The trouble with pharmaceutical abuse

By Aaron Wherry - Tuesday, November 20, 2012 at 1:53 PM - 0 Comments

While Leona Aglukkaq writes to the provincial health ministers about OxyContin and prescription drug abuse, John Geddes questions the Harper government’s approach.

Health Minister Leona Aglukkaq might have a point when she argues that banning a generic version of OxyContin, as some provincial governments have urged her to do, would amount to unfairly taking aim at a “tempting political target,” while in the process ignoring proper procedure for approval of prescription drugs.

But if Aglukkaq is right that new versions of highly addictive controlled-release oxycodone should be allowed for the sake of patients who would benefit, she leaves open a bigger question: Why has Conservative policy stubbornly insisted on pretending that prescription drug abuse is an issue separate from the abuse of illegal drugs?

‘Flight’ is fit to fly

By Brian D. Johnson - Tuesday, October 30, 2012 at 10:37 AM - 0 Comments

Paramount Pictures

Not everyone has a fear of flying. But what if the smooth-talking captain on your morning flight had just swigged the last of a beer left on the hotel night table, smoked some pot, snorted a line of cocaine to jolt himself awake, then slipped two mini-bottles of vodka into his orange juice before taking off into violent turbulence? So goes the opening sequence of Flight, a compelling new film starring Denzel Washington as an addicted airline pilot named Whip. And that’s only half the premise. Shortly after takeoff, a mechanical failure sends the plane into a harrowing nosedive. Whip, a former fighter pilot, rolls the aircraft upside down to stop the dive and executes a miraculous crash landing that saves most of the passengers. Then the movie turns into an addiction drama, as the pilot’s heroic feat is tarnished by an inquiry into his fitness to fly.

What’s remarkable is that this picture comes from director Robert Zemeckis, the former whiz kid best known for such wholesome fare as Back to the Future and Forrest Gump, and the motion-capture animation of Polar Express and Beowulf. In the past three decades, the closest he’s come to provocation is Who Framed Roger Rabbit’s cartoon vamp sighing, “I’m not bad, I’m just drawn that way.” With Flight, the director tackles his first live-action movie since Tom Hanks shared a beach with a volleyball in Cast Away (2000). And it opens with a full frontal shot of a naked flight attendant crawling out of our hero’s hotel bed. After the crash, as a gonzo drug dealer (John Goodman) waltzes into his hospital room to the tune of Sympathy for the Devil, we could be watching a Scorsese film.

“You make the movie you’re making,” Zemeckis shrugs when asked about his sudden move from special-effects blockbusters to risqué drama. “We were going to get an ‘R’ for cigarette smoking, so we might as well tell the truth.” The U.S. R rating requires adult accompaniment for viewers under 18. “You can’t make a movie like this for $150 million. It cost $30 million—both Denzel and I waived our fees.”

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The end of the dry reserve?

By Charlie Gillis - Thursday, April 19, 2012 at 10:31 AM - 0 Comments

Fernando Morales/The Globe and Mail/CP

As a young man in the mid-1980s, Glenn Pelletier took elaborate steps before coming home to the Cowessess First Nation, the reserve in southeastern Saskatchewan where he grew up. Pelletier, who was working in Calgary at the time, would pull over his 1972 Mercury Montego before reaching reserve land so he could stash his weekend supply of whisky in his rusted hulk of a car. Cowessess was a dry community—or so Pelletier thought. “I figured if I got stopped there and the cops found my liquor, they’d take it away,” he says. “So I’d put it under the seat, in the trunk, in a suitcase. Wherever.”

Years later, Pelletier learned the truth: Cowessess was not officially dry in those days, and never had been. All that time, his elders had hoodwinked him and his friends, throwing around the phrase “dry reserve” so often the youngsters assumed the band had passed a bylaw imposing prohibition. It was a masterpiece of brainwashing—and testimony to the power of an idea. At the time, the “dry” movement was sweeping Aboriginal communities across Canada, where leaders saw it as a means of curbing the catastrophic effect of alcohol abuse on their populations. Why wouldn’t Cowessess do the same?

Much has changed. Pelletier, now a band councillor, hasn’t taken a drink in seven years. And prohibition is an idea that he and many Aboriginals are happy to leave behind. In February, 67 per cent of residents in the remote Arctic hamlet of Kimmirut voted to rescind their dry status, bringing the number of dry communities in Nunavut to six, down from eight just a few years ago. Voters opted instead for a system where residents wishing to ship liquor into the community can apply to an “alcohol education committee.” The decision stunned outsiders, because Kimmirut had been the site of an alcohol-fuelled shooting of a young RCMP officer in 2007, an incident that drew nationwide attention to the hamlet’s substance abuse problems.

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Not exactly an accurate reflection

By John Geddes - Friday, December 3, 2010 at 9:40 AM - 134 Comments

Government video of DrugsNot4Me.ca

There’s no denying the federal government’s new anti-drug TV ad tells a disturbing story. A freshly scrubbed adolescent in her well-appointed bedroom looks like she might be about to relax with a couple of Justin Bieber tunes. Instead, an eerie soundtrack starts up. “One, two, kicked out of school,” sings a hollow, girlish voice straight out of a horror-movie trailer. “Three, four, snort some more.” Soon she’s trashing the room, then randomly snipping off some of her own hair, and finally scratching at the angry needle marks on her forearm. “Five, six, need my fix.” It’s a relief when the spooky carousel music stops and a calming adult narrator advises kids to check out Health Canada’s DrugsNot4Me website.

The ad, which is called “Mirror,” was launched on Nov. 17 by Health Minister Leona Aglukkaq. Her department is spending $1.06 million to make the spot so ubiquitous on teen-oriented TV that two-thirds of 13- to 15-year-olds are expected to see it by next March. The Conservatives also hope it carries a message for their mothers and fathers. “To Canadian parents,” Aglukkaq said, “we’re on your side, and you have our support in helping your kids say no to drugs.” Few would argue with that goal, of course, but researchers and front-line doctors who work with teen addicts are critical of key elements of the strategy.

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No screen test available

By Julia Belluz - Thursday, September 16, 2010 at 1:20 PM - 0 Comments

Tara Walton/Toronto Star

When Michael Douglas announced in August that doctors had found a walnut-sized tumour at the base of his tongue, he explained that the cancer was caused by years of carousing: “I smoked cigarettes and I drank,” he said matter-of-factly, “and this particular type of cancer is caused by alcohol.”

That smoking leads to cancer of the oropharynx—the tonsils, soft palate, side and back walls of the throat, and base of the tongue—is well-known. But less familiar to many is the link between heavy alcohol consumption and cancer. As a recent study in the journal Head & Neck showed, 60 per cent of patients diagnosed with oral cancer identified smoking as a cause, while 20 per cent said alcohol. The medical community, however, has long known about the correlation, and now Douglas—who was treated for alcohol and substance abuse in 1992—is proving to be the de facto spokesperson for the disease.

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Testing junior for drugs

By Josh Dehaas - Thursday, September 16, 2010 at 9:20 AM - 0 Comments

Getty Images

A municipal council in the Netherlands wants to help parents find out whether their children are using drugs. So Edam-Volendam (where the famous Edam cheese is made) will supply 1,500 home testing kits for parents with children aged 15 to 19. The kits can find traces of cannabis, cocaine, amphetamines, opiates and PCP, among other illicit drugs, in saliva. The aim is to address the town’s drug problem, which is the fourth highest in the province of North Holland.

Councillor Gina Kroon-Sombroek told Radio Netherlands that the kits could help discourage children from taking the drugs in the first place. “Parents can say, ‘I’ve got that test, so bear in mind you can be tested.’ Our hope is that it’ll stop young people experimenting with drugs,” said Kroon-Sombroek. Interestingly, despite a liberal drug policy, young people in the Netherlands consume far less drugs than other teens. A 2008 study by the World Health Organization found that only 35 per cent of Netherlanders had used cannabis by the age of 21, compared to 54 per cent of Americans. As for the test, Edam-Volendam’s council said it will be easy for parents to use. That may be true, assuming they can convince their teenagers to provide a saliva sample on demand.

Science-reporting smell test of the week

By Colby Cosh - Tuesday, May 4, 2010 at 2:26 PM - 80 Comments

Here’s the lede of a science story from Saturday’s Winnipeg Free Press:

WINNIPEG — Depression and substance abuse plague about half of American women who reported having an abortion, according to a new University of Manitoba study.

The study, published in the current issue of the Canadian Journal of Psychology, suggests there’s an association between mental disorders and abortion…

Eager to investigate this shocking headline claim—the Edmonton Journal, picking up the story, literally gave it the headline “Depression or drug abuse found in half of women who aborted”—I set out to find the study. This presented something of a problem, since there has not been a “Canadian Journal of Psychology” since 1993. I spent a little while rifling through Canadian Psychology and the Canadian Journal of Experimental Psychology until a helpful reader on Twitter clued me in. Yes, you guessed it: it can be found in the Canadian Journal of Psychiatry. First place I should have looked, really.

That’s an understandable mistake. It’s a bit more of a problem that the first sentence of the article—an article that includes a warning from the lead author to the effect that it is “important the study is not misinterpreted”—is totally false. Because of, y’know, misinterpretation.

The paper, entitled “Associations Between Abortion, Mental Disorders, and Suicidal Behaviour in a Nationally Representative Sample”, does what it says on the tin: the data are taken from interviews with a demographically representative subset of the U.S.’s National Comorbidity Survey Replication project. It is hard to know what numbers the reporter added or multiplied or pulled out of a hat to reach the conclusion that “Depression and substance abuse plague about half of American women who reported having an abortion.” (I spoke to the lead author of the study, and she can’t figure it out either.) But a good guess would be that she looked at this section from the article’s main chart—

—and simply added together the estimated lifetime incidence of depression among women who had had an abortion (29.3%) and the lifetime incidence of substance-use disorders (24.6%). It will probably have occurred to you that there might be some overlap there between depression and substance abuse, which go together like poached eggs and hollandaise. You don’t need a Ph.D. to know that the depression group is likely to contain almost all of the women in the substance-abuse group.

And this naïve math (which is hardly attributable to a failure to grasp hyper-advanced statistics) is compounded by the wording of the offending sentence, which doesn’t say that “some percentage of abortion recipients have, at some point before or after getting an abortion, experienced depression or substance abuse or both.” It uses present tense, unjustifiably implying that all the women in question are plagued by both problems now.

This mess is already being picked up, “carelessly” garbled even further, and circulated around the globe by pro-lifers, despite the personal entreaties of the scientist who helped the newspaper with its reporting and the many, many methodological and interpretive caveats in the original study. This kind of thing is exactly why a lot of scientists hate talking to reporters. Nor does it make sincere research into therapeutic abortion any easier. The UM study can’t be used to attribute psychiatric morbidity to abortion, but it could be used by fair-minded pro-lifers (let’s assume for the sake of argument that there were some) to raise questions about abortion’s place in our society and argue for a research program.

Oh, I know: we’re a hundred years away from that kind of discussion being possible. But the inadvertent propagation of urban legends only pushes that day further into the future.