In this second part of 'Aropax Hell' we touch on the behind the scenes documentation and "The" memo - "it would be commercially unacceptable to include a statement that efficacy had not been demonstrated, as this would undermine the profile of paroxetine" - that exposed GSK's intention to place the money before the box - as it were. A concerted plan to educate sales rep's from wavering under the strain of humane thoughts was launched.

We touch on Study 329 which produced the very data GSK decided to hide. Self harm, highly addictive and non-efficacy: things look bad for paroxetine. Problems continue to unfold and GSK released studies "showing suicide, hostility, etc". It's clear that the jury verdict [original document] holding GSK 80% liable for the murder-suicide case of Donald Schell was reported widely and led to the BBC Panorama investigation - which actually continues in court today [timeline]. The argument over addiction or discontinuation semantics proceeds splendidly with the courts eventually catching on to the shortfalls of addiction definitions.

BBC Panorama: Secrets of the Drugs Trials - can't see embed? Pop in here.

Struggles with paroxetine are complicated. We can see a gradual "chronology of admission" as GSK confirms dangers effect all ages and quietly reveal it's a major risk during pregnancy. At last after more time - and possibly energy - than earning a PhD, GSK admit what we wanted: paroxetine is an absolute tragedy regardless of age, and can induce suicid ideation in at risk adults.. Thankfully, the FDA agree.

Ultimately, Eliot Spitzer lodged a class action [original PDF] on behalf of New York residents deceived by GSK. The FDA succeeded in agitating for close reviews of paroxetines trials: the famous and detailed Article 31. This episode includes  more out-takes of Dr. Alistair Benbow lying heroically as authours drag his name through mud [2]. GSK itself continually releases token "warnings" and basks in the credit-for-responsibility spotlight.

Our TGA is silent, yet vocal on Straterra - the type of medication one leap up from SSRI's targeting norepinephrine also. Read the documentation, find your own answers. Never use paroxetine - but it is your choice.

This Episode has an Extended News section focusing on the god-bothering moralists distress over those bastions of evil, debauchery and altered consciousness. No, not the pub - The Medically Supervised Injecting Centre. But, this isn't relevant?

Piers Akerman who is a writer for The Daily Telegraph" - Sydneys sister to Melbournes Pulp and Print Court wrote this hysterical gem. Piers, foolishly quotes the misinformative trickery of Drug Free Australia and Dr. Stuart Reece in his hilarious leap from the window sill of journalistic integrity. Kicking off with supportive waffle for The Independent in UK, which raised sales splendidly by "apologising" for a brilliant and much needed call to end prohibition of cannabis a decade ago, Piers races ahead of the Biblical rants of Stuart Reece [last episodes winner] by on-publishing a sentence containing "estimated", "could have" and - my personal favourite - "if" as fact. The tripod holding the sign "run away" snares Piers in one stupefying intellectual thrust. Go Piers!

The Kings Cross Medically Supervised Injecting Centre - Uniting Church report here on why it took the decision - is a world class facility, and recognised as such. The British government is considering such a trial because of this very success. A strict review found the Kings Cross pilot study was a success, other key findings supported Harm Reduction and recommendations were made to commence the same in the UK. Incredibly, in 2007, Australia still has Victorian obsessions with the behaviour of others - as witnessed by the tripe we pay to read, and the fact this "room" is a pilot study.

Whilst an accepted and respected legislative bill gives weight to the need of such facilities. It's up for review this year - hence the efforts of Drug Free Australia to sell it's hysteria. Family and Friends For Drug Law Reform, in March 2007, demolished DFA's so called "report". National experts never question its value. This approach has been repeated by numerous independent bodies. Germany has dozens of these facilities, as they are vital to the public health landscape. Canadas Insite is often attacked with the same non-logic: 'addicts aren't worth the cost of government small change'. Insite also, succeeds in its mission. References abound. Critics write fictional opinion pieces - not science. European Report on "Drug Consumption Rooms" - 97 page PDF.

A full reply to Akermans piece - for which he is yet to apologise to his readers and the health community - from Dr. Ingrid van Beek, the Centres director, on May 3, 2007 is as follows:

Mr Akerman cites Drug Free Australias "review of the statistics" of the first 18 months operation until October 2002, of the Medically Supervised Injecting Centre (MSIC) in Kings Cross, as evidence that it has "failed" (DT 3/5/07) despite a range of health professionals respectfully pointing out the various flaws in its extrapolations over the past several years.

The irrefutable statistics are that in the 6 years the MSIC has now been operating, around 400,000 injecting episodes have occurred in this clinical facility instead of public parks, back alleys and public toilets etc improving public amenity; more than 2,000 drug overdose cases have been successfully treated undoubtedly saving lives and drug users have been referred to treatment and other relevant services on more than 6,000 occasions. Meanwhile the number of drugs users in the Kings Cross area has decreased 40%, the number of ambulance callouts to overdoses has decreased 86% and drug-related crime has decreased 30 - 40%. These facts perhaps explain why 80% of local residents living in the area over these past 6 years support the MSIC.

Please also note that the MSIC is funded by the confiscated proceeds of crime and not tax payer revenue and that I am employed by the Area Health Service and not the Medical Faculty of the University of NSW, which employs the MSIC's evaluation team.

Dr Ingrid van Beek

Medical Director, MSIC.

All articles specific to Aropax/Paroxetine are here

All articles specific to Injecting Facilities are here

Music thanks to Garageband.com

All welcome,

Gags.