interesting article....

>>
Bad research clouds state death reports
Henry Pierson Curtis
of The Sentinel Staff
Published in The Orlando Sentinel on May 21, 2000

Angry, grieving. 'My son does not belong on that list' of
designer-drug-related deaths, says Joel Waters (above). Mitchell Waters, 15,
(above, right) died of a heart ailment but was taking a prescription that
contained a drug on the list.


Talking about drug deaths. Jim McDonough (center), the state's chief drug
fighter, tells a summit in February in Tallahassee attended by Sen. Toni
Jennings (left) and Rep. John Thrasher about club-drug deaths. His numbers
have since been questioned.



Pearl Mastros, 80, died in a nursing home.

Mitchell Waters, 15, died playing basketball.

Tavani Smith, 4, died in a hospital.

Each of these Central Floridians died of known causes. Yet they and many
others like them were portrayed by the state as victims of designer-drug
abuse.

An analysis by The Orlando Sentinel found glaring mistakes in research by the
Office of Drug Control in its campaign to spotlight the dangers of so-called
"rave" drugs.

Its official tally of rave-drug deaths reached 254. But blaming that many
deaths on the club scene was grossly misleading. The state's research
included dozens of errors.

Lumped together with the deaths of hard-partying teens, the state counted:

Terminal cancer patients who committed suicide.

Senior citizens who took painkillers under doctors' supervision in hospitals
and nursing homes.

A 58-year-old St. Petersburg man who died after a heart-bypass.

Middle-aged abusers of common street drugs.

A Miami crib death.

In Central Florida alone, a computer-assisted Sentinel review found 25 of the
60 local deaths counted by the state had no ties to club drugs. Another 10
deaths already had been counted as heroin-related.

In total, more than half the deaths were from some other cause, and in some
cases, it was clear their inclusion was absurd.

How the state came to identify pre-schoolers and grandmothers as victims of a
drug culture known for pierced tongues and all-night dancing does not have a
simple answer.

Since 1994, Orlando has had a growing problem with club drugs -- GHB,
Rohypnol, MDMA and others. At "house parties" and in more than a dozen clubs
around town, teens and young adults gather to listen to music and dance. And
get high.

Based on the Sentinel's analysis, the death count across Central Florida is
25 -- a tragic statistic, but less than half what the state claims. The drug
office has begun removing cases from the list since the Sentinel raised
questions.

Despite increasing efforts to fight it, the abuse thrives across the state.
Today, the designer-drug craze is the latest hot topic in the drug war.

Florida has jumped into the fight in a big way. Last summer, state officials
staged Operation Heat Rave, a statewide raid on clubs. Then last winter, Gov.
Jeb Bush's staff of drug experts began searching from Key West to Pensacola
for proof of the deadly epidemic stalking nightclubs and the rave scene.

Jim McDonough, the state drug-fighting chief, unveiled the results of that
study at a drug summit earlier this year, using the findings to warn
lawmakers of the dangers ahead, despite progress in his first year as head of
the drug office.

With Bush, Senate President Toni Jennings, R-Orlando, and House Speaker John
Thrasher, R-Orange Park, on the stage behind him, he cited the work as "a
very thorough, autopsy-by-autopsy review." McDonough told the
standing-room-only crowd at the Capitol that club drugs were killing many
more youngsters than anyone had suspected.

Since then, McDonough has defended the work. He asked why a reporter would
question shortcomings in the research instead of helping his staff fight drug
abuse.

"If we made a mistake, we want to correct the mistake," he said. "There's no
attempt here to put out bad data. We are trying to get the facts. We have
discovered that we have a club-drug problem in this state that is immense,
and we want to do something about it."

The Office of Drug Control acknowledges some of its errors. Two dozen deaths
of elderly men and women as old as 84 were deleted from the list after the
Sentinel questioned the findings. In some of those cases, records showed that
the medical examiners involved had urged the state's analysts not to count
them as drug deaths.

And there are other glaring mistakes.

"My son does not belong on that list," said Joel Waters of east Orange
County. His 15-year-old son, Mitchell, collapsed while playing basketball at
school last year. An undiagnosed heart ailment caused his death.

But the teenager had taken Adderall, a drug prescribed by his doctor to treat
an attention-deficit disorder. It contained amphetamine, a drug on the list.
No one in Tallahassee inquired about his cause of death before labeling the
15-year-old honor student as a victim of illegal-drug abuse.

"If they're working to get extra numbers to get extra money, they're working
in the wrong direction," said Waters, a construction contractor. "I worked
for the government. Statistics are something people manipulate."

These days, Florida's drug fight is an enormous effort.

Bush created the Office of Drug Control in 1999 to coordinate prevention,
treatment and enforcement efforts, announcing his goal of cutting drug abuse
in Florida in half by 2004. It coincides with the national drug strategy to
cut abuse countrywide by the same amount.

A key element of the strategy was to make the new office "research-based,
measurable and accountable for performance." To head the program, Bush
brought in McDonough, a former U.S. Army colonel who served as head of
strategy for the Office of National Drug Control Policy from 1996 to 1999. He
supervises Florida's $540 million campaign and is credited with energizing
drug-fighting efforts here.

On Dec. 2, almost a year after McDonough's arrival, the National Institute on
Drug Abuse in Washington, D.C., issued a nationwide alert about the
increasing abuse of designer drugs.

It turned the club scene into the drug war's latest thing. Ten days later,
McDonough's staff contacted the state's 22 medical examiners, saying it
wanted to create a list of all designer-drug-related deaths. Staff members
wanted the information in time for a statewide drug summit on Feb. 11.

The drug office asked the state Medical Examiners Commission to send reports
on every death from 1997 through 1999 that tested positive for any of 20
listed drugs. The request caught the medical examiners unprepared. There is
no uniform system for tracking these drugs.

The Office of Drug Control, interviews and records show, would take
responsibility for deciding which deaths were designer-drug-related. The list
included such common rave drugs as MDMA, an amphetamine-based hallucinogen;
and GHB, a sedative once sold legally in health-food stores.

But it also listed chemicals such as fentanyl, a painkiller, and ketamine, an
anesthetic. Both appear occasionally on the rave scene.

But they also are commonly used in hospitals and veterinary clinics. From the
outset, the state's definition of designer drugs struck medical examiners as
unusually broad. It seemed to some that the Office of Drug Control was asking
for too much, too quickly and without knowing how to analyze it.

"Some of those drugs on their list of 20 designer drugs are not designer
drugs," said Dr. Shashi Gore, chief medical examiner of Orange and Osceola
counties. "Ketamine is not a designer drug. Pure amphetamine is not a
designer drug. Nitrous oxide -- come on! It's a drug of abuse, but not a
designer drug."

Consider the case of Tavani J. Smith, one of the deaths McDonough told
legislators that he had personally reviewed.

No spikey-haired party animal, Tavani was a 4-year-old boy who loved the
Power Rangers and cold milk. He woke up on Feb. 17, 1999, complaining of a
headache that would persist all day. He arrived at the emergency room of
Orlando Regional Medical Center at 9:08 p.m. after his mother consulted her
son's doctor.

Nurses gave the boy several drugs to sedate him so a doctor could do a spinal
tap to test for meningitis. One of those was ketamine.

At 1:25 a.m., Tavani stopped breathing. Autopsy reports show he died from
"probable adverse reaction to ketamine/brevital administration."

But the drug-control staff classified the child as a poly-drug abuser who
died from an overdose of ketamine.

"This is crazy, very crazy. They need to go back to school," the youngster's
grandmother said. "Tavani was a baby. How could they do that? That's crazy."

Steve Lauer, chief of staff and creator of the designer-drug list,
acknowledged that he hadn't known that ketamine was used in hospitals.

Asked about that and other mistakes, Lauer said, "I'm not a doctor. I'm a
layman. I have a large number of these. I simply took what they gave me."

Lauer said he should not have included previously counted heroin deaths. In
some cases, Lauer said he forgot about the advice from the the Medical
Examiners Commission not to count deaths of elderly men and women. And the
details in other cases clearly should have raised questions.

Among them: a 58-year-old man who died the day he left a hospital after a
heart operation, a 52-year-old nursing-home patient who fell and hit his
head, and a 74-year-old cancer patient who died in a Miami-Dade County
hospital from an accidental overdose of morphine.

McDonough said he was too busy overseeing the drug-fighting effort to discuss
cases like that of Rose Pope, 82, who died in St. Petersburgh eight days
after being hit by a car.

The Office of Drug Control blamed medical examiners for the mistaken
inclusion of elderly victims on the list. But the examiners' staffers say the
drug experts in Tallahassee got exactly what they asked for.

"I spent weeks trying to educate them on what they were really looking for. .
. . I talked until I was blue in the face," said Larry Bedore, director of
operations for Dr. Joan Wood, chief medical examiner of Pasco and Pinellas
counties and head of the state Medical Examiners Commission.

One-hundred-fifty pages of memos, draft policies and other correspondence
between the commission and the Office of Drug Control show that medical
examiners had tried to limit the number of drugs to be tracked.

That might have helped to prevent the counting of victims such as Francois
Cineus, a 6-month-old Miami boy who died from sudden infant death syndrome
but who had tested positive for ketamine.

There were other mistakes not quite as obvious as infants and senior
citizens. The original list also included deaths involving drugs that have
been around since the 1940s and don't fit what drug investigators consider
the "party" drug scene.

Locally, for example, the state counted seven amphetamine-related deaths of
middle-aged men, including that of a 42-year-old Lockheed Martin missile
engineer, a 41-year-old man who shot himself after losing his job and a
37-year-old pedestrian killed by a hit-and-run driver.

Gore, the Orange-Osceola medical examiner, said none of those cases should
have been counted as designer-drug-related deaths.

"I think it's very inappropriate. They should have consulted us for sure,"
Gore said. "They need somebody who really knows what's happening."

The reality is that the drug-abuse crisis is complex. People in different age
groups and in different walks of life take different drugs. There is no
one-size-fits-all strategy to combatting the problem. That requires a
sophisticated breakdown of the problem.

For example, amphetamine and a related drug, methamphetamine, can be combined
with other chemicals to make the designer drug Ecstasy. But, by themselves,
they attract a different crowd of users.

"The typical meth user is a completely different stereotype from the typical
party-drug user," said Guy Hargreaves, a special agent with the federal Drug
Enforcement Administration. "There really is a major distinction."

Methamphetamine users in Florida range from teenagers to working men and
women in their 50s and 60s. They are predominantly poor, rural whites or
Mexican-Americans, agents said. Few, if any, have ties to what the Office of
Drug Control considers the rave or club scene, agents said.

"The kids I'm talking about wouldn't know a rave if one crawled up their leg
and bit them," said DEA Special Agent Tom Feeney, head of a High Intensity
Drug Trafficking Area methamphetamine task force in Tampa.

"They call it, 'Poor Man's Cocaine.' "

Designer and party drugs attract a much more affluent group of users. Most
tend to be non-Hispanic, middle class and between the ages of 15 and 25,
according to drug agents working for the DEA, Florida Department of Law
Enforcement and the Orange County Sheriff's Office. The state's list,
however, included 93 deaths of people 35 or older.

Another complication is that these drug deaths are rarely as simple as
someone who sniffed or swallowed one drug. Most of Florida's cases involve
users who mixed a variety of drugs and alcohol.

And many deaths involve car wrecks or other accidents.

Drug-treatment specialists say the flaws in the research are so significant
that they could hurt efforts to convince the public about the deadliness of
designer drugs.

"Questionable data on the nature of the problem will tend to put all data in
question," said Jim Hall, executive director of Up Front Drug Information
Center in Miami and a researcher in trends for the National Institute of Drug
Abuse. "That's certainly a concern we have . . . There's a tendency not to
believe any of that government drug data."

Hall's colleagues working for drug-treatment programs in Tampa, St.
Petersburg, Orlando, Jacksonville, Tallahassee and west Florida voiced
similar concerns. Provide misleading or false information to teenagers -- the
most at-risk group -- and they'll never trust you, they said.




Posted May 21 2000 1:01AM


------------------------------------------------------------------------------
--
Featured Advertisers





------------------------------------------------------------------------------
--
Advertising information









------------------------------------------------------------------------
Missing old school friends? Find them here:
http://click.egroups.com/1/4055/3/_/611428/_/959016173/
------------------------------------------------------------------------

Subscribe/Unsubscribe/List Info:
http://www.onelist.com/community/dancesafe

Want to chat about drugs and their effects?
Join http://www.onelist.com/group/dance-drug-discussion




_______________________________________________________________________
hemp-talk is a discussion list about Washington State hemp politics. To
*UNSUBSCRIBE*, email majordomo@... with "unsubscribe hemp-talk" in
the body of your message. For more details, visit http://hemp.net/lists