Pubdate: Sun, 21 May 2000
Source: Orlando Sentinel (FL)
Copyright: 2000 Orlando Sentinel
Contact:  633 N.Orange Ave., Orlando, FL 32801
Website: http://www.orlandosentinel.com/
Forum: http://www.orlandosentinel.com/interact/messageboards/
Author: Henry Pierson Curtis
Bookmark: additional articles on Ecstasy may be found at 
http://www.mapinc.org/mdma.htm

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.
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