Sat, 30 May 2009 ![]() The "pharmacy diet" scam is simply out of control here in Australia. However, I first wish to remind readers of the basic reason those we pay for sound advice also leap to deceive us via such tacky plays on fear, guilt, anxiety. Greed. Money. Profit. If you happen to reside in the fine Southern continent of Australia you can witness a strange manifestation of consumer exploitation in every neighbourhood pharmacy. This open letter to The Pharmacists of Australia from Australian Skeptics helps clarify what is simple, unadulterated consumer exploitation. At best it is [or rather was, given Aussie pharmacists well proven double standards] an unexpected qualification of legitimacy by mere association with medical science that in part motivated the drafting of such a letter. Items advocating clearly dangerous and/or useless, 'new age', natural [so are lightening strikes], homeopathic, aromatherapeutic, magnetic stimulation, crystal energetic, pyramid power, detoxification remedies, ear candles, similar products or even practices claiming to enhance/maintain/repair/develop or augment in some way or another such vaguely described, yet "essential" bodily, mental or spiritual functions abound within Australian pharmacies. And they abound right next to recognised and proven treatments. Indeed the placing of demonstrably non efficacious preparations, alongside products with genuine, documented validity deserves scorn in and of itself. The intuitive feeling of trust that accompanies the consumer associating product X with the decades of reliability of product Y in its familiar and comfortable packaging, is a powerful motivator. Minimal thinking and maximal "satisfaction". You may well have doubted the flushing of "negative energies" through unwilling sphincters as "essential care for the holistic You!" - if not actually impossible - until you saw the Betadine antiseptic ointment nearby. Legitimacy by association? Isn't that a bit ambitious? Perhaps. Yet we know that human beings seeking advice or treatment trust - and decide to act upon - advice given by a person wearing a white coat. Correct for other variables and results frequently follow that white coat. We learn to expect valuable advice and respond accordingly. At worst it is a coldly calculated grab for consumer dollars involving products the pharmacist him/herself mocks and derides because of the junk science involved. I have a friend who manages a pharmacy with the slogan: "Passion, People, Price" - or words to that effect. "I'm a skeptic too", he announced as I outlined the scam surrounding the Anti-snor "acupressure" ring. But, he went on snorting derisively, that it's not up to him to advise on "sympathy spending" [I think he meant 'retail therapy'] managing to admit in one breath that his "natural" products were junk but he was still kindly helping customers by allowing the subconscious human need to waste money. He has a valid point: we can spend our money where we wish. Besides, franchise product choice is not his decision, nor is dissuading customers from spending likely to be a positive career move. Indeed the decision to limit or remove alternative junk from pharmacies won't come from ranks of staff. It will likely arise at a senior level when industry image matters more than profit. Then a "phasing out" period will follow accompanied by consumer information designed to paint the all-knowing pharmacist as a health professional without peer. Why? At some point the ipso facto professional image of the community pharmacy will begin to erode. Poor competition ensures we remain ignorant of varied approaches, and Pharmacy Guild tactics are ruthless if not brutal when it comes to holding onto their monopoly. Remember the feverish drive by the Pharmacy Guild against supermarkets stocking pharmaceuticals? Seven out of ten items sold in supermarkets are cigarettes, lied one poster in my local pharmacy. Would you trust your health advice to sellers of dangerous products? Therein lies the irony. The angle chosen by pharmacists was concern for your health. We now know without a percentile point of doubt this too was a scam. Supermarkets are examined for price, cleanliness, product quality, claims on packaging, petrol docket value, plastic bag use and so on. Frequently these topics dominate TV, radio and print media. Pharmacists suffer no such intrusion and this is to our disadvantage. Still, I value my pharmacist interlocutors advice, enjoy his critical wit and might label his greatest crime as not suffering fools gladly. Dastardly deeds for their own sake is not what I'm arguing. Intentionally harming, placing others at risk or promoting junk science as an end in itself is not the aim of pharmacists. Indeed it is the association between clinical skill and unproven remedies that concerns those of us who advocate understanding evidence over accepting claims. Recently, our morning chat was interrupted. He rolled his eyes dramatically because a scooter driving elderly lady required a bottle of cough syrup located near the dispensary. As said friend had decided Swine Flu was "a media rort" at best, Mrs. Scooter was lucky to be served at all. But I had to grin inwardly. The poor lady couldn't move without mowing down ranks of tacky, flimsy shelving. And what was on this shelving? Jelly beans, novelty desk clocks, gym socks, ear candles, antisnor rings, vitamins, vitamins, vitamins and ample detox kits. Bizarre. To think our pharmacies - aside from our hotels - are the final bastions of legal pre-toxing and now stand under assault from "healthy" scams that could harm you as easily as the Class A drugs kept in the dispensary safe. In this episode Firesnake examines what appear to be quite useless diet plans, on offer at major pharmacy chains. Of particular note is the pushing of poorly monitored and expensive dietary supplements onto children, the lack of training or skill required by staff and incredibly, the arrogant response by Tony Ferguson - a rogue Pharmacist only too well known for his "independent" money making scams over the years. Tony runs "Weightloss and Wellness Centres". He also pushes his programmes from Terry White Chemists. Recently Australian consumer magazine Choice reviewed Pharmacy Diet Plans. The Courier Mail described Choice as "slamming" such plans. Briefly Choice concluded:
Tony Ferguson seized the opportunity. Guessing that media outlets are as fed up - no pun intended - as the rest of us with self styled gurus, Ferguson used his own web site to "reply" then within weeks launched a new TV advertising campaign bursting with positive "testimonials". 600,000 People Can't be Wrong but Choice Magazine can't get it right with weight loss investigation! Tony Ferguson "One of Australia's leading consumer comparison magazines, Choice Magazine, has got it wrong! "says weight loss authority and pharmacist Tony Ferguson. Renowned for helping Australians make accurate and informed decisions, Choice have unfortunately made a mistake with their review of the weight loss industry including Australia's pharmacy supported weight loss leader , the Tony Ferguson Weightloss Program. In addition the magazine did not review the entire program , only half of it despite being invited to do so. Ferguson explains that: "They also ignored the psychological aspects of weight loss in their review. The leading authorities in treating obesity around the world acknowledge that being overweight is much more than a product of eating too much and exercising too little. That is an outdated method of losing weight which has failed Australians for almost two generations now." Ferguson is using old evasion tricks here. Firstly, he introduces variables that have nothing to do with the aims of diet programs, thus pleads unfair. Next he uses some Peacock terminology - "The leading authorities in treating obesity around the world...", basically sound like they agree with Tony although it's irrelevant and conveniently unreferenced. You may read Tonys full reply here. Keep in mind the panel of experts assembled by Choice described Fergusons latest scam and Ultra Lite as "disgraceful and irresponsible". Given these physiologically brutal approaches aim to maximise ketosis [see below] and no warning is forthcoming one must agree. Choice magazine does have an entry on healthy eating for those interested. Here's how Choice introduced their programme review:
Choice also looked at Meal replacements, standard of replacement, consultant training and ongoing training, claims surrounding weight loss and client suitability - eg; one does not have to be overweight or an adult in programmes other than Dr. Tims Success. This certainly raises serious questions over body image and possible self abuse with such low levels of supervision. Considering the pressure on teens and even children today to conform to the perfect body type, Fergusons plea of "psychological aspects" sounds like a cruel game of mockery. To think a perfectly healthy teen can be supplementing healthy eating with "replacement shakes" on advice from a barely trained part-time consultant is at best careless opportunism on the part of these programmes. The Choice report looks closely at nutritional value, the upsell of diet pills, flaxseed oil, fiber supplements, vitamins, minerals an so on. In the case of Betty Baxter fiber was so low, constipation is likely. Xndo slap you in the face with $1.60 per drink [called a serve] which is much the same as buying any other commercial drink. There is ample advice within the Choice report. The decision to appoint independent nutritionists is welcomed and it appears pharmacy diets fail us in almost every manner possible. In fact the highly predictable findings of cheap and tacky equipment and dusty storage areas or corners labelled "consultancy areas", fits nicely with the dollar focus of Australian Pharmacists in general. Choice also explain the concept of ketosis, which is the default side effect of starving yourself of proper nutrients. We award Tony Ferguson a CPDCT - Clear and Present Danger to Critical Thought score of 7.0 out of 10. Well done Tony. Choice explained: Some organs of your body, such as the brain and red blood cells, need glucose for energy, and if you don’t eat enough carbohydrates to supply them, your body will break down protein – from your muscles if you’re not eating enough protein – as an energy source for these organs. What are the benefits? Quick initial weight loss (mainly due to fluid loss) may increase your motivation. Some people claim the fluid loss also reduces feelings of bloating. Ketosis can also help make you feel less hungry. And the downsides? Some undesirable side-effects are mild dehydration, poor athletic performance, nausea, bad breath, risk of blood pressure problems, an increased risk of osteoporosis and muscle and blood vessel damage. It may also make concentrating on mental tasks more difficult. CHOICE verdictThese programs are of obvious financial benefit to the pharmacies, and a constant stream of short-term clients will shift a lot of product off the shelves. Will you lose weight? If you follow them closely, yes. Will the pharmacy setting provide you with your own highly skilled weight-loss advisor? Our experts think not. Considering the inadequate training of consultants, little ability to tailor programs and deal with individual circumstances and habits, as well as the lack of close, qualified supervision, CHOICE does not recommend these programs. The current regulations and voluntary codes of practice covering weight-loss programs are insufficient. CHOICE wants to see a national accreditation system, including minimum standards for training, covering all programs, consultants and leaders who counsel people on losing weight. It's with genuine effort I find myself holding back from simply abusing the window dressing that is the "pharmacy industry" here in Australia. The truth is, it would do little good and one cannot excuse legislators or ignore the hopeless policies bound in red tape. Presently, Pharmacy Guild members worship at the alter of the dollar and whilst able to promote sound health and science, have clearly chosen to promote a culture of "lock-n-load" profiteering that suits existing Guild restrictions on proprietorship numbers. There's a huge, growing, aging, drug dependent market out there. Australias pharmacists long ago decided to limit premises to the precious few who play by the rules and rule by the pay. Woo-woo, junk science and reckless dieting by dollar may well be here to stay. So, how can we limit or prevent junk science and 'new age' rubbish from basking in the integrity of white coated pharmacists? Get medications into supermarkets as fast as is sensibly possible. Faced with competition pharmacists will have fewer choices than placing marketing above medication efficacy hence consumer health. All relevant articles are here.
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Sat, 4 April 2009 ![]() In the second part of this finger wag at junk science journalism, we take a closer look at the reports one has to look for. It's the Lancet meta-analysis on cannabis use and the onset of psychosis whatdunnit, and responses to moral panic vary. Transforms press release,Cannabis health risks should not lead to knee jerk policy making, is a measured and sensible statement. The futile reclassification of cannabis so beloved by drug free warriors, advised against by scientists and utterly ignored by pot smokers is seen for the rhetoric it is. A federal court has taken a look at the Environmental Protection Agency's science on secondhand smoke and called it junk. Indeed, a view that is, in EPA Administrator Carol Browner's words, "widely accepted" is not the same as scientific proof. However one feels about the personal hazards of smoking, this ruling is a victory for science and against what Judge Robert Bork has called "authoritarian regulation propelled by moral intimidation." Here's the Washington Post news story, followed by a link to a Washington Times commentary piece by science author Michael Fumento.... Still, I can live with that. I may even quietly gaze intently at coffee shop menus, partaking of the delectable aroma of brewed coffee, the caress of warm carbon producing air and rejoicing at the nicotine junkies shivering on the footpath. I suppose for men, the cold helps reboot the vitality of sperm the nicotine kills. For women well, they just go old and wrinkly at breakneck speed. And that would drive anyone to smoke I guess. So, Reuters says one joint is as bad as 5 cigarettes on your lungs, when really, in every test but one, tobacco had negative effects while cannabis effects were statistically insignificant. Cannabis seems to negatively effect only one aspect of lung function, air flow. But when it comes to hyping the dangers, that single finding is sufficient to ignore the other findings and claim cannabis to be 5 times more damaging than tobacco. Notice that the Reuters' headline says 5 times even though the study says 2.5 to 5.
It seems the source of this incorrect extrapolation is here. Another more strongly worded piece on another study, from that colourful time is headed, Outrageous anti-pot lies: media uses disgraceful cancer scare tactics. The author is Paul Armentano. I respect Pauls right to be angry. For one, he's translated very difficult findings on cannabinoid behaviour across multiple disciplines, many times. Secondly the fact this junk went to press before the study was published renders the human rights and public health aim something of a joke. Reuters, Fox and even - oh, my! - Australias ABC got it very wrong. The study was welcomed by many experts, but others counselled caution. Leslie Iverson, of the University of Oxford, a member of the advisory council, said: “Despite a thorough review the authors admit that there is no conclusive evidence that cannabis use causes psychotic illness. Their prediction that 14 per cent of psychotic outcomes in young adults in the UK may be due to cannabis use is not supported by the fact that the incidence of schizophrenia has not shown any significant change in the past 30 years.” [Huffington Post article]
It takes only a short time to discover the UK government failed its public, and did so amidst calls for legalisation, all round easing of penalties and the steadily growing cries for mature policy changes. There simply is no 'pro-drug' lobby. In the ideology struggle it's war mongering, scare tactics and punitive responses, versus respect for science, human rights and harm reduction. Articles of relevance here. Comments[0] |
Sat, 14 March 2009 ![]() Welcome to a two part look at sloppy science reporting from Australias "premier flagship science programme"; Catalyst. In part one, we examine the falsehood and hype to spring from - of all things - a meta-analysis on cannabis use and psychosis, published in the Lancet in 2007. Update- June 2009: Synthetic Delta-9-THC can improve symptoms of schizophrenia. Regular readers may be familiar with the view held in the humble Firesnake Holeplex that the association between cannabis ingestion and psychotic illness is very complex. Specifically the relationship between Cannabidiol [CBD] and its proven role as an anti-psychotic. Could sufferers gravitate toward smoking for relief? Similarly, we know anandamide is lacking in individuals who experience psychotic episodes. ∆ 9-THC imitates anandamide. Again, could smokers gravitate for relief? The paper referenced above supports this view regarding ∆ 9-THC.
This Four Corners article references activity in the UK in late 2001. Despite Australian researchers favouring a cautious approach the facts have been distorted by drug-free proponents. Simply put, 'medicinal cannabis is a covert attempt to legalise cannabis by the back door'. No research, no pilot studies, no bipartisan discourse. A fact sheet here helps place things in context. The NSW cancer council have cautious information here. Ample information may be accessed here at the Medical Cannabis Information Service. In July 2003 Catalyst reported on the issue of medicinal cannabis. However, there is a more relaxed and arguably more common interpretation of the term ‘self medication’ that would strike accord with many consumers, carers and clinicians. This explanation states that people with psychotic illness use cannabis not to relieve the positive symptoms of their illness but to relieve unpleasant feelings or emotions - described in medical parlance as ‘negative symptoms’ - that may be a secondary result of their mental illness. Most people with schizophrenia would admit that cannabis use makes their hallucinations worse but research shows that a high proportion of people with schizophrenia use cannabis to cope with unpleasant feelings such as worry or boredom (Spencer in Castle & Murray, 004; Schofield et al, 006). If you also relax the requirement that the onset of mental illness must precede first cannabis use, the research does in fact support a version of the self medication hypothesis. [6. Motives influencing use of cannabis by people with psychosis: is there evidence for self medication?]
The most important problems in studying the relation between cannabis use and psychosis are reverse causality and the transitory intoxication effect.
If individuals with imminent psychotic disorder start to use cannabis to alleviate symptoms, the psychosis could be causing the cannabis use, rather than the other way around. In most of the studies included in the present meta-analysis, Theresa Moore and colleagues were able to adjust for the effect of psychotic or imminent psychotic symptoms and they were able to ensure that psychotic outcomes were not due to the transitory effect of intoxication. In observational studies, even the most thorough analysis cannot definitely rule out the possibility that confounding or bias can be responsible for the association between cannabis exposure and psychotic symptoms. However, in the present paper, the assessment of adjustment for confounding factors and transitory effects of cannabis intoxication is done more thoroughly than in previous reviews, and the odds ratio results for psychosis are more reliable and also more modest than seen in previous publications. We therefore agree with the authors’ conclusion that there is now sufficient evidence to warn young people that cannabis use will increase their risk of psychosis later in life. Oh my! The Lancet meta-analysis authors actually wrote the words "could cause...". But we see in the media release; it "will cause...". So er, which authors do they agree with? Technically, none, zip, nada, nill. A mis-trial if ever I saw one. Remember, this sad monotone topped the news releases. A meta-analysis topping media announcements? A false claim circulated to tens of thousands of trash tabloid journalists? Editors dance over submitted works for months but can't proof read their own jottings? Sigh. The future of funding research journals looks set to be complicated.
Watching the media cover marijuana is fascinating, offering deep insight into conventional wisdom, bias and failure to properly place science in context. The coverage of a new study claiming that marijuana increases the risk of later psychotic illnesses like schizophrenia by 40% displays many of these flaws. What are the key questions reporters writing about such a study need to ask? First, can the research prove causality? Most of the reporting here, to its credit, establishes at some point that it cannot,though you have to read pretty far down in some of it to understand this. You know when cannabis hits the news you’re in for a bit of fun, and this week’s story about cannabis causing psychosis was no exception. The paper was a systematic review and then a “meta-analysis” of the data which has already been collected, looking at whether people who smoke cannabis are subsequently more likely to have symptoms of “psychosis” or diagnoses of schizophrenia....
Dr Cohen: This is where dopamine is pumped out into the midbrain. In fact too much dopamine in this area is called the wind of psychotic fire.
Jonica: What a great name. Dr Cohen: And antipsychotic medications block dopamine in this region and ameliorate psychotic symptoms. Jonica: OK, so the mechanism is actually really clear, that this is how cannabis causes psychosis. Dr Cohen: That’s right.
Related articles here. Comments[0] |
Sat, 14 February 2009 ![]() The madness of reefer madness reaches fever pitch. This episode we hear how Harry J. Anslinger gets a clever idea from the "machine gun ban" to devise a truly ridiculous mode of licencing cannabis. This ensures he is able to convince Congress to pass the Marijuana Tax Act of 1937. More articles of interest are in the ever growing pile here. Comments[0] |







