Drug poisoning statistics in the US

Note how prevalent psych drugs are as a danger to kids.

Information on drug poisoning suicide deaths in the US is not available at a very granular level. However, the following table¹ does give a breakdown of 2012 suicide drug poisoning deaths:

Method	No.	%
Other and unspecified drugs, medicaments and biological substances	3,632	54.0%
Other gases and vapours	1,003	14.9%
Anti-epileptic, sedative-hypnotic, anti-parkinsonism and psychotropic drugs, not elsewhere classified	969	14.4%
Narcotics and psychodysleptics [hallucinogens], not elsewhere classified	662	9.8%
Non-opioid analgesics, antipyretics and anti-rheumatics	160	2.4%
Organic solvents and halogenated hydrocarbons and their vapours	126	1.9%
Other and unspecified chemicals and noxious substances	78	1.2%
Alcohol	47	0.7%
Other drugs acting on the autonomic nervous system	42	0.6%
Pesticides	10	0.1%
Total	6,729

According to the CDC¹, 81% of intentional poisoning suicides were caused by drugs - both legal and illegal. The most commonly used drugs identified in drug-related suicides were psychoactive drugs, such as sedatives and antidepressants, followed by opiates and prescription pain medications¹. Self-harm poisoning was the leading cause of emergency department visits for intentional injury in 2010². In 2011, it was estimated by SAMHSA³ that attempted suicide led to 228,366 emergency department (ED) visits. Almost all involved a prescription drug or over-the-counter medication. It is worth noting that with only 5,465 actually succeeding in suicide using drugs, it means there were 42 ED visits for every successful suicide. Sobering odds of success, and there are probably lots of attempts that don’t even end up in hospital. Most patients attempting drug-related suicide had some form of follow-up after their ED visit, with the outcomes of their ED visits as follows:

• 49% were admitted for inpatient hospital care (18.3% to an intensive or critical care unit [ICU]), 9% to a psychiatric unit, and 22% to other units including combination psychiatric/detox units)
• 25% were transferred to another health care facility for specialist treatment
• 7% were referred to detox/treatment
• 15% treated and discharged to home

Evidence suggests that alcohol had been ingested in around a third of people who died by suicide, and in 29% of those admitted to ED departments. In nearly two thirds of cases more than one drug was involved. Pain relievers were found to be involved in 38% of drug-related suicide attempts. Narcotic pain relievers were involved in over a third of that number, and cetaminophen products were involved in just under a third. Benzodiazepines (anti-anxiety drugs) were found to be involved in 29.3% of drug - related suicide attempts. Alprazolam (Xanax) and clonazepam each accounted for about a third. Antidepressants appeared in 19.6% of visits. About half of those visits involved an SSRI antidepressant such as citalopram, sertraline, or fluoxetine. Trazodone, a SARI antidepressant, was involved in about a quarter. Antipsychotics, as a whole, appeared in 12.9% of visits, with the vast majority being the newer types of atypical anti-psychotics e.g. Quetiapine. The American Association of Poison Control Centers (AAPCC)⁴ publishes data on phone calls they receive into their 55 centers which are designed to track the incidence of poison exposure (both intentional and unintentional) nationally. In 2012 they recorded 2,873 deaths by poisons (itself some way short of the figures provided by US Department of Health and Human Services for suicide alone), and the table below shows the drugs that appeared most frequently as the cause of death by poisoning. Top 25 substance categories associated with deaths reported by 55 U.S. Poison Centers 2012

Substance	No.	%
Sedative/hypnotics/antipsychotics	377	14.1%
Miscellaneous cardiovascular drugs	350	12.2%
Opioids	255	8.9%
Acetaminophen (paracetamol) in combination	183	6.4%
Miscellaneous stimulants and street drugs	176	6.1%
Acetaminophen (paracetamol) only	159	5.5%
Miscellaneous alcohols	145	5.0%
Miscellaneous antidepressants	126	4.4%
Selective serotonin reuptake inhibitors	89	3.1%
Miscellaneous antihistamines	69	2.4%
Tricyclic antidepressants	69	2.4%
Miscellaneous fumes/gases/vapors	67	2.3%
Acetylsalicylic acid	65	2.3%
Miscellaneous muscle relaxants	57	2.0%
Miscellaneous anticonvulsants	56	1.9%
Oral hypoglycemic	56	1.9%
Non-nonsteroidal anti-inflammatory drugs	50	1.7%
Miscellaneous unknown drug	44	1.5%
Miscellaneous unknown drugs	44	1.5%
Miscellaneous chemicals	33	1.1%
Miscellaneous hormones and hormone antagonists	31	1.1%
Anticonvulsants: gamma aminobutyric acid & analogs	29	1.0%
Miscellaneous anticoagulants	23	0.8%
Miscellaneous diuretics	23	0.8%
Cannabinoids and analogs	20	0.7%
Miscellaneous hydrocarbons	19	0.7%

It should be noted that these percentages from their source do not add up to 100% as they are only the top 25 causes. It should also be noted that the above figures each represent the number of mentions in cause of death, not number of deaths. Any one fatality may have had exposure to more than one substance. Indeed, consistent with data from SAMHSA, the breakdown of drugs shown for many of the fatalities reported by AAPCC showed more than one drug. Sources

1. Centers for Disease Control and Prevention, Web-based Injury Statistics Query and Reporting System (WISQARS), fatal injuries report figures (http://webappa.cdc.gov/sasweb/ncipc/leadcaus10_us.html).
2. National Hospital Ambulatory Medical Care Survey: 2010 Emergency Department Summary Tables (10 and 17) (www.cdc.gov/nchs/data/ahcd/nhamcs_emergency/2010_ed_web_tables.pdf). See also Centers for Disease Control and Prevention, National Center for Injury Prevention and Control (NCIPC), Prescription Drug Overdose in the United States: Fact Sheet www.cdc.gov/homeandrecreationalsafety/overdose/facts.html.
3. Substance Abuse and Mental Health Services Administration (SAMHSA), Office of Applied Studies. Drug Abuse Warning Network (DAWN): National estimates of drug-related emergency department visits for 2011, Table 22 (www.samhsa.gov/data/sites/default/files/DAWN2k11ED/DAWN2k11ED/DAWN2k11ED.pdf).
4. James B Mowry, PHARMD; Daniel A Spyker PHD, MD; Louis R Cantilena  JR, MD, PHD; J Elise Bailey MSPH; and Marsha Ford MD; 2012 Annual Report of the American Association of Poison Control Centers' National Poison Data System (NPDS): 30th Annual Report, Clinical Toxicology vol. 51 Oct 2013 (available from www.aapcc.org/annual-reports).

Patient killed by 'massive overdose' of anti-psychotic drug after nurse 'mistakenly gave him 21 times what he needed'

From a much longer report in the MIRROR.

A patient died from a massive overdose of anti-psychotic drugs after being given 21 times the medication he needed by a nurse, a court has heard.

Joshua Gafney was handed 4,200mg of clozapine instead of just 200mg by Amanda Young after the nurse visited him at his home.

Mr Gafney, 22, was handed a glass containing six bottles of the drug by 40-year-old Young when he needed just under a teaspoon-worth, just hours before he died on February 8 2012.

Bristol Crown Court heard how the nurse claimed she "did not see" crucial labels on Mr Gafney's medication, causing her to confuse the dosage.

She mistakenly believed each 14 ml bottle contained 50 mg of the powerful drug - when in fact this figure was per millilitre meaning there were actually 700 mg in the bottle.

His mother immediately raised concerns, which Young, from Summerlands Hospital, Somerset, attempted to resolve by putting some water in the solution.

Just two hours after the nurse left the family home in Yeovil, Somerset, Joshua was found unresponsive in bed by his mother, Tina Marren.

In spite of desperate attempts by his sister, Jasmine Gafney, and paramedics, to save Joshua, he was declared dead that evening.

A postmortem examination found Mr Gafney had died as a result of acute clozapine toxicity - an overdose.

N.J. medical bribe scheme reached grand scale

Selections from the extensive report on NewJersey.com

The first hint of the vast bribery scheme came with the arrests of a North Jersey doctor and three businessmen who, authorities said, found a way to turn a diagnostic lab with offices in Parsippany and Garfield into a virtual gold mine.

Two years later, federal prosecutors in Newark have racked up convictions of 38 people, including 25 doctors from New Jersey, New York and Connecticut, in what is believed to be one of the largest — if not the largest — laboratory bribery prosecutions in the United States, both in terms of money and the number of physicians caught with their hands out.

“To our knowledge, this is the largest number of medical professionals ever prosecuted in the same case,” U.S. Attorney Paul J. Fishman said last week.

“It shows how pervasive this practice can be. It has also made people in the profession sit up and take notice and made the deterrent message that much louder,” he said.

In recent weeks two doctors, one weeping and both remorseful, have been sentenced after helping prosecutors catch others in cases that add to the broadening panorama of corruption.

By the numbers

• 25 doctors and one physician’s assistant pleaded guilty to accepting bribes.
• 16 of the doctors live in New Jersey; seven in New York; and two in Connecticut. The physician’s assistant is also from New Jersey.
• 12 other defendants who worked at Biodiagnostic Laboratory Services have pleaded guilty.
• The amount of bribes pocketed by individual doctors ranged from $10,500 to $1.8 million.
• In return for bribes, the doctors referred over $100 million in blood tests to the lab.
• So far, 12 doctors have been sentenced to terms ranging from one year of probation, for a cooperator, to more than three years in federal prison and fines of up to $75,000.

The government is seeking a combined forfeiture of more than $87 million from the 38 defendants, including $50 million from former BLS owner and president David Nicoll and $25 million from his brother, Scott Nicoll.

And it’s not over. Additional arrests of doctors who profited from the scheme are anticipated, prosecutors say.

Here is the section we are interested in from this extensive report on this large and complex scheme

A psychiatrist from Fort Lee, who practiced in Paterson, and a doctor from Ramsey are among 12 physicians who have already been sentenced. The psychiatrist, Claudio Dicovsky, admitted accepting $220,000 from BLS, but put a halt to the payments long before the feds came knocking. In January, he was placed on probation for three years, including one year of house arrest with electronic monitoring, and ordered to perform 1,500 hours of community service.

Psychiatric drugs do more harm than good, says expert

From the Guardian

Psychiatric drugs do more harm than good and the use of most antidepressants and dementia drugs could be virtually stopped without causing harm, an expert on clinical trials argues in a leading medical journal.

The views expressed in a British Medical Journal debate by Peter Gøtzsche, professor and director of the Nordic Cochrane Centre in Denmark, are strongly opposed by many experts in mental health. However, others say the debate around the use of psychiatric drugs is important and acknowledge that there has been overuse of antipsychotics to quieten aggressive patients with dementia.

Gøtzsche says more than half a million people over the age of 65 die as a result of the use of psychiatric drugs every year in the western world. “Their benefits would need to be colossal to justify this, but they are minimal,” he writes. He claims that trials carried out with funding from drug companies into the efficacy of psychiatric drugs have almost all been biased, because the patients involved have usually been on other medication first. They stop their drugs and often experience a withdrawal phase prior to starting the trial drug, which then appears to have a big benefit. He also claims that deaths from suicide in clinical trials are under-reported.

In trials of the modern antidepressants fluoxetine and venlafaxine, says Gøtzsche, it takes only a few extra days for depression in the placebo group – given dummy pills – to lift as much as in the group given the drugs. He argues that there is spontaneous remission of the disease over time. Results from trials of schizophrenia drugs are also disappointing, he argues, and those for ADHD (attention deficit hyperactive disorder) are uncertain. “The short-term relief seems to be replaced by long-term harms. Animal studies strongly suggest that these drugs can produce brain damage, which is probably the case for all psychotropic drugs,” he writes.

“Given their lack of benefit, I estimate we could stop almost all psychotropic drugs without causing harm – by dropping all antidepressants, ADHD drugs and dementia drugs … and using only a fraction of the antipsychotics and benzodiazepines we currently use. This would lead to healthier and more long-lived populations. Because psychotropic drugs are immensely harmful when used long-term, they should almost exclusively be used in acute situations and always with a firm plan for tapering off, which can be difficult for many patients.”

[...]

The rest of the article was filler from doctors saying "but wait, we need MORE drugs"

ABC15 Investigation: AZ mental hospital fails to investigate, protect patients from sex abuse

ABC15 TV has been investigating the Arizona State Hospital, and here is the tip of a very big iceberg. There is much more in the original and related reports. What we share below is merely a highlight.

The Arizona State Hospital has failed to protect vulnerable patients from sex abuse and dangerous sexual activity; and in several cases, officials have failed to investigate serious allegations, according to a two-year ABC15 investigation.

[...]

The ABC15 Investigators reviewed thousands of pages of hospital, police and court records to compile a list of sex crime allegations at the Arizona State Hospital. By cross-referencing the records, ABC15 was also able to identify repeat offenders and victims.

From 2012 through 2014, we found: 

• There were 63 allegations of sex crimes, including rape, sex abuse and molestation.
• ASH investigated 24 of those allegations.
• ABC15 could only confirm 10 allegations resulted in reports with Arizona Adult Protective Services (APS) or law enforcement.

State law states that APS or a peace officer be notified immediately if there’s a “reasonable basis to believe that abuse or neglect of the adult has occurred.”

But several hospital sources have told ABC15 incidents go unreported, and they fear retaliation if they do report incidents outside of ASH.

“Staff has been basically threatened that if they do contact APS that repercussions will happen,” said one hospital source. “It goes unreported because staff is in fear of their jobs.”

Unreported allegations and crimes by healthcare officials can be a serious matter.

Arizona State Hospital has a long history of problems, it is a target rich environment for investigators Here are some of the Videos related to this report

Bangor psychiatrist ordered to stop treating women

As reported by the Bangor Daily News

A Bangor psychiatrist must stop treating women after allegedly developing an unprofessional relationship with a female patient, according to a state medical licensing board.

Dr. Fred Risser may treat only men and must submit to independent monitoring of his practice to ensure he meets prescribing and recordkeeping standards, his May 12 consent agreement with the Maine Board of Licensure in Medicine states.

While a 30-year-old female was his patient in 2009 and 2010, Risser drove the woman to the pharmacy in his personal vehicle, advocated for her while she was in jail, deposited money into her jail bank account, stored her personal property at his home and allowed her access to his home while he was away, according to the agreement. Risser treated the patient at his private practice in Bangor and at Community Health and Counseling Services in Ellsworth.

In June 2013, Risser met with the licensing board and agreed to take classes in boundaries and professionalism, medical ethics, recordkeeping and the use of medications to treat psychiatric disorders. He also agreed to transfer the patient to another psychiatrist, the agreement states.

In April 2014, Community Health and Counseling warned Risser about prescribing tranquilizers to patients on opioid replacement medications, a combination that raises the risk of overdose and death.

Then in May 2014, a 51-year-old patient he treated in Ellsworth told the board Risser slapped her on the buttocks while escorting her up the stairs to an appointment.

Community Health and Counseling fired Risser in May 2014 for unprofessional conduct, according to the agreement. In signing the consent agreement, Risser neither admitted nor denied the allegations but acknowledged the board had enough evidence to determine the alleged incidents occurred if the issue were to proceed to a formal hearing. He must reimburse the board $4,344 for the cost of the investigation.

In other words, he did it.

Pfizer settles lawsuits tying sex and gambling addictions to dopamine meds

As reported by Fierce Pharma, from a report in the Financial Review

Pfizer ($PFE) is settling class-action litigation brought by patients who claimed the drugmaker did not adequately warn them of possible side effects of drugs they were taking to treat their Parkinson's disease or restless leg syndrome. While this kind of litigation is routine, the side effects were not. Instead patients said the drugs created addictions they didn't previously have, causing them to gamble away their life savings, or become obsessed with shopping or sex.

The confidential settlement with 172 patients, said to be for millions of dollars, was approved by a judge in federal court in Australia, the Financial Review reports, although payments were delayed until they are assessed by an independent review. Pfizer had agreed to the settlement late last year, ahead of a trial of the cases brought by people who took Pfizer's Cabaser and Dostinex between 1996 and 2010 to treat tremors associated with Parkinson's disease or RLS.

"Pfizer entered into settlement resolution discussions in order to avoid the cost of litigating this claim and to avoid a lengthy trial," a Pfizer spokesman told the publication. "Pfizer remains willing to litigate this matter in court if necessary."

The drugs work by providing dopamine agonists that imitate the effects of dopamine in the brain, something Parkinson's patients lack. A study published last year in JAMA Internal Medicine found that the "psychiatric side effects" of uncontrollable urges were not as rare as first believed. It found that they occurred in at least 10% of patients, but said they probably were underreported because patients were ashamed to talk about what they had done.

The authors of the study said the potential was large enough, greater than suicide risks of antidepressants for example, that the FDA should require a "black box" warning on the labels on dopamine agonists, a class that includes Requip from GlaxoSmithKline ($GSK), UCB's Neupro and Mirapex from Boehringer Ingelheim. The German company was sued by a New York man some years back who said that taking the drug had turned him into a "pathological gambler," who ruined him as he gambled away $3 million.

According to the Financial Review Eli Lilly and Aspen Pharmacare also settled with 32 patients in 2013 in similar case involving the drug Permax.

Dr Joseph Bray is faces being struck off after he had an affair with a patient at The Priory in Southampton and allegedly made sexual comments towards another

A Report from the Daily Echo in the UK

A HAMPSHIRE psychiatrist had an affair with a patient and made sexual comments about another, a hearing was told.

Now married father of two Dr Joseph Bray faces being struck off by a fitness to practice tribunal. The tribunal heard Bray began flirting with a woman known as Patient B during counselling sessions and later began a sexual relationship with her. During three consultations he stroked Patient B’s hair, kissed her on the side of the head and told her “if only I was 20 years younger”.

Mr Williams said the consultations ‘crossed boundaries’, including giving out his personal email address, and added: “The doctor has demonstrated that he is willing to cross boundaries of a relationship with Patient B and to go all the way to a full-blown relationship.” The tribunal also heard he treated a patient who came to him for help coping with her husband’s womanising by comparing her appearance against her husband’s mistress.

The hearing was told in a ‘crudely-worded’ consultation Bray, 57, used Google to search for pictures of the mistress and then compared their physical appearances.

Bray allegedly told the woman, known only as Patient A, “men aren’t biologically programmed for monogamy,” and added: ‘‘When my wife dies, I will shag as many women as I can.’’ Patient A was said to feel ‘’awkward and uncomfortable’’ over the counselling she received from Bray after she attended the £3,000 a week Priory Hospital, Southampton, in ‘‘emotional distress.’’

Paul Williams, counsel for General Medical Council, told the tribunal in Manchester:

“Dr Bray’s persistent focus on the context of emails received by the husband made her feel awkward and uncomfortable. She felt it was sufficient to say the content was explicit.
“She says she found it distressing and unprofessional for the doctor to Google her husband’s mistress and begin passing comments about women.
“These are utterly inappropriate remarks during a consultation and so deeply sexualised in nature.
"She says it was unprofessional for him to make personal remarks regarding her appearance, even if complimentary.”

Mr Williams added: “The conversation turned from simple relationship matters to physical appearance, attraction and discussing sexual matters.”

The consultant, who lives in the New Forest, had been working at The Priory Hospital since 2007. Bray admits acting inappropriately during his consultation with Patient A but denies his conduct was sexually motivated. He admits all allegations regarding his conduct and inappropriate, sexual relationship with Patient B.

The Psychiatric & Mental Health Rape Reporter says that up to 25% of psychiatrists & psychologists use their patients for sex.

Edward Hallowell, noted Boston area psychiatrist, charged with indecent assault

report from Boston's Channel 5

A noted specialist in the fields of attention deficit disorder and attention deficit hyperactivity disorder is facing charges related to the alleged groping of a woman.

Dr. Edward M. Hallowell, who was in Waltham District Court on Monday for a hearing on the charge of indecent assault, is accused of squeezing the buttocks of a makeup artist last October. Hallowell, a psychiatrist and instructor at Harvard Medical School, was videotaping an interview in Watertown. The woman, whose name was redacted from the police report, filed the charges about a month after the alleged incident.

She said that Hallowell put his hand on her shoulder and touched her. "He followed my shape and he took his time," the police report says.

When interviewed, police said he called the incident a "terrible misunderstanding." “My client has a long and distinguished record in his field," said William Crowe, Hallowell's attorney. "It was not his intention to offend anyone and he is troubled his actions were perceived in any way as inappropriate. We are confident that Dr. Hallowell will be cleared and this matter will be resolved in his favor," Crowe said.

Hallowell is the founder Hallowell Center for Cognitive and Emotional Health in Sudbury.

Mark and Cheryl Miller in February of 2004 testifying about the Zoloft-induced suicide of their 13 year old son Matt after only 7 pills.

"How dare you?"

An important column by activist Nancy Rubenstein del Giudice on the Mad in America Website

Here is a large snippet from the article

I am grateful to Phil Hickey and Robert Whitaker for challenging Jeffrey Lieberman in the manner they did, because, at this point my response to him is more of an emotional one and it can best be summed up this way; "How dare you?"

Dr. Lieberman, how dare you suggest that you should not have to endure critical examination? In case you missed the college experience, anthropology is all about looking at cultures and their institutions, and since your profession has sought to redefine what it means to be human, anthropologists have an absolute duty to examine that endeavor.

I am not sure what country you think you live in, but this is the one that celebrates freedom of speech and freedom of the press, and the New York Times is not here to protect your profession or any other.

How dare you ignore the thousands of people who have been harmed by psychiatric drugs and diagnostic lies over the last several decades. If you and your colleagues were the least bit concerned about people and society you would by now have mounted a full-scale investigation into hospital and physician records to find all the people who were told they had a "chemical imbalance" and needed to take psychiatric drugs for the rest of their lives, like a diabetic takes insulin. Dr. Pies' well known assertion that this is only propagated by "uninformed" psychiatrists is belied by the fact that these "uninformed" psychiatrists run hospital psych wards all over the country.

You would find all the people who had an adverse reaction to an SSRI and were told this had "unmasked an underlying illness," and were then put on polypharmacy cocktails leading to disability. That would be the responsible thing to do. But car manufacturers make changes for public safety, and they are not "well-educated professionals" who have sworn to "Do no harm."

How dare you call Robert Whitaker a menace to society? The real menace to society is a profession that has knowingly lied for decades to vulnerable people for profit, and refuses to take responsibility for the harm done.

For the past five years that I have worked for The Law Project for Psychiatric Rights, I have known over a thousand individuals who have literally lost everything because they are disabled after withdrawal from SSRIs, benzodiazapines, "mood stabilizers," and neuroleptics prescribed for sleep. They are a burden to their families, unable to qualify for disability because the medical profession refuses to learn and continues to deny the reality of their iatrogenic suffering.

How dare you ignore these young people whose twenties have been ripped away from them? As they suffer for years, unable even to leave the house, they watch their peers build families and careers and enjoy their youth. Any responsible group of people, instead of digging their heels in and denying this is happening would be diving in first to learn, and then to help. Because people matter. Because doctors are suppose to care about patients. Instead, we have a public health epidemic of iatrogenesis.

Former Halifax psychiatrist charged with child pornography offence

Vis the Global News

A former psychiatrist in Halifax is facing a child pornography charge in relation to a case that’s more than a decade old.

Dr. Curtis Steele, 82, was charged with making child pornography after police launched an investigation last year to look into claims he had taken naked pictures of a 14-year-old female patient.

Steele was arrested on Thursday after he turned himself in at the police station.

He was released under conditions and will appear in court on June 16.

16 separate hospitals and their respective corporate parents have agreed to collectively pay $15.69 million related to fraudulent billing of psych services

Press Release From the US Department of Justice

Sixteen Hospitals to Pay $15.69 Million to Resolve False Claims Act Allegations Involving Medically Unnecessary Psychotherapy Services

The Justice Department announced today that 16 separate hospitals and their respective corporate parents have agreed to collectively pay $15.69 million to resolve False Claims Act allegations that the providers sought and received reimbursement from Medicare for services that were not medically reasonable or necessary, the U.S. Department of Justice announced today. 

“Hospitals that participate in the Medicare program must ensure that the services they provide and bill for are based on the medical needs of patients rather than the desire to maximize profits,” said Principal Deputy Assistant Attorney General Benjamin C. Mizer of the Justice Department’s Civil Division.  “The Department of Justice is committed to ensuring that those who seek to abuse the Medicare program will be held accountable for their actions.”

This case concerns claims to Medicare for Intensive Outpatient Psychotherapy (IOP) services.  IOP services represent a continuation of ambulatory psychiatric services and provide active treatment to individuals with mental disorders using a variety of treatment methods.  Medicare will pay for an appropriate course of IOP treatment provided a number of specific requirements are met including, most notably, that the services in question are reasonable and necessary for the diagnosis and treatment of the patient’s condition.

These settlements resolve allegations that, beginning as early as 2005 and in some cases continuing into 2013, the hospitals knowingly submitted claims for IOP services that did not qualify for Medicare reimbursement because: the patient’s condition did not qualify for IOP; the patient’s treatments were not provided pursuant to an individualized treatment plan designed to help the patient address specific mental health needs and reach achievable goals; the patient’s progress was not being adequately tracked or documented; the patient received an inappropriate level of treatment; and/or the therapy provided was primarily recreational or diversional in nature, and not therapeutic.  The IOP services in question were typically performed on the providers’ behalf by Allegiance Health Management (Allegiance), a post-acute healthcare management company based in Shreveport, Louisiana, but billed to Medicare by the providers.

The providers who have reached agreements to resolve these allegations with the United States include:

• Health Management Associates Inc. (HMA), and the following 14 hospitals formerly owned and operated by HMA: Central Mississippi Medical Center in Mississippi, Crossgate River Oaks in Mississippi, Dallas Regional Medical Center in Texas, Davis Regional Medical Center in North Carolina, East Georgia Regional Medical Center in Georgia, Gilmore Regional Medical Center in Mississippi, Lake Norman Regional Medical Center in North Carolina, Lehigh Regional Medical Center in Florida, Medical Center of Southeastern Oklahoma in Oklahoma, Natchez Community Hospital in Mississippi, Northwest Mississippi Regional Medical Center in Mississippi, Santa Rosa Medical Center in Florida, Southwest Regional Medical Center in Arkansas, and Summit Medical Center in Arkansas, which agreed to collectively pay $15 million;

• Community Health Systems and its subsidiary Wesley Medical Center in Mississippi, which agreed to pay $210,000; and

• North Texas Medical Center in Texas, which agreed to pay $480,000.

In October 2013, the United States resolved similar allegations with LifePoint Hospitals Inc. and two of its subsidiaries, PHC-Minden L.P., doing business as Minden Medical Center, and PHC-Cleveland Inc., doing business as Bolivar Medical Center, which collectively paid $4,672,469.80.

“This case demonstrates that the U.S. Attorney’s Office for the Eastern District of Arkansas will aggressively pursue civil health care fraud cases, where the integrity of the Medicare system has been undermined,” said U.S. Attorney Christopher R. Thyer of the Eastern District of Arkansas.  “Medical care providers who abuse Medicare hurt all taxpayers, and today’s announcement highlights our commitment to protecting our national health care system, as well as the Arkansans who depend on it.”

“Our agency is dedicated to investigating health care fraud schemes such as this, which divert scarce taxpayer funds meant to provide for legitimate patient care, including services for the often underserved mentally ill population,” said Special Agent in Charge Mike Fields of U.S. Department of Health and Human Services-Office of Inspector General (HHS-OIG).

The allegations resolved by today’s settlements arose from a lawsuit filed under the False Claims Act.  The act allows private individuals known as “relators” to sue on behalf of the United States and to share in the proceeds of any settlement or judgment that may result.  The relator in this case will receive $2,667,300. 

These settlements were the result of a coordinated effort by the Civil Division’s Commercial Litigation Branch, the U.S. Attorney’s Office for the Eastern District of Arkansas and HHS’ Office of Audit Statistics and OIG.

These settlements illustrate the government’s emphasis on combating health care fraud and marks another achievement for the Health Care Fraud Prevention and Enforcement Action Team (HEAT) initiative, which was announced in May 2009 by the Attorney General and the Secretary of Health and Human Services.  The partnership between the two departments has focused efforts to reduce and prevent Medicare and Medicaid financial fraud through enhanced cooperation.  One of the most powerful tools in this effort is the False Claims Act.  Since January 2009, the Justice Department has recovered a total of more than $24 billion through False Claims Act cases, with more than $15.3 billion of that amount recovered in cases involving fraud against federal health care programs.

The claims settled by these agreements are allegations only, and there has been no determination of liability. 

Psych Meds Put 49 Million Americans at Risk for Cancer

Psych Meds Put 49 Million Americans at Risk for Cancer
Written By: Kelly Brogan, M.D.

With 1 in 5 Americans taking a psychiatric medication, most of whom, long term, we should probably start to learn a bit more about them. In fact, it would have been in the service of true informed consent to have investigated long-term risks before the deluge of these meds seized our population over the past thirty years.

You may be unaware of a literature that suggests long-term treatment with all psychiatric medications is more likely to leave you with a lesser quality of life. Here's one more reason to reconsider life partnership with your psychiatric medication – it may contribute to your cancer risk.

What if I told you that this cancer data came from pre-clinical trials conducted for FDA licensure of these medications? That these trials are documented in the package inserts themselves.

Because of the inherent challenge of studying cancer at the population level, using these rodent studies was felt to be important by Amerio et al because they are not subject to publication bias – a major issue in psychiatry – and the methods are consistent across drug class.

Reasonably, even the IARC/WHO back this up, stating:

"although this association cannot establish that all agents and mixtures that cause cancer in experimental animals also cause cancer in humans, nevertheless, in the absence of adequate data on humans, it is biologically plausible and prudent to regard agents and mixtures for which there is sufficient evidence of carcinogenicity in experimental animals as if they presented a carcinogenic risk to humans".
(International Agency for Research on Cancer (IARC) and World Health Organization, 2000).

What does the data show?

A signal of harm. Plain and simple. In their paper, Carcinogenicity of psychotropic drugs, Amerio et al. found:

• 63.6% of antidepressants were associated with carcinogenicity, specifically mirtazapine, sertraline, paroxetine, citalopram and escitalopram, duloxetine and bupropion.
• 90% of antipsychotics agents were associated with carcinogenicity. All agents were associated with carcinogenicity except clozapine.
• 70% of benzodiazepines/hypnotics were associated with carcinogenicity, specifically clonazepam, zolpidem, zaleplon, diazepam, eszopiclone, oxazepam and midazolam. 
• 25% amphetamines/stimulants were associated with carcinogenicity, with methylphenidate specifially associated.
• 85.7% of anti-convulsants ("mood stabilizers") were associated with carcinogenicity. The only agent not associated with carcinogenicity was lamotrigine. Specific agents associated with carcinogenicity were valproate, carbamazepine, gabapentin, pregabalin, oxcarbazepine and topiramate.

Cancer? How could psych meds cause cancer?

I've said it before and I'll say it again, and again. There's no free lunch with pharmaceuticals. We must disabuse ourselves of the notion that we can yank only one thread out of the spider web. When you pull it, the whole thing moves.

When you expose your body to pharmaceutical grade chemical influence, it is forced to adjust.

We think of these medications as "fixing" brain problems, but we are just beginning to learn some of the many effects they have on the body as a whole, and the unmapped individual differences in metabolism and toxicant threshold effects, on the body's mechanisms for survival in adversity – aka cancer.

Researchers today, including research in pregnant women, are asking the wrong safety questions. They are asking questions that made sense two decades ago, before we learned about the microbiome, epigenetics, and transgenerational effects of these individual variables. Particularly the differential effects on female vs male physiology.

Look what happened when they bothered to ask about the effects of Zyprexa on gut bacteria:

This study furthers the theory that gender may impact on the nature of, and susceptibility to, certain side effects of antipsychotics. In addition, we demonstrate, what is to our knowledge the first time, an altered microbiota associated with chronic olanzapine treatment.

The challenge is, that the population-level effects can take decades to emerge and the incentive to limit study of adverse effects is very high. In the meantime you may have been entered into an uncontrolled and unconsented experiment. Take this information for what it is, an invitation to take a different, safer path to healing.

Note: "© [2015] GreenMedInfo LLC. This work is reproduced and distributed with the permission of GreenMedInfo LLC. Want to learn more from GreenMedInfo? Sign up for the newsletter here http://www.greenmedinfo.com/greenmed/newsletter."

Queensland Health psychiatrist accused of having bogus qualifications

A Report from ABC News (Australian Broadcast Co)

A hearing has begun into a former Queensland Health psychiatrist who worked as a doctor with allegedly bogus medical qualifications.

Vincent Victor Berg was employed as a psychiatrist at the Townsville General Hospital's mental health unit between July 1999 and January 2002. Concerns about the authenticity of the Russian-born migrant's medical qualifications only came to light during the Tony Morris led Health Inquiry in 2005. Berg is facing 22 charges including 10 counts of uttering, six counts of fraud, five counts of attempted fraud and one count of forgery.

During the first day of the committal hearing in the Southport Magistrates Court, arresting officer Detective Sergeant Steven Bignell said Berg sent allegedly fake psychiatric qualifications from the Voronezh University in Russia to the Australian Medical Council.

The sergeant told the court he travelled to Russia to speak with staff at the university and was told they did not offer a psychiatric course in 1977 when Berg claimed to have studied there. The detective tendered a letter from the Russian university that stated Berg's qualifications were a "crude forgery". Berg's Queensland Health photographic identification card was also tendered to the court showing he was employed in the Townsville Hospital as a medical registrar.

The Russian migrant was charged by police in 2009 and it has taken six years for the matter to progress to the committal hearing stage. The long delay has been due in part to Berg previously representing himself and seeking a number of adjournments. Legal Aid stepped in late last week and the defendant is now being represented by criminal lawyer, Michael Gatenby.

The hearing continues.

Physician Sentenced for $5.5 million Medicare fraud scheme involving fraudulent billings by a psychiatric hospital

As seen in this report

A Miami-area medical doctor was sentenced recently to 60 months in prison for his role in a $5.5 million Medicare fraud scheme involving fraudulent billings by a psychiatric hospital in Hollywood, Florida.

Assistant Attorney General Leslie R. Caldwell of the Justice Department’s Criminal Division, U.S. Attorney Wifredo A. Ferrer of the Southern District of Florida, Special Agent in Charge George L. Piro of the FBI’s Miami Field Office and Special Agent in Charge Shimon Richmond of the U.S. Department of Health and Human Services Office of Inspector General’s (HHS-OIG) Miami Regional Office made the announcement.

Barry Kaplowitz, 54, of Aventura, Florida, a licensed physician, was convicted of making false statements related to health care matters on Feb. 20, 2015, following a six-week jury trial. In addition to the recent prison sentence, U.S. District Judge Cecilia M. Altonaga of the Southern District of Florida ordered Kaplowitz to pay more than $2.9 million in restitution.

According to evidence presented at trial, Kaplowitz served as the medical director at Hollywood Pavilion (HP), a state-licensed psychiatric hospital, from approximately 2008 to 2011. During that time, Kaplowitz signed false and fraudulent medical records in order to make it appear that HP’s patients qualified for and received intensive outpatient services, even though they did not. The evidence demonstrated that Kaplowitz signed patient files for over 400 patients certifying that he had provided mental health services to each of them, even though he never saw nor provided any treatment to the patients. HP used these falsified medical records to submit over 2,800 false claims to Medicare totaling over $5.5 million. Medicare paid $2.9 million on those false claims.

Five other individuals have previously been convicted and sentenced in this case:

• Karen Kallen-Zury, of Lighthouse Point, Florida, HP’s former chief executive officer, was sentenced to 25 years in prison;
• Daisy Miller, of Hollywood, the clinical director of HP’s inpatient facility, was sentenced to 15 years in prison;
• Michele Petrie, of Fort Lauderdale, Florida, the head of HP’s intensive outpatient program, was sentenced to six years in prison;
• Christian Coloma, of Miami Beach, Florida, the director of physical therapy for an entity associated with HP, was sentenced to 12 years in prison; and
• Christopher Gabel, of Davie, Florida, HP’s former chief operating officer, was sentenced to six years in prison.

Psychiatrist Dr. William Lewek given max sentence for burying body in his own back yard

Taken from a Report From the Democrat and Chronicle. there is more informtion and a video at this link.

Monroe County Court Judge Christopher S. Ciaccio cited Arendt on Friday as he sentenced a Rochester psychiatrist to up to four years in prison for burying a body in a Park Avenue neighborhood backyard.

While William Lewek has numerous substance abuse and physical and mental health issues, Ciaccio said, none of those are adequate explanation for why he kept Matthew Straton's body hidden for nearly three months, even as police and increasingly frantic family and friends looked for him.

Instead, Lewek "simply put his needs and fears above others'," Ciaccio said as he gave Lewek the maximum sentence on the felony charge of tampering with physical evidence.

That physical evidence was the body of 32-year-old Straton, who died in October 2013 at Lewek's Rowley Street house and who Lewek then dragged outside and buried. The county Medical Examiner's Office was never able to ascertain what killed Straton, though during sentencing Friday there were numerous references to it very likely being of a drug overdose.

"Matt had been thrown out like a bag of garbage," Straton's mother, Kym, told the court prior to sentencing, as she described the family's frantic efforts to try to find him for more than two months. "I have nightmares of what Matt looked like when he finally was discovered."

{...]

We also have this video from the initial arrest

Psychotropics Lead List for Youth-Related Drug Poisoning Calls

As Reported by the Psychiatric News section of the American Psychiatric Association Website

The Referenced Report is available here in PDF Format

A new report shows that almost half of the calls made to United States poison control centers on behalf of those aged 19 and under are related to medication—with psychotropic drugs representing 50 percent of the top 10 medications contributing to unintentional poisoning.

Safe Kids Worldwide, in partnership with the American Association of Poison Control Centers (AAPCC), conducted a study to identify the types of medications that contribute to the volume of calls made to poison control centers for drug poisoning in children and teens.

Safe Kids said in statement that the study was designed to “take a deeper look at two specific groups of calls related to medicine: unintentional-general exposures, when kids get into medicine without intending to take it (such as when a young child takes medicine on a nightstand); and unintentional-therapeutic errors (such as when a child is given too much medicine or the wrong medicine).” The study did not include cases in which medications were taken intentionally.

After evaluating data generated from the National Poison Data System of calls made to poison control centers in 2013, analysts from Safe Kids found that 1.34 million calls were associated with poisoning of a child or teen, with 547,042 of those calls related to unintentional-general exposures or unintentional-therapeutic errors. Though 75 percent of the calls made for unintentional drug poisoning involved young children aged 1 to 4 compared with 3 percent for teens, serious health outcomes resulting from unintentional poisoning were six times greater in those aged 15 to 19. The most common mistakes made by teens were forgetting to take a medicine and then doubling up or taking two medicines with the same ingredients, the study found. Atypical antipsychotics and amphetamines intended for the treatment of attention-deficit/hyperactivity disorder were the top two medication classes for serious health outcomes in teens.

Other psychotropic medicines commonly reported for unintentional poisoning throughout all studied age groups included benzodiazepines, clonidine, and methylphenidate. Nonpsychotropic drug classes included antihypertensives such as beta blockers and analgesics such as ibuprofen and acetaminophen.

AAPCC Executive Director Stephen Kaminski, J.D., said the current report points to an urgent need to continue to educate families on using medicines responsibly.

“Our nation’s 55 poison centers play a crucial role in keeping Americans safe by providing poison prevention and free, expert information and advice,” said Kaminski. “In addition to the public, emergency clinicians and pediatricians rely on poison-center professionals to help treat their patients. In fact, about 20 percent of all poison-center exposure calls come from health care providers. It’s good to know that expert help is just a phone call away when the unthinkable happens.”