March 18, 2009

IS CSI THE STANDARD? NOPE, JUST DREAMING

Despite the public image created by CSI this and CSI that, the truth is that detectives rarely, if ever, have the luxury of working on only one case at a time. They truly don't have a full team of experts working exclusively on that case start to finish. And even the technology shown that does exist---some of it is such an exaggeration of reality and some of it is in someone's dreams isn't available to all agencies and isn't€™t available on each and every case. If only it were true!!!

In reality, you come in to a desk piled high with new cases and you jump back and forth from one to the other, trying to meet deadlines before the suspect gets released, hoping you have the evidence you need, trying to interview all the possible witnesses on several cases at once, etc. And each day more cases may join the pile. If you don’t have a suspect’s name in hand, there often will be little or no testing done any time soon
..Even with a suspect in custody, it's tough getting the testing in time for filing or in time for prosecution (with rape evidence especially). And no, the DNA and fingerprint databases aren't as complete and rapid as TV would have you think. And no, law enforcement and coroners can't tap into every possible computer system in the world, immediately identifying every little shred of trace evidence, getting detailed diagrams and chemical analysis re every address in the world (like they do on Crossing Jordan, for example)!!!!! It is not for lack of desire, but sheer lack of funding, lab capabilities and personnel or lack of actual technology in existence to do so. Reality bites!

High-tech TV shows make the public's expectations soar far beyond reality. So, all segments of the public had best get over anti-law enforcement attitudes and get behind the police. Give them the cooperation, the ability and inspiration to get it all done right each and every time. A few years back the DNA evidence was piled to the ceiling in labs across the nation with no apparent hope of catching up at the level of funding and staffing they faced. Well, enough pressure came to bear that Congress finally got into the fray and provided some funding for departments to play 'catch up' on DNA analysis. Things started to happen! Time to take the same approach with DUI and sexual assault and homicide evidence in general. In fact, every state should do a full-blown audit of their sexual assault, drunk/drugged driving and drug laws to see how many holes there are. The number of drugs being abused has expanded rapidly and law enforcement labs and hospitals-- aren't able to keep up.

The 'standard drug panel' of testing done by hospitals and crime labs (usually a panel of 5 or 7 or 9 most common drug categories) falls far short of what is happening in the real world. There isn't a hospital level drug screen for gamma hydroxy butyrate (GHB) yet, so that's a huge problem. It is being missed routinely in many situations (indeed this drug is hard enough to catch because of time lapse and how quickly it dissipates, but testing capability is something that can be improved). Law enforcement and government officials say it isn't a big problem because there aren't big statistics on it. But how can there be statistics without the ability to identify it??? Many crime labs are not set up for it and even more can't identify the GHB analogs, GBL, BD and others. Only a handful of outside drug testing labs are up to speed on GHB issues and those that do, well, it’s an expensive extra test that many police departments and coroners can't afford or at least bulk at requesting. Drug abusers who like MDMA (Ecstasy) are now playing with more and more of the approximately 200 tryptamines and phenethylamines, yet training and testing capabilities lag. It is stunning how many states have horribly inadequate 'impaired driving' laws. Many cover only alcohol impairment or a couple of specific drugs. Hey, impaired driving is impaired driving, no matter what drug they are taking! I've run into states that have zero ability to identify GHB, for example, even when their trained officers recognize the symptoms of it in impaired driving or rape cases. I mean states that haven't even set up protocols to send it out for testing to the labs that most law enforcement agencies use!!! Well, comes back to budget in many cases.

The crucial thing that will help beat the drug rapists is hair testing for GHB. Not the usual hair testing being done with other drugs. This requires special instrumentation and a procedure called 'segmentation.' It is more time consuming and thus more expensive. So why isn't it being done in the US? Because we need to push for it, get the drug testing companies and government, etc., to realize now much it is needed. The price will come down once it becomes more commonly available.

Get behind your police agency and help them bump up the standard!!! Let's catch even more bad guys and protect the good folks.

IS 'FAST-TRACKING' SOMETHING TO BE PROUD OF?

The Food and Drug Administration talks about their 'fast tracking' for approving drugs like it is something to be proud of. But what it really seems to mean is that corners are cut, things are rushed, drugs get to market faster and YOU and I become the guinea pigs for their on-the-market drug testing!!! When Phen-Fed was taken off the market, they were in a huge rush to get another 'fat pill' out there. Had to get something out there. Enter Meridia. Where is it now???? Right there on the list of drugs that FDA whistleblower Dr. David Graham says are putting the public heath at risk.

The scary thing is that the drug companies do the testing. They submit what they want to submit to the FDA and the FDA does little to nothing to double check it. Oh yeah, they have drug evaluation committees, but 1) they don't listen to them if the recommendation isn't what they already plan to do (ala the Xyrem issue) and 2) there was a big expose a few years back because a huge percentage of the evaluators the FDA uses work for the very companies making the drugs that they are being asked to review!!! The FDA dismissed the expose with oh well, there aren't a lot of drug consultants out there, so we have to do it. The FDA signed off on many of them, knowingly kissing off their conflict of interest.

I have to agree with Dr. Mercola, Graham is my new hero. http://www.mercola.com/2004/dec/18/vioxx.htm Of course, Graham has been exiled from reviewing drugs and you can't reach him through the HHS employee list because his email has been removed from there. Typical.

TV DRUG ADS NEED TO BE BANNED! ALL OF THEM!

Drug ads should be banned completely. It's a very big element of why drugs are so expensive. Spend less on the ads and spend more on properly testing the drugs and properly educating doctors about what is available. We shouldn't be running to the doctor saying, “Oh, I need some of the 'abcd' drug because some sports star or ice skater told me so.' Doctors should KNOW what drugs are available, diagnose the condition and prescribe appropriately. But in fact, doctors are often pressured to use the new big-money drugs and it becomes difficult at times to use some of the old standard drugs that work quite well. And, of course, there are some docs who are among the bad guys, over-prescribing and perhaps even abusing drugs themselves. We need to find some balance, but we should start with banning drug ads in the media.

Celebrex and Vioxx are the classic examples. They have been promoted more extensively than any other drugs on earth and are outrageously expensive. Yet their level of pain relief is only roughly that of Motrin and Aleve (remember, they were prescription-only drugs not so long ago). No reason they should be so expensive, other than 1) pure greed and 2) gotta pay for all that excessive advertising. Look where Vioxx is now-----Dumped after hurting so many. Celebrex and Betra (comparable drugs) may well be right behind it. Oh, and they tell you that these drugs don’t upset your stomach like Motrin does. What a lie! Talk to the pharmacists; they know better. That’s just the pitch the drug companies make and doctors foolishly listen to them. Granted, ibuprofen (Motrin, etc.) upsets a lot of stomachs but it isn’t alone in that regard.

The Viagra ads are another classic. Recently the most current ad was going to be pulled because it doesn't address 1) the disease or condition treated (just see your doctor now for a free trial six-pack) and 2) doesn't mention the risk factors (heart attack, death, etc.). Gosh, it is my understanding that those two things are required in ads but not since they dropped Bob Dole and his Limp Noodle Syndrome have they been mentioned. Yet it took this long for any action? Duh, the ad pulled is just the MOST offensive of the whole series (with those stupid blue horns rising from his head) but they all violated the supposed requirement. Guess money rules as usual.

Did the FDA also make a mistake in approving GHB (disguised as Xyrem)? I think so.

But---Look how many deaths it took to bring attention to Vioxx????? Xyrem won't kill that many because the number of Xyrem users won't be anywhere near the number of Vioxx prescriptions. So, it will be ignored completely, no matter what the percentages. In fact, an FDA official told me point blank (before GHB was approved) that he did NOT CARE how many it killed or how many became addicted to it, he was going to approve it anyway. Gee, think he is too closely allied with that drug company???? Despite the fact that I made his statement public in the FDA hearing on Xyrem, it sparked no interest at all in the FDA. They didn't care what he said or how close he was to the drug company. Even the investors in Xyrem's company, on their message board, laughed about the'inappropriate' relationship between the FDA and the company but thought it was cool as they expect to make big bucks from this drug.

Meanwhile, Project GHB (www.projectghb.org) is getting an increasing number of emails from those with problems taking Xyrem, given to them by doctors who have NO clue whatsoever what they are dealing with. The FDA refused to exempt this drug from off-label use (a shaky policy that allows doctors to play with your health by playing with drugs for uses other what it has been tested and approved for). Even the FDA's own drug review panel said, 'If any drug should be exempted from off-label use, it is this one.'

One doctor recently foolishly--gave Xyrem to a woman with sleeping disorders who also had other health problems and a history of alcoholism. He adamantly insisted that Xyrem is NON-ADDICTIVE. How wrong he is!!! And, this patient already had a history of alcoholism. The patient was also taking other pain drugs with high abuse potential without anyone really confronting with the patient the issues of potential addiction and abuse. The PATIENT recognized a growing tolerance to GHB (the doctor continued to insist that it isn't addictive throughout) and the PATIENT recognized that care should be taken with any medications. The patient tossed the Xyrem and pushed away from some of the other drugs. And, reported that within a few weeks felt better than in a long time.

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