Saturday, January 30, 2016

NY Times' penetrating look at the heroin epidemic gets the cause and solution all wrong


On October 30, 2015 the NY Times published an in-depth article on the heroin epidemic, focused on New Hampshire, which saw the greatest increase in deaths from drug overdoses (74%) in the US between 2013 and 2014.  New Hampshire is a bucolic place, where villages of tidy white capes and saltboxes lie sprinkled among the mountains and pine forests.

Manchester, New Hampshire's largest city, has a population of 110,000.  In one 6 hour period on September 24, Manchester police responded to 6 separate heroin overdoses. Manchester saw over 500 overdoses and over 60 deaths between January 1 and September 24, 2015.

At presidential campaign stops throughout the state, candidates were forced to respond to the problem when New Hampshire citizens demanded answers.  Hillary has a $10 billion dollar plan for prevention and treatment of abuse.  Chris Christie prefers treatment to jail time for first offenders. Obama announced a $5 million initiative in August to combat heroin addiction and trafficking. NH has designated a drug czarNH Senator Ayotte says,"We've got to reduce the stigma."  Narcan, an opiate antidote that has been made widely available, is admittedly a band-aid.  It saves lives from acute overdoses, but does absolutely nothing to stem the tide of abuse.

 
The solutions being touted by politicians and the media include "working together:" police, citizens, and health-care facilities--though to what end is unclear; educating; reducing the stigma of heroin use (now that users are predominantly white and middle class we can relabel addiction a disease, not a crime); adding treatment facilities; and adding more police.

I call this salutary--but almost entirely missing the mark.  


Overdose deaths and heroin users are at an all time high in the United States. Between 2 and 9 of every thousand Americans (0.2-0.9% of the population) is currently using heroin. In Maine, 8% of babies are born "drug-affected"--a stratospheric rise from 178 babies in 2006 to 995 babies in fiscal 2015.  A NEJM study found opiate-addicted babies in neonatal ICUs quadrupled between 2006 and 2013. 


Despite what you have heard, the cause of our current heroin epidemic is not as simple as doctors over-prescribing narcotics, or users switching to heroin when prescription drugs became more scarce and expensive.

While nationally, heroin overdose deaths jumped from 1.0 per 100,000 in 2010 to 3.4 per 100,000 in 2014, the number of prescribed narcotics held steady over the same period.  A 2015 UN document noted that, "A recent [US government] household survey in the United States indicated that there was a significant decline in the misuse of prescription opioids from 2012 to 2013" (page 46). A January 14 NEJM article (from NIH) challenges the prevailing assumption that making prescription opioids harder to get was the major driver of increasing heroin use.

 According to CDC itself, "CDC has programmatically characterized all opioid pain reliever deaths (natural and semisynthetic opioids, methadone, and other synthetic opioids) as 'prescription' opioid overdoses." That means illegally produced drugs in these categories are being designated as prescription drugs, when they are not. A further confounder is that heroin metabolizes to morphine, which is a prescription drug. So if fully metabolized at the time of autopsy, a death due to heroin may be labeled as due to a prescription narcotic.

The real cause of the current heroin epidemic is massive amounts of heroin flooding into the US, exceeding what can be sold in our large cities, and now finding its way into even the tiniest hamlets. The NY Times story failed to mention this.


Here's the problem with the NY Times' and the politicians' solutions:  neither fifty individual states nor thousands of towns and villages can treat, educate, exhort, investigate or imprison their way out of the heroin maelstrom, when the next fix is cheap and just around the corner. There are nowhere near enough social workers, foster parents, police, prisons, treatment facilities or sources of funding.  Narcan and clean needles don't cut the mustard. And most active addicts don't want to be treated, coming to treatment only when pushed by the legal system.

There is only one possible solution, and that is stemming the supply.  Until this is understood, and acted on, the epidemic of heroin abuse will continue unabated.

In my September 7 blog post, I showed that 96% of US heroin does not come from Mexico and Colombia, as claimed by multiple US government sources.  Mexican and Colombian production is inadequate to supply even half the US market.

At least Canada knows where its heroin comes from:  "According to the Royal Canadian Mounted Police National Intelligence Coordination Center, between 2009 and 2012 at least 90 per cent of the heroin seized in Canada originated in Afghanistan." (page 46)

If one wants to get into the weeds on this issue, a 2014 RAND report titled What America’s Users Spend on Illegal Drugs: 2000-2010 is a good place to start.  The  report, performed under contract for DHHS and released by the White House, looks at multiple databases and identifies many problematic issues with estimates of heroin country-of-origin.

It shows that while Colombian opium was allegedly supplying 50% of a growing US heroin market between 2001 and 2010 (pages 82-83), Colombian production actually sank from 11 metric tons in 2001 to only 2 in 2009.

Furthermore, US government estimates for the 2000-2010 decade of Mexican production relied on a claimed 3 growing seasons per year, while in reality there were only 2. RAND admits Mexican production estimates by the US government were juiced: 
"The US government now recognizes that the previous estimates were inflated. There are no back-cast revised estimates (marijuana and poppy/heroin) for the whole country of Mexico prior to 2011."
Mexico historically produced lower quality, "black tar" heroin, used west of the Mississippi, while the influx of heroin to the US, and particularly in the eastern US, has been of higher quality white powder. The DEA's 2015 National Heroin Threat Assessment notes, "Availability levels are highest in the Northeast and in areas of the Midwest, according to law enforcement reporting," which would make no sense if the heroin originated in Mexico. In fact, the same report revealed that the Southwest US had the lowest number of respondents of any US region (only 4.3%) who felt heroin was the greatest drug threat, compared to 63.4% of law enforcement respondents in New England.

Meanwhile, according to RAND"in recent years, there have been no [heroin] seizures or purchases from Southeast Asia [Myanmar, Laos, Thailand] by DEA's Domestic Monitoring Program."

Back in 1992, DEA estimated that 32% of US heroin came from Southwest Asia (mainly Afghanistan). Since then, Afghan opium production has tripled. But in the years 1994 through 2010 only 1-6% of US heroin had a southwest Asian origin, according to DEA's Domestic Monitoring Program. Yet Afghan production accounts for 85-90% of the world heroin supply. 

It would be great if we could point to improved US interdiction at the source, or to poppy field eradication to explain this anomaly.  But neither is the case. Seizures of heroin in Afghanistan dropped from 27 metric tons in 2010  to 8 metric tons in 2013, according to the UN, figure 41. Only 1.2% of Afghan poppy fields were eradicated in 2014, also according to the UN.

The UN Office on Drugs and Crime 2013 Report acknowledges that US estimates of where its heroin comes from (about 50% from Colombia) make no sense:
"Continued inconsistency in the information available from the Americas on opiate production and flows makes an analysis of the situation difficult – while Mexico has the greater potential production of opium, it is Colombia that is reported as the main supplier of heroin to the United States. The Canadian market seems to be supplied by producers from Asia." (page 30) 
"It is unclear how Colombia, given its much lower potential production, could supply larger amounts to the United States market than Mexico." (page 37)
It is undeniable: there has been profound, systematic deception by the US government to inflate estimates of the amount of heroin coming from Mexico and Colombia, presumably to conceal the actual origin of most US heroin, and possibly to protect its means of entry into the US.

We know where and how to look for heroin. Afghanistan and Myanmar are the world's #1 and #2 producers, accounting for over 95% of world production.   Historically, heroin bound for the US leaves these countries by air. There are a manageable number of flights departing Afghanistan and Myanmar.  We could put all the needed personnel in place, today, to fully inspect every flight and every airport.

The fact that we have looked the other way and pointed in the wrong direction is itself the smoking gun.


_________________________________________________________________________


The comment below was made to a cross-posting of my article on the Global Research Facebook page, and speaks to trafficking heroin from Afghanistan to the US--Meryl Nass

Hold on, folks. Don't be so hasty. [He is responding to a
prior comment blaming the military for the heroin trafficking.]

As a veteran who served in Afghanistan, I can tell you that the military
involvement is limited and knowledge/awareness even more so. The CIA and
contractors are running unmarked cargo aircraft out of our airbases at
Bagram and Kandahar. Yes, Air Force personnel load the shrink-wrapped
palates onto the planes, but they don't know what's inside.

For those of you who doubt that, let's recall the case of Ciara Durkin.
Ciara was a Massachusetts National Guardsman who died "under mysterious
circumstances" from a rifle bullet to her head at Bagram. Details reveal
that her death was not suicide, as some may be quick to suspect: She was
shot from a distance as she left the base chapel. She worked in finance and
had recently wrote a letter to her family that she "uncovered something."
That was in 2007.

Let's not forget Pat Tillman. He was killed in 2004, right before I left
the country. A member of the Army Rangers, his unit was working extensively
in the opium territory along the Pakistani border. While everyone has heard
that his death was officially ruled "friendly fire," what most don't know
is that he had undergone a change of heart while serving in
Afghanistan--out of FOB Salerno, where I spent my 30th birthday. A man of
conscience, he could have been swayed by the racism, prejudice, and general
de-humanization the US military had affected toward the Afghani people. Or,
he could have taken issue with the fact that the official policy towards
all military personnel was "hands-off" of the opium fields. He was
certainly in position to do so. Whichever was the case, we'll never know.

It is the CIA that is primarily responsible for the clearance of targets
for military operations . . . and of aircraft allowed to enter/leave the
Afghani airspace. The military--all branches--merely comply with the
orders, authorizations, or restrictions handed down.

And let's not forget that many of our military are themselves having
changes of heart, awakenings of conscience, or whatever you want to call
it. They are disheartened and disillusioned about the occupation--its goals
and intentions. They are stuck, however, and unable to change anything,
protest, question, or even disobey without facing court marshal or
fratricide. This is why so many end up depressed, turn to drugs themselves,
or commit suicide. They see the unmarked planes being loaded. They are told
to "look the other way," or "you don't see anything," or "that plane
doesn't exist." But they do see them and they know they exist . . . and are
powerless to do anything about it.

No, please, don't blame the military. Blame the CIA. Blame the civilian
contractors. It's Air America all over again. First it was a geopolitical
strategy to divert a major source of revenue for Iran, but then it surely
took on a life of its own when they realized how much money they could
bring in by controlling the world's heroin supply. And so they have. And
with such an undocumented and unlimited supply of money, they don't care
about Congress or even the POTUS. With all of the destabilization
operations, Color Revolutions, and direct support for IS, it would seem
that they've gone rogue. God help us all! 

Sunday, January 10, 2016

Vaccines: You can't say No. But they're free

It is interesting... in the days when Americans paid for vaccines ourselves,  in cash, we were allowed to choose them for ourselves.  We did so, judiciously and appropriately.

No, I'm putting the wrong slant on this:  there was no "allowed" about it.  Back then, who ever imagined a future US government inserting itself into our health decisions, phones and every online click?


When I was a young adult, we thought only a Soviet gulag would treat its citizens like this.


We thought we had a Constitution that was the ultimate law of the United States.  We thought the job of the Supreme Court was to guarantee that US laws complied with our Constitution.


That was the world I knew.  My children know a different world entirely.  The Surveillance State, the corporatization of our public institutions, and endemic political corruption is all they have ever seen. 


They also grew up when health insurance and the Vaccines for Children program started covering the cost of American childrens' vaccinations.


Then came Obamacare, which was going to improve our health and save us money (ha!) by paying the costs for disease prevention.  "Prevention" under Obamacare turned into a few measly tests (which my ACA insurer is unable to identify) and a whole lot of vaccines--covered 100%! Several thousand dollars' worth of vaccines. The Affordable Care Act required all new health insurance policies to cover all vaccines recommended by CDC.  


And the 21st Century Cures Act, passed by the House in 2015 and pending in the Senate, will require CDC/ACIP (CDC's Advisory Committee on Immunization Practices) to rapidly consider for addition to the recommended list of vaccines every newly licensed vaccine. Many states automatically require every CDC-ACIP listed vaccine in order to attend school. This is one way the federal government manages to insert itself into our healthcare, an area legally excluded from federal control by the 10th Amendment to the Constitution:

The powers not delegated to the United States by the Constitution, nor prohibited by it to the States, are reserved to the States respectively, or to the people.
Last spring, in the blink of an eye, a sprinkling of measles grew a bumper crop of legislation in states throughout the US, informing parents the state would no longer educate their children, unless they let the state doctor them, as well.  

According to FOX News analyst (and retired New Jersey Superior Court Judge) Andrew Napolitano, if you don't give your children all state-mandated vaccines, the state can take your children from you, and the state--New Jersey--will educate them, doctor them and raise them for you:
New Jersey law... shows no deference to parents’ rights and permits exceptions to universal vaccinations only for medical reasons (where a physician certifies that the child will get sicker because of a vaccination) or religious objections. Short of those narrow reasons, in New Jersey, if you don’t vaccinate your children, you risk losing parental custody of them.

Requiring flu shots for preschoolers shot down in NYC/ NY Times

The NY Times had a comprehensive article about NYC's preschool flu shot mandate last January 2015. I blogged about the issue here; and now, in December, a judge has thrown out the mandate.

Children aged 6 months to 5 years and who attended any preschool program licensed by NY City were required to receive a flu shot.  The schools had to be the enforcers; if they failed to comply, they could be fined up to $2,000.  This rule was imposed in 2014 under outgoing Mayor Bloomberg, by decree of the unelected Board of Health.

Only two states, New Jersey and Connecticut, have imposed similar preschool flu mandates. Preschool flu shots were not required elsewhere in NY state.

If the shots worked well, choosing to get one might be a good idea.  But they work rather poorly. Estimates of efficacy range from 40% (CDC) to 1-3% (Cochrane Collaboration).

Because it is very difficult to assign side effects to vaccines, and because flu shot composition generally changes every year, it is impossible to know what the vaccine's side effects will be, until at least a year after the flu season is over.  This means that it is very difficult to determine the risk versus benefit of a flu shot before you get one.  Why subject our youngest citizens to vaccines for which both the benefit and risk are invariably unknown when they are used?

The judge ruled against the mandate on the basis that the NY legislature voted on other mandated vaccinations, and only the elected legislature, not NYC's health board, holds the authority to mandate vaccines.

UK govt trying to stop compensation it already granted for Narcolepsy cases linked to GSK's Pandemrix swine flu vaccine/ Guardian

Over 1,300 people who received the Pandemrix swine flu vaccine in 2009-10 developed narcolepsy.  Demographically,  adolescents were hardest hit. The vaccination caused profound neurologic disability and frequent personality changes in those affected.   


All governments that gave out swine flu vaccines were required (by manufacturers, the World Health Organization and pre-existing contracts that had been inked years earlier in the expectation they would be used for a deadly bird flu pandemic) to assume all liability for any injuries the vaccines might cause. Poland was the only country that publicly balked, and did not offer vaccine to its citizens.

After the swine flu pandemic ended, Finland noticed a spike in narcolepsy cases.  Since then, many studies have been done in about a dozen countries, and it has been established that Glaxo's Pandemrix swine flu vaccine caused a 10-16 fold increase in new narcolepsy cases. After years of debate, this part of the science is settled.


Although initially claiming the vaccine was not implicated in narcolepsy,  in 2013 the UK government admitted that the Pandemrix vaccine had in fact caused narcolepsy.  Some injured parties who were refused initially, were compensated with government funds.


However, in 2015 the UK government requested the right to appeal its earlier granting of compensation.  Most of those affected were adolescents, and the UK is now suggesting that they are less disabled than a working adult might have been. From the Guardian:

... Government lawyers are seeking to block compensation payments to people who developed the devastating sleep disorder, narcolepsy, as a result of a faulty swine flu vaccine. The Pandemrix vaccine made by GlaxoSmithKline (GSK) was given to 6 million people in Britain and millions more across Europe during the 2009-10 swine flu pandemic, but was withdrawn when doctors noticed a rise in narcolepsy cases among those who received the jab. 
Government lawyers are seeking to block compensation payments to people who developed the devastating sleep disorder, narcolepsy, as a result of a faulty swine flu vaccine.
In June 2015, a 12-year-old boy was awarded £120,000 by a court that ruled he had been left severely disabled by narcolepsy caused by Pandemrix. The win ended a three-year battle with the government that argued his illness was not serious enough to warrant compensation. 
The government has paid out to the boy’s family, but has nonetheless asked the court of appeal for permission to challenge the decision. A successful appeal would effectively deny compensation to 100 more families awaiting damages and could rule out any prospect of damages for other children who are injured by different vaccines in the future.
The government argues that vaccine damages should be decided on the immediate, rather than the future, impact of the vaccine-related injury. In this case, that would mean comparing the life of a 12-year-old boy with narcolepsy with a healthy boy the same age. Any effect on his future sex life, his ability to drive, his ability to work or go to university would be completely disregarded. 
“That is a radical interpretation of the law. It is very hard to show that you are disabled enough [to qualify for compensation] if the vast majority of your disability had to be ignored,” said the boy's attorney. “If their interpretation was accepted by the court of appeal, it would virtually abolish the prospects of anybody ever getting any vaccine injury compensation in the UK, because vaccines are mainly given to children and usually very young children.”
In the US, a new industry-friendly FDA Commissioner (Robert Califf, MD) is likely to be confirmed by the Senate this month. The 21st Century Cures Act, a bill that makes approval of drugs and devices easier, and promises to expedite the addition of new vaccines onto CDC-ACIPs list of recommended/required school vaccinations, was passed by 83% of the House and will soon be voted on by the Senate.  Other efforts are underway to weaken FDA regulation of drug safety and rush products to market.  Three hundred plus vaccines are in development. The head of FDA's vaccine center, Karen Midthun, MD, has announced her imminent retirement.

One might suspect that a cabal of industry and government insiders are working feverishly to deny any possibility of industry-provided compensation for injuries caused by drugs, medical devices and vaccines, before a slew of new, hurriedly approved products hits the market.  [In fact, since the 2011 Supreme Court Brucewitz decision, US vaccine manufacturers have had no liability for vaccine injuries in both federal and state courts. The goal of the UK government may be to reduce the definition of compensable injuries over there, before the wave of new vaccines appears.]


UPDATE: Feb 4, 2016 TechTimes
"A 10-year-old boy who developed narcolepsy from swine flu vaccine won £120,000 (nearly $175,000) in damages after a six-year legal bout. In 2010, Josh Hadfield received a Pandemrix vaccine and in three weeks developed narcolepsy, a condition that made him fall asleep almost every five minutes regardless of activity..."

Friday, January 8, 2016

FDA, CDC, NIH all have Foundations to Collect Industry Money to "Advance their Missions"

I blogged (here and here) about how the Inspector General System, set up by Congress to provide independent oversight of the 70 plus executive branch federal agencies, has been prevented from doing its job during the Obama administration.  In this post I discuss another way 3 federal health agencies (FDA, CDC, NIH) have been redirected from their public mission: private slush funds (Foundations) exist for each of the agencies.  In other words, there is a private back-channel for money to come in and go out from these agencies. To what purpose?
"... the Foundation provides a unique opportunity to bring all parties to the table (FDA, Patient Groups, Academia, other Government entities, and Industry) to work together in a transparent way to create exciting new regulatory science... " [And yet, the mission statement goes on to claim] "... it [the Foundation] does not participate in, nor offer advice to the FDA on regulatory matters or policy issues."
Fabulous.  "Exciting new regulatory science" in the current FDA context, means less careful drug/device approval. Over the past few years FDA has introduced 3 new pathways by which a drug, vaccine or medical device can be approved faster, and with less evidence than before. A new FDA Commissioner is expected to be confirmed soon by the Senate, despite his industry connections (he was paid by seven pharmaceutical companies in the year before his 2015 temporary FDA appointment).  He has called for more efficient, faster drug approvals.

Using a Foundation to transfer funds is certainly not the only means by which industry has its way with the executive branch agencies, but it is instructive nonetheless to see who donates and how much.

For the FDA Foundation, six pharmaceutical companies paid $350,000 each in 2013, two entities paid $400,000 each and one $500,000.  The following were named (page 17) while others were unnamed in the tax return.

 Eli Lilly $ 400,000.00
 AstraZeneca 350,000.00
 GlaxoSmithKline 350,000.00
 Johnson & Johnson 350,000.00
 Merck 350,000.00
 Novartis 350,000.00
 Pfizer 350,000.00

In its 2014 tax filing, 5 unnamed entities gave the Foundation $500,000 each.
Do these amounts look like voluntary donations?  Why are the amounts so similar?  They look more like some sort of "tax" or "tithe" the companies were told to pay.  Is the Foundation the FDA's "enforcer"?

One liability in the 2014 tax return was for $255,000--a "grant refund payable."  Did FDA fail to carry out the conditions of the grant?  What conditions might those have been?

And check this out:  even though the FDA Foundation (Reagan-Udall Foundation for the FDA) is a 501C3, the FDA pays its operating expenses:
"Core Operations will be run on a day-to-day basis by the Executive Director and will be funded through:
  1. FDA funds specifically prescribed under the statute to be appropriated to the FDA and then transferred to the Foundation ($500k-$1.25m)"
While the FDA Foundation collects over $4 million a year, this turned out to be peanuts.  The CDC Foundation received over $42 million in "donations" in 2013.  The NIH Foundation received almost $73 million in 2014.  What did these funds buy?

NIH (like CDC) has an industry slush fund, with NFL its largest donor, allowing NFL veto power over concussion research/ ESPN

The story about the NIH funding for concussion research is confusing, because neither NIH nor the NFL will say exactly what transpired.  But the NFL gave (or merely promised) $30 million to the NIH Foundation in 2012.  But it seems there were strings attached.  NFL was unhappy with a researcher given the NIH grant, and appears to have rescinded the money--refusing to pay for the study that NIH promised to fund, apparently using NFL money.  Now NIH says it will fund the study itself. Under what set of conditions does the NIH Foundation take industry money, one might ask?  

We've learned that, like CDC, NIH has a Foundation (the Foundation for NIH, or FNIH) which seems to be a conduit through which it can receive industry funds and do industry bidding, while the taxpayer funds NIH to the tune of $30 billion/year.  The 30 million dollar NFL grant to FNIH is said to be the largest the Foundation has received.

According to ESPN
"The NFL, which spent years criticizing researchers who warned about the dangers of football-related head trauma, has backed out of one of the most ambitious studies yet on the relationship between football and brain disease, sources familiar with the project told Outside the Lines...
From 2003 to 2009, the NFL published its own research denying that football players get brain damage; much of that research was later discredited. But since then, the NFL has poured tens of millions of dollars into concussion research, allowing the league to maintain a powerful role on an issue that directly threatens its future...
Dr. Walter Koroshetz, director of the NIH's National Institute for Neurological Disorders and Stroke, told Outside the Lines this week that he had asked the FNIH over a period of several months if the NFL would be providing funding for the study but never received a definitive response. He said he attempted to expand the study over the summer to include other researchers -- a proposal that might have satisfied the league. But the NIH ultimately decided to fund the study on its own... 
The NFL's $30 million grant -- its largest single donation -- is administered by the Foundation for the NIH (FNIH), a nonprofit organization that solicits donations for NIH research... 
From the Foundation for NIH: 
"The Foundation for the National Institutes of Health procures funding and manages alliances with public and private institutions in support of the mission of the National Institutes of Health (NIH), the premier medical research agency...
The FNIH was established by Congress in 1990 as a not-for-profit 501(c)(3) charitable organization. The Foundation began its work in 1996 to facilitate groundbreaking research at the NIH and worldwide. As an independent organization, it raises private funds and creates public private partnerships to support the mission of the NIH—making important discoveries that improve health and save lives."

Thursday, December 31, 2015

Since 2010, prescription overdose deaths dropped slightly while heroin overdose deaths tripled/ CDC

Prescription Painkiller Sales and Deaths graph illustrating that deaths from prescription opioid painkillers have quadrupled from 1999 to 2013 in lock step with sales. Sources:Automation of Reports and Consolidated Orders System (ARCOS) of the Drug Enforcement Administration (DEA), 2012 data not available Centers for Disease Control and Prevention. National Vital Statistics System mortality data. (2015) Available from URL: http://www.cdc.gov/nchs/deaths.htm


FIGURE 2. Drug overdose deaths* involving opioids,†,§ by type of opioid¶ — United States, 2000–2014
The figure above is a line chart showing drug overdose deaths involving opioids, by type of opioid, in the United States during 2000-2014.
Source: National Vital Statistics System, Mortality file.
* Age-adjusted death rates were calculated by applying age-specific death rates to the 2000 U.S. standard population age distribution.
Drug overdose deaths involving opioids are identified using International Classification of Diseases, Tenth Revision underlying cause-of-death codes X40–X44, X60–X64, X85, and Y10–Y14 with a multiple cause code of T40.0, T40.1, T40.2, T40.3, T40.4, or T40.6.
§ Opioids include drugs such as morphine, oxycodone, hydrocodone, heroin, methadone, fentanyl, and tramadol.
For each type of opioid, the multiple cause-of-death code was T40.1 for heroin, T40.2 for natural and semisynthetic opioids (e.g., oxycodone and hydrocodone), T40.3 for methadone, and T40.4 for synthetic opioids excluding methadone (e.g., fentanyl and tramadol). Deaths might involve more than one drug thus categories are not exclusive.

Wednesday, December 23, 2015

Editorial: Federal corruption watchdogs are being denied access to necessary information/ LA Times


See the blog post below this one (from the NYT) on how Inspector Generals from over 70 federal agencies have been (illegally) (and continue to be) denied information by the agencies they are supposed to oversee. This thwarts the Inspector Generals from doing their jobs to root out corruption and mismanagement.  This denial of information is supported at the highest levels (i.e., by the White House).  The Inspector General system, placing independent watchdogs in executive branch agencies, was instituted by Congress in 1978 as a check and balance to executive branch power. 

Now, a month later, the LA Times has editorialized about this huge problem to our democracy.  They suggest that Congress fix it during the next session.  I think a lawsuit might speed things along, since the executive branch is not complying with the Inspector Generals Act:
Since Congress created the first inspectors general for federal agencies in 1978, these in-house watchdogs have proved their worth again and again. Inspectors general have investigated the CIA's inhumane “enhanced interrogation methods,” revealed abuses in the FBI's acquisition of telephone and other records, and documented the selective enforcement by the Internal Revenue Service of regulations governing political spending by tax-exempt groups. 
Given the nature of their mission, it is not terribly surprising to learn from inspectors general for several federal agencies that their work is being hampered by the unwillingness of the officials they monitor to provide some necessary information — despite the fact that the Inspector General Act requires that inspectors general have access to “all records, reports, audits, reviews, documents, papers, recommendations or other material” necessary to do their job. 
The Justice Department has come under particular — and deserved — criticism for stymieing the work of its inspector general. Beginning in 2010, FBI lawyers argued that some records couldn't be shared because of protections in federal law. In July, the department's Office of Legal Counsel concluded that the inspector general could be denied access to some information in three categories: the contents of wiretaps, grand jury proceedings and credit information.
The author of that opinion, Deputy Assistant Atty. Gen. Karl R. Thompson, concluded that the Inspector General Act's requirement that inspectors general have access to “all records” must be qualified in light of the provisions of the federal Wiretap Act, the Federal Rules of Criminal Procedure and Section 626 of the Fair Credit Reporting Act. His opinion said that the department could provide the inspector general with information protected by these laws for “many, but not all” of its investigations. 
That isn't good enough for Michael E. Horowitz, the department's inspector general, who said that without greater access “our office's ability to conduct its work will be significantly impaired.” But the problem isn't confined to the Justice Department. In a letter to congressional leaders, the council representing inspectors general from throughout the government warned that the Office of Legal Counsel's opinion “represents a potentially serious challenge to the authority of every inspector general and our collective ability to conduct our work thoroughly, independently and in a timely manner.” 
In fairness to the Justice Department, laws must be read in conjunction with others. And, legal interpretation aside, it's important to protect the privacy of personal information, including financial records and the products of electronic surveillance, which can capture private conversations of innocent people. But in such sensitive situations, information can be provided to inspectors general with the understanding that it will be redacted in any public report. 
A Justice Department spokeswoman said that the department would support legislation to clarify Congress' intent. Fortunately, there is a bipartisan effort in Congress to make it clear that, irrespective of other laws, inspectors general are entitled to “all records” necessary for them to perform their vital function. Enacting such a law must be a priority when Congress returns to work.