According to a April report in the Arizona Daily Star, the program in Integrative Medicine at the University of Arizona is running $1 million in the red and must significantly cut patients and staffing. The first to go is Dr. Andrew Weil's $160,000 annual salary which was slashed to zero. The report states that the program is entirely dependent upon private support and has never received any funding from the university or state. For unknown reasons, the donations fell off this year. At the time of the report, the clinic was treating about 200 patients, whose status will not be affected--however, those on the waiting list will have to wait longer for admission. Officials hope to restore the program to financial stability by the beginning of next year. University officials plan to ask the state legislature for about a million dollars of support next year. There is optimism that legislators who personally favor CAM will come to the rescue.
From the sad but true department: Louise Lortie, a "naturotherapist," was sentenced by a judge in Hull, Quebec to three years in prison for the death of a 12-year-old diabetic girl. The judge found Lortie guilty of criminal neglect after she recommended that her patient rely on a combination of salt baths and herbal remedies instead of insulin to treat her diabetes. Three days later the Lisanne Manseau girl died in a diabetic coma. Crown prosecutor Martin Cote noted in an interview outside the courtroom, "The message that had to be sent to the community had to be clear and, as I told the judge, when you have someone who has access to the media and who indicates that she's not responsible for her actions, that it's someone else's fault, it's important that the judge takes that into consideration and sends a very loud and clear message that that's not to be repeated." [Christopher Guly, The Ottawa Citizen, c.February, 2000]
Carol Norred, a Certified Registered Nurse Anesthetist (CRNA), researcher and PhD candidate at the UCHSC Department of Anesthesiology and School of Nursing, recently published a study in the American Association of Nurse Anesthetists (AANA) stating that patients who use complementary and alternative medicines within two weeks of surgery may experience adverse side effects. The study, titled "Use of Complementary and Alternative Medicines by Surgical Patients," appears in the February issue of the AANA Journal. She studied 500 patients having elective surgery and found evidence of likely side effects from the use of unconventional medicines taken up to two weeks before surgery. The study goes on to categorize complementary and alternative medicines (CAM) according to potential "adverse effects" with drugs used during surgery. The study concluded that some supplements can increase bleeding and prolong coagulation time during surgery. These include alfalfa, chamomile, some Chinese herbs, garlic, ginkgo, kava, licorice, vitamin E and fish oil. Supplements such as Black Cohosh, used to treat menopause, menstrual cramps and osteoporosis, tend to lower a patient's blood pressure during surgery. Conversely St. John's Wort, used to control depression, was found to raise blood pressure as well as cause confusion, agitation and drowsiness in surgical patients. Norred believes that more scientific research is needed to safely integrate CAM into the management of surgical patients. As always, an "open dialogue between patients and providers can prevent complications related to the use of unconventional medicines." The AANA advises full disclosure of herb, vitamin supplement use before any surgical operation. [Park Ridge, IL, BW HealthWire, 3/14/00 via NewsEdge Corporation]
A 10-year-old girl suffocated during a "rebirthing" process. Candace Newmaker of North Carolina, was wrapped tightly in a blanket and pillows to simulate a womb. Therapists would push on the "womb" to simulate uterine contractions. Candace, an adopted child, had not bonded with her parents--a condition termed "attachment disorder." Therapists theorize that re-enacting the birth experience may enable the patient to relive early developmental phases that were missed. A video tape of the session revealed that the girl told her therapists seven times that she could not breathe. The therapists urged her to push her way out of the blanket through a twisted end. Therapists Brita St. Clair, Jack McDaniel, and Julie Ponder, all employees at Connell Watkins and Associates counselling office, which specializes in "attachment therapy, in Evergreen, Colorado were arrested and charged with "child abuse resulting in death." The charge carries a 16-year minimum mandatory sentence, and a maximum 48 years in prison. Watkins has been ordered to discontinue rebirthing in her practice. [Reuters, 5/18/00; and 5/23/00]
Chai-Na-Ta Corp, the world's largest producer of North American ginseng, filed for creditors' protection under the federal Companies Creditors Arrangement Act in the British Columbia Supreme Court. It seems the market prices for North American ginseng has fallen drastically in recent years. As recently as 1996, the suburban Langley, BC-based firm was among the Toronto Stock Exchange's Composite Index 300. But it has fallen on tough financial times as the international price for ginseng root plummeted in recent years. According to Chai-Na-Ta president Gerry Gill, the entire industry is under pressure as prices continue to decline. "Market prices for North American ginseng continue to be depressed, putting the entire industry under pressure," Chai-Na-Ta's stock price on the TSE hit close to $26 in March 1994. However, on November 12, 1999, the stock closed at 27 cents. The company has been trying to refinance its debt with it's principle lenders. Gill believes that market conditions will improve as the ginseng supply declines. Currently, 99% of Chai-Na-Ta's ginseng harvest is exported through Hong Kong to China and southeast Asia. It's widely used there for its medicinal qualities. According to Gill, Chai-Na-Ta expects to present its restructuring proposal to creditors in the next 30 days. [Wyng Chow Vancouver (CP) 11/13/99]
Does deep religious faith help the healing process? A number of recent studies seem to point in that direction. This seems especially true with the increasing popularity of fundamentalist Christianity, New Age beliefs, and alternative medicine. So is there really a link between spirituality and the healing process? But a couple of studies coming out of Columbia University suggest otherwise. Dr. Richard Sloan and colleagues at Columbia University in New York City contend that the link spirituality, and health is " weak and inconsistent". After all, common sense tells us that people of faith tend to lead healthier lives, i.e. non-use of tobacco and alcohol products. Sloan goes on to say," Avoidance of these risks may influence their overall health to a much greater extent than simple religious belief. Their review appears in the February 20 issue The Lancet. Although the Columbia University team also produced a study that found regular churchgoers did indeed have a lower risk of illness and death than non- churchgoers, they reported a flaw in their own study, i.e the fact that ill health may prevent many individuals from attending church in the first place. Based on that, the Columbia University team concludes "doctors should remain cautious when 'recommending' faith as a possible aid to physical recovery".. While a link between faith and healing remains unproved, "respectful attention must be paid to the impact of religion on the patient's decisions about health care," they conclude. [2/19/99, Reuters Health, The Lancet; 353:664-667]
Late last year, Blue Cross started Natural Blue-Holistic Health Choices. The company signed an agreement with American Specialty Health Networks (ASHN). The Blue Cross and Blue Shield of South Carolina's customers can now access this information and purchase health products, with discounts, from special links on Blue Cross Websites. What's more, there are links to a multitude of web sites where members can access information concerning alternative healthcare, along with a list of local providers providing discounts on such products as vitamins, herbal supplements, books and tapes. [Columbia, SC, 2/17/00, PRNewswire via NewsEdge Corporation]
Another short chapter has been written in the saga of one state's flirtation and struggle with quackery. First, some background information. In 1983, the influence of a powerful state political leader led to the establishment of a Homeopathic medical licensing board in Nevada. The state quickly became a magnet for troubled and delicensed medical renegades who practiced a grab-bag of quackery. Most popular were galvanic devices used as part of so-called "energy medicine." The "energy" was alleged to be of the cosmic, metaphysical kind dubbed chi, prana, vital energy, and the like, by healing systems rooted in ancient superstitions. Few, if any, of the licensees were actually practicing traditional homeopathy. It was an incredible situation in which a fake system (homeopathy) was being faked, so that consumers could be exploited with another fake system (energy medicine). The devices are boons to quackery because they enable practitioners to create the illusion of diagnosing, treating or prescribing for phantom diseases. This places them in full control of the clinical situation. It also provides a defense against other physicians who testify as medical experts because they know nothing of these allegedly specialized devices which influences juries to favor the innovative defendant. In 1987, the legislature became aware that it had been snookered by the energy medicine merchants. The result was a new homeopathic practice act that specifically limited licensees to the homeopathic substances prepared according to the "methods of Hahnemannian dilutions and succussion, magnetically energized geometric pattern as defined in the official homeopathic pharmacopoeia of the United States." Wow! what language. This was a classic example of the institutionalization of pseudomedical gibberish by scientifically illiterate lawmakers! Well, the medical renegades didn't like it much either, and have plotted to undo the limitations of the practice act ever since.
The most recent attempt was to expand its licensee's scope of practice by instituting its own new regulations to include virtually any type of alternative medicine as long as patients consented. However, opposition by the Nevada State Medical Association and the Board of Medical Examiners, plus the vow by Reno pathologist W.J. Diamond to sue the homeopathic board if it adopted its self-imposed practice expansion, caused homeopathic board chairman, Dr. Fuller Royal, to drop the proposal. [Las Vegas Review-Journal. 4/30/00]
Comment. Royal refers to the resistance of standard medicine to the expanded scope as "a turf war," and vows to try again in the future. Of course, it isn't a true turf war in which equivalently competent practitioners are competing for the privilege of delivering legitimate health services. This is an issue of the legalization of buccaneer medical entrepreneurialism versus accountable evidence-based medicine, with consumers caught in the middle. The lesson to be learned here is that opposition by standard medicine can still be an effective way to thwart the advancement of quackery. Too many in leadership positions have given up fighting for the tenets of professionalism and consumer protection.
Officers looking for information on past patient accounts seized 9 computers from the Sacramento billing office of the chiropractic offices of a chain known previously as the California Back & Neck Pain Specialists. Charges include false billing and workers' comp fraud. The chain and its former owner, Lester Simmons, DC, have been under investigation since 1996 according to the chain's new owner chiropractor Craig Elder. Elder has renamed the business America's Back & Neck Pain Specialists. [Sacramento Bee, 11/13/99]
Sometimes it may work, and it seems harmless enough, so why not try acupuncture for what ails you. While admitting that the procedure is usually harmless, researchers Vickers and Zollman, found that, when a systemic infection does occur, it can be devastating. In a published review of acupuncture, the single reported fatality from acupuncture was due to streptococcal toxic shock-like syndrome. The case involved a 41-year-old man receiving acupuncture for shoulder pain. He collapsed three days later with the skin of his shoulder succumbing to a rapidly spreading erythematous and necrotic condition. Despite immediate extensive antibiotic treatment, he died within twenty-four hours. Although life threatening complications involving acupuncture is rare, the literature reports 11 such cases in 1998. Although several other cases of infection that were severe enough to require intensive treatment were also found, there were frequent delays in accurate diagnosis because patients were hesitant to tell their doctors they had tried the procedure. Two cases of angina from electroacupuncture have been reported. Both cases were confirmed when symptoms recurred during re-exposure. This is the first such finding. The survey concluded that acupuncture does occasionally have serious adverse events and even the rare fatality. Most of these outcomes were negligence related. It should be obvious that all concerned with setting standards, delivering training and maintaining competence in acupuncture be familiar with the lessons taught by these events. [BMJ 19 February 2000;320:513]
ASSESSING THE QUALITY OF BOTANICAL PREPARATIONS
The passage of the Dietary Supplement Health and Education Act of 1994 (DSHEA) stimulated 5 years of unprecedented growth of the herbal and nutritional supplement industry. While it seems growth is slowing, US consumers are using increasing amounts of herbal and nutritional products, along with, or instead of conventional medicine. Physicians and pharmacists seek answers to consumer questions out of concern about the safety and efficacy of these substances. In trying to answer these questions, authors McDermott and Motyka take a look at issues in regard to product quality and standardization of the botanical preparations, and present an outline of issues for healthcare professionals to consider when making recommendations regarding botanical products. They begin by defining the problem as it exists since the passage of DSHEA, the act that allowed the large array of herbal and nutritional supplements to enter the marketplace. As is well known, these products are produced and marketed outside the jurisdiction of the Food and Drug Administration (FDA). It is up to manufacturers to ensure the safety of supplements. Authors state that problems related to the quality of herbal supplements can be found throughout the lay and professional literature. They place reports into four categories: intentional addition of an active drug causing for therapeutic or adverse effects; unintentional substitution of the herbal with a toxic species; environmental contamination of the herb with a chemical or pathogen; and suboptimal or varying amounts of active ingredient within a formulation. They go on to give specific examples of each category as found in the literature. [Medscape, 2000, Inc]
Here's one for the citizens of Florida. Due to deceptive practices Humana Health Plan Inc. will refund a total of $800,000 to about 2,100 Florida Medicare beneficiaries. It seems they were allegedly enticed to join the plan with a deceptive hearing aid offer. According to Florida Attorney General Bob Butterworth, Humana admitted no wrong doing but agreed to revise its marketing practices. According to Butterworth, Humana promised consumers who joined its Gold Plus Plan a free set of hearing aids or a $700 discount on more expensive models. But members who opted for the high-end models paid a higher base price for them than people not covered by the plan, offsetting the so-called discount, he explained. "Such practices are reprehensible under any circumstance, but the fact that many of the victims were elderly people on fixed incomes makes them even more so," Butterworth said. Members who chose the more expensive hearing aids will be refunded the amount they were overcharged. [Reuters Health, 2/17/2000]
According to a report in Archives of General Psychiatry researchers have found the first evidence that people suffering from antisocial personality disorder (APD) have less gray matter in the front part of their brains than healthy people. Gray matter is the thinking part of the brain. Researchers caution, however, less gray matter isn't the only factor in the making of a sociopath. Societal factors such as drug or alcohol abuse, as well as upbringing also contribute to the problem. Other physical traits like high levels of the male hormone testosterone, birth complications or a breakdown in other parts of the brain can all contribute to antisocial behavior.In collecting data researchers used magnetic resonance imaging to measure the prefrontal cortex gray and white matter of 21 men with APD. Then they compared the measurements to 34 healthy men and 26 men who had abused drugs. Findings revealed that the volume of gray matter was 11% less in the sociopaths when compared to healthy men. For more information on antisocial personality disorder, see Internet Mental Health or Columbia University's Internet site. [HealthSCOUT, 2/15/00]
Portugal's Lusa news agency reported that Manuel Dinis Pimentel, a Portuguese man, went on trial in Portugal's Azores Islands charged with murdering eight people. The prosecutors said the eight had died over a two week period, in summer 1998, after Pimentel applied a solution containing pesticides to their skin. He claimed to have his own cancer cures as well as cures for other serious diseases. Pimentel, who had been treating patients with his own remedies for 20 years on the far-flung Azores islands of Pico, Faial and Sao Jorge, was also charged with 21 cases of attempted murder and 21 cases of fraud. Pimentel, who faces 25 years in jail if found guilty, denies murder and says the people died because they failed to tell him they were also suffering from other illnesses, such as diabetes. [Lisbon, Reuters, 2/23/00]
There is no such thing as a "half-truth." Something is either true or untrue. Granted, the term "misleading" is used for the clever lies hucksters use to label and advertise their wares, but such are ultimately judged to be false. Your and my representatives have again showed us where their hearts are. As if it weren't enough for dietary supplements hucksters to be given free reign as to what they may bottle and sell, now they may legally make misleading claims as to the value of their nostrums. The Food, Drug & Cosmetic Act defines a drug as:
articles intended for use in the diagnosis, cure, mitigation, treatment, or prevention of disease in man or other animals; and articles (other than food) intended to affect the structure or any function of the body of man or any other animals. Section 201.(g)(2)
This sensible, scientifically accurate definition has been dismembered by the shyster lawyers now serving as legislators in our congress. Hucksters may not mention specific diseases in their marketing claims, but they are permitted to pretend to alter the structure and function of the body--something that is factually inseparable from diseases and disorders. For instance, the quacks cannot say that their pills and potions treat or cure arthritis, but they may say "helps support healthy joints." They cannot say that the dietary supplement prevents, treats or cures "heart disease," but they can say that it "keeps your arteries clean," or "... from being narrowed." They cannot mention Alzheimer's disease but can say that a supplement "helps mental functioning or memory." Consumers clearly cannot distinguish between these carefully-worded phrases.
Comment. If members of congress don't understand this they are stupid. If they realize how deceptive this is but do it anyway they are crooks. In either case, they are unqualified to be public representatives. The media should be screaming about this travesty. Is the money they earn by advertising dietary supplements sealing their lips, or do they too hold strong beliefs about the power of special foods, herbs, and vitamins to prevent disease and produce a kind of superhealth?