Feds, state warn Delaware Psychiatric Center about shredding evidence

From Delaware's The News Journal

Revelations that documents were being shredded at the Delaware Psychiatric Center at the same time federal and state agencies were investigating the hospital have prompted stern warnings from the United States Attorney's Office and Delaware Attorney General Beau Biden.

In a letter Friday to DPC, U.S. Attorney Colm Connolly's office warned Vince Meconi, secretary of the Department of Health and Social Services, that Connolly did not take the possible destruction of evidence lightly.

"We are concerned about this reported document destruction, and write to remind you and your employees of your duty to preserve any materials that may be relevant to reasonably foreseeable litigation, as well as your duty to not destroy or impair any documents so as to interfere with their availability in an official proceeding," wrote First Assistant U.S. Attorney David C. Weiss. "Accordingly, we ask that you cease any document destruction efforts that relate to DPC."

After revelations about patient abuse and retaliation against nurses who report the abuse were first chronicled last month in The News Journal, Connolly notified Justice Department regulators in Washington about possible civil rights violations at DPC. At least six state and federal agencies are examining conditions at the trouble-plagued state hospital, including a task force recently established by Gov. Ruth Ann Minner.

The News Journal broke a story about the shredding program last week. Meconi and other state officials said DPC was not involved, even though DPC's administration building was on the list of buildings visited by the contract shredding firm. According to the firm, the shredding operation ended Friday.

Connolly and Biden declined to comment for this story.

DPC director Susan Watson Robinson said only that she received Connolly's letter Monday, which "reminded us of our obligation not to shred any documents."

In a written response to the U.S. Attorney's Office, which Robinson provided along with the Justice Department warning, Meconi said that "no DPC documents have been destroyed or discarded, nor will they be destroyed or discarded during the course of any state of federal investigation or inquiry."

"All records pertaining to DPC remain intact and accessible to any law enforcement or monitoring agency," Meconi wrote. "In addition to your directive, we have previously been directed not to destroy or discard DPC documents by the state Department of Justice."

The "document shredding program" has prompted calls for Meconi's resignation from Rep. Gregory F. Lavelle, R-Sharpley, who described the shredding as "the straw that broke the camel's back."

It also prompted action from State Treasurer Jack Markell.

Markell sent a letter to the co-chairs of Minner's task force, Rita Landgraff and Peter Ross, requesting they "make every attempt to address a series of pressing questions being raised by Delawareans."

"Over the past several weeks, I have heard again and again while traveling the state a deep level of concern over the many and continuing unanswered questions about ongoing care at the Delaware Psychiatric Center," Markell said. "With this letter, I am hoping to bring a more focused voice to many of those concerns that I share with so many other Delawareans, and to request of Governor Minner's task force that they try to make every attempt to provide these answers to the concerned families and friends raising them."

In his letter to the task force, Markell asks a lengthy series of questions, covering a broad scope of problems identified in the ongoing News Journal special report.

"There's a lot of unanswered questions," he told The News Journal. "I think the task force's work could benefit the state and the public if they tried to answer some unanswered questions. The commission they've been given is important, but I think there's a lot of unanswered questions that could restore public trust. The letter speaks for itself, in terms of my motivations."

Markell wants the co-chairs of Minner's task force to determine whether security cameras -- promised early on during The News Journal's investigation -- have been ordered, and whether DPC would be better off with a psychiatrist in charge.

He also wants to know why a request made by The News Journal under the state's Freedom of Information Act for copies of every patient-abuse report filed since 2001 was rejected. He hopes that the task force reviews the forms.

Another series of Markell's questions pertains to documented patient abuse. On July 2, patient Preston Hudson's jaw was broken in three places inside DPC's admissions unit.

On July 15, The News Journal quoted Jay Lynch, spokesman for the Department of Health and Social Services, saying that Hudson's claims of being beaten by employees of the hospital "are not credible" and that Hudson tripped on the edge of a mat.

On Aug. 6, an attendant was indicted for second-degree assault and patient abuse in the case. Anthony R. Liggians Jr., 32, of Wilmington, was fired by DPC shortly before the charges were filed. His criminal case is pending.

"The original statement by DPC that the patient 'tripped' is, frankly, suspect, in light of this indictment," Markell wrote. "The Department's spokesman said hospital investigators initially relied on internal reviews and medical records to conclude Hudson's claims were not credible. What exactly did those medical records say? Did the doctor who performed the surgery indicate that the patient likely tripped? Is there to be any accountability beyond the indictment of the attendant?"

Of the shredding, Markell asked: "What is the shredding policy for DPC if one exists at all? What exactly was shredded and why was this particular time chosen for the shredding?"

On Monday, Robinson said Markell will get his answers during an upcoming public hearing by the legislative committee investigating DPC.

"All of these questions are the ones that we're looking forward to answering at the Sept. 11 hearing," Robinson said. "We're happy that in his letter, he acknowledges there are a lot of employees that are dedicated to providing high-quality patient care."

Markell is expected to face Lt. Gov. John C. Carney in a Democratic primary next year to replace Minner. On Monday, Carney said he called Meconi about the shredding.

Last week, Gov. Minner has expressed her "utmost confidence in Secretary Meconi and his leadership team."

Asked Monday if he shared the governor's confidence in Meconi, Carney repeated his concerns about the shredding.

"I am very concerned overall about this issue of public trust," Carney said. "I think the administration out there needs to change their attitude a little toward the whole process, and be more responsive to the questions being asked."

3 More Arrested In Connection With Psychiatrist's Drugs-For-Cash Ring

From this CBS 2 report out of LA

hree more arrests were made in connection with an alleged drug-prescription-for-cash ring that authorities say was run by a Murrieta psychiatrist.

James Dylan Hall, 21, Saege Hall, 18, and Janine Hall, 45, all of Temecula, were taken into custody Friday by deputies serving a search warrant in the 29700 block of Calle Pantano, said Murrieta Sgt. Tony Conrad.

Psychiatrist Joel Dreyer, arrested July 24 at his Murrieta home, was charged with five counts of issuing a false prescription. He remains behind bars on $50,000 bail, awaiting a preliminary hearing.

James Hall was booked into the Southwest Detention Center, on suspicion of probation violation and remained jailed in lieu of $25,000, pending arraignment tomorrow.

Saege Michael Hall was booked on suspicion of narcotics possession and was released on $25,000 bail, pending arraignment Sept. 21.

Janine Keating Hall was booked in the county jail on suspicion of drug possession and was released on $5,000 bail, pending arraignment Sept. 21.

Detectives serving the search warrant found 38 grams of marijuana and an undisclosed amount of Vicodin and Xanax tablets.

Investigators determined that Dreyer's prescriptions were being filled at 30 to 40 pharmacies in the Murrieta and Temecula areas, according to a U.S. Drug Enforcement Administration agent who attended a hearing last month.

The DEA and state Medical Board began investigating Dreyer after pharmacists noticed seemingly healthy young people coming in with prescriptions for powerful painkillers and anti-anxiety drugs.

Police said an informant went to Dreyer and paid to get a prescription. That was when Murrieta police got involved, and the agencies began coordinating their efforts.

Typically, the doctor would charge $100 per prescription without any kind of examination, said Murrieta police Lt. Dennis Vronman.

Dreyer, 69, worked with troubled teens in group homes, as well as in private practice.

None of the teens was suspected of involvement in the alleged scheme, Vrooman said.

Famous Wrestlers Who Died Before the Age of 60

The death rate among wrestlers is alarmingly high. Via this post on About.Com.

The point on this is, not only the toll the profession takes on entertainment wrestling, but the damage drugs do is tragic, especially as prescribed by unscrupulous doctors.

Famous Wrestlers Who Died Before the Age of 60

(Since 1985 Before the Age of 60)

Chris Von Erich - 21
Mike Von Erich - 23
Louie Spiccoli - 27
Art Barr - 28
Gino Hernandez - 29
Jay Youngblood - 30
Rick McGraw - 30
Joey Marella - 30
Ed Gatner - 31
Buzz Sawyer - 32
Crash Holly - 32
Kerry Von Erich - 33
D.J. Peterson - 33
Eddie Gilbert - 33
The Renegade - 33
Owen Hart - 33
Chris Candido - 33
Adrian Adonis - 34
Gary Albright - 34
Bobby Duncum Jr. - 34
Yokozuna - 34
Big Dick Dudley - 34
Brian Pillman - 35
Marianna Komlos - 35
Pitbull #2 - 36
The Wall/Malice - 36
Leroy Brown - 38
Mark Curtis - 38
Eddie Guerrero - 38
John Kronus - 38
Davey Boy Smith - 39
Johnny Grunge - 39
Vivian Vachon - 40
Jeep Swenson - 40
Brady Boone - 40
Terry Gordy - 40
Bertha Faye - 40
Billy Joe Travis - 40
Chris Benoit - 40
Larry Cameron - 41
Rick Rude - 41
Randy Anderson - 41
Bruiser Brody - 42
Miss Elizabeth - 42
Big Boss Man - 42
Earthquake - 42
Mike Awesome - 42
Biff Wellington - 42
Brian Adams (Crush) - 43
Ray Candy - 43
Nancy Benoit (Woman) - 43
Dino Bravo - 44
Curt Hennig - 44
Bam Bam Bigelow - 45
Jerry Blackwell - 45
Junkyard Dog - 45
Hercules - 45
Andre the Giant - 46
Big John Studd - 46
Chris Adams - 46
Mike Davis - 46
Hawk - 46
Dick Murdoch - 49
Jumbo Tsuruta - 49
Rocco Rock - 49
Sherri Martel - 49
Moondog Spot - 51
Ken Timbs - 53
Uncle Elmer - 54
Pez Whatley - 54
Eddie Graham - 55
Tarzan Tyler - 55
Haystacks Calhoun- 55
Giant Haystacks - 55
The Spoiler - 56
Kurt Von Hess - 56
Moondog King - 56
Gene Anderson - 58
Dr. Jerry Graham - 58
Bulldog Brown - 58
Tony Parisi - 58

There are also these tidbits that are interesting (slightly edited for content):

Eric Cohen, a bit of an expert on entertainment wrestling, and a guy who actually admits this, says:

“The death rate among wrestlers is alarmingly high. The only time this story was covered by the national media was on HBO's Real Sports with Bryant Gumble. That segment featured Vince McMahon mocking the interviewer and slapping the notes from his hands. In addition, the only wrestler to speak up for the wrestlers, Roddy Piper, was fired after the piece aired.”

Cohen says that the athleticism involved in faking the matches puts a tremendous toll on the wrestlers’ bodies, so prescription pain killer use and abuse is high, and over time, weakens their bodies and kills them. Well, if that’s true, then retired football players would be dropping dead by age 40.

Police found the latest dead WWE wrestler, George Caiazo, AKA: John Kronus, dead in his girlfriend’s apartment. . . Officials are treating it as a "suspicious death" based on his age (38), and the fact that there was no ax sticking out of his head. Autopsy and toxicology reports are still pending.

Doctors Who Have "Close Relationships" With Drug Makers Prescribe Newer, Pricier Drugs

Just in case there was any confusion on the issue. From The Consumerist weblog

The New York Times is examining doctors who take money from drug companies for 'educational' speaking engagements in which they lecture other doctors about the company's drugs. The NYT says research shows that "doctors who have close relationships with drug makers tend to prescribe more, newer and pricier drugs -- whether or not they are in the best interests of patients." From the NYT:

"When honest human beings have a vested stake in seeing the world in a particular way, they're incapable of objectivity and independence," said Max H. Bazerman, a professor at Harvard Business School. "A doctor who represents a pharmaceutical company will tend to see the data in a slightly more positive light and as a result will overprescribe that company's drugs."

In Minnesota, a state in which drug company payouts are disclosed to the public, "More than 250 ... psychiatrists together earned $6.7 million in drug company money -- more than any other specialty. Seven of the last eight presidents of the Minnesota Psychiatric Society have served as consultants to drug makers, according to the Times examination."

A former drug company representative was forthright in her explanation of the phrama industry's goals:

"The vast majority of the time that we did any sort of paid relationship with a physician, they increased the use of our drug," said Kathleen Slattery-Moschkau, a former sales representative for Bristol-Myers Squibb and Johnson & Johnson who left the industry in 2002. "I hate to say it out loud, but it all comes down to ways to manipulate the doctors."

This is all the more reason you should research the medicines you take and discuss them with your doctor. Consumer Reports "Best Buy Drugs" is an excellent place to start.

Drug makers step up giving to Minnesota psychiatrists

More on the money big drug companies are giving to psychiatrists. From this report

One in three Minnesota psychiatrists has received funding from drug manufacturers in the past five years, including seven past presidents of the Minnesota Psychiatric Society, two state drug policy advisers and 17 faculty psychiatrists at the University of Minnesota.

While drug company funding is hardly limited to mental health providers, a review of the latest Minnesota public data shows a much higher proportion of psychiatrists receiving money for research, lectures and consulting than other medical specialties.

Drug companies reported $2.1 million in contributions to Minnesota psychiatrists in 2006, up from $1.4 million in 2005.

It's arguable whether the money influences how doctors prescribe drugs or how doctors on influential advisory boards recommend how and when drugs should be used. The psychiatrists who take the money see it as a necessity in a system that needs more education about mental illness and shortchanges mental health research.

Health policy advocates believe the drug companies are getting a return on their investment regardless of whether the doctors know the money is influencing them.

"They wouldn't keep doing it - piling on more and more dollars - if they didn't think it was successful," said Joel Albers, a St. Paul pharmacist and health economist.

From 2002 through 2006, the nation's drug manufacturers reported $73 million in gifts, grants and reimbursements under Minnesota's one-of-a-kind reporting law. Payment records for 2006 were released earlier this summer and have been added to a Pioneer Press database at twincities.com that allows readers to search by name for doctors, nurses or institutions that have received money.

The state's reporting system is imperfect, as drug companies apply different criteria for the types of payments they must disclose. Some include scientific grants that are in doctors' names but actually go to their research institutions. Others include only the meals, gifts and perks Minnesota lawmakers were targeting when they passed the reporting law a decade ago.

The tally nonetheless is a crude indicator of the involvement and influence of the drug industry in medical care nationwide, especially in areas like psychiatry that rely heavily on some of the nation's most expensive drugs.

Such lawmakers as Sen. Chuck Grassley, R-Iowa, have been scrutinizing the Minnesota data and proposing federal laws to either disclose or restrict the money drug companies give doctors. Locally, the Minnesota Department of Human Services is considering tighter restrictions on members of its drug formulary committee, who advise the state on which drugs are most effective and offer the best value.

One committee member, Dr. John Simon, has received more than $570,000 since 2002 from six drug companies, according to state reports. Most of that was from Eli Lilly, whose antipsychotic drug Zyprexa is the most costly each year for Minnesota's fee-for-service health program for the poor and disabled.

While the committee offers guidance on numerous medications, its advice on mental health drugs is crucial. More than 200,000 Minnesotans are enrolled in the fee-for-service program, and 80 percent of them take at least one psychiatric medication.

Simon said pharmaceutical companies pay him to speak at conferences and clinics about their drugs or about the conditions treated by their drugs. While the situation hasn't occurred, he said, he would abstain from any committee votes involving drugs he has been paid to discuss.

He did vote in December 2004 for an unrestricted state policy with respect to Strattera, a nonstimulant drug Lilly makes for attention deficit disorder. Upon reflection, he said, he should have abstained or acknowledged his funding from Lilly before voting. However, he said, he also cast votes advising restrictive policies on Lilly drugs that regulate insulin and cholesterol.

"I certainly don't need to take care of the pharmaceutical companies," said Simon, who was appointed to the formulary committee by the Minnesota Psychiatric Society. "They're big boys and can take care of themselves by other means."

"Most of the psychiatrists who are really good," he added, "have ties to industry."

State records show 187 psychiatrists received $7.4 million from drug companies from 2002 through 2006. Twenty-eight received at least $50,000 during that period, while others received smaller amounts for gifts or speaking engagements. The median amount received was $2,700, which is three times the median amount of $900 for other types of doctors who received payments.

The state psychiatric society is reviewing literature and research on drug company influence and plans to offer members training on how to avoid conflicts, said Dr. Jeff Hardwig, society president.

"Does drug company marketing affect our practice? I think the answer must be yes," said Hardwig, a northern Minnesota psychiatrist with no drug company ties. "Practicing psychiatrists must be aware of how that might influence them and be on guard against undue influence."

Simon said psychiatrists are getting a greater share of drug company money because primary care doctors need more education about mental illness and how to treat it: "Go into your family practice clinic and complain about chest pain and see what they say, and then go in and complain about bipolar disorder and see what they say."

Former pharmaceutical executives said drug companies are interested in teaching doctors about treatment standards, because that will increase the number of doctors who act on that information and prescribe their pills. However, they said, pharmaceutical companies usually start by hiring doctors who are frequent prescribers of their drugs.

Psychiatric drugs are unique. If patients have success with certain medications, their doctors aren't likely to switch them, even when cheaper alternatives are available. That increases the stakes for drug companies to make sure their drugs are tried first.

It also makes decisions by formulary committees and other advisory boards particularly important. If Minnesota's formulary committee votes to restrict how a certain drug is prescribed, the state usually follows that recommendation.

A spokesman for industry trade group PhRMA said earlier this year that the money reflects valuable research and education that is advancing medicine. The group has questioned the relevance of the state database, because it mixes research grants with gifts and other types of unrelated payments.

Dr. David Adson, of the University of Minnesota, reportedly has received more than $560,000 since 2002 from drug companies. However, Adson said, most of that money is for research grants that pass directly to the university.

Like Simon, Adson has a state advisory role: He is the clinical leader of a program that notifies doctors whenever their prescriptions for antipsychotics and other psychiatric drugs are out of step with clinical standards.

Top psychiatrists are in demand, so it isn't surprising to find them giving paid lectures or conducting drug-company research while also serving on advisory committees, said Al Heaton, pharmacy director for Blue Cross and Blue Shield of Minnesota. But Heaton, who also serves on the state formulary committee, said those connections need to be disclosed upfront.

"It's better to have it kind of come out from under the rock, and people can create their own opinions and judgments, versus if it's not disclosed, and then you find out after the fact," Heaton said. "Then you just assume it was bad."

The psychiatric society nominated Simon to the state formulary committee because of his expertise and credentials, Hardwig said, but is considering whether it should ask him to step down.

Simon told the society this week he would do so if asked, to avoid even the appearance of a conflict.

MaryJo Webster contributed to this report. Jeremy Olson can be reached at 651-228-5583 or jolson@pioneerpress.com.

Search the database at twincities.com to see if your doctor received payments from pharmaceutical companies.

First Person Shooter Syndrome

A satirical post featuring another invented psychological disease. As seen in Robot People Magazine

In the virtual gaming world, a plague has ravaged the population, and this time, head crabs and flaming skulls that turn you into Zombies are not the problem. The new illness is a psycological one. It is called 'FPSS' or 'First Person Shooter Syndrome.'

"We're seeing FPSS cases popping up everywhere," said Dr. Duke Freeman, head of psychology at John Hopkins University. "I mean, it has been around since the early 90s, but it has gotten significantly worse since the improvement of graphics, the invention of better physics engines and more immersive environments."

According to Dr.Freeman, FPSS is a psychological condition that causes games to feel like they are in a first person shooter, when they are really walking around in the real world. FPSS can apparently lead to paranoia and aversion to certain surroundings such as railroads and industrial warehouses.

Jacob McEwen knows first hand the trouble FPSS poses to gamers. He has had it since playing the popular game Half-Life 2 for 35 hours straight.

"It is weird, i know it's completly irrational, but I'm totally averse to big, industrial settngs now. Anything that looks rusted out or rickety, it freaks me out. Whenever I walk into dark rooms, I instinctivly reach for my flashlight and my gun, then I realize I don't actually carry either," said McEwen. "I was walking through a supermarket a few days after my HL2 marathon and I saw a bunch of first-aid kits on the floor. Someone had knocked them over by accident I guess. My first reaction though was 'oh ####! A bunch of medikits. Something ####ing tough must be coming up soon!'It really scared me."

McEwen has also had several problems with simply getting into his own home.

"I remember I came home after going to a party or something, and I had locked my front door before leaving. I was so pissed when I tried the handle and found it locked. I thought "SHIT! Now I have to go all over the fucking place looking for another entrance!" It didn't even occur to me that I could use my keys."

He has had similar trouble when trying to get over the waist high wall in the back yard when he or his roommate throws their frisbee too far. McEwen spends hours looking for ramps or short ladders before he realizes he can climb.

According to McEwen, he often finds himself reaching for a non-existant gravity gun to get things from accross the room when he feels too lazy to get up off the couch.

"I don't believe that FPSS makes a person more violent or physically agressive," said Dr.Freeman. "I think it just increases your fear of abandoned buildings, sewers, and explosive barrels."

However, vocal anti-videogame activist and "lawyer" Jack Thompson disagrees. After reading the public report on FPSS, Thompson spoke out.

"FPSS proves that video games are responsible for all murders ever. In history."

When informed that First Person Shooters have only existed for the last 15-20 years, Thompson screamed that we were lying homosexuals, then sued us for criminal harrasment.

Ex mental health worker charged in massive child sex case

From the Belfast Telegraph

This is the former Ulster charity worker accused of storing more than 23,000 images of child sex abuse on his computer.

Londonderry man John Llewelyn James (39) is now at the centre of one of the biggest alleged cases of child pornography ever uncovered in Northern Ireland.

The 39-year-old, from Garvagh Road in the city, was allegedly found to be in possession of 23,642 indecent images of children. Some of the material was classed as level five - the most serious level.

A court has refused him bail after police said he admitted having a " strong sexual interest in children".

James was a part-time worker with the North West Forum for people with disabilities when indecent images were allegedly found on his work computer in March 2006.

Police were informed and seized the computer along with his laptop.

He had previously worked with a mental health charity which trained GPs and emergency staff in Derry on how to deal with mentally ill patients.

At a recent bail hearing in the High Court the judge was told that James admitted he had accessed the images via the internet at work and at home.

He also admitted to having a sexual interest in children aged six to 14 and police said they feared he posed a significant risk to children.

High Court Judge Mr Justice Gillen refused bail saying that the protection of vulnerable children was one of the highest priorities invested in the courts.

When James first appeared in court charged with making and possessing indecent images of children reporting restrictions were enforced to prevent him from being named over fears for his safety. However, the restrictions were lifted in the High Court last week.

During his first court appearance, his defence solicitor Charles Kane said that James was willing to undergo therapy.

He raised concerns that his client might self-harm and added that there was no risk of James reoffending if he had no access to the internet.

Charging him with the offences at Londonderry Magistrate's Court in April, resident magistrate Mr Barney McElholm described child pornography as "a cancer" in society and said there does not appear to be "any way to successfully treat people with paedophile tendencies".

He added: "There would not be the amounts of money to be made by criminal elements if it was not for people willing to download, view and pay for [child pornography]. This cancer in our society has to be tackled at every level."

£10bn cost of a society 'addicted to pill-popping'

More British newspapers are picking up the story of the pill-popping epidemic. From the Daily Mail.

Britain is becoming addicted to popping pills, with a huge increase in prescriptions stretching the Health Service to its limit.

The cost of drugs handed out by GPs over the past five years has jumped by 27 per cent, breaking the £10billion barrier.

Experts claim growing demand for a "pill for every ill" and poor prescribing by doctors and nurses is to blame for the increase.

There is also criticism of drug companies which are accused of marketing their medicines ever more aggressively to GPs.

Family doctors prescribed 918million medicines last year compared with 721million five years ago. That is an average of 81 prescriptions per GP every day compared to 64 five years ago.

Every week more than 730,000 prescriptions for anti-depressants are handed out and 870,000 antibiotics.

Liberal Democrat health spokesman Norman Lamb said it was outrageous there had been such a sharp rise in anti-depressant prescriptions while patients were denied access to antiblindness drugs because of rationing.

"The NHS is not a bottomless pit," he said. "There are going to have to be some very tough decisions about where we prioritise funding.

"This is a very disturbing trend and there is a danger that we end up in a society where we think everything can be resolved by the latest pharmaceutical development. And there is a danger that we stop taking responsibility for our own lives."

The British Medical Association said recently the rising drugs bill meant NHS care - such as obesity operations and IVF treatment - may have to be rationed in the future.

It warned too many GPs were handing out weightloss pills rather than ensuring patients looked after their own diet and level of exercise.

Mental health experts are also concerned GPs are prescribing antidepressants when a course of counselling would be more appropriate.

This month a senior psychiatrist criticised the medicalisation of depression, saying GPs were handing out anti-depressants to patients who were simply "down in the dumps".

MP Richard Taylor, a GP, said: "People now think it is better to take a pill than do something themselves about their own health.

"For example people want obesity drugs, when the basic thing about obesity is to take exercise and eat only what you need."

However, Professor Mayur Lakhani, chairman of the Royal College of GPs, said more drugs were being prescribed because there were clinical benefits. "Lives are being saved," he said.

A spokesman for the Department of Health said: "More drugs are being prescribed due to advances in medical technology, which means we can treat more conditions."

Psychiatrist charged with illegal drug sales, arrested during raid

The shrink in question is a 45 yr old mother with 2 grown sons. also arrested. From this police blotter, the final item in the list.

A mother and her two children were arrested Friday night in connection with an investigation into a Murrieta psychiatrist charged with selling prescriptions for addictive drugs, according to a Murrieta Police Department press release.

Janine Keating Hall, 45, was booked on suspicion of possession of controlled substances. Her 18-year-old son, Saege Michael Hall, was booked on suspicion of possession of controlled substances for sale. Her 22-year-old son, James Dylan Hall, was booked on suspicion of violating probation.

Murrieta detectives served a search warrant at the 29700 block of Calle Pantano in Temecula on Friday evening and said they found 38 grams of marijuana, Vicodin and Xanax. Murrieta police said the search warrant was in connection with an investigation into Dr. Joel Dreyer.

Dreyer was prescribing large amounts of addictive drugs such as painkillers Oxycontin and Vicodin for $100 per prescription, police said.

There may have been at least 50 people, ranging from patients to other medical professionals, who worked with Dreyer to divert medication to the black market, police have said.

Pharmageddon: the prescription pill epidemic

From the Independent

Our increasing reliance on pills has resulted in a 27 per cent rise in prescriptions written by doctors in just five years. It's costing the NHS £10bn a year, £200m of which is wasted on drugs that are never used. Nina Lakhani reports on a dangerous addiction

Britain is in the grip of a prescription drug-taking epidemic, with unprecedented numbers of medicines being handed out by GPs, costing billions of pounds and stretching already tight NHS resources to breaking point.

Prescription drug use has increased by 27 per cent in the past the five years and the NHS drug bill topped £10bn in 2006. GPs prescribed 918 million medicines last year compared with 721 million five years ago, according to figures obtained by The Independent on Sunday.

Health experts put rocketing prescription numbers down to medical advances, but also point to poor prescribing by GPs, growing public demand for a "pill for every ill" and aggressive marketing tactics by the pharmaceutical industry, which prompted one MP to warn that the UK is heading towards what he called "pharmageddon".

Paul Flynn, the Labour MP, warned that a failure to change attitudes would be disastrous. He said: "We are heading towards pharmageddon. The medicalising of society is convincing people they need a pill for everything. Drug companies recruit patients, particularly good-looking and articulate ones, to help promote new drugs in the media. Life and death decisions should not be taken by tabloids."

Doctors now write an average of 81 prescriptions a day compared with 64 five years ago. More than 730,000 prescriptions for antidepressants are being handed out each week, to the point where they almost match those for antibiotics at 870,000 a week.

More than £1bn has been wasted in the past five years on buying and disposing of drugs that were never used by patients, according to new research by the Conservative Party. GPs prescribe thousands of drugs patients don't want or take, according to this survey. The money wasted would pay for a year's worth of the breast cancer drug Herceptin for more than 10,000 women or 100,000 cycles of IVF.

Andrew Lansley, the shadow Health Secretary, said: "Every penny wasted is a penny lost to the improvement of NHS treatment. In an NHS that has a postcode lottery on access to NHS drug treatments, surely we must ensure that only those drugs that are really needed and will be used are prescribed."

News of the wastage comes at a time of growing disquiet at stories of patients being denied access to potentially life-changing drugs on the grounds of cost. Earlier this month, the High Court rejected an appeal by Alzheimer's sufferers for early treatment with a drug they claim helps to slow down the progress of the disease.

The increase in prescriptions will add pressure on GPs to improve their performance. Sir John Bourne, head of the National Audit Office, told the IoS: "If GPs more often followed official guidelines and prescribed generic and other cheaper drugs where suitable, there would be more money to treat patients and pay for expensive or innovative treatments."

GPs aren't 'tuned in' to mental health issues

Doctors are being criticised for overprescribing. Leading psychiatrist Professor Gordon Parker claims that too many people are being wrongly diagnosed with depression and prescribed drugs for perfectly "normal" emotions. Ninety per cent of GPs have said they prescribe antidepressants because there are not enough counselling alternatives, but voluntary organisations that provide such services rarely receive GP referrals. Paul Farmer, chief executive of Mind, said: "Many GPs are not tuned into mental health issues or support services that are available outside the NHS, and what is missing are the mechanisms to make that happen smoothly and effectively. It should be as easy to prescribe a course of counselling as it is to write a prescription."

Defending GPs, however, Professor Mayur Lakhani, chair of the Royal College of GPs, said that the increase should be celebrated as a sign of medical advances. He said: "The argument that society has become medicalised and there is a 'pill for every ill' is an exaggerated one, with no evidence. It is a great time to be a doctor. So much more can be done now. The challenge is for the Government to respond to the aspirations of doctors and patients in saving lives."

But some doctors argue that pressure from growing patient expectations is also behind the increase in prescriptions. Dr Chris Steele, GP and resident doctor on ITV's This Morning, said: "People expect to leave their GP appointment with a prescription in their hand, so if they don't, they are very disappointed. If you tell a patient that you are not prescribing something but want them to do 30 minutes' exercise every day and reduce the fat, sugar and salt content in their diet, a glazed look comes over their eyes and it is like to talking to a brick wall."

Evidence that patients want a "pill for every ill" is supported by the fact that more than 900 million non-prescription or over-the-counter items were also sold last year, and there is growing alarm at the number of people buying drugs from unregulated online pharmacies. Dr Richard Taylor, GP and independent MP for Kidderminster, said: "People now think it is better to take a pill than do something themselves about their own health; for example people want obesity drugs, when the basic thing about obesity is to take exercise and eat only what you need.

"We should be emphasising prevention for every kind of illness, for example, most skin cancers are preventable and a 'statins for all' approach is not helpful at all. Taking money out of treatment to put it into prevention is impossible at the moment; it would need a big change in the current climate. But what needs to be publicised is better self-control."

With 950 drugs currently being developed and no signs of diminishing public expectations, the costs look set to spiral further. Last month Roger Boyle, the Government's heart disease tsar, advocated cholesterol-lowering drugs for every man over 50, arguing that this would save the NHS money in the long term.

Dr Boyle faced criticism for his advice. Critics claimed that his proposal would "medicalise" millions of healthy people and that it failed to recognise that there is no such thing as a risk-free drug. The NHS is not a bottomless pit, they argue, and it has reached a tipping point. The British Medical Association has said for the first time that many health treatments will have to be rationed in the future because the NHS cannot cope with escalating patient demands.

Professor Karol Sikora, a leading cancer specialist, argued that a two-tier system is inevitable. He said: "The NHS is not a bottomless pit. To be fair, it should provide a good core package of cost-effective drugs and the others people should pay for themselves with health insurance. This is an unpopular stance that will not win me any votes, but there is no other solution. The NHS can't provide everything and we need to address this properly."

Some GPs argue that some clinical decisions come down to who shouts the loudest. "It is not possible for the NHS to keep paying for everything. Herceptin makes the front pages, so people with breast cancer get Herceptin, whereas people with Alzheimer's and age-related macular degeneration don't attract the attention, so they miss out," said Dr Taylor.

[...]

Doctor Returns Award to the American Psychological Association-- Because it Sanctions Torture

Via the Intelligence Daily a doctor voices her concerns.

I am writing to inform you that I am returning my Presidential Citation dated 2/02/06 and awarded to me by then President of the American Psychological Association, Dr. Gerald Koocher. I have struggled for many months with this decision, and I make it with pain and sorrow. I was honored to receive this award and proud to be a member of APA. Over the years I have spoken at national conventions many times and had enjoyed an excellent relationship with the APA and its staff. With this letter, I feel as if I am ostracizing a good friend.

I do not want an award from an organization that sanctions its members' participation in the enhanced interrogations at CIA Black Sites and at Guantanamo. The presence of psychologists has both educated the interrogation teams in more skillful methods of breaking people down and legitimized the process of torture in defiance of the Geneva Conventions.

The behavior of psychologists on these enhanced interrogation teams violates our own Code of Ethics (2002) in which we pledge to respect the dignity and worth of all people, with special responsibility towards the most vulnerable. I consider prisoners in secret CIA-run facilities with no right of habeas corpus or access to attorneys, family or media to be highly vulnerable. I also believe that when any of us are degraded, all of human life is degraded. This letter is as much about us as it is about prisoners.

In our Ethics Code we agree to promote honesty and accuracy. Our involvement in these projects has been secretive and dishonest. Finally, as psychologists we vow to do no harm. Without question, we violate this oath when we allow people in our care to be deprived of sleep or subjected to sensory over-stimulation or deprivation.

I cannot accept the August 19, 2007 Reaffirmation of APA's Position Against Torture (Substitute Motion Three.) Under this motion, psychologists will be allowed to continue working on interrogation teams that are not subject to the Geneva Conventions. This motion places our organization on the side of the CIA and Department of Defense and at odds with the United Nations, The Red Cross, the American Psychiatric Association and the American Medical Association. With this reaffirmation we have made a terrible mistake.

I know that the return of my Presidential Citation from Dr. Koocher will be of small import, but it is what I can do to disassociate myself from what I consider to be a heinous policy. All of my life I have tried my best to stand up for those with no voices and no power. The prisoners our government labels as enemy combatants are in this category.

I return my citation as a matter of conscience and in the hopes that the APA will reconsider its current unethical position. We have long been a wonderful organization that respected human rights and promoted tolerance, kindness, and peace. Nothing is more fundamental to our core orientation and professional service to others than our commitment to all people's inherent dignity, safety and welfare. I hope my letter may be useful in restoring the APA to its long-respected and important stance as a beacon of integrity and kindness for all human beings.

Respectfully,

Dr. Mary Pipher

Backlash Grows on Psychologist Torture Resolution

from the Daily Kos, with lots of extended quotes from the relevant links

My thanks to the ever-energetic Stephen Soldz (whose blog "Science, Psyche, and Society" is must reading) for bringing attention to some major fallout over the American Psychological Association's scandalous so-called anti-torture resolution. This resolution formally condemned torture and cruel, unusual, inhumane and degrading forms of behavior inflicted on detainees in Bush's phony "war on terror". But its fine print gave the stamp of approval to certain forms of torture, including sensory deprivation, sleep deprivation, isolation, and even the use of psychotropic drugs on prisoners if not used for the immediate purpose of eliciting information. And the APA put its stamp of approval on psychologists working in settings where basic human rights, like habeas corpus, are not respected.

Soldz has written to colleagues to publicize the editorial in the Houston Chronicle yesterday, "Human wrongs: Psychologists have no place assisting interrogations at places such as Guantanamo Bay"

---

In addition to newspaper condemnations of APA's pathetic resolution, prominent psychologists are responding as well. Well-known psychologist and author Mary Pipher, of Reviving Ophelia fame, has taken up the cause. She has chosen to return an APA Presidential Citation she received in 2006 from then-APA president Gerald Koocher. Koocher has been a big supporter of the current APA position on allowing psychologists to work in Bush's coercive and inhumane detention camps.

A Zyprexa Drug Rep Confesses All

Just in case you haven't seen this one before. In this video Shahram Ahari, a former pharmaceutical company representative, tells how he sold the drug Zyprexa. Nearly a decade after its introduction, a drug once hailed as a breakthrough treatment is being assailed for its negative side effects.

Florida Kids on Antipsychotic Drugs

A series of TV news reports on the increasing number of children on anti-psychotic drugs for ADHD, etc

Online pharmacies a growing source of illegal drugs

From this report

People addicted to prescription drugs are increasingly avoiding doctors and hospitals to get their supply.

Instead, they're relying on the Internet.

Drug shipments from illegal online pharmacies were once so frequent in Appalachia that delivery companies had to add trucks to their routes.

Police have cracked down on such deliveries, but are still confronted by a booming global network of so-called rogue pharmacies operating online.

A recent study by the National Center on Addiction and Substance Abuse at Columbia University found hundreds of Web sites illegally dispensing drugs like Vicodin and Xanax without prescriptions.

All that's required in most cases is a credit card.

The federal Drug Enforcement Administration says such pharmacies are not only illegal, but dangerous.

Congress is considering legislation that would stiffen penalties for illegal online prescription drug sales.

Which countries permit Rx drug ads on television?

As seen here

Q: How many countries in the world allow prescription drug commercials on television?

A: 2.

Q: Which ones?

A; The U.S. and New Zealand. reference Forbes and CBC News.

And this is, of course, great for drug companies, advertising agencies and television networks in the U.S. The latter have come to depend more and more on the revenues of those ads.

According to the New England Journal of Medicine, direct-to-consumer advertising increased by 330 percent in the ten year period after 1996.

Now the FDA plans to study how 2,000 people react to television drug ads, to determine whether they have an overwhelmingly positive impression of products despite audio warnings about potential side effects.

Kind of interesting that it took the FDA ten years to make that decision. And that virtually none of the other industrialized countries have followed the U.S.

You think so?

New York State says poor care preceded teen's hanging at county facility

From Rochester, NY. Just my opinion, but it looks like another case of where an industrial outsource firm for psychiatric care has dropped the ball for profit. from this report.

A state commission has concluded that a private company gave inadequate mental health treatment to a teenager who hanged himself in Monroe County Jail.

A report by the state Commission of Correction stopped short of saying that Correctional Medical Services Inc. of St. Louis, which contracts with the county to provide medical care to jail inmates, was responsible for the death of 16-year-old Javon Leggett on Aug. 29, 2004.

But the report charged that:

• A Correctional Medical Services employee who wasn't trained to deal with high-risk inmates or depressed adolescents was assigned to Leggett after what might have been a previous suicide attempt six weeks before Leggett's death.
  
  
• Leggett wasn't referred for follow-up mental health care or medication even though he was interested in both, and was removed from suicide watch three days after the apparent suicide attempt.
  
  
• The company was at fault for failing to provide properly trained mental health providers and recommended that Monroe County review whether it should continue to retain the company.

Despite the report, however, the county renewed its contract with Correctional Medical Services on Jan. 1. The one-year extension was for $7.5 million.

The report marks the second time that a state investigation into an inmate death at the jail has sharply criticized private companies for inadequate medical or mental health care.

In May 2002, the Commission of Correction said inmate Candace Brown died in September 2000 when she received "grossly and flagrantly inadequate care" from Prison Health Services Inc. after her opiate withdrawal was untreated.

Prison Health Services of Brentwood, Tenn., provided care in the jail from 2000 to 2004, when Correctional Medical Services replaced it with a three-year, $17.7 million contract approved by the County Legislature. Prison Health Services agreed to pay $450,000 to Brown's family to settle a lawsuit.

The report on Leggett's death, issued in March 2005, was kept private until it was filed earlier this year as part of a lawsuit against the county and Correctional Medical Services by Leggett's mother, Loretta Leggett.

Rochester lawyer Van Henri White, who represents Loretta Leggett, said the critical report has prompted him to seek a settlement with the county and the company.

"They've refused to talk about settlement," he said. "I've tried everything to convince these people that this is a case that should be settled."

A spokesman for the county declined to comment about the case because it involves pending litigation. A spokesman for Correctional Medical Services said he couldn't comment about the case because it involves confidential mental health records.

Both the county and the company have filed legal papers seeking to have the lawsuit dismissed on the grounds that they acted properly.

In its papers, Correctional Medical Services said its care to Leggett met or exceeded the standard of care and maintained that it's uncertain whether Leggett committed suicide or accidentally hanged himself while attempting to get transferred from the jail to Rochester Psychiatric Center.

Leggett was charged in May 2004 with assault and robbery. He pleaded guilty on Aug. 20, 2004, and was expected to receive five years' probation and six months in jail. But a deputy found him dead in his cell, hanging from a sheet tied around his neck, on Aug. 29, 2004.

Six weeks earlier — on July 16, 2004 — Leggett was found under his bunk in what was documented in medical records as an attempted hanging. Leggett, who had a sheet around his neck, said he was stressed out but denied a suicide attempt.

Correctional Medical Services assigned an employee who had a master's degree in social work — but was unlicensed — to perform a "lethality assessment" of Leggett to determine whether Leggett was in danger of committing suicide. Leggett was watched constantly as a suicide risk until July 22, when the social worker decided Leggett was feeling better.

After seeing the social worker again on July 26, Leggett had no more mental health follow-ups, the Commission of Correction said in its report.

"Overall, the evolution and treatment afforded Leggett was inadequate," the report said. "There was no referral to a psychiatrist, psychologist and nurse practitioner to evaluate Leggett for medication. There was no treatment plan, no follow-up for release after constant supervision, no monitoring, no medication."

After being involved with altercations with other inmates in the week before he killed himself, Leggett was punished by being assigned to "administrative segregation," the report said.

On Aug. 27, two other teen inmates who were found with sheets around their necks said they were feigning suicide in an attempt to get transferred to Rochester Psychiatric Center, where they believed they would have more privileges. Leggett was part of that plan, the other inmates told deputies.

Two days later, Leggett hanged himself in his cell. He died despite attempts to resuscitate him at the jail and at Strong Memorial Hospital.

Legislative Panel Begins Hearings into Troubled Mental Hospital

From WBOC in Delaware

Tales of patient abuse and poorly trained employees highlighted a legislative hearing Tuesday into problems at the state-run Delaware Psychiatric Center.

Relatives of patients at the New Castle hospital told lawmakers of loved ones being sexually assaulted and beaten by staffers, and of difficulties trying to get information from state officials about their welfare.

Pleading with lawmakers for help, Janice Ambrose tearfully told of her 21-year-old daughter, who has been diagnosed with borderline personality disorder, being sexually assaulted at least twice and put in restraints for long periods of time.

Ambrose recounted one visit in which she saw drugged patients sitting in chairs in a common room while staffers watched TV with their feet propped on chairs, laughing as a naked man ran down the hallway.

"This state has a problem from the bottom up and the top down," said Ambrose, who fears leaving her daughter at DPC but said she has nowhere else to turn.

"I can't even get an outpatient psychiatrist to see her," she said. "I need some help, my daughter needs help."

Margaret Losink said she learned of a November incident in which her daughter allegedly was gagged and restrained so severely that she was left with bruises only by reading about it in the news.

"She never told me because she said she had to go back there," said Losink, who said her daughter has been in and out of DPC for 12 years. "The hospital says she bruises easy, and she's a spitter."

Preliminary results from an investigation by the Centers for Medicare and Medicaid Services that was prompted by the newspaper articles cited nine patient safety incidents during the past 12 months in which federal regulations were not met. In one case, a DPC staffer was indicted for assault earlier this month after a patient's jaw was broken. Hospital officials initially said the patient had slipped on a mat and hit his face on a bed.

Also this month, a former DPC attendant was indicted on three counts of rape and six counts of patient abuse after allegedly raping a patient in a toilet and a staff break room last year.

Gloria Christmas, a nurse on duty when Losink's daughter was restrained last fall, denied that she was gagged.

"She talked during the whole seclusion and restraint," Christmas said. "... At no time was the towel put in her mouth."

Other DPC employees also defended the facility Tuesday night, saying the hospital staff generally is concerned about patient care and that a few bad actors should not be allowed to bring the institution into disrepute.

"I take my job very seriously and I do it to the best of my ability," said Zanthea Benson, a 17-year employee. "... We can't let a few bad apples spoil the bunch."

Asked by members of the committee how the hospital could be improved, Benson and Kenneth Burton, a DPC licensed practical nurse, both suggested stronger hiring practices to ensure that employees have the skills and temperament to deal with difficult situations and patients.

"You have those who are there for the patients, and you have those who are there," Benson said. "If you're not there for the patients, I don't think you should be there."

Before convening the hearing, committee members wrangled over allowing DPC employees and others to testify behind closed doors, and over obtaining confidentiality privacy waivers from employees and patients so that Department of Health and Social Services officials can respond to allegations.

Democrats on the committee urged chairman Richard Cathcart, R-Middletown, to shorten the panel's schedule so DHSS officials can testify before its scheduled second meeting on Sept. 11 in Wilmington.

Rep. Melanie Marshall, D-Bear, also asked Cathcart to allow DHSS Secretary Vincent Meconi, who has called the committee's format unfair, to speak for a few minutes Tuesday night. Cathcart denied the request, adding that Meconi's complaint of unfairness "doesn't hold water."

"We are going to give him every opportunity to present his comments," said Cathcart, adding that he hopes the panel can hear most or all of the closed-door testimony before the Sept. 11 meeting.

Psychiatrist Pleads 'No Contest' to Charges of Sexual Misconduct. Was Medical Director of Local Hospital.

From a report in North Dakota

A Yankton doctor has been found guilty of having sex with a patient.

Dwight F. King was charged last spring with 15 counts of sexual penetration by a psychotherapist.

Authorities say two patients were involved.

As part of a plea agreement, King plead no contest to one count of having sex with a patient at his home in May of 2005. A plea of no contest has the same effect as pleading guilty.

Sentencing has been set for October 3rd.

King who is free on bond primarily practiced at the Yankton Medical Clinic, but he also saw patients at Avera Sacred Heart Hospital The neurologist and psychiatrist was medical director at the hospital's rehabilitation center.

New Minnesotta Law Tracks Drug Companies’ Payouts

As seen here and also reported elsewhere

A groundbreaking Minnesota law is shining a rare light into the big money that drug companies spend on members of state advisory panels who help select which drugs are used in Medicaid programs for the poor and disabled.

Those panels, made up mostly of physicians, hold great sway over the $28 billion spent on drugs each year for Medicaid patients nationwide. But aside from Minnesota, only Vermont and Maine require drug companies to report payments to doctors for lectures, consulting, research and other services.

A review of records in Minnesota found that a doctor and a pharmacist on the eight-member state panel simultaneously got big checks – more than $350,000 to one – from pharmaceutical companies for speaking about their products.

The two members said the money did not influence their work on the panel, and the lack of recorded votes in meeting minutes makes it difficult to track any link between the payments and policy.

But ethics experts said the Minnesota data raise questions about the possibility of similar financial ties between the pharmaceutical industry and advisers in other states.

“In the absence of disclosure laws, there’s certainly no way to know,” said Jack Hoadley, a research professor specializing in Medicaid at Georgetown University in Washington. “There are a lot of physicians in general who have at least some contract or grant funding out of pharmaceutical companies, and additional (who) do speaking engagements.”

The AP began looking at the records in mid-June. Soon after, the Minnesota Medicaid Drug Formulary Committee began considering a conflict-of-interest policy that would require members to disclose such financial relationships and recuse themselves from voting in some cases. The committee is expected to act on the policy next month.

John E. Simon, a psychiatrist appointed to the panel in 2004, earned more than $350,000 from drug companies between 2004 and 2006. Pharmacist Robert Straka served from 2000 to 2006 and collected $78,000 from various drug makers during that time.

Both men, and the committee chairman, said the payments did not influence their work with the committee.

But state officials said they would examine the panel’s past actions for any bias tied to the payments, and they will start screening appointees to more than two dozen advisory councils for similar links to the drug industry.

They will also require the Drug Formulary Committee to begin recording how each member votes at its meetings.

The Minnesota advisory panel’s recommendations to the state Human Services Department are almost always followed. The committee guided $240 million in spending on drugs for 202,000 patients last year. That’s slightly less than a third of all the state’s Medicaid patients – mostly disabled and mentally ill people whose medical bills are paid directly by the state.

The top drugs for Minnesota Medicaid patients covered by the panel’s advice in recent years have been schizophrenia treatments from Eli Lilly & Co. and AstraZeneca PLC – Lilly’s Zyprexa from 2000 to 2004, followed by AstraZeneca’s Seroquel in 2005 and 2006. About a third of the drugs on the state’s preferred drug list are made by companies that paid Simon, Straka or both.

A medical ethicist said state drug advisers should not take pharmaceutical companies’ money because of the power the panel exercises over the poorest, most vulnerable patients.

“This is a high-stakes committee,” said Dr. Arthur Caplan, chairman of medical ethics at the University of Pennsylvania School of Medicine. “If you’re going to have your hand on that tiller, you don’t want to think that anybody is trying to push it.”

Some other states have taken tough measures to guard against that. Nevada bars anyone from serving on its Pharmacy and Therapeutics Committee who is in any way paid by or affiliated with a corporation that makes prescription drugs.

“It’s as clean as we can get or we can dream up,” said Charles Duarte, the state’s Medicaid administrator.

In Idaho, committee members can be fired on the spot for failing to disclose a conflict of interest.

Here’s what the Minnesota records show:

Simon, a Minneapolis psychiatrist, earned $354,700 from companies including Eli Lilly and AstraZeneca from 2004 to 2006 in honoraria, speaker’s and consulting fees, and other payments ranging from $500 to $93,012. His stint on the formulary committee began in June 2004.

Simon said he continues to speak about new medicines for pay, giving talks an average of every week or two. He said the engagements let him share his expertise with primary care doctors and other health care workers who care for mentally ill patients.

Simon said his work for drug companies – primarily Eli Lilly, which has paid him nearly half a million dollars since 1998 – has not posed a conflict of interest because the antipsychotics, antidepressants and dementia drugs he promotes have never been discussed by the panel.

He declined to name the drugs, citing confidentiality agreements. If those drugs came up for discussion, he said, he would disclose his connections and abstain from voting.

Simon said he should be able to vote on drugs made by the companies that pay him, as long as they don’t come from the neuroscience or psychiatric divisions that pay him. But, he said, he would not oppose a stricter standard.

“There’s absolutely no record of my biasing in favor of one company or another or any of them,” Simon said. “I figure the preferred drug should be the one that cuts the best deal with the state.”

Spokesmen for Eli Lilly and AstraZeneca said their companies’ relationships with Simon had nothing to do with his role on the panel.

Lilly spokesman Phil Belt said Simon even voted against Lilly products, including a growth hormone and an insulin.

“It just wouldn’t be appropriate to assume or imply that our relationship with him is in any way a product of or influenced by his role on the Drug Formulary Committee,” Belt said.

Straka, a University of Minnesota pharmacy professor, earned $78,100 in honoraria and other fees from 2000 to 2006, including $36,745 from Schering-Plough Corp. and $24,623 from Merck & Co. He served on the panel from September 2000 to March 2006.

Straka said he was paid for educational talks usually arranged by medical groups who lined up the sponsors. He said he routinely discloses his ties with drug makers and did so as a formulary committee member, both verbally and in writing.

“I have no problem with the issue of fully disclosing things. I do that all the time,” Straka said.

But a public records request by the AP turned up no information about Straka making such disclosures. Nor do such statements appear in the committee’s minutes going back to February 2001. Other committee members and staff interviewed by AP could not recall him disclosing compensation from drug makers.

The information about Straka’s earnings might not have come out at all, because drug companies are not required to disclose payments to pharmacists under the Minnesota law. Many did so anyway in his case, with some listing him as an “M.D.” in their reports.

Some of the committee’s past discussions appear awkward in light of the payments.

The December 2004 minutes noted Simon speaking up for a staff proposal to put Strattera, an Eli Lilly drug for attention deficit disorder, into a category of its own with no prescribing restrictions. There’s no mention of his significant financial ties to Lilly.

“Dr. Simon affirmed the Department’s decision, stating that having a noncontrolled substance, nonstimulant drug available without PA restrictions was a valuable option,” the minutes said. PA refers to prior authorization, the procedure used to limit use of a drug.

Simon said Strattera was never the subject of his paid talks. He said he’s certified in addiction psychiatry and supported ease of access to the non-stimulant Lilly drug because he’s concerned about overuse of stimulant drugs.

Two months earlier, in October 2004, the committee took up cholesterol-lowering statin drugs, including Pfizer’s Lipitor and Merck’s Zocor. Straka’s motion to include both Lipitor and Zocor on the state’s preferred drug list passed on an unusually divided 3-2 vote, although no individual votes were recorded.

The January 2005 minutes say Straka questioned a staff request to revisit the issue after the agency discovered that giving both drugs preferred status would cost an extra $1 million a year. The panel voted 6-1 to let the state pick one statin to cover. Again, individual votes weren’t recorded.

The minutes say nothing about Straka being paid by Pfizer or Merck – although the companies’ disclosure reports show him getting $3,000 from Pfizer and more than $24,000 from Merck by that point.

When asked if the payments influenced his actions on the panel, Straka responded with an emphatic no.

“Absolutely not,” said Straka. “I vote based on facts, I vote based on evidence and that’s completely discussed at those meetings.”

Dr. William Korchik, the panel’s chairman, said he supports disclosure of committee members’ relationships with drug companies, “whether it’s stock, research or speaker’s fees.”

Korchik said he didn’t know the extent of the financial relationships until contacted by AP. But Korchik defended the panel’s work, saying the ties did not bias a group that works mainly by consensus.

“This whole thing may be an issue of appearance of conflict, but I really feel comfortable that the committee has not been hoodwinked,” he said.

Al Heaton, a pharmacist who has served on the committee since the early 1990s, is the only panel member mentioned in the last six years of minutes for disclosing a potential conflict of interest and abstaining from a vote – on bone drugs he had gotten funding to research years earlier.

“I think that’s important to know,” said Heaton, the director of pharmacy at Blue Cross and Blue Shield of Minnesota.

“An individual may be perfectly honest and totally objective, but finding it out afterward, then you always wonder were they or were they not?”