Tuesday, August 24, 2010

Decriminalize Heroin and Cocaine, says top U.K. Doctor

The Star

A debate over the decriminalization of heroin and cocaine has erupted again in Great Britain after a private statement by the one-time head of the Royal College of Physicians was leaked to a drug-reform campaign group and the media.

Sir Ian Gilmore, the former president of the Royal College of Physicians, made the statement about his feelings on the country’s drug policies in a private bulletin to the members of the college.

In it he called for a change in tactics, decriminalizing illicit drug use and treating addiction as a health problem not a criminal problem.

The two-line statement, which was leaked to Transform, a drug-reform campaign group, was private, Gilmore said in a telephone interview Wednesday with the Star. But he was “happy” to defend it.

“My position is since 1971 successive governments have pursued a policy that we should be a society free of hard drugs, stop them from getting into the country and prevent growth in production and if people use them put them in prison,” said Gilmore.

“My point is that it has not succeeded and it is time to have a debate about a more pragmatic approach and treat heroin addiction as a health problem rather than a criminal problem.”

Gilmore made the statement after a recent analysis in the British Medical Journal that convinced him the country’s drug policy for Class A drugs such as heroin had failed, he said.

The editorial said the prohibition of drugs was “counterproductive,” made public-health problems worse, and stimulated organized crime and terrorism.

His call for a re-thinking of the drug laws in Great Britain comes on the heels of comments made by the chairman of the Bar Council of England and Wales, who said last month it was “rational” to consider “decriminalizing personal drug use.”

Gilmore believes that more money should be put into medical resources to deal with heroin addiction, for example, rather than spending money on trying to stop the production or importing of drugs.

He also made the point in his statement that in the United Kingdom there have been a number of encouraging trials with heroin addicts that resulted in those individuals returning to work because they were no longer committed to criminal behaviour to support their habit.

As a physician he has seen all too clearly the medical complications – HIV and hepatitis C – that come from heroin addiction and the use of dirty needles, he said. “I’m not suggesting anyone go down to the street corner and buy heroin.”

Rather he would like to see a regulatory framework set up to allow these drugs to be controlled by law. “It’s not a radical approach,” he said. “Many others have said it.”

Many British politicians and opposition members have expressed that view privately, Gilmore said. But there are huge pressures on government to adopt and continue a tough-on-drugs policy.

Keith Vaz, the chairman of the House of Commons home affairs select committee, has said in the Telegraph that the legalization of drugs “would simply create the mistaken impression that these substances are not harmful, when in fact this is far from the truth.”

But Gilmore rejects the position that his position sends a message that Class A drugs aren’t dangerous. “That’s not our intention,” he said. “Heroin ruins lives, he said. “If there was a change in the way addiction was managed, it would also have to come with an information campaign.”

In 2000 a Royal College of Physicians report, with the Royal College of Psychiatrists, said there were no easy answers to the problem of drug misuse in society.

At the time the report said “three-quarters of the U.K.’s expenditure on drug-related problems is devoted to enforcement and international supply reduction, but that there is little evidence that the money is well spent,” according to a statement on the Royal College of Physicians website.

The report also identified a need for more investment in research to understand the ill-effects of drugs and in-treatment programs for addiction. The authors called for a public debate on the issue.

In a statement the Royal College of Physicians said it plans to review the findings of the report with the Royal College of Psychiatrists under the leadership of its new president.

Gilmore’s statement has been praised by Transform, saying his statement was the “nail in the coffin” on current drug laws in Britain, the Telegraph said.

Monday, August 16, 2010

Witness: Doctor Kept Secret Medical Files on Smith

Associated Press

Prosecutors showed jurors their most explosive evidence against Anna Nicole Smith's doctor Thursday — journal entries in which he writes of partying with her during a gay pride parade and wonders, "Can she ruin me?"

The journals, identified by investigators who found them in Dr. Sandeep Kapoor's desk in his bedroom, also showed that Kapoor was addicted to the sleeping medication Ambien in the years just before he took over Smith's treatment.

"Hung over. Gay pride parade," begins the entry from June 13, 2005. "Rode in parade with Anna Nicole."

He wrote of crowds gathering around her limousine while six police officers were keeping back the paparazzi.

He writes of drinking expensive champagne with Smith's boyfriend, Howard K. Stern, in the limousine. "It was mesmerizing, watching the crowd wave at us, Anna and me all buffed out on the car," the entry says.

Then there was the party at a club, he wrote: "Drinks, booze, orgy. I was making out with Anna, my patient, blurring the lines. I gave her Valium and Methodone. Can she ruin me?"

Kapoor, Stern and Dr Khristine Eroshevich have pleaded not guilty to charges that include conspiring to provide Smith with excessive drugs, prescribing to an addict, and prescribing to Smith under fraudulent names.

They are not charged with causing her 2007 death from a drug overdose.

On cross-examination Thursday, Kapoor's lawyer, Ellyn Garafalo, elicited testimony from California Medical Board Senior Investigator Jon Genens that the hand written journals comprised 800 pages and only the two pages cited in court mentioned Smith.

On Wednesday, Dr. Victor Kovner, who sold his practice to Kapoor, told of warning him not to socialize with celebrities.

Carmen Aguillera Marquez, a senior investigator for the California Medical Board, testified that she found the journals in four composition books in Kapoor's bedroom desk shortly after finding a file of Smith's medical records hidden under a pile of clothing in the doctor's closet.

She said she turned the materials over to Genens, the leader of the 10-member law enforcement team which entered Kapoor's home with a search warrant and with guns drawn seven months after Smith died of a drug overdose in February, 2007.

Genens testified that earlier journal entries detailed the doctor's Ambien addiction.

"I didn't sleep much last night," says an entry from May 28, 2001. "I didn't have Ambien which I am now addicted to."

Nearly a year later, he wrote, "I'm addicted to Ambien. I've got to get off it."

Genens said the last entry regarding Ambien addiction was in December 2003. Kapoor began treating Smith in April, 2004. Some of her medical charts have shown she took Ambien.

Garafalo noted that the last entry about Ambien was more than three years before Kapoor wrote a prescriptions for Ambien to Stern. Genens agreed.

Genens and Marquez said Kapoor told them he did not have any patient files at home. But when she poked her hand into a pile of neatly folded clothing on the floor of his bedroom closet, she said, she felt papers and extracted a file folder with Smith's name inside, along with one of her pseudonyms and the name of her son.

Genens testified that three different files were found — two in the home and one in Garafalo's office — detailing a single home visit made to Smith a year before she died. One of them mentioned that she had a possible opiate addiction, he said.

With the medical records displayed on a courtroom screen in Los Angeles, Genens noted that one had the notation: "benzo addicted? To avoid." The apparent reference to addiction to sedatives known as benzodiazopines was missing from the second set of files for the same day, he said.

Superior Court Judge Robert Perry warned jurors repeatedly Thursday that the investigators' testimony is being offered only against Kapoor.

In a hearing Thursday outside the jury's presence, Perry questioned the relevance of the documents and Deputy District Attorney David Barkhurst said, "Our contention is Dr. Kapoor was creating those records after the visit for some nefarious reason."

Wednesday, August 11, 2010

Prepping Parents for Straight Talk on Drugs and Alcohol

Oak Park Journal

Talking to their teens about drugs can be difficult for some parents. Starting next month, parents in Oak Park and River Forest will receive some help to make those conversations a little easier for them and their kids.

The first in an ongoing series of "parent cafes" will launch in September. The cafes are among the ideas that sprouted from the drug and alcohol abuse forums held over the summer and hosted by the Citizens' Council at Oak Park and River Forest High School, 201 N. Scoville.

The cafes are for parents to get together and talk about substance abuse issues, said Lisa Lowry, an OPRF parent and a licensed social worker. She's coordinating the parent groups. She described the cafes as a 'how-to' dialogue for parents.

Volunteers have been training in recent weeks to facilitate the groups. Lowry, a parent of two OPRF students, said the dates are still to be determined as well as venues. The first series of caf├ęs will be in a public venue, and the hope, Lowry said, is for parents to host smaller groups themselves at their homes or other places.

"This is really meant to promote better parent and teen dialogue around those issues, which are tough issues to talk about," she said. "We want to empower parents to not feel helpless."

The cafes will address related issues, such as school policies concerning drugs and alcohol. The public sessions will take place in churches, the libraries and other venues interested in hosting. Another goal, said Mimi Skapek, of the Citizens' Council, is to maintain the momentum that started with the substance abuse forum at OPRF in May.

That event drew roughly 400 people to hear speakers discuss the drug and alcohol problem among many middle school and high school aged students in the community. The Citizens' Council, an OPRF-school board approved group of parents and non-parents, launched their anti-drug effort earlier this year. The members wanted to do something about the problem after hearing from school officials at their February meeting about student drug use.

The council hosted a public roundtable discussion in June as a follow-up to the drug forum. That event drew about 100 people, all brainstorming for solutions. Ideas included closing the campus to all students during lunchtime, hiring more campus drug counselors, and finding ways for parents to communicate more effectively. Several people volunteered to join action teams following the roundtable, hoping to turn those ideas into action plans.

"This is about continuing that conversation that started after the forum," Skapek said of the parent cafes. "The parents are really leading this. They want to see this happen."

Skapek added that the cafes are just one solution the parents are working on. Lowry and two other parents are leading action teams focusing on initiatives to address the high school and middle schools. Other teams are working on solutions that include the Oak Park Township and local law enforcement.

Lowry is not a member of the council but volunteered to be an action team leader after attending the spring forums. Lowry, however, said she's been concerned about the substance abuse problem at OPRF for at least the last decade. She also is not a clinical drug counselor but works with kids dealing with such issues as attention deficit disorder. But some of those kids have had substance abuse problems, Lowry said - and most of those clients were from Oak Park and River Forest.

"I've been frustrated for a lot of years and I'm very energized that people seem more ready for a public conversation," Lowry said. "OPRF is a great school doing a lot of great things, but this one aspect just needs to be dealt with."