Wednesday, December 28, 2016

CDC's Weasel Words and Weasel Employees Force Flu Vaccinations on Healthcare Workers

In the last post, I explained that CDC was the source of the plan to investigate rates of healthcare worker flu vaccinations.  CDC collaborates with the Centers for Medicare and Medicaid Services to use staff (and patient) flu vaccination rates to calculate hospital "quality" -- and the "quality" number determines up to 4% of acute care hospitals' total Medicare reimbursements.

It turns out that the same person, Faruque Ahmed, PhD of CDC's Immunization Services Division is both the responsible person for getting NQF #0431 (healthcare worker [HCW] yearly flu shots) accepted as a quality measure, and is first author of CDC's meta-analysis of healthcare worker/ healthcare personnel flu shots and whether they benefited patients. Studies over 64 years fail to show that staff vaccinations reduce flu infections and deaths in patients--but good luck figuring that out from the gobbledygook they published.

I wondered how Dr. Ahmed squared forcing a million American healthcare workers to get yearly flu shots with his evaluation of the lack of evidence to support them.

While I can't tell you what he thought, I can tell you what he and his coauthors did.  They created a smokescreen.  

First, they wrote long, confusing sentences so it was very difficult to extract their meaning. For example:
"... It would have been preferable to have data on influenza‐specific mortality and hospitalization, but direct ascertainment of these specific outcomes is problematic because of the difficulty of distinguishing whether hospitalizations and deaths due to exacerbation of chronic illnesses and other conditions are attributable to the complications of influenza or to other reasons; estimates of influenza‐associated mortality and hospitalization are usually computed at the population level using statistical modeling techniques..."
Second, they said that although they had evaluated the world literature on this subject from 1948 to mid 2012 (over 6,000 articles had been considered and eventually whittled down to 8), the quality of the evidence of the 8 papers that made the cut was only moderate or low.

Third, the authors did some handwaving about the importance of evidence quality and transparency when making recommendations. Yet they admit that the quality of evidence they used was poor, and their recommendation is characterized by utter lack of transparency.

Fourth, the paper concludes in surprising fashion.  Despite lack of discussion of safety, the authors assert that the benefits of staff vaccinations outweigh the harms (which they never weighed) and that they "can" enhance patient safety.  Note that they didn't say vaccinations do enhance patient safety, only that they can.  Presumably they refer to an alternate universe in which there is an alternate body of medical literature:
"For any clinical question, the quality of evidence will vary based on the question and the context, and the best available evidence should be used for developing recommendations. An evidence‐based approach for developing recommendations requires transparency concerning the evidence and transparency in how judgments regarding the quality of evidence were made. Key factors for developing recommendations include the quality of evidence, balance of benefits and harms, values and preferences, and health economic analyses.[7, 39] The benefits of HCP influenza vaccination, which include likely reduction in morbidity and mortality among patients and reduction in illness among HCP themselves, outweigh possible harms. HCP influenza vaccination can enhance patient safety."
To coin a phrase, "You're doing a heck of a job, Faruque."  And CDC thinks so, too:

Biographical Sketch:

"Dr. Ahmed’s responsibilities at CDC include developing and directing an innovative, cutting edge, and methodologically sound research program on adult immunization to move health services interventions and evaluations into national, state and local vaccine-preventable diseases prevention strategies, programs and policies. The research includes evaluation of immunization services activities in both the public and private sectors, and translation of science into practice. Dr. Ahmed is a recipient of the Partners in Public Health CDC Civil Service Honor Award."

Thursday, December 22, 2016

Hospital that fired workers for refusing annual flu shots must reinstate them with back pay--and exploring the odd mechanisms used to impose vaccine mandates on healthcare workers, while CDC claims there are "no legally mandated vaccinations for adults"

A hospital in Erie, PA fired 6 healthcare workers for refusing the annual flu shot.  Taken to the EEOC, the hospital has settled by offering them their jobs back with $300,000 in back pay.

The interesting piece to me is the acknowledgement that the hospital imposed its mandate (with over 99% compliance of its remaining workers) in order to get higher Medicare reimbursements.

Yet the federal government, via CDC, claims it does not impose mandates, and suggests that it is actually illegal to force US adult civilians to get vaccinated. (Cite below)

What is going on?  

The federal government has created and co-created a variety of organizations which are supposed to help determine how to improve the "quality of care."  These organizations are called 1) QIOs, established by Medicare

and 2) organizations like the National Quality Forum, a federally-established, public-private health quality assessment organization

Medicare is used as a cudgel (while the federal government hides behind the “quality improvement” skirts of organizations it created) to forcibly impose certain cherry-picked "quality" measures on medical institutions, by lowering reimbursement rates to institutions that do not comply well enough with the “quality improvement" measures it selected, and raising rates for those that do.

At the same time, CDC wants you to think requiring flu shots has nothing to do with them:

“CDC does not issue any requirements or mandates for state agencies, health systems, or health care workers regarding infection control practices, including influenza vaccination. There are no legally mandated vaccinations for adults, except for persons entering military service. CDC does recommend certain immunizations for adults, depending on age, occupation, and other circumstances, but these immunizations are not required by law.”
Yet  CDC elsewhere on its website acknowledges what is really going on:  

“...Facilities must report employee coverage rates of flu vaccination as a quality measure: "Currently, the Centers for Medicare and Medicaid Services (CMS) requires reporting of influenza vaccination coverage for workers in acute care hospitals as a part of the Inpatient Quality Reporting Program through the Centers for Disease Control and Prevention’s (CDC) National Health Care Safety Network, a web-based data reporting system using National Quality Forum (NQF) #0431. Each hospital’s influenza vaccination coverage among their health care personnel will be included as a quality measure on Medicare’s consumer-based Hospital Compare program.”
What CDC failed to say was that the National Quality Forum's "quality measure" #0431 (which requires hospitals to report their staff's flu shot rates) was both initiated by and stewarded through the approval process by CDC.  CDC also failed to say that this measure was not only part of the Hospital Compare program, but it has been included as part of a composite measure of hospital quality affecting each hospital's Medicare reimbursement rate.

The bottom line is that the federal government squeezed hospitals by requiring hospitals to report the rates of yearly influenza vaccinations of both hospital staff and hospital patients, including these two measures in a global calculation of hospital "quality." A hospital's "quality" number determines approximately 3.75% of its overall Medicare reimbursements rate in 2017 (with yearly adjustments to this number).  In the healthcare industry, 3.75% is enough to make a hospital sink or swim.  The hospitals, predictably, acquiesced by demanding their employees be vaccinated or fired.

But the federal government insists it imposes no mandates.  Yet its actions created a de facto mandate.  Where are the lawyers who will litigate this in federal court?

I don’t understand why cases are going through EEOC, where employees may win, when their wins do not impact the de facto healthcare worker flu shot mandates that continue to be imposed in most US healthcare institutions today.

But here is the worst part:  healthcare worker vaccinations have not been shown to protect patients from influenza, according to 3 meta-analyses by the Cochrane Collaboration and, the World Health Organization
and CDC itself

Each of these three groups examined the world literature on the effects of healthcare worker (HCW) vaccinations in 2012-13, and each determined that there was no statistically significant evidence that healthcare worker influenza vaccinations prevented either influenza cases or influenza deaths in their patients.  You cannot get better evidence than this.  Healthcare worker flu vaccinations, despite what the public has been told, do not improve patient care.  Furthermore, there is no good evidence that flu shots benefit the over-65 Medicare patients who are also being vaccinated to comply with a second "quality" measure.  

To my knowledge, no one has looked to see if hospital inpatients have poorer outcomes because of these shots, but they certainly might.  The shots cause a generalized inflammatory reaction that might adversely affect patients with, for example, autoimmune diseases, pneumonia or heart attacks.

Few people are aware of the tremendous financial pressures being brought on healthcare institutions and providers to give them a yearly influenza vaccine.

In August 2014, soon after the evidence against HCW flu shots was published by Cochrane, WHO and CDC (so how could the feds not know?) the federal government added healthcare worker flu vaccination rates as one of the "quality" measures determining hospitals' Medicare payment rate, the science be damned.

That no one in media or healthcare administration seems to know about this incredible preponderance of evidence against healthcare worker flu shots is itself interesting.  

P.S.  Here is the Federal Register listing of all the "quality measures" by which hospitals are being judged.  The list starts on page 50246.  Note that both patient flu vaccination rates and healthcare staff flu vaccination rates affect hospitals' bottom lines in FY 2017.

Update:  I have written more about the process by which CDC misleads us on this issue here.

Saint Vincent settles federal lawsuit filed by workers who claimed religious discrimination.
By David Bruce 
Saint Vincent Hospital has agreed to rehire six former employees it fired after they refused to get flu shots in late 2013 and early 2014 due to their religious beliefs.
The Erie hospital also will provide about $300,000 in back pay and compensatory damages to the employees as part of an agreement to settle a lawsuit filed on behalf of the workers by the Equal Employment Opportunity Commission in September. A consent decree that ended the case and detailed the settlement terms was filed Tuesday in U.S. District Court in Erie.
The commission had claimed Saint Vincent violated Title VII of the Civil Rights Act of 1964 when it fired the six workers, who refused to be vaccinated after the hospital implemented a mandatory flu vaccination policy for all employees. The hospital granted medical exemptions to 14 other workers.
"The consent decree filed this week between the EEOC and Saint Vincent Hospital does not constitute any admission of violations by Saint Vincent or a finding on the merits of the case," Dan Laurent, a spokesman for Allegheny Health Network, Saint Vincent's parent organization, said in an email. "Although we have vigorously and respectfully disagreed with the EEOC's position and characterization of how employee claims outlined in this lawsuit were handled by the hospital, we have reached a resolution of the matter in the interest of avoiding the expense, delay and burden of further litigation on all parties."
As part of the consent decree, Saint Vincent must pay the following employees back pay and compensatory damages:
  • Bryan Nash - $81,712.86;
  • Aleksandr Gevorkyan - $81,814.81;
  • Aza Galustyan - $54,493.85;
  • Joshua Dolecki - $19,608.17;
  • Lisa Waller - $29,503.37;
  • Beth Theobald - $32,866.94.
In addition to providing the money, Saint Vincent must also offer to reinstate each former employee to their previous job with the same pay and benefits. If the job is not vacant, Saint Vincent must offer the employee a similar job if one becomes vacant over the next two years at any of the defendant's facilities within a 50-mile radius of Saint Vincent.
Saint Vincent implemented the mandatory flu shot policy to receive the maximum reimbursement for treating Medicare patients. At least 95 percent of the hospital's entire workforce had to be vaccinated to meet the requirements, Saint Vincent officials said in 2014 shortly after the policy went into effect. Saint Vincent said in February 2014 that 99.4 percent of its workforce had been vaccinated or received an exemption.Those who sought a religious exemption for a flu shot were told they must provide proof of doctrine from an established religious organization. Several employees who provided letters from clergy were still denied exemptions by the hospital.
The consent decree states that Saint Vincent, from now on, "shall not require proof that an employee's or applicant's religious objection to vaccination be an official tenet or endorsed teaching of any religion or denomination."
The hospital also cannot conclude that a person's "religious belief, practice or observance is not sincerely held simply because (Saint Vincent) deems the belief, practice or observance unreasonable, inaccurate, unfounded, illogical or inconsistent in Saint Vincent's view."
Saint Vincent, which was founded by the Roman Catholic Sisters of St. Joseph of Northwestern Pennsylvania, stopped requiring all employees to get a flu shot after it joined Allegheny Health Network, Laurent said.

Saturday, December 10, 2016

The Heroin Epidemic and the News/ DC Dave

The following piece was written by DC Dave, who shares my take on the opioid crisis, and its roots in the US deployment in Afghanistan.  He has elaborated on the heroin epidemic, noting how the mass media have shied away from a realistic discussion and interpretation of the epidemic of injected opioids sweeping the world, which killed (newly reported this week by CDC) 15,000 Americans in 2015.  Why did it take a year to come up with the 2015 number?   I previously discussed the fact that CDC has been assigning deaths in which fentanyl was found (even when the death was obviously due to injection) as "prescription opioid deaths." I suspect that as fentanyl use and deaths skyrocketed faster than those due to heroin during the past two years, this turned into a problem for CDC.  Fentanyl tends to be mixed with heroin or to replace heroin as a similar, stronger, cheaper alternative narcotic, which can be synthesized without poppies or opium.  So assigning all fentanyl deaths to prescription drugs is being noticed, and criticized.  The states and communities know whether people are dying from prescription fentanyl or from a needle.  My last post showed that Massachusetts is now releasing its own statistics.  While CDC claims over 50% of narcotic OD deaths are due to prescription drugs, Massachusetts says sorry, but our illicit narcotic OD deaths are 80%, and prescription OD deaths are only 20%.  Here is DC Dave's piece:

Heroin Epidemic and the News

When you discover something that seems to you to be important but then you notice that the people who tell us what is supposed to be news are ignoring it, you know that it must be really important.  I can cite a number of examples just from my own web site.  Most recently we had the almost total press blackout of the justice system wrist slap of the man most responsible for the flood of illegal aliens into the country.  It figures that they would black out the news of the piddling punishment that the man, Stan Eury, received, because they had blacked out his prosecution, and most of what they had reported on his operations previously had, amazingly enough, been favorable.

Before that we had their total failure to report in 2004 that the long suppressed report on the suspicious 1949 death of Secretary of Defense James Forrestal had at long last been made public.  The press silence was extremely telling.  They couldn’t report it because it was full of information that contradicted what they had unanimously told us for 55 years, that is, that Forrestal, the leading opponent in the U.S. government of recognition of the new state of Israel, had killed himself. 

Before that, in 1997, the press had completely blacked out the news that Kenneth Starr’s report on the death of deputy White House counsel Vincent W. Foster, Jr., contained, by judges’ order, 20 pages that thoroughly undermined the conclusion that Foster had committed suicide.  In Part 3 of my “America’s Dreyfus Affair, the Case of the Death of Vincent Foster,” I called it “The Great Suppression of ’97.”

These stories are plainly of enormous importance, and the fact that they are completely ignored by the American news media magnifies their importance.  So too is the story of the heroin-death epidemic that is currently ravaging the country.   In this case the news hasn’t been ignored completely, but it has been spun in such a way that one would hardly realize its magnitude.  In the first place, only the lesser news organs dare suggest that the sharply rising death rate in the country from drug overdoses might be coming from widely available cheap heroin.  “Heroin’s Death Toll Reaches Another Gruesome Landmark,” a headline that appeared above an October 16, 2016, article in the leftist Mother Jones magazine is one that you will never see in The Washington PostThe New York Times, or one of their many clones around the country.  The article’s subtitle was even more disturbing: “Most states now lose more citizens to overdoses than to car accidents.” 

The heroin factor in drug overdose deaths is also played down by the major news media by focusing all of what inadequate attention they have given to the problem on the deaths from prescription opioids.  The Washington Post furnished a good recent example of what I am talking about on October 22 of this year.  I posted an online comment, which received a supporting response from a medical doctor.  Since, together, they get us right into the heart of the distorted reporting on the matter, I reproduce them both here:

I believe this is a very misleading statement: "Prescription narcotics cause more overdose deaths every year than any street drug, including heroin." 
The following is from an article by Meryl Nass, MD:  
"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 will be labeled as due to a prescription narcotic." 
Dr. Nass observes further: "While nationally, heroin overdoses 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.'" *
Furthermore, the statistics do not distinguish between accidental and intentional drug overdose deaths. You know what you're getting from a prescription drug, but not from heroin bought on the street. I believe that all this fuss about out-of-control prescription drugs is a big smokescreen to cover for what is overwhelmingly an epidemic of deaths from heroin overdoses. Most of that heroin comes from Afghanistan and the producers are protected by our government.

To which “Pathologist, MD,” replied:

You are exactly spot-on correct. I've been saying this for over two years to deaf/blind ears/eyes including the CDC who's just fine with their bogus statistics. A competent high school math student should be able to debunk CDC stats which are hyperbole and designed for one thing - the addictionologists who've taken over at the CDC (like Andrew Kolodny - a psychiatrist/addictionologist who worked with Tom Frieden while they were together in NYC before Friedenbecame head of the CDC). If anyone will do a bit of research, instead of getting to the root causes of this problem, a band of zealots took over the CDC so-called 'prescription drug epidemic' and embellished everything in the language of addiction when only a small fraction of legitimate chronic pain patients have ANY problems with addiction issues (around 5%). Instead, they inflate numbers and create problems for patients while doing nothing for the real problem - illicit drugs and mostly young addicts. Then the major networks (like CNN and 60 minutes) pile on without doing any research whatsoever to further embellish the illegal side by taking pain medication away from legitimate patients. And NO ONE wants to hear from patients - I'm a 30 year senior in-house staff hospital physician who can't get an audience with anyone in power - they'd rather mislead everyone. Editors of major media outlets are aware of this but have chosen to take the low road and are doing nothing but making it all worse for everyone. Whether they're innumerate (bad at math) or prefer hyperbole, it's all the same. Misinformation on a grand scale and screwing over patients. How honorable.

Ignoring for the moment the last point in my letter, that most of the heroin behind the drug overdose surge is coming from Afghanistan, we can easily find support for Dr. Nass’s claim that heroin deaths are mainly behind the drug-death surge in the CDC’s own literature

From 2000 through 2013, the age-adjusted rate for drug-poisoning deaths involving heroin nearly quadrupled from 0.7 per 100,000 in 2000 to 2.7 per 100,000 in 2013. During this 14-year period, the age-adjusted rate showed an average increase of 6% per year from 2000 through 2010, followed by a larger average increase of 37% per year from 2010 through 2013…

Several factors related to death investigation and reporting may affect measurement of death rates involving specific drugs. For example, toxicological tests to determine the types of drugs present may vary by jurisdiction. Measurement errors related to these factors are more likely to affect substance-specific death rates than the overall drug-poisoning death rate. In 2013, 22% of drug-poisoning deaths did not include information on the specific types of drugs involved. Some of these deaths could potentially involve heroin or opioid analgesics.

Metabolic breakdown of heroin into morphine in the body can make it difficult to distinguish between deaths from heroin and deaths from morphine based on the information on the death certificate. Some deaths reported to involve morphine could actually be deaths from heroin.  This may result in an undercount of heroin-related deaths.

A person examining the tables and charts in that report entitled “Drug-poisoning Deaths Involving Heroin: United States 2000-2013” can easily come to the conclusion that it is readily available cheap heroin that is primarily responsible for the surge in drug overdose deaths in recent years.  As Dr. Nass says in another article, “The true cause of the current heroin epidemic is massive amounts of heroin flooding into the U.S., exceeding what can be sold in our large cities, and now finding its way into even the tiniest hamlets.”

Local Reporting Better
One of those hamlets is Nashville, the county seat of my home county of Nash in North Carolina.  The chief of Nashville’s police department recently instituted a program inviting addicts to turn themselves in for treatment, with a promise of no punishment by the law.  
Of the 32 people who responded, “29 were addicted to heroin or opioid painkillers, two were crack-cocaine users and one abused alcohol.” "If you've got a thousand-percent increase here, it's not really something you can sweep under the rug," [Town Manager Hank] Raper said. "It's already here. It's not a matter of 'We'll address it when it gets here.' I think you're in denial if that's what you think."
The town manager noted that many users migrate to heroin after receiving legitimate prescriptions for opioids like hydrocodone, oxycodone, codeine and morphine.
“People who abuse heroin also defy demographics -- with young and old, rich and poor, whites and minorities all developing a physical and psychological dependence on the substance.
"Children are addicted to heroin," Raper said. "Elderly senior citizens, 80, 90 years old, are hooked on heroin. Wealthy individuals, poor individuals. It's a cheap drug. For $10, you can buy a hit of heroin. That's really not unaffordable to anybody. If you want it bad enough, you can find 10 bucks."
The Wilson Daily Times, in which this article appeared, seems not to have gotten the word from propaganda central that they’re supposed to shy away from the dreaded “h” word and to call this an “opioid epidemic” instead.  The article carried this title, “Police can’t arrest their way out of the heroin epidemic.  Nashville tries a different approach to break the cycle.”  Further down in the article we see the section heading, “Heroin Epidemic,” followed by this lead sentence, “A scourge in the northeastern United States for years, heroin has gained popularity in the Tar Heel State, where many of its users found the drug cheaper and easier to obtain than opioid painkillers.” 
We can find an echo of this small town North Carolina newspaper in Lancasteronline, from Lancaster, Pennsylvania.  “Frustration mounts as Lancaster County drug epidemic grows,” says the headline from October 16, 2015, and the first sentence cuts right to heart of the matter, “They don’t all agree on the way the war on drugs should be fought, but prosecutors, emergency responders, educators and health professionals in Lancaster County say heroin use is an epidemic here.”  The article continues in that vein, zeroing in on heroin, not opioids in general:
The frustration has its roots in the number of people who overdose on heroin here. Robert Patterson, a lieutenant with Lancaster EMS, said emergency medical technicians have treated 585 people for overdoses in the eight months from February through September; and 163 were treated with naloxone.

Naloxone is the heroin antidote that first responders now carry as do emergency medical personnel. He said overdoses happened not just in the city but in 22 different townships in the county so far in 2015.

“Pennsylvania is now the third worst state in the country for heroin abuse,” said [Craig] Stedman, the district attorney, “and one of the worst for mortality (from heroin).”
Stedman said arrests for bulk heroin are up, indicating larger supplies are coming into the county.

“The Drug Task Force had three cases of bulk heroin in 2011-2012, nine cases from 2012-2013,” Stedman said. “They’ve investigated 38 cases of bulk heroin in 2014 and there were already 27 cases through the first half of 2015.”
By correctly labeling the problem as a heroin overdose epidemic and then talking about its abundant supply these small newspapers steer us in a direction that the big opinion molders like The Washington Post and The New York Times don’t want us to go. 
In its power and influence, the Raleigh News and Observer falls squarely between the two small and two large newspapers I have cited.  Its reporting on the heroin epidemic has, for the most part, mirrored that of its larger cousins, but it did manage to print one bold letter to the editor:  
Regarding the Sept. 19 news article “US attorneys focus on prescription opioid and heroin abuse”: I am weary of articles blaming the opium (opioids/opiates) epidemic on our physicians. When opium products became rampant on our streets again, officials had difficulty explaining this epidemic to the public. Our government faced similar problems in the 1960s when our military troops were sent to Vietnam and the Golden (opium) Triangle.

Let’s follow the money trail. According to the United Nations, almost two-thirds of illegal street opium is cultivated in Afghanistan, but not processed there. Most opium is processed into pills, powders, patches and heroin in factories in other foreign countries. The vast majority of opium products sold on the streets is not processed in U.S. factories, not at any time ordered by our physicians or dispensed by our pharmacies. According to the U.N., most opium products used illegally in the U.S. are believed to be processed in Mexican and other factories in Central and Latin America. It is estimated the illegal opium trade is a $69 billion to $79 billion a year business.

While some bad apples exist, U.S. physicians didn’t start and don’t maintain the illegal opium epidemic, so stop the scapegoating. There is a better question. Why are we still in Afghanistan?


Even though from something of a local celebrity, such a letter is very unlikely to have seen the light of day in The Washington Post or The New York Times or any other big city newspaper in the country, because it carries a message that they are working hard to keep a lid on.

A Google Search

A simple web search reveals the mainstream news suppression starkly.  Readers may go as I did to Google and type in “Heroin epidemic Afghanistan.” I have listed in order below, with links, the articles that came up on the first page of the search.  Pay particular attention to the news organs that produced them.  All are well worth reading in their entirety; I have quoted the opening passages from three of them for particular emphasis upon their message.   The third article, one might notice, is the second of Dr. Nass’s two articles that I have linked to previously above:

MINNEAPOLIS — The “War on Drugs” and the “War on Terror” are more intertwined than that media and our elected officials would like us to think.

And this became full front and center when the U.S.-led global crusades overlapped in Afghanistan, leaving in their wake a legacy of death, addiction and government corruption tainting Afghan and American soil.

In the U.S., the War in Afghanistan is among the major contributing factors to the country’s devastating heroin epidemic.

Over 10,000 people in America died of heroin-related overdoses in 2014 alone– an epidemic fuelled partly by the low cost and availability of one of the world’s most addictive, and most deadly, drugs.

The heroin epidemic resembles the days when “Crack cocaine” became the major drug that destroyed communities across the United States and other parts of the world including the Caribbean that began in the early 1980’s. The Crack epidemic coincidently began around the same time when the Iran-Contra Scandal was being exposed. U.S. cities such as Los Angeles, Miami and New York City experienced a rise in crime and disease. The Center for Disease Control (CDC) reported back in 2015 that “heroin use in the United States increased 63% from 2002 through 2013.” Fast forward to 2016, heroin is sweeping across the United States at unprecedented levels.

Barack Obama ended opium eradication efforts in Afghanistan in 2009, effectively green lighting Afghan opium and the heroin trade. U.S. policy has allowed Afghan opium and heroin since. And heroin deaths here tripled from 3,036 in 2010 to 10,574 in 2014; so has heroin use, from 1,500,000 in 2010 to 4,500,000 heroin users in 2014.

Now let us take stock.  The first thing one should notice is that none of these very informative and well-researched articles was in a mainstream United States news organ.  The closest thing to it is the last one which appeared in Newsmax, which I have previously identified as a likely intelligence operation headed up by thenotorious Christopher Ruddy.  As its opening passage indicates, consistent with the mission of the web site, it acknowledges a connection between the U.S. heroin scourge and our involvement in Afghanistan, but it spins the story to blame everything on the Obama administration. 

Not until I got to the second page of my Google search did I encounter anything from the generally recognized U.S. mainstream press, and that was this one from NBC News:

That sounds promising, but as one can see from the opening passage below, the spin that the network puts on the story almost makes one dizzy:
In Afghanistan, opium production is growing like a weed — and nothing, not even billions of dollars of U.S. money, has been able to quell it. 
According to the United Nations, the war-torn nation provides 90 percent of the world's supply of opium poppy, the bright, flowery crop that transforms into one of the most addictive drugs in existence. 
And as the Centers for Disease Control and Prevention sounds the alarm about a worsening heroin epidemic here in the U.S., opium production in Afghanistan shows no signs of slowing down. 
"Afghanistan has roughly 500,000 acres, or about 780 square miles, devoted to growing opium poppy. That's equivalent to more than 400,000 U.S. football fields — including the end zones," John Sopko, Special Inspector General for Afghanistan Reconstruction, said in a speech in May. 
The U.S. has spent $8.4 billion in counternarcotics programs in Afghanistan. But opium output keeps rising: Fifteen years ago, Afghanistan accounted for just 70 percent of global illicit opium production. 
Did you get that, dear reader?  We are being flooded with cheap heroin originating in Afghanistan not in any way because of U.S. intervention in the country but in spite of the U.S. invasion and the history of the CIA fattening its coffers through engaging in the extraordinarily profitable illicit drug trade.
Is it any wonder that the confidence of the American public in its major news media is at an all-time low?  Most people in the country still get most of their news from the major television networks, but people who are dependent upon them would hardly know that we even had this heroin epidemic, that is, if, in all likelihood, it hadn’t already hit pretty close to their own homes.  So wary are the mainstream media of using the “h” word and addressing the problem head on, that it is left to government officials like the Attorney General of Virginia to produce a documentary like “Heroin: The Hardest Hit” or the BBC to give us “Smack in Suburbia.”  How much more effective might those documentaries have been in alerting people to the problem had they been aired on a major American television network!  
One can’t help thinking that they don’t give this horrible new scourge the attention it deserves because, if they did, people would begin asking too many questions, and a big income stream that likely filters down to all of them might be jeopardized.

* A better link to Dr. Nass’s article, it has been pointed out to me, is at her web site, because there you can read the additional valuable observations of a military veteran of Afghanistan:

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! 

David Martin
December 1, 2016


I received the following depressing email message from Dr. Nass on December 3, 2016:

I am going to bring up a side issue, since your earlier email quoted me on the method used by CDC to assign a death to prescription opioids vs heroin. (She is referring to my article, which I sent her by email.  ed.)

CDC has not released the 2015 data on deaths.  I have been waiting for it.

I have a strong suspicion that CDC’s “programmatic” way of assigning deaths to prescription opioids has now gotten CDC into hot water, such that if they use the “programmatic” method for 2015-6 everyone will know they are FOS.  

This is because a) so much heroin is cut with fentanyl, a fully synthetic opioid that can be obtained by prescription, but is probably entering the US from illegal synthesis in huge quantities.  Mg for mg it is up to 50 times more potent than heroin.  So not only do you need less for the same kick, you don’t require any opium to make it.

In Massachusetts, more of the ODs (by a small margin) contained fentanyl than heroin. Like 80% and 70% respectively.  If CDC calls all the ODs that involved fentanyl 'prescription drug ODs', when the cops and medical examiners know they involved injected heroin and fentanyl, CDC will be seen to be a liar.  So they are withholding the stats, imho, until they design a different method of calculation and have come up with a plausible story for the change in methodology.

Yes, I am very concerned about heroin from Afghanistan, and there was allegedly a very good crop last season.

But fentanyl is catching up to it so even if we get out of Afghanistan, the problem will not be ameliorated.

BTW we do not have enough medical examiner resources to check every OD for what did it.  And this will likely worsen since the numbers the medical examiner system now has to deal with, using flat resources, has gotten so high.  This may enable CDC to do some mealy mouthing about the whole issue.

Fentanyl is mentioned in one of the videos to which we link in the penultimate paragraph.  It was news to me when I heard it, and I believe I was remiss in not calling attention to it because it represents such a lethal threat to unsuspecting heroin users.  It is one opioid that is a good deal more dangerous than heroin.

David Martin
December 5, 2016