information on Tranquillisers and Antidepressants on 0151 932 0102.
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