Consumer Health Digest #08-38
Your Weekly Update of News and Reviews
September 16, 2008
Consumer Health Digest is a free weekly e-mail newsletter edited by Stephen Barrett, M.D., and cosponsored by NCAHF and Quackwatch. It summarizes scientific reports; legislative developments; enforcement actions; news reports; Web site evaluations; recommended and nonrecommended books; and other information relevant to consumer protection and consumer decision-making.
"Stroke doctor" in trouble again. The Osteopathic Medical Board of California has charged David Steenblock, D.O. with gross negligence, repeated negligent acts, excessive treatments, failure to maintain adequate records, and falsely representing his credentials. Steenblock operates the Brain Cell Therapeutic Clinic in Mission Viejo, California, which claims to "give the maximum amount of recovery possible for stroke and traumatic brain injury." The complaint states that he charged a 77-year-old stroke patient more than $26,000 for services that included 87 sessions of hyperbaric oxygen, 84 physical therapy treatments, 20 intravenous treatments, and 8 testosterone injections. Steenblock asserts that stroke victims suffer from a long-term lack of oxygen to the brain cells and that his neuro-rehab program is "designed to bring oxygen back to these starved cells, reduce swelling, and provide the nutrients needed to help the cells remove their waste and restore normal metabolic function." However, there is no scientific evidence that increasing oxygen delivery to the brain after an acute episode of stroke is over can stimulate cells to regenerate.
This is the third time Steenblock has been in trouble. In 1991, he was charged with negligence in connection with two patients he had treated. In 1994, the case was settled with a stipulation under which he agreed to serve five years of probation, pay $10,000 for costs, and take extra continuing education courses in pharmacology, medical charting, and ethics. In 1997, Steenblock was charged with violating his probation by not paying the $10,000 assessment and by using three unlicensed "physical therapy assistants" to administer patient services. (In 1997, the employees were convicted of practicing physical therapy without a license.) In 2000, after Steenblock had paid the $10,000 and hired a licensed physical therapist to supervise the others, the board assessed another $3,500 toward costs but decided not to penalize him for "aiding and abetting the unlicensed practice of physical therapy."
New book can help parents decide about HPV vaccine. The HPV Vaccine Controversy, by Shobha S. Krishman, M.D., dissects the arguments for and against administering human papillomavirus vaccine (Gardasil) to preadolescent girls. HPV infection can cause genital warts, about 70% of cervical cancers, and several other types of cancer. The vaccine can sharply reduce the incidence of these cancers, but, for maximum effect, must be given before sexual activity begins. In the United States, more than 20 million people are infected and about 6 million get a new genital HPV infection each year. Proponents argue that the only way the vaccination can work as a public health measure is if it is widely used. Opponents claim that its use will endorse and encourage teenage sexual activity, although no scientific data support that belief. There is also controversy about whether HPV vaccination should be mandated or offered on a voluntary basis. In 2006, the FDA approved Gardasil for preventing cervical cancer in girls and women ages 9 to 26. This month, the agency added approval for preventing vulvar and vaginal cancers. [FDA approves expanded uses for Gardasil to include preventing certain vulvar and vaginal cancers. FDA news release, Sept 12, 2008] The FDA Web site has additional information.
Illegal Internet drug prescribing is widespread. Columbia University's National Center on Addiction and Substance Abuse (CASA) has reported on the availability of controlled drugs through online pharmacy sites. During the first quarter of 2008, CASA's investigators found that about 85% of 365 Web sites that advertised or sold drugs like OxyContin, Valium, Xanax, Vicodin, Ritalin, and Adderall did not require a prescription. The 28-page report—"You’ve Got Drugs!" V: Prescription Drug Pushers on the Internet—is CASA's fifth annual White Paper on this subject. The report also notes:
- Of the sites not requiring prescriptions, 42% explicitly stated that no prescription was needed, 45% offered cursory “online consultations,” and 13% made no mention of a prescription.
- Some sites sold prescriptions that could be filled at local pharmacies.
- Of the few sites that require prescriptions, half permit them to be faxed, allowing significant opportunity for fraud.
- Only two of the sites were certified by the National Association of Boards of Pharmacy as Verified Internet Pharmacy Practice Sites.
- Benzodiazepines (like Xanax and Valium) continue to be the most frequently offered drugs for sale with 90% of sites selling them; followed by opioids (like Vicodin and OxyContin) at 57% of sites, and stimulants (like Ritalin and Adderall) at 27%of sites.
- The U.S. Drug Enforcement Agency estimates that in 2007, 11% of prescriptions filled by traditional pharmacies were for controlled substances compared to 80% of prescriptions filled by Internet pharmacies.
- No controls block access to these sites by children and teens.
The CASA report recommended that Internet search engines block all advertisements for controlled prescription drugs that do not come from licensed and certified online pharmacies and that the United States negotiate treaties with foreign governments to help curb the problem. The report can be purchased in print form or downloaded free of charge from CASA's Web site.
This page was posted on September 18, 2008.