“One of the saddest lessons of history is this: If we’ve been bamboozled long enough, we tend to reject any evidence of the bamboozle. We’re no longer interested in finding out the truth. The bamboozle has captured us. It is simply too painful to acknowledge — even to ourselves — that we’ve been fooled.” — Carl Sagan, “The Fine Art of Baloney Detection” (February 1, 1987)

This morning, just as I was about to start writing my weekly Duty to Warn column, I glanced through the Duluth News-Tribune and couldn’t help but notice a full-page ad on page A3. The ad was titled “Rallying to Address Opioid Addiction”. The color-printed ad likely cost well over a thousand dollars and was paid for by an entity that I had never heard of before called “Rx ALI Minnesota” (Rx Abuse Leadership Initiative). The group was apparently a fresh new “alliance” of “concerned” corporate entities that were suddenly interested in the opioid crisis that is affecting all portions of America.

Or maybe the interest of some of the major alliance entities sponsoring the ad had some ulterior motives, such as trying to obscure the guilt that they should be acknowledging in actually causing the addiction and suicidality crises in the first place, wanting to pretend to be a part of the solution rather than admitting that they were a major cause for the crisis. Big Businesses often finagle their way into positions of power and influence when decisions are being made that might affect their share price and prestige. 

I recalled reading an editorial a few days ago in the Duluth News-Tribune that was written by the CEO of CADCA (Community Anti-Drug Coalition of America, one of the ad sponsors) concerning the opioid crisis. CADCA’s HQ and its CEO are both located in the Washington, DC area, so what motivated him to specifically write to Duluth? Many of today’s News-Tribune ad sponsors were named in that December 13, 2018 editorial. I knew right away that the proximity of the two items was no coincidence.

So I had to dig further.

Among the 16 named corporate entities that were listed in the ad, I was first alerted by the inclusion of PhRMA, the notorious billion-dollar trade association that represents hundreds of wealthy, politically powerful – and very sociopathic - pharmaceutical corporations that have truly been the major causes of prescription drug addictions, prescription drug over-doses (both accidental and intentional), prescription drug-induced mental ill health, prescription drug-induced physical and mental disabilities, prescription drug-induced shortened lifespans, prescription drug-induced dementia, prescription drug-induced poverty/homelessness (because of prescription drug unaffordability) and prescription drug-induced suicidality. 

Here is a list of some of the entities that were trying to keep hidden the deep-pocketed pharmaceutical corporations that were trying to finagle their way into the efforts of well-meaning groups that are honestly addressing the crisis:

1) PhARMA, which represents all American Big Pharma corporations, is also in partnership with a number of the other groups in the News-Tribune ad. Being naturally suspicious of the ulterior motives that seem to be behind every Big Pharma corporation’s marketing schemes – as we all should be. Every “good deed” that comes from Big Business corporation needs to be regarded with caution.

I checked the websites of the seven seemingly most influential groups of the 16 for details on their hidden corporate sponsors, the boards of directors, the CEOs and the staffs, and I discovered many conflicts of interest that were listed in the websites. Following is a partial list of the other six groups that had the most to hide. I leave it up to the reader to figure out what is going on.

2) The Addiction Policy Forum (APF, with a $17,000,000 annual budget) takes money from Dublin-based Alkermes Pharmaceutical corporation which manufactures opioid drugs, opioid antagonists and brain-damaging anti-psychotic drugs, including the notoriously neurotoxic anti-psychotic drug respiridone. APF also takes money from a British drug company called Indivior, which makes a new type of depot antipsychotic drug (actually respiridone) that only requires monthly injections. The CEO of Indivior is on one of the APF’s boards.

3) CADCA (the Community Anti-Drug Coalition of America) also takes money from Alkermes; Purdue Pharma, L.P., the notorious marketer of OxyContin (!); Johnson & Johnson (which, among hundreds of other medicinal products, used to aggressively market the highly addictive childhood “ADHD” drug Concerta (identical to Ritalin), the anti-psychotic drugs Risperdal and Invega and is now marketing the monoclonal antibody drug Remicade, which costs upward of $19,000 a month (which equates to $228,000 per year). CADCA also takes money from Mallinckrodt PLC which markets the highly addictive drugs Hydrocodone, Oxycodone, Methylphenidate (generic Ritalin) and Dextroamphetamine sulfate. Other drug companies that give money to CADCA include ENDO, Verde Technologies and Ortho-McNeil (which markets tramadol, a synthetic opioid).

4) JUSTUS Health, takes money from Johnson & Johnson, Pfizer (the biggest pharmaceutical company in America, which markets the addictive SSRI antidepressant Zoloft, the dependency-inducing and brain-damaging antipsychotic Geodon and the highly addictive benzodiazepine Xanax) and Janssen (which markets Percodan [an older synthetic opioid], two anti-psychotics, Haldol and Respirdal and even Fentanyl (!).

5) The MRHA (Minnesota Rural Health Association) has as its current president, Sue Obderholden, who is a long-time member of NAMI (National Alliance on Mental Illness) the notorious national organization that is heavily funded by PhRMA and every Big Pharma corporation in America that makes and markets psychiatric drugs, many of which are highly addictive and brain-altering. Among NAMI’s many Big Pharma corporate sponsors are Alkermes, Janssen, TEVA, Lilly, etc;

6) NCL (National Consumers League) which recently promoted a pharmacy organization’s campaign called “Remember to Take Your Medication Month”. 

7) Lakeville Public Safety Foundation (which innocently accepted a $10,000 grant from PhARMA and the Addiction Policy Forum (to promote safe used-prescription drug disposal in the Lakeville, MN area)
I didn’t take the time to check for any conflicts of interest in the smallest sponsoring organizations that were listed in the ad. I believe that veteran’s groups, sheriff’s departments, realtors and the Grange have no ulterior motives or conflicts of interest and are just altruistically interested in being part of the solution of a true medical/pharmaceutical crisis. 

It needs to be noted that the current chairman of the PhRMA board is the CEO of Biogen, the CEO of Johnson & Johnson is the chairman-elect of the PhRMA board and the board treasurer is the CEO of Novartis (Ritalin, Clozaril, Focalin (dexmethylphenidate). 

The following information about Big Pharma was mostly obtained from Wikipedia:

“Antipsychotic drugs are now the top-selling class of pharmaceuticals in America, generating annual revenue of about $14.6 billion. Every major company selling the drugs - Bristol-Myers Squibb, Eli Lilly, Pfizer, AstraZeneca and Johnson & Johnson - has either settled recent government cases, under the False Claims Act, for hundreds of millions of dollars or is currently under investigation for possible health care fraud. Following charges of illegal marketing, two of the settlements set records last year for the largest criminal fines ever imposed on corporations. One involved Eli Lilly’s antipsychotic Zyprexa and the other involved Pfizer’s Bextra (a Cox-2 inhibitor whose mechanism of action is similar to Merck’s notorious anti-inflammatory drug Vioxx and Pfizer’s Celebrex). In the Bextra case, the government also charged Pfizer with illegally marketing its antipsychotic, Geodon; Pfizer settled that part of the claim for $301 million, without admitting any wrongdoing. 

“On 2 July 2012, GlaxoSmithKline pleaded guilty to criminal charges and agreed to a $3 billion settlement of the largest health-care fraud case in the U.S. and the largest payment by a drug company. The settlement is related to the company’s illegal promotion of prescription drugs, its failure to report safety data, bribing doctors, and promoting medicines for uses for which they were not licensed. The drugs involved were Paxil, Wellbutrin, Advair, Lamictal and Zofran for off-label, non-covered uses. Those and the drugs Imitrex, Lotronex, Flovent, and Valtrex were involved in kickback schemes.“ 

To conclude this week’s column, I attach one of my old Preventive Psychiatry E-Newsletters (which I published while I was still in practice) from 2005 concerning prescription drug-induced suicidality. 
The article was written by Dr. Ann Blake Tracy, and the original research was done by Dr Ari Khan and colleagues. The original papers were first published in 2001, but the important data was widely ignored by the FDA, the CDC, the NIH, the NIMH, the AMA, the APA, the AAFP and every psychiatrist and physician and every Big Pharma corporation that should have been paying attention (if the well-being of their patients was really important, that is). 

Obviously the corporate elites that decide what research gets proper attention had no interest in these truths mentioned below. The share prices of the makers and marketers of brain-altering prescription drugs would have been badly impacted if Khan’s research had been given proper publicity. These corporate elites, some of which are listed above, had the power to bamboozle anybody and everybody, including both the mainstream media and the medical professional media. 

Read the following important suicidality information from back in 2002 and weep.

Preventive Psychiatry E-Newsletter # 18

Astonishing 6,500+% Increase in Rates of Completed Suicides from BOTH SSRIs and Atypical Antipsychotics!! 

By Dr. Ann Blake Tracy, Executive Director,
International Coalition for Drug 
Awareness – 9-8-2002

First we had the thalidomide tragedy, the fen-phen fiasco, then LSD and PCP as prescription drugs, yet none of them begins to compare with the following scandal. Never in the history of the FDA do I recall something as tragic or terrible or as shocking or as criminal as this revelation is! Mass murder by prescription is the only expression that fits.

 
Blockbuster Study - 68 Times Greater 
Suicide Risk with Serotonergic Meds!

New research presented at a recent NIH  (National Institute of Health) sponsored meeting demonstrates a 68 times greater risk of suicide with the new serotonergic antidepressants (SSRIs) and (so-called “atypical”) antipsychotics than if a patient never took anything.
These shocking figures of increased risk show that a patient’s chances of suicide jump from 11 out of 100,000 to as much as 718 out of 100,000 if one is taking one of these new SSRI antidepressants (Prozac, Zoloft, Paxil, Luvox, Celexa) - medications touted to alleviate depressive symptoms and rid one of suicidal tendencies. And the risk is even higher for the new serotonergic antipsychotics (Zyprexa, Risperdal, Seroquel) - 752 out of 100,000!
Our gratitude for alerting us to this new research goes to Vera Hassner Sharav with the Alliance for Human Research Protection (AHRP) (www.researchprotection.org)
Dr. Arif Khan presented his research at a recent meeting sponsored by the National Institute of Mental Health. This was a meeting of the New Clinical Drug Evaluation Unit. The essence of the research was an analysis of the data on the suicide rate for patients who participated in the clinical trials for these new drugs - over 71,604 people. Now these are the clinical trials where these drugs were tested on the public to see if they were “safe and effective.” This clinical data is then presented to the FDA for approval for marketing of these new compounds.

In his presentation Dr. Khan made note of what we learned long ago when this information was revealed through court documents in SSRI wrongful death cases - that is, that “actively suicidal” patients are excluded from the clinical trials on the SSRI antidepressants. What he found shocking about this is that despite the fact that actively suicidal patients were excluded from these clinical trials the suicide rate among those taking these medications ABSOLUTELY SKYROCKETED from 11 out of 100,000 to 718 out of 100,000!! (718/11 = 6500% increase.)

What is really frightening at this point is the realization that millions of patients are going into withdrawal from these drugs. The rapid or abrupt withdrawal from these antidepressants can produce suicide, mania, seizures, psychotic breaks, etc. at an even greater rate than while on the drugs. Extreme caution MUST be taken.

Here are the suicide rates (for the 5 classes of prescription drugs that were analyzed by Khan). Keep in mind as you read through these that the rate of 11 out of 100,000 persons per year is the suicide rate for the population at large.

1) 752 per 100,000 for those treated with atypical antipsychotics--risperidone (Risperdal), olanzapine (Zyprexa), and quetiapine (Seroquel); (752/11 = 6800% relative risk increase)

2) 718 per 100, 000 for those treated with the SSRIs - Selective Serotonin Reuptake Inhibitors (Prozac, Zoloft, Paxil, Luvox, Celexa); (718/11 = 6500% relative risk increase) (See the American Journal of Psychiatry article for the analysis of suicidality and antidepressant drugs at: Khan A, Khan S, Kolts R, Brown WA. “Suicide rates in clinical trials of SSRIs, other antidepressants, and placebo: analysis of FDA reports,” Am J Psychiatry 2003;160: 790-2.)

 
3) 425 per 100, 000 for those treated for “social anxiety disorder” with nefazodone (Serzone), mirtazapine (Remeron), and bupropion (Wellbutrin/Zyban); (425/11 = 3800% relative risk increase)
 
4) 136 per 100,000 for those treated for panic disorder--with benzodiazepine alprazolam (Xanax); (136/11 = 1200% relative risk increase)

5) 105 per 100, 000 persons for those treated for obsessive-compulsive disorder with anticonvulsant valproate (Depakote). (105/11 = 950% relative risk increase)

These figures clearly speak for themselves. A massive number of wrongful death suits will obviously follow, but at least loved ones will know why they have lost those who meant so much to them via such tragic circumstances.

Keep in mind as you read through this data that the new “atypical” anti-psychotics listed here are basically a combination of the older anti-psychotics and the SSRIs. They too have a strong effect upon serotonin levels, (actually blocking serotonin receptor sites as well as dopamine – Ed note). 

Also the most likely reason researchers saw an even higher rate of suicide in placebo with the anti-psychotics is that these patients were likely being abruptly discontinued from their older anti-psychotics for the clinical trials. This abrupt withdrawal can easily cause suicidal depression.

Dr. Ann Blake Tracy, Executive Director, International Coalition for Drug Awareness
www.drugawareness.org and author of Prozac: Panacea or Pandora? - Our Serotonin Nightmare (800-280-0730)

No Credible Evidence for Anti-Suicidal 
Effect from Psychotropic Drugs

Carl Sherman, Contributing Writer 
to Clinical Psychiatry News Online

BOCA RATON, FLA. - Psychotropic therapy did not appear to have a marked impact on suicide risk, examination of a large database indicated-in fact, no class of medication had much more or less effect than placebo, Dr. Arif Khan said at a meeting of the New Clinical Drug Evaluation Unit sponsored by the National Institute of Mental Health.

Overall, attempted and completed suicides among patients with diverse psychiatric conditions are substantially more frequent than had been expected, the analysis suggested.
“Given that suicide is such a complex behavior ... we have to ask if medication is the only way to [approach] it,” said Dr. Khan of Northwest Clinical Research Center, Bellevue, Wash.
The conventional response to suicidality in psychiatry is pharmacotherapy. The assumption that this will be beneficial “is never challenged much,” Dr. Khan said, and raises ethical questions about clinical trials, such as whether patients assigned to placebo may be exposed to increased mortality risk. Some observers, on the other hand, have suggested that psychotropics may themselves increase the risk of suicide.

In fact, the only biologic treatments for which there are many data on this score are ECT and lithium, which have been shown to reduce suicidality. More limited data support a similar effect for clozapine.
Dr. Khan reported an analysis of clinical trial data for drugs approved by the Food and Drug Administration between 1985 and 2000. This included suicide and attempted suicide rates for more than 71,604 patients treated with the atypical antipsychotics risperidone (Risperdal), olanzapine (Zyprexa), and quetiapine (Seroquel); all the selective serotonin reuptake inhibitors Prozac, Zoloft, Paxil, Luvox, Celexa; nefazodone (Serzone), mirtazapine (Remeron), and bupropion (Wellbutrin/Zyban); the benzodiazepine alprazolam (Xanax; and the anticonvulsant valproate (Depakote).

One striking finding was the elevated rate of completed suicides for patients during these trials. Compared with the rate of 11/100,000 persons per year for the population at large, the rates of completed suicide were 752/100,000 persons per year for those in anti-psychotic trials; 718 in antidepressant trials; 425 in trials of medication for social anxiety disorder; 136 for panic disorder; and 105 for obsessive-compulsive disorder.

This was particularly surprising in light of the attempt, in most clinical trials, to exclude patients who are actively suicidal, Dr. Khan said.
Figures on attempted suicide found similarly increased risk. The figures implied that 5% of patients who enroll in anti-psychotic trials will attempt suicide in the following year; 3.7% of those in antidepressant trials will make an attempt; and 1.2% of those in trials of medication for anxiety disorders will attempt suicide.

Suicide rates were higher, in the trials taken as a whole, for patients who were assigned to placebo than to the investigational drug (1,750/100,000 persons per year vs. 710/100,000 persons per year). But because participants were exposed to placebo for far less time than to the drugs (a mean of 33 days vs. 148 days), this could not be assumed to indicate an anti-suicidal effect of medication, he said. (The most likely reason researchers saw an even higher rate of suicide in placebo with the anti-psychotics is that these patients were likely being abruptly discontinued from their older anti-psychotics for the clinical trials. This abrupt withdrawal can cause suicidal depression. – Ann Blake Tracy)

In the case of trials for depression and anxiety disorders, suicide rates were in fact higher among those who received the investigational drug than placebo, Dr. Khan said.
The high rates of suicide among patients studied might suggest an “iceberg effect” in the general population. The numbers that come to light under the close scrutiny of the clinical trial situation indicate the extent to which attempted and completed suicides are concealed or mislabeled in the community, Dr. Khan speculated.