DrugSense FOCUS Alert #172 May 23, 2000
Florida Prohibitionists Artificially Inflate Drug Death Figures
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DrugSense FOCUS Alert #172 May 23, 2000
In an attempt to maintain some credibility, a few anti-drug strategists have tried to establish measurable goals. For instance, the governor Florida recently announced that his office would cut illegal drug use in the state by 50 percent in five years.
However, even the most committed drug warriors know by now that filling prisons, spreading absurd anti-drug propaganda and shredding the Constitution aren't effective. In fact those tactics have helped to boost reports of illegal drug use throughout the 1990s. So what's a prohibitionist to do? In Florida, the state drug czar's office has been inflating the number of deaths attributed to illegal drug use, presumably so the office can justify its outrageous budget now and show a dramatic decline in such deaths in a few years. As revealed in a report from the Orlando Sentinel (below), several deaths that had nothing to do with "designer drugs" have been attributed to "designer drug" use.
The Sentinel reports that Florida drug czar Jim McDonough, displaying the arrogance of a real czar, reacted to proof of mistakes in drug death records by asking "why a reporter would question shortcomings in the research instead of helping his staff fight drug abuse." Please write a letter to the Orlando Sentinel to say promoting bad data and escalating the drug war will only encourage drug abuse, not fight it.
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Source: Orlando Sentinel (FL)
Pubdate: Sun, 21 May 2000
Source: Orlando Sentinel (FL)
Copyright: 2000 Orlando Sentinel
Address: 633 N.Orange Ave., Orlando, FL 32801
Author: Henry Pierson Curtis
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BAD RESEARCH CLOUDS STATE DEATH REPORTS
Angry, grieving. 'My son does not belong on that list' of designer-drug-related deaths, says Joel Waters. Mitchell Waters, 15, died of a heart ailment but was taking a prescription that contained a drug on the list.
Talking about drug deaths. Jim McDonough, the state's chief drug fighter, tells a summit in February in Tallahassee attended by Sen. Toni Jennings (left) and Rep. John Thrasher about club-drug deaths. His numbers have since been questioned.
Pearl Mastros, 80, died in a nursing home.
Mitchell Waters, 15, died playing basketball.
Tavani Smith, 4, died in a hospital.
Each of these Central Floridians died of known causes. Yet they and many others like them were portrayed by the state as victims of designer-drug abuse.
An analysis by The Orlando Sentinel found glaring mistakes in research by the Office of Drug Control in its campaign to spotlight the dangers of so-called "rave" drugs.
Its official tally of rave-drug deaths reached 254. But blaming that many deaths on the club scene was grossly misleading. The state's research included dozens of errors.
Lumped together with the deaths of hard-partying teens, the state counted:
Terminal cancer patients who committed suicide.
Senior citizens who took painkillers under doctors' supervision in hospitals and nursing homes.
A 58-year-old St. Petersburg man who died after a heart-bypass.
Middle-aged abusers of common street drugs.
A Miami crib death.
In Central Florida alone, a computer-assisted Sentinel review found 25 of the 60 local deaths counted by the state had no ties to club drugs. Another 10 deaths already had been counted as heroin-related.
In total, more than half the deaths were from some other cause, and in some cases, it was clear their inclusion was absurd.
How the state came to identify pre-schoolers and grandmothers as victims of a drug culture known for pierced tongues and all-night dancing does not have a simple answer.
Since 1994, Orlando has had a growing problem with club drugs -- GHB, Rohypnol, MDMA and others. At "house parties" and in more than a dozen clubs around town, teens and young adults gather to listen to music and dance. And get high.
Based on the Sentinel's analysis, the death count across Central Florida is 25 -- a tragic statistic, but less than half what the state claims. The drug office has begun removing cases from the list since the Sentinel raised questions.
Despite increasing efforts to fight it, the abuse thrives across the state. Today, the designer-drug craze is the latest hot topic in the drug war.
Florida has jumped into the fight in a big way. Last summer, state officials staged Operation Heat Rave, a statewide raid on clubs. Then last winter, Gov. Jeb Bush's staff of drug experts began searching from Key West to Pensacola for proof of the deadly epidemic stalking nightclubs and the rave scene.
Jim McDonough, the state drug-fighting chief, unveiled the results of that study at a drug summit earlier this year, using the findings to warn lawmakers of the dangers ahead, despite progress in his first year as head of the drug office.
With Bush, Senate President Toni Jennings, R-Orlando, and House Speaker John Thrasher, R-Orange Park, on the stage behind him, he cited the work as "a very thorough, autopsy-by-autopsy review." McDonough told the standing-room-only crowd at the Capitol that club drugs were killing many more youngsters than anyone had suspected.
Since then, McDonough has defended the work. He asked why a reporter would question shortcomings in the research instead of helping his staff fight drug abuse.
"If we made a mistake, we want to correct the mistake," he said. "There's no attempt here to put out bad data. We are trying to get the facts. We have discovered that we have a club-drug problem in this state that is immense, and we want to do something about it."
The Office of Drug Control acknowledges some of its errors. Two dozen deaths of elderly men and women as old as 84 were deleted from the list after the Sentinel questioned the findings. In some of those cases, records showed that the medical examiners involved had urged the state's analysts not to count them as drug deaths.
And there are other glaring mistakes.
"My son does not belong on that list," said Joel Waters of east Orange County. His 15-year-old son, Mitchell, collapsed while playing basketball at school last year. An undiagnosed heart ailment caused his death.
But the teenager had taken Adderall, a drug prescribed by his doctor to treat an attention-deficit disorder. It contained amphetamine, a drug on the list. No one in Tallahassee inquired about his cause of death before labeling the 15-year-old honor student as a victim of illegal-drug abuse.
"If they're working to get extra numbers to get extra money, they're working in the wrong direction," said Waters, a construction contractor. "I worked for the government. Statistics are something people manipulate."
These days, Florida's drug fight is an enormous effort.
Bush created the Office of Drug Control in 1999 to coordinate prevention, treatment and enforcement efforts, announcing his goal of cutting drug abuse in Florida in half by 2004. It coincides with the national drug strategy to cut abuse countrywide by the same amount.
A key element of the strategy was to make the new office "research-based, measurable and accountable for performance." To head the program, Bush brought in McDonough, a former U.S. Army colonel who served as head of strategy for the Office of National Drug Control Policy from 1996 to 1999. He supervises Florida's $540 million campaign and is credited with energizing drug-fighting efforts here.
On Dec. 2, almost a year after McDonough's arrival, the National Institute on Drug Abuse in Washington, D.C., issued a nationwide alert about the increasing abuse of designer drugs.
It turned the club scene into the drug war's latest thing. Ten days later, McDonough's staff contacted the state's 22 medical examiners, saying it wanted to create a list of all designer-drug-related deaths. Staff members wanted the information in time for a statewide drug summit on Feb. 11.
The drug office asked the state Medical Examiners Commission to send reports on every death from 1997 through 1999 that tested positive for any of 20 listed drugs. The request caught the medical examiners unprepared. There is no uniform system for tracking these drugs.
The Office of Drug Control, interviews and records show, would take responsibility for deciding which deaths were designer-drug-related. The list included such common rave drugs as MDMA, an amphetamine-based hallucinogen; and GHB, a sedative once sold legally in health-food stores.
But it also listed chemicals such as fentanyl, a painkiller, and ketamine, an anesthetic. Both appear occasionally on the rave scene.
But they also are commonly used in hospitals and veterinary clinics. From the outset, the state's definition of designer drugs struck medical examiners as unusually broad. It seemed to some that the Office of Drug Control was asking for too much, too quickly and without knowing how to analyze it.
"Some of those drugs on their list of 20 designer drugs are not designer drugs," said Dr. Shashi Gore, chief medical examiner of Orange and Osceola counties. "Ketamine is not a designer drug. Pure amphetamine is not a designer drug. Nitrous oxide -- come on! It's a drug of abuse, but not a designer drug."
Consider the case of Tavani J. Smith, one of the deaths McDonough told legislators that he had personally reviewed.
No spikey-haired party animal, Tavani was a 4-year-old boy who loved the Power Rangers and cold milk. He woke up on Feb. 17, 1999, complaining of a headache that would persist all day. He arrived at the emergency room of Orlando Regional Medical Center at 9:08 p.m. after his mother consulted her son's doctor.
Nurses gave the boy several drugs to sedate him so a doctor could do a spinal tap to test for meningitis. One of those was ketamine.
At 1:25 a.m., Tavani stopped breathing. Autopsy reports show he died from "probable adverse reaction to ketamine/brevital administration."
But the drug-control staff classified the child as a poly-drug abuser who died from an overdose of ketamine.
"This is crazy, very crazy. They need to go back to school," the youngster's grandmother said. "Tavani was a baby. How could they do that? That's crazy."
Steve Lauer, chief of staff and creator of the designer-drug list, acknowledged that he hadn't known that ketamine was used in hospitals.
Asked about that and other mistakes, Lauer said, "I'm not a doctor. I'm a layman. I have a large number of these. I simply took what they gave me."
Lauer said he should not have included previously counted heroin deaths. In some cases, Lauer said he forgot about the advice from the Medical Examiners Commission not to count deaths of elderly men and women. And the details in other cases clearly should have raised questions.
Among them: a 58-year-old man who died the day he left a hospital after a heart operation, a 52-year-old nursing-home patient who fell and hit his head, and a 74-year-old cancer patient who died in a Miami-Dade County hospital from an accidental overdose of morphine.
McDonough said he was too busy overseeing the drug-fighting effort to discuss cases like that of Rose Pope, 82, who died in St. Petersburgh eight days after being hit by a car.
The Office of Drug Control blamed medical examiners for the mistaken inclusion of elderly victims on the list. But the examiners' staffers say the drug experts in Tallahassee got exactly what they asked for.
"I spent weeks trying to educate them on what they were really looking for. . . . I talked until I was blue in the face," said Larry Bedore, director of operations for Dr. Joan Wood, chief medical examiner of Pasco and Pinellas counties and head of the state Medical Examiners Commission.
One-hundred-fifty pages of memos, draft policies and other correspondence between the commission and the Office of Drug Control show that medical examiners had tried to limit the number of drugs to be tracked.
That might have helped to prevent the counting of victims such as Francois Cineus, a 6-month-old Miami boy who died from sudden infant death syndrome but who had tested positive for ketamine.
There were other mistakes not quite as obvious as infants and senior citizens. The original list also included deaths involving drugs that have been around since the 1940s and don't fit what drug investigators consider the "party" drug scene.
Locally, for example, the state counted seven amphetamine-related deaths of middle-aged men, including that of a 42-year-old Lockheed Martin missile engineer, a 41-year-old man who shot himself after losing his job and a 37-year-old pedestrian killed by a hit-and-run driver.
Gore, the Orange-Osceola medical examiner, said none of those cases should have been counted as designer-drug-related deaths.
"I think it's very inappropriate. They should have consulted us for sure," Gore said. "They need somebody who really knows what's happening."
The reality is that the drug-abuse crisis is complex. People in different age groups and in different walks of life take different drugs. There is no one-size-fits-all strategy to combatting the problem. That requires a sophisticated breakdown of the problem.
For example, amphetamine and a related drug, methamphetamine, can be combined with other chemicals to make the designer drug Ecstasy. But, by themselves, they attract a different crowd of users.
"The typical meth user is a completely different stereotype from the typical party-drug user," said Guy Hargreaves, a special agent with the federal Drug Enforcement Administration. "There really is a major distinction."
Methamphetamine users in Florida range from teenagers to working men and women in their 50s and 60s. They are predominantly poor, rural whites or Mexican-Americans, agents said. Few, if any, have ties to what the Office of Drug Control considers the rave or club scene, agents said.
"The kids I'm talking about wouldn't know a rave if one crawled up their leg and bit them," said DEA Special Agent Tom Feeney, head of a High Intensity Drug Trafficking Area methamphetamine task force in Tampa.
"They call it, 'Poor Man's Cocaine.' "
Designer and party drugs attract a much more affluent group of users. Most tend to be non-Hispanic, middle class and between the ages of 15 and 25, according to drug agents working for the DEA, Florida Department of Law Enforcement and the Orange County Sheriff's Office. The state's list, however, included 93 deaths of people 35 or older.
Another complication is that these drug deaths are rarely as simple as someone who sniffed or swallowed one drug. Most of Florida's cases involve users who mixed a variety of drugs and alcohol.
And many deaths involve car wrecks or other accidents.
Drug-treatment specialists say the flaws in the research are so significant that they could hurt efforts to convince the public about the deadliness of designer drugs.
"Questionable data on the nature of the problem will tend to put all data in question," said Jim Hall, executive director of Up Front Drug Information Center in Miami and a researcher in trends for the National Institute of Drug Abuse. "That's certainly a concern we have . . . There's a tendency not to believe any of that government drug data."
Hall's colleagues working for drug-treatment programs in Tampa, St. Petersburg, Orlando, Jacksonville, Tallahassee and west Florida voiced similar concerns. Provide misleading or false information to teenagers -- the most at-risk group -- and they'll never trust you, they said.
To the editor:
I was fascinated by the article "Bad research clouds state death reports," (May 21). The facts are disturbing, but even more shocking is what's left unsaid: The tortured statistics aren't a mistake.
The state czar requested bad data and he received bad data. As medical examiners tried to point out, broadly defining the parameters of the death reports forwarded to the czar's office would definitely inflate the numbers. Fortunately, the plan's flaws were exposed by the Sentinel. The czar now looks, at best, incompetent.
Why risk looking that way if there isn't a good payoff? There are good reasons for the czar to make "designer drug" deaths look more common than they really are. More deaths make the massive taxpayer funds spent on the drug war seem necessary. Better yet is the potential long-term gain. In a few years, the czar's number crunchers can say, oops, we made a mistake, we shouldn't be recording some of these deaths as being caused by designer drugs. And, bingo, the goal of reduced drug deaths is attained - on paper, at least. Even if the actual numbers go up, the initial bad data makes it look like the zero tolerance tactics of the drug prohibition are succeeding. The drug warriors know they will fail, but armed with this knowledge they now try to define success in terms of planned failure. It might be comical if it weren't causing so much destruction.
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