Big PhRMA Seeks Stoner Cred

Candy Bergen has just published a memoir called "A Fine Romance." According to the New York Times, the actress "parses the nation’s infatuation with the CBS sitcom 'Murphy Brown,' in which she starred for a decade as a take-no-prisoners, formerly booze-guzzling television reporter." (If Cockburn didn’t send the verb parse to the guillotine, let’s do so now.)

It was November 5, 1997 —a year to the day after California voters legalized marijuana for medical use—that Murphy Brown, diagnosed with breast cancer, smoked marijuana to deal with the effects of chemotherapy. Today, with the media totally marijuana-infused, the episode on prime time TV seems insignificant. But back then it was unprecedented, a cultural milestone.

And how far we have come! Today we have drug companies deploying stoner types in prime time advertisements for their potentially fatal products! As I write this, Kevin Nealon is pushing a blood thinner called Xarelto, aka Rivaroxaban, which is made by Bayer and distributed by Jansen. Xarelto is the first drug approved by FDA without there being a known antidote. The losers die of internal bleeding. The other side effects are not easy to find on the Xarelto site. You have to go deep into the product information to find that Xarelto caused back pain in 22% of users (vs. 7% of placebo users) in the biggest clinical trial.

Kevin Nealon is featured in the Xarelto push alongside golf great Arnold Palmer and NASCAR driver Brian Vickers. Nealon starred on the Showtime hit “Weeds,” playing Doug, the likable accountant who advises Nancy (Mary Lousie Parker, a housewife who becomes a dealer) to set up a legitimate small business as a front.

In an early episode Doug comes over to Nancy’s house, she’s not there, and he and her stoner brother-in-law go into her personal stash, only to discover that a rat has found it, too. They get loaded and hunt for the rat, which they intend to shoot with a pellet gun. They use peanut butter as bait and get it all over the furniture. They trash the living room and kitchen, then crash in a stoned stupor.

In the next episode, Nancy shows up at Doug’s office to make a delivery and he tells her he doesn’t need anything. He takes out his wallet and shows her the reason why.

DOUG: It’s my medical marijuana card. I got a note from a clinic doc for a hundred bucks. Went down to the pot store and mama, I was home! It’s a weed wonderland, Nancy. It’s like Amsterdam, only better, because you don’t have to visit the Anne Frank house and pretend to be sad and stuff. See this lollipop?

NANCY: It isn’t...

DOUG: (Medium shot of Doug sucking) Yes! I’m getting high right now. You can’t even tell.

NANCY: How is it possible?

DOUG; The genius of Prop 215: medical marijuana for sick people. And seriously, who couldn’t use a little medication, right? My friend’s friend’s friend gave me the address of the clinic, I went down there, and loaded up. [From his desk he takes a baggie full of big colas.] I love California! I can’t wait to tell the poker game about it. The one buzz kill is you can only buy eight ounces a visit.

NANCY: That’s half a pound!

DOUG: Well, they allow you to make two visits a day, but you know with all the traffic on the 110 it’s practically impossible.

Hats off to the ad agency that booked Kevin Nealon for the Xarelto gig. A celeb so far ahead of the curve on cannabis has automatic credibility when it comes to anticoagulants.

Deadly Drug Allergies

Most fatal allergy attacks in the U.S. are caused not by insect stings or food, but by pharmaceuticals —antibiotics and radiocontrast drugs— according to a recent study in the Journal of Allergy and Clinical Immunology. And the rate of drug-induced fatalities almost doubled between 1999 and 2000. Here's Nicolas Bakalar's summary in the NY Times:

Using data from the National Center for Health Statistics, researchers found 2,458 cases of fatal anaphylaxis from 1999 through 2010. Almost 60 percent of the deaths, or 1,446, were caused by reactions to drugs, and in cases where the specific drug was known, half were caused by antibiotics. The rate of drug-induced fatal reactions almost doubled over the period.

Insect stings caused 15.2 percent of the fatalities and food 6.7 percent. The cause was not recorded in a fifth of the cases... Older age was associated with a higher risk for death and that blacks had a higher risk of dying from drugs and food reactions. For insect sting deaths, rates among whites were almost three times as high as rates among African-Americans.

The lead author, Dr. Elina Jerschow, an assistant professor of medicine at the Albert Einstein College of Medicine in the Bronx, said, “We are using more imaging studies than other countries, and they’re potentially life-threatening."

Just imagine how much media attention there would be if every couple of days an American was keeling over dead from an allergy to cannabis (an extremely rare event, as noted in recent correspondence from Stephen Robinson, MD).

Neonicotinoids Kill — Not Just Bees Ever since the '50s, when the tobacco companies suppressed and then challenged the scientific evidence that cigarettes cause lung cancer, manufacturers of toxins keep their products on the market by insisting that "more research is needed." An extended stall in the name of science ensues — and the poisoning of our world.

In 2012 the European Food Safety Authority reported that neonicotinoid pesticides were killing off bee colonies. In 2013 three neonicotinoids were banned in Europe. (Of course they are still applied by the ton by farmers in the U.S.)

The manufacturers —Syngenta and Bayer CropScience— questioned the regulators' findings in a lawsuit that is still dragging on. Now the European Academies Science Advisory Council has issued a report, based on more than 100 peer-reviewed papers, which concludes that neonicotinoids are killing many species, including earthworms, parasitic wasps, and lady bugs. Since the latter provide organic insect control, Syngenta and Bayer are effectively killing off the competition with their synthetic pesticides. In few more years they'll be able to say there are no alternatives to neonicotinoids. It's a corporate win-win!

How slick and deceitful are the scientists who vouch for the safety of neonicotinoids (in journals reliant on ads from Syngenta, Bayer, et al)? Typically their studies involved testing the ability of bees to survive a single exposure to a given neonicotinoid. But as Dave Jolly pointed out in a New York Times piece about the European Academies Science Advisory Council report, "the effect of the chemicals is cumulative and irreversible, meaning that repeated sublethal doses will eventually be deadly if a certain threshold is passed."

Cannabis v. Tylenol for Back Pain

A public defender in Nevada was asked by a judge last week for "peer reviewed medical research articles relating to treating back pain with marijuana." The best we could provide was what Ethan Russo, MD, called "a balanced shot" from the Canadian Arthritis Society:

In a position paper issued today (9/9/14), The Arthritis Society calls for more research into the efficacy and safety associated with the use of medical cannabis as a therapy to alleviate symptoms of pain and fatigue caused by a chronic disease.

“More and more Canadians are accessing medical cannabis as a treatment option for severe arthritis symptoms,” explains Society president and CEO Janet Yale. “We have a duty to the people we serve to ensure that the scientific basis for the use of medical cannabis is clear and appropriate, with patient safety and improved care our foremost priorities.”

Thousands of Canadians have already received authorization from Health Canada to use medical cannabis and as many as two thirds of those people are using the drug to help manage pain due to arthritis...

“For a subject that’s drawing so much public attention, both in Canada and around the world, the paucity of quality scientific research into cannabis is concerning,” explains Dr. Jason McDougall, professor of pharmacology and anaesthesia at the University of Dalhousie, and chair of the scientific advisory committee of The Arthritis Society. “Given the number of people taking cannabis now, or who are thinking about taking it, the need for evidence-based research into efficacy and safety could not be more pressing.”

No sooner had we forwarded the above to the public defender, then we read about a large study by Australian researchers published in the British Medical Journal disproving the efficacy of Tylenol (the corporate alternative to cannabis for back pain). As summarized by Nicholas Bakalar in the Times, the authors

"found high quality evidence that Tylenol is ineffective in treating low back pain or disability. It also found evidence that the drug quadruples the risk of an abnormal liver function test, but the clinical significance of that finding is unclear. The studies of pain from knee and hip arthritis found a small but clinically insignificant short-term pain-relief effect for acetaminophen compared with a placebo."

We sent the BMJ item to Russo, who commented, "Acetaminophen is garbage as an analgesic, and is an insidious hepatotoxin responsible for thousands of annual deaths."

We hope the judge considers the defendant's real-world options in evaluating his or her use of cannabis.

Wonderful Oliver Sacks

An essay by Oliver Sacks on the time he has left — given a diagnosis of metastasizing liver cancer— left one of our correspondents wondering if maybe the great neurologist hadn't heard about cannabis concentrates working miracles on occasion. We assume that Sacks is fully informed. One of the people to whom he dedicated "Musicophilia" is Orrin Devinsky, the physician who has been monitoring the use of Epidiolex — GW Pharmaceuticals' pure CBD concentrate — by epileptic children at NYU.