This week on the Mad in America podcast, we are joined by Dr. Jon Jureidini.

Jon is a child psychiatrist who also trained in philosophy, critical appraisal and psychotherapy. He has a continuing appointment as a professor in the School of Medicine at the University of Adelaide. He heads Adelaide University’s Critical and Ethical Mental Health research group, which conducts research, teaching and advocacy to promote safer, more effective and more ethical research and practice in mental health; and the Paediatric Mental Health Training Unit, providing training and support to medical students, GPs, allied health professionals, teachers and counsellors in non-pathologising approaches to primary care mental health.

He has an international reputation for his work on the evidence base for psychiatry and is a strong advocate for addressing the social determinants of mental health.

Jon, together with co-author Leemon B. McHenry, wrote the book The Illusion of Evidence-Based Medicine published in 2020. The book was followed by an opinion piece which appeared in the British Medical Journal in March 2022.

In this interview, we discuss the issues with evidence-based medicine and what led to the debasement of a system originally conceived to challenge extravagant claims and poor science.

The transcript below has been edited for length and clarity. Listen to the audio of the interview here.

James Moore: Dr. Jureidini, welcome. Thank you so much for joining me today for the Mad in America podcast.

Jon Jureidini: It’s a real pleasure to be here. Thank you.

Moore: We’re here today to talk about your 2020 book, authored with Leemon B. McHenry, entitled The Illusion of Evidence-Based Medicine. I’d like to come on to talk about the book and the paper but first, I was interested to know a little about you.
You’re a professor of psychiatry and pediatrics at the University of Adelaide in Australia and you’ve written extensively on clinical trials, misleading drug promotion and corporate influence in medical education. I just wondered how was it that you came to have this kind of critical focus on these issues.

Jureidini: The first experience I had of thinking this might be an issue was actually something that seems quite trivial. I was at a conference and it was in an exhibition hall of drug companies and I raced around and grabbed all the freebies I could. I sat down in a chair and looked at this crap that I’d accumulated that I didn’t really want and I thought, something strange is going on here. That kind of piqued my interest.

It happened that our professor of pharmacology had put around a series of guidelines about interacting with industry and I kind of laughed at it and thought, how Calvinist. After having had that response, I reflected more and then I ran into Peter Mansfield, who ran an organization called Healthy Skepticism, which was quite influential in its time. He educated me about these issues.

Moore: Before we turn to the book, I wanted to ask about the concept of evidence-based medicine. Is it just an academic concern which should involve journal editors and researchers or should it also be of concern to the average person in the street?

Jureidini: The trouble is the average person is not in a position to appraise the evidence and is therefore reliant on other people to do that. Maybe that’s a bit of an overstatement because there are people outside of medicine who have done a fabulous job of appraising the evidence, Robert Whitaker being one of them. But the average person considering decisions about their own health isn’t well equipped to do that kind of analysis.

I’ve been accused of scaremongering and I say, “It’s not me creating the fear. It’s actually a very scary business, evidence-based medicine, and something we should be very concerned about.”

Moore: Your book tells a story of the many ways in which the profit-driven motive of the pharmaceutical industry undermines the integrity of science and you talk of the corrupting influence of commercial objectives.
There are many players in this process, from pharmaceutical manufacturers and their research and marketing teams, to journal editors, medical education providers and then ultimately prescribers. Mentioned often in the book is the role of what’s called key opinion leaders. Particularly in psychiatry, key opinion leaders seem to be very prominent. Could describe for us what a key opinion leader is and some of the ways in which they interfere with and influence the science?

Jureidini: That term is used by the pharmaceutical industry, primarily. What they are looking for are like-minded individuals who share their views about medicine and who can be used to unwittingly promote their products. A typical situation would be a young clinician with academic aspirations who has some ideas that are broadly sympathetic to the drug company’s agenda. The drug company recognizes that, grooms the young academic and helps them in their career.

One of the things that’s really hard when you’re getting started as a medical academic is to get research funding. The people who’ve already been funded are the people who then get funded, so you’ve got to find a way to jump onto that treadmill. Drug company sponsorship for research is a good way of doing that.

It happens in two ways. One, you get invited to become a chief investigator in a study that’s already been designed by a company. The duties of the chief investigator are not particularly onerous, you just have to contribute patients and your unit gets well rewarded for that and you get to go to chief investigators meetings which are typically held in nice cities around the world, that’s one way.

The other way is investigator-initiated research. If I’ve got an idea about how to use an existing drug, it won’t matter much to the company about whether there’s any scientific merit in that proposal. They’ll want to support me in doing that. They might get a publication out of it with their name on it but, more importantly, they are grooming me as a budding academic researcher and then are able to trade off my reputation. They will invite me to give talks at conferences, to participate in company-sponsored events at conferences that are disguised to look like they’re part of the legitimate program, and sometimes they are because companies influence the conference organizers.

The key opinion leader is not generally motivated by financial reward although there can be, if not direct financial reward to the key opinion leaders, certainly to their academic research teams. It’s more about career advancement. If you look at heads of department around Australia and I have reasonable confidence in saying around America too, you will struggle to find somebody who has got to a head of department position in psychiatry without having a leg up from industry.

Moore: It comes across in the book that key opinion leaders seem to be amplifying product marketing messages to give a seal of approval and contributing to perhaps the ghostwriting or ghost management really of journal articles, so they’re quite enmeshed in the process, aren’t they?

Jureidini: Absolutely and the other thing that a key opinion leader can do that a drug rep can’t do is promote off-label prescribing. The company itself is prohibited from promoting to doctors that they should use drugs off label. A key opinion leader is not, and so the key opinion leader is the person who promotes off-label prescribing with all of the dangers associated with that.

Now, off-label prescribing in and of itself is not necessarily a bad thing but most off-label prescribing that occurs in psychiatry is poorly thought out and poorly supported by evidence.

Moore: There were some terms in the book that I hadn’t come across before, you talk about astroturfing and evergreening, so could you tell us more about those?

Jureidini: Astroturfing is about fabricating consumer groups. The highest profile parents group for ADHD is actually a drug company-sponsored entity. What you get out of that is a consumer voice which can be more powerful than something that’s coming from industry. It appears to be independent, but it’s not.

Evergreening is about patent extension. A patent is usually 20 years but by the time the drug gets onto the market, there might be only a few years left. If you can come up with a new indication for the drug then you can get an extension of the patent. With blockbuster drugs—ones that turnover at least a billion dollars a year—just 12 months of patent extension is very valuable to a company. So you get these more-or-less fabricated conditions like social anxiety disorder or female sexual dysfunction that are used purely and cynically to extend patents and make profits for industry.

Moore: In the book, it’s mentioned that in the 1800s and early 1900s, the pharmaceutical companies’ extravagant claims for their drugs at the time were labeled the “Great American Fraud.” This created the need to regulate and police their claims and ultimately led to evidence-based medicine as an attempt to bring that into line. 
After reading your book, I had to ask myself, are we really any better off now in 2022 than we were in those wild times?

Jureidini: I think we are. I don’t want to denigrate the concept of evidence-based medicine, because evidence-based decision-making is a good thing. Our concern is that true evidence-based medicine isn’t what’s practiced, largely because of the influence of industry but there are other reasons too.

One of the most striking shortcomings in the current approach to evidence in medicine is the absence of rigorously trying to set out to disprove a favorite hypothesis. What happens mostly in medicine is that people get an idea that they like and then try and massage the data to support that point of view rather than having a good idea and thinking “I’d really like that idea to be meaningful but before I go out there and tell people that I’ve got this great idea, I want to do whatever I can to challenge the idea.”

Drug companies in particular do bigger and bigger studies with more and more people in them which makes it more likely that the results are going to reach statistical significance. The general perception is the bigger the study the better. But actually, if you can demonstrate in a very small study that there’s a significant effect, that’s much more meaningful than demonstrating it in a large study.

In our book, we talk about research into scurvy in the 18th century. There were two patients in each group in that study but because lime juice containing vitamin C was actually a straightforward preventative and cure for scurvy, it only took a total study of 14 people to prove a really important medical development.

I think that should stand as a paradigm of good practice, that if you can show something in a small study and if it’s something stands out, then that’s much more likely to be meaningful than something that you need a meta-analysis of 15 different studies to show a fractional benefit, which is the case with antidepressants.

Moore: Talking a little bit about clinical trials, in the book you go into some detail about GlaxoSmithKline’s infamous Study 329 which evaluated the antidepressant paroxetine, and also Forest Laboratory’s citalopram study. In the book, you say, “In a post-truth world we want to restore objectivity to the scientific testing of medicines.”
That’s quite a goal and quite a target, isn’t it? How could we start to move toward a place where we can have confidence that clinical trials are free from corporate influence and conducted for science rather than acting as a marketing tool for a particular drug?

Jureidini: The more or less complete solution to that would be to take pharmaceutical research out of industry. It was put into industry because that seemed to be the most economically feasible way of doing it. It proved to be economically feasible for industry but not beneficial for patients.

It’s not the case that industry generously pays for research. Industry passes on all of the cost of research and more in the way that they market their drugs. So they carry out all this research and still make huge profits and they tell us how expensive research is to do. If that were all true then they should be really happy to relieve themselves of the responsibility of research and a tax could be exacted on them to cover that research or the money instead of going to the cost of drugs could go to government who could then commission properly conducted research, but that’s not going to happen.

Something that could happen and would be feasible would be that people carrying out research could only publish just their data, not their conclusions or any analysis of it. The data would be published on a suitable website with access for properly qualified people who could then analyze the data and report on it. The company could as well, but they would have no more access to the data than an independent person would.

There was an initiative called All Trials, which attracted a lot of attention. It was a step forward in that it required that the protocols of trials be published and the results always being published. In fact, GlaxoSmithKline was a big mover in getting that off the ground and that seems like a virtuous act by the company until you know that in a legal settlement they were ordered by the Attorney General in New York to publish all their trials. Cleverly, they made a virtue out of a necessity and they made themselves look like great corporate citizens and a big supporters of the All Trials initiative. So you need to be a bit skeptical about supposed positive acts by companies.

Who do the data belong to? Drug companies say they belong to them and talk about intellectual property. From our point of view, they belong to the participants who’ve made a sacrifice and a risk in participating in trials. Our obligation to them is to make the best possible use of the information that’s been generated in the interest of patients more generally. I think that patient interest trumps intellectual property considerations.

Moore: It was surprising to read how difficult it was for you to access data behind Study 329 and the Forest Laboratories citalopram study.

Jureidini: We’ve had a more recent episode where we’re just finishing off a reanalysis of a study called TADs, the Treatment of Adolescent Depression, which is probably the most influential trial of antidepressants in adolescents.

By the time we got on to Duke University, we were too late to get hold of the individual patient records and they had already been destroyed. But in existence, and very important, were the serious adverse event reports. There were 60 or so serious adverse events, and Duke still had the original reports that were filled out at the study sites by the people who were carrying out the study.

At high cost, they agreed to make them available to our team and we did some negotiation and got the cost down a little bit. We wrote a contract between our university and Duke University that would enable us to have access. Then, at the last minute, they said, “Actually, we’ve gone to our ethics committee and we can’t give you those documents because they can’t be sufficiently redacted to protect the identity of the patients.” This was clearly untrue because I had already provided the same documents to Columbia University in an earlier analysis of suicide and antidepressant trials.

What was equally interesting was that we went to our university and said, “Please support us in enforcing this contract that Duke has already entered into.” But our university wouldn’t do that. We got an American law firm to support us but again, our university wouldn’t let us pursue a legal means. Then when we wrote the whole thing up, our university wouldn’t let us publish any of the correspondence that we’d had with them about it.

One of the things that we do go on about in our book and in the opinion paper is the way in which academic institutions have sold out to industry more generally, and how concerning that is.

Moore: You said how difficult it was to access the data. When the regulators come to approve a drug, do they get to see the raw data from trials, or is that not part of how the approval is given?

Jureidini: This is not an area of expertise for me but my understanding is that the regulator is often quite accepting of what’s fed to them by industry. I’ve been involved in one case where the judgment by the FDA was in fact a cut and paste from documents submitted to them by industry.

There are famous cases of people in the FDA taking a proper interest in what is being presented to them. Unfortunately, they don’t seem to have been well supported by their agency when they’ve tried to do something about that. They have been treated very poorly and have to be whistleblowers rather than it being resolved within the agency. We know there’s a revolving door with people within the FDA working their careers towards senior positions within industry, and the FDA is funded by pharmaceutical licensing fees, so that relationship is far too close and blurry for patients to feel safe.

Moore: There’s this whole web of interlinked parts of the puzzle in terms of how industry does its influencing. Your book also says that political lobbying by the pharmaceutical industry is the single most important factor in the corruption of the regulatory system. It goes on to say the pharmaceutical industry is the largest lobby in Washington DC.

Jureidini: It’s interesting because in Australia, being a small jurisdiction, there are two or three psychiatrists who more or less own the public and political discourse. While their entanglement with industry is not huge, they’ve got to the stage where they get all the funding they want from government. Nevertheless, they experience significant career advancement through their engagement with industry and although both speak strongly to social determinants of mental health, they are always sticking up for pharmaceutical intervention.

With the recent publicity about the final putting to rest of the “chemical imbalance,” these key opinion leaders in Australia are wheeled out to say, “Well, yes we knew that all along, but that doesn’t mean that antidepressants aren’t great drugs for anybody who takes them.” So they’re not directly motivated by industry to do that, so you’ve got the voice of apparently well-intentioned, well-qualified public citizens and then you’ve got the direct lobbying. As you rightly pointed out, there are more pharmaceutical lobbyists in Washington than there are Congress members.

The political pressure is not just being applied from one direction, it’s coming from multiple directions. As Leeman pointed out in our book, it is a product and celebration of neoliberalism, and our health is not something that should be prone to that political and economic approach.

Moore: And dramatic creep in terms of identifying things to treat. I seem to remember it was one of the senior people in Merck saying that they wanted Merck products to be more like Wrigley’s chewing gum, something that people just have every day rather than to be seen solely as treating diseases.

Jureidini: Exactly, and that shapes the research agenda as well. Tropical diseases, for example, that kill and disable millions and millions of people get relatively little research from industry because if they do find a treatment it would most likely be something that people take for a couple of weeks and then stop. There’s not the same level of profit in it.

Moore: I’m sure you are aware that there’s been this issue about withdrawal effects from antidepressants and this idea that withdrawal problems are mild and self-limiting over a couple of weeks, We know that this came from the pharmaceutical industry. I was interested to read that the genesis for that might actually have been from a disagreement about the withdrawal effects of paroxetine being a short half-life drug and fluoxetine being a longer half-life drug. Two pharmaceutical companies essentially trying to out-argue each other as to which was the easiest to withdraw from.

Jureidini: Fluoxetine (Prozac) was the first to market and it was losing its market share to paroxetine (Paxil). Part of it was the more energizing effect of Paxil because it’s a shorter-acting drug and quite a nasty drug, but Lilly, the makers of fluoxetine, found a way of getting back at GlaxoSmithKline by saying, “Well your drug is going to have more withdrawal effects because ours is longer acting drug and won’t create the same problems.”

It’s a rare example of vigorous competition between companies though, because most of the time, what’s good for Glaxo is good for Lilly. If you promote fluoxetine, doctors aren’t necessarily going to prescribe fluoxetine. They just recognize that there’s not a lot of difference between different antidepressants. If Lilly is busily doing something that increases the sales of fluoxetine, they’ll also be increasing the market for paroxetine. Market size is probably a bigger issue for companies than market share.

Moore: You end the book with what you call a Radical Proposal and we’ve talked a little bit about that in terms of having trials independently assessed and the data taken out of industry. But, I wondered what else you felt there was anything more we could do to achieve intellectual honesty. I’m thinking of things like the Restoring Invisible and Abandoned Trials (RIAT) initiative that I know you’ve been involved with. Are there other things happening that might start to chip away at this monumental problem?

Jureidini: Yes, I think of the RIAT initiative. We’ve been involved with two of those and I think it’s a great initiative. Maybe half a dozen studies have been done, and one thing that you recognize is how incredibly time expensive it is to do this kind of work and how difficult it is to get it published.

It’s relatively easy for the company to get their shoddily reported study published in the first place, but you wouldn’t believe how hard it was for us to get our BMJ study on reanalyzing Study 329 published. We had 27 pages of reviews on the first submission. There were six months of to-ing and fro-ing between us and the BMJ and people were at each other’s throats.

It was an incredibly demanding, stressful process. In the end, the BMJ were very flattering about it and Fiona Godlee said it was one of the proudest moments of hers as the editor of the BMJ, but they didn’t make us feel like that. We felt like we were having to justify every full stop and capital letter, whereas the people who published the trial initially, albeit not in the BMJ, had just had ghostwriters prepare it. They’d present it to one journal and get rejected. Then present it to another one, do about half of what the reviewer’s asked them to do, and there it was in print.

Moore: At the end of the book, in the appendices, there are a number of letters presented that you or Leemon wrote to senior people in pharmaceutical companies or to journal editors. You get some sense there of how difficult a job this is. You must feel like you’re bashing your head against a brick wall most of the time.

Jureidini: I was at a conference in Sydney a while ago the title of which was “Truth Decay.” It was about the range of things affecting health where post-truth politics were having a negative impact. One of the presentations, by a lovely and very smart man, was about conspiracy theories in health. Interestingly, his chosen topic was people who criticize antidepressants. Here was an academic who thought that our criticism of antidepressants was actually manifesting a conspiracy theory rather than good science. So you can see that the odds are against us in trying to have an impact.

Moore: The book goes into some detail about ghostwriting and the ghost management of clinical trial reports. Could you share with us some of what you found about that during your research?

Jureidini: The most egregious example of ghostwriting and ghost management that I have come across was in the Forest citalopram study. Through legal action, there has been access to company documents.

One of them has a person from the ghostwriting agency writing to a person from marketing in Forest Pharmaceuticals saying, “It’s not clear yet who’s going to write this paper” (as opposed to who’s going to be the author). What they’re saying is they haven’t quite decided who in their team is going to prepare the manuscript, much less who they’re going to claim to have written the paper and who’s going to be listed as the author on the manuscript.

We see drafts of the manuscript prepared by the medical writing agency, as they call themselves and passed over to Forest marketing backwards and forwards. At a very advanced stage of development, out of courtesy more or less, the manuscript is sent to Karen Wagner, who’s the named first author, for her to make a few editorial comments before the medical writer then submits it to a journal. Then they choose a journal that would prefer a brief report so they can get away with not reporting some of the negative findings that would be required in a more extensive report of their paper.

Ghostwriting is a problem academically. It shouldn’t be the case that somebody claims scientific credit for writing a paper that they haven’t written. But from a patient’s point of view, that doesn’t really matter as long as the science is accurately represented. A patient doesn’t really care whether Karen Wagner really wrote that paper or not.

But what a patient does care about is whether the science is accurately represented. The bigger problem than ghostwriting is ghost management, where the whole process of what’s put into the paper and how the science is distorted is controlled by the company through their medical writing agencies. That does matter to patients because it means that false information or potentially fatal information is included in published articles.

Moore: There are some chilling examples in the book where you see the interface between the science and marketing messages and where the two don’t line up. There’s some real sleight of hand to finesse the wording such that, in some cases, goes as far as turning a negative result into a positive result.

Jureidini: Where it’s most dodgy is in the reporting of adverse events. The RIAT reanalysis that we’ve done has not turned out to be dramatically different in the efficacy findings. It’s the way it’s reported that’s the problem there, the spin that’s put on it. But what’s really bad is the way in which adverse events are hidden quite deliberately and cynically.

I think probably the most important thing in our Study 329 reanalysis that was published in the BMJ is a table where we describe 10 ways in which adverse events can be hidden or misrepresented in publications and they’re all incredibly common and used very widely.

Moore: Could you give us some examples of those? One that I do recall was clumping together adverse events to make them look as if they’re more general and not so serious.

Jureidini: If you’ve got some severe psychiatric adverse events you create a category called “neurological event” and you make psychiatric events a subsection of that, then you compare the overall figures. Headaches go into that category and they’re incredibly common, so the noise drowns out the signal.

Alternatively, if you’ve got a drug that has an activating effect that can cause nasty side effects like akathisia, you give different patients different labels. Then you say it’s got to occur 5% of the time or in 5% of patients to be reportable. So by dividing it up, you don’t reach the threshold of 5%.

Or you can rename something. In Study 329, they placed kids who had made suicide attempts under the category of “emotional lability.” Any clinician seeing the label of emotional lability would think, well, the drug made them laugh a bit outlandishly or cry a bit inappropriately, but no, that’s actually code for suicide attempts.

Moore: Study 329 is perhaps one of the more well-known examples of this, has it ever been retracted?

Jureidini: No. I mean, it’s quite amusing looking back on it now, though it wasn’t very amusing at the time. We wrote to the journal; when the journal editor changed we wrote to the new editor. We wrote to Brown University where the named author came from and we wrote to GlaxoSmithKline. We occasionally got replies, but no action.

Moore: So theoretically there are prescribers out there who could still look on that study as a basis for the safety and efficacy of prescribing that particular product and yet, it’s been comprehensively debunked.

Jureidini: Every few years we do a literature search on citations of that study. We found up until quite recently that up to 30 or 40% of the citations of it were either positive or at least uncritical. In fact, I think only a small minority were actually critical, citing it in a way that acknowledged its shortcomings.

Moore: Is there an answer to ghostwriting? I guess going back to your earlier suggestion of it if we could take the whole business of clinical trials out of industry and making independent, presumably that would also deal with issues of ghostwriting because it would then become about the science, not about the marketing message that is applied post-hoc to the science.

Jureidini: Exactly, and the closest I can get to that in advising young doctors is to tell them to only read the methods and results of the paper. In the original publication of Study 329, what was written in the methods and results about efficacy was accurate if you knew how to look at it, but what was written in the abstract and conclusions was entirely misleading.

Now, that didn’t provide any protection against the misleading nature of the way adverse events were reported but it did provide some protection against being led to draw incorrect conclusions as people were doing with that study.

Moore: It must be quite a challenge for prescribers to look at trials and read anything more than the abstract because they’re under so much time pressure. They probably don’t have the time or resources to go and look at the data analysis and the statistics. They’re probably just going by some very high-level messages and the abstract, aren’t they?

Jureidini: Yes, but it only becomes an issue if that paper is going to change your practice. There are a couple of ways in which you can protect yourself from making bad decisions about prescribing drugs that have been misrepresented.

The first is to favor old drugs over new drugs because if a drug has been around for a long time, it’s likely that any adverse effects of it have become more apparent. If it’s survived, that’s probably a good thing. The second thing is to restrict yourself to one or two drugs from any class and get to know those drugs well and only be motivated to change those drugs if you’ve got strong grounds to think that there’s a dramatic benefit to be gained from a new drug.

There are drug bulletins around that doctors can use that provide a kind of screening for that. Prescrire, the French drug bulletin, will tell you if a new drug that comes on the market is worthy of consideration.

Then if you are thinking of using a new drug or treatment, you do need to spend a lot of time looking in detail at the data. You can’t rely on guidelines, and my advice is to form a critical appraisal group, kind of like a journal club, but to find somebody who can mentor a group of physicians in strongly critically appraising literature. But you don’t have to do it very often, because new drugs or new treatments that are going to change your practice don’t actually come along that often.

It looks like they do because new drugs come onto the market but most of them are “Me-too” drugs like all of the antidepressants that came along after fluoxetine and don’t require your attention.

One more thing is about surrogate measures. The idea is that a lot of misleading information comes from placing too much credence on things like changes in blood pressure or lipid levels or, in the case of psychiatry, symptom measures, without looking at mortality or hospitalization or even quality of life measures that measure more substantial outcomes.

The hierarchy of evidence in the conventional pursuit of evidence-based medicine is based on the methodology that’s been used to gather the data. You have a meta-analysis at the top and then a big randomized controlled trial and then cohort studies and then single case studies. What that doesn’t take into account is the importance of what’s being measured, so that hierarchy needs to be respected as well.

Vioxx is probably the best example of something that, at the level of symptomatic improvement, looks like a really good drug but once you started to measure important outcomes like hospitalization and mortality, we discovered that it was a really bad drug.

There’s a long list of drugs that have looked really good when they’ve first been developed because all that has been measured are the surrogates. Once the more important measures like hospitalization and mortality have been investigated, it turns out this drug does more harm than good.

Moore: And as you said earlier, it might be decades before there’s enough data available on the effects of that drug in the clinical setting.

Jureidini: Yes, but with Vioxx, it was years rather than decades. If people had stuck with the old drug for just a while, it would have been long enough for them to avoid the new drugs. It’s great to be an early adopter if you’re buying a new computer or something like that, but it’s not a good idea to be an early adopter with medical treatments.

Moore: Jon, thank you so much for spending some time with me today to talk about your book. It’s very accessible but very sobering reading. It makes clear how evidence-based medicine has been corrupted by corporate interests, failed regulation and the commercialization of academia.
I hope that initiatives like Restoring Invisible and Abandoned Trials and the setting up of journals free from industry influence help to restore some balance.
I can’t imagine how difficult it is to set yourselves up in opposition to people in some of the most profitable businesses on earth who seem to have an endless supply of money to invest in marketing, legal protection and in influencing and all the rest of it. I think it’s an incredibly brave thing to do, so thank you for your work, Jon.

Jureidini: Thank you very much for having me.


  1. Thank you James for another compelling, valuable and informative podcast. Dr. Jureidini is an inspiration to those of us whose loved one’s lives have ben destroyed by the Evidence Debased Medicine in psychiatry. The denial of AKATHISIA induced by SSRIs and its accompanying emotional blunting and changes in feelings, emotions and behaviours has endured for over 30 years as a result of the ghost written, data manipulate ‘clinical trials’ which are a very effective means by which to hide life threatening adverse drug reactions. Courage, commitment gifted scientific ability and integrity. Outstanding.

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  2. What you say, “The pharmaceutical industry’s responsibility to its shareholders means that priority must be given to their hierarchical power structures, product loyalty, and public relations propaganda over scientific integrity,” makes perfect sense.

    We need to eradicate the entire Mental Health System.


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  3. I guess I can only respond to this by noting just how common this type of corruption is. It is not only limited to psychiatry but is also a problem in all sorts of other sectors of the economy. And, mainstream economics in academia basically refuses to even acknowledge or recognize this problem, insofar as I understand, and to that degree, they should be debunked as a corrupt discipline most likely taking money and bribes perhaps not from Big Pharma so much as from plenty of other similarly corrupt business sectors.

    I am particularly struck by this:

    “Jureidini: I think we are. I don’t want to denigrate the concept of evidence-based medicine, because evidence-based decision-making is a good thing. Our concern is that true evidence-based medicine isn’t what’s practiced, largely because of the influence of industry but there are other reasons too.

    One of the most striking shortcomings in the current approach to evidence in medicine is the absence of rigorously trying to set out to disprove a favorite hypothesis. What happens mostly in medicine is that people get an idea that they like and then try and massage the data to support that point of view rather than having a good idea and thinking “I’d really like that idea to be meaningful but before I go out there and tell people that I’ve got this great idea, I want to do whatever I can to challenge the idea.””


    Where else have we seen this kind of problem? I do know that, in Ancient Rome, for instance, lead poisoning was a favored medical practice. ESPECIALLY among the upper classes. Or at least the middle classes. (I bet there were a bunch who saw the writing on the wall and swore off it. If so, Rome was not a society that very thoroughly documented all opinions, as they did not have printing presses, let alone the internet. So, such dissent would have left no trace 2000 years later.)

    However, I believe that there was, long ago, such a thing as the “guild system” which was said to get in the way of “progress.” A guild system involving the trades. And what were they called? Luddites?

    Here’s the thing. A very basic understanding of the economy can be envisioned, simply by noting all the things we need, and then thinking about what systems of exchange have to happen, in order for everything to work out right. Meanwhile, technological progress in the production of food and other necessities allows for the transfer of labor from such sectors as food to other sectors.

    Furthermore, if jobs are eliminated in work producing “essentials,” other sectors of the economy HAVE to expand in order to keep people employed and busy and with the money necessary to buy the necessities now produced efficiently by fewer people. Once efficiency is improved re: production of necessities, we must create inefficiency in other parts of the economy, or I should say superfluousness in other parts of the economy, in order to make the economic system work and keep people employed.

    Absent that, only government welfare can suffice. However, you might as well say that many superfluous jobs created in response to excess efficiency in necessities are little more than glorified welfare masquerading as work. In a class system, we say the lower classes are “on welfare” or “on the dole.” But the upper classes? Oh they are deservedly being paid much more, to do “a whole lot of good.”

    I am reminded of the door to door insurance salesman. We must always interrogate and question which parts of our economy really TRULY are “doing a whole lot of good.” Just because there is a lot of hype doesn’t mean you should believe it.

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    • Another thing we have to remember is, way back then, they did not have the mainstream media or widespread literacy like we have today, yet they still needed to manage society somehow.

      Indeed, local lords and monarches and all that sort of WERE the “mainstream media” in a sense. They’d ride horses through different areas, right? Wear special clothes and have well trained knights and other acrobats do all sorts of impressive things. The super fancy clothes and super fancy jewelry all were stuff clearly created by very skilled and knowledgeable humans, e.g., were impressive. And then they’d tell people what to do.

      Yes, they were “Key Opinion Leaders.” But how do you convince illiterate peasants to listen to a “Key Opinion Leader?” Well, also they did have church and religion. However, since you can’t educate everyone into all the details you know, you have to figure out what works and do it. Religion worked for a lot of things. But, then, absent the printing press, what else did they have beside foot binding for women?

      Think about some of the torture done on mostly men? Now here’s the thing. Stalin’s man made famines, I think, really do prove that, when you are running and managing an intricate economy, which is like a machine that is getting all the right necessities to all the right people at all the right rates — it HAS to be steady — everyone really does have to coordinate.

      But, what you will have is many local people in various areas will be serving as cogs in the wheel of this vast system which, if it is allowed to be disrupted too much, it really will partially collapse and people will go hungry. The problem is, someone who is serving as a cog in the wheel of a larger system does not know economics and does not know or understand how the system works. They may not know that taking a certain forbidden action might have a ripple effect on the system that could cause damage to a lot of people — especially if everyone starts doing it — and they won’t understand how important it is not to do it, unless someone literally gets disemboweled for having broken such rules, or whatever other of the punishments were, some very gruesome.

      But this is because, in a decentralized society, there really is a language barrier. It really is not easy to manage.

      Today, we have literacy and communications industries. This allows for all sorts of new technology to “explain” to the public how to act right to fit into the system right. Except, it’s still not so simple. Society kind of figures out how to manipulate people into playing their appointed role in the system, usually in indirect ways. The people being manipulated doesn’t know they are being manipulated by elites, understand. To some degree they can’t know because jealousy over certain arbitrary inequality would occur. People would be unhappy. Or insulted if you told them the truth about where you have judged their “place” in the economy is. You know how it is, “we’re having you work here because you are stupid” or “we’re having you work here because you come across as unattractive and pathetic.”

      Think of the stereotype of promoting the incompetent worker to a high position, solely to ensure they don’t screw anything up, e.g., they are nothing more than a glorified welfare recipient. But their family connections require that they not be insulted. So they get promoted instead.

      Except this is starting to get very long. Key thing is, what’s going on in psychiatry now — and other parts of the economy — represents, well, actually economist Paul Krugman for the New York Times really did recently write that even in the beginning of the 20th century, we had a society where technological progress had WAY outstripped the ability of elites to manage society with such technology present. And that it has only gotten worse. And we are in an era where it’s as if too much technological progress happened too fast, too fast for society to even know how to figure out how to manage things right. And that’s part of the problem.

      That would be part of the problem with psychiatry too. Namely, that it’s not just about the bad behavior or ill intentions of Big Pharma. If we fixed psychiatry and other parts of medicine, let us suppose we do a REALLY REALLY good job of it. That’s 33 percent of the economy by now, isn’t it? Let’s do such a good job that we shrink the healthcare system to 10 percent of the economy. What kind of catastrophe would that be?

      Krugman also did write long ago that he predicts, in the future, we may well have a society that is sort of run by a few very colorful Key Opinion Leaders. Or that the internet will result in something like that happening. Colorful thought leaders who are very influential in part because they are very colorful and not drab. Simply because it is not good enough to just explain to people, in a drab way, what they need to understand to cooperate with societal “progress” or maybe I should call it “stability.” You need to know how to grab their attention right, so they really listen and understand.

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  4. “It happens in two ways. One, you get invited to become a chief investigator in a study that’s already been designed by a company. The duties of the chief investigator are not particularly onerous, you just have to contribute patients and your unit gets well rewarded for that and you get to go to chief investigators meetings which are typically held in nice cities around the world, that’s one way.”

    “You just have to contribute patients ” — Chilling, when you think about what this really means. Paying for the largesse of the drug maker with actual patient bodies, lives. And if the contributed patients wind up with akathisia or other “adverse events”, say, suicide, I guess that’s just the cost of doing business. These people sure have a lot of blood on their hands.

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    • Yes KateL, it is chilling.

      I read a book some years ago that was 4 reports about the issues being faced by the National Socialists during the processing of a part of their population, and the production of items for the war effort. That too was chilling, the way these Public Officers were suggesting a slowing down of the killing of particular ‘skill sets’ due to the need for their particular skills. One that comes to mind was those who made truck seats, which as you can imagine a truck is not much use without. Comfort for the driver delivering the Einsatzgruppen to a town for ‘purging’ important.

      What the Doc here is talking about is true of all areas of medicine. In fact, I think that in some ways the introduction of this corruption has come from other areas, and into psychiatry/mental health. Though the effect of that corrupting seems to have different behavioural outcomes.

      I know that what I have observed about the State enabling the “editing” of documented legal narratives to conceal criminal conduct may be why any research coming out of Australia would receive such scrutiny. The wholesale “editing” of legal narratives to do cover ups a common occurrence, and the refusal of any authorities to pursue the matters quite easily identified (Try and make a complaint about being tortured (or point out the duty of a public officer to report suspected misconduct)? “We’ll fucking destroy you” the response. Not really fitting with the Convention Australia ratified but …. who cares)

      Moving frauds sideways in your ‘industry’ is not really a good solution when your word is your honor. In fact, I think that providing such ‘institutional protections’ actually attracts a certain type of person, who being aware there are no negative consequences for serious criminal conduct will take on a Machiavellian type of ‘character flaw’.

      Unauthorised experiments on patients contributed to studies easily “edited” out of existence should things not turn out the way you might have expected…….. and with police available to retrieve any documents proving the offending, arbitrary detentions authorised by our Chief Psychiatrist based on the “observed behaviours suggesting a mental illness” once the “Outpatient” has been beaten senseless by police? And lets not mention the ‘spiking’ with date rape drugs which “never happened” because “edited” (wasn’t that a problem me still having the proof?)

      Chilling? I doubt very much the public in Australia is even aware of how chilling it has become. The ‘unintended negative outcomes’ requiring the passing of a Euthanasia Act because the Mental Health Act covers a lot of human rights abuses and concealment of criminal conduct…… but didn’t actually go that far, and the ‘joint enterprise’ nature of the offending needed to be ‘cut’.

      Himmler had the same problem with the report of Josef Hartinger and required laws to enable the ‘outcomings’ at Dachau to continue, and resolved it in the same manner.

      But what else would one expect for a State where torture and disappearances are methods of discipline? Snatched from your bed by police after being ‘spiked’ with date rape drugs and never to see your family again because ….. they were witnesses to it all and need to comply with the “edited” version of reality. How dare you question our authority to do this to citizens?. Especially when the Chief Psychiatrist has rewritten the law to allow it to occur, and removed the protections afforded the community.

      “If the party could thrust its hand into the past and say of this or that event, it never happened–that, surely, was more terrifying than mere torture and death.” Orwell 1984.

      The government we now have has been described as “being totally obsessed with secrecy”. And given the way they are enabling “editing” of reality, no wonder. But what matters is that you get your research published……. and if that takes a bit of “editing” or fabrication of data, so be it.

      Integrity could be restored to the ‘system’ quite rapidly, though unlike the Emperor of Wu, you would need to have the stomach for what needs to be done to achieve that end.

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      • Just pondering these ‘disappearances’ being done by the State government.

        You would think that given I had been ‘spiked’ with date rape drugs without my knowledge, and was being transported against my will by police to a locked ward of a ‘mental institution’ (I note it is serving more than one purpose for the State, though the term is applied in much the same way as Auschwitz was considered a ‘work camp’), that I would have been allowed to contact my ‘next of kin’, a lawyer, or my doctor?

        Not a chance, in fact they ensured that I could not contact my daughter by denying me access to her telephone number, when I asked about speaking to a lawyer this request was denied, and my doctor? Well, they definitely couldn’t have that occur, because they knew I didn’t actually have a psychiatrist and were breaking the law by completing fraudulent Forms to create the appearance I was an “Outpatient”. Police did not provide a referral source, as they had been called and asked to assist with a violent psychotic drug abusing wife beater who was an “outpatient” in possession of a knife, and refusing to talk to his ‘carer’. Though I note the ‘switch’ was made to create the appearance I was a Police referral once back at Ariel Castro Memorial Hospital. Hey look how easy kidnapping is in my State 🙂

        I did make a phone call eventually, though I also see that the contents of that call (to a lawyer at the Law Centre) were documented by a nurse to ensure that the ‘doctor’ (who was conspiring with the Private Clinic psychologist to conceal the offending) was informed of what I had discussed with ‘outsiders’. Documents adjusted accordingly (see the email to the Office of the Chief Psychiatrist where my ‘threats of litigation’ were used to justify my ill treatment, and denial of ‘due process’). Look out, he has talked to a lawyer, someone get a needle full of the chemical kosh into him asap.

        I did actually manage to get a receipt for my person, in the form of a “with complements’ slip with a comment about me being put on Forms by the Community Nurse. Quite a funny guy when you think about that, tortured, kidnapped and he says “with compliments”. Note the deception of creating the appearance of being a Police referral before even leaving the scene of his crimes?

        I suppose the problem with contacting my next of kin was that they would then have had to inform my daughter of me being ‘spiked’ with date rape drugs, and they were actively concealing the offences related to that fact….. intoxication by deception ( 3 years), stupefying with intent to commit an indictable offence (20 years), etc etc. And that was all going to be resolved once they ‘chemically restrained’ me for wearing a loud shirt in a public place (that would be considered “reasonable” right?).

        You really have to love Australia though. They have the rest of the world convinced this is a democracy, when in fact it has regressed into a Police State where arbitrary detentions, torture, ‘refouler’ are sorted out with document “editing”.

        The only person the State would allow to act as my ‘next of kin’ being the person who had arranged to have me ‘spiked’ with date rape drugs and who then planted a knife for police to find. Hardly someone who could be considered to be ‘acting in my interests’ right? Glad she didn’t request that I be ‘assisted to die’ under the new laws given the ease with which my right to consent was passed by the State to the person who ‘spiked’ me with date rape drugs to incapacitate me.

        Still, I guess when your acting like a pack of rapists, why wouldn’t you try and isolate your victim and make sure you got rid of any evidence, and got your story straight in case anyone bothered to ask.

        All sorted now though, the documents have been released showing the offending and everyone simply ignores the documented facts. How humiliating for the victims is that? To be showing the offences which are as plain as the nose on my face, to be denied with bare faced lies?

        Personally I think that my wifes close personal friendship with the Ministers psychologist sister, and her ‘advice’ to my wife, may have something to do with his response of ‘get treated’ to my allegation of acts of torture, despite the facts showing he may be uttering with what are fraudulent documents. Decide for yourself.

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  5. Interesting take on the mind numbing bureaucratize:


    “Moore: It was surprising to read how difficult it was for you to access data behind Study 329 and the Forest Laboratories citalopram study.
    Jureidini: We’ve had a more recent episode where we’re just finishing off a reanalysis of a study called TADs, the Treatment of Adolescent Depression, which is probably the most influential trial of antidepressants in adolescents.

    By the time we got on to Duke University, we were too late to get hold of the individual patient records and they had already been destroyed. But in existence, and very important, were the serious adverse event reports. There were 60 or so serious adverse events, and Duke still had the original reports that were filled out at the study sites by the people who were carrying out the study.

    At high cost, they agreed to make them available to our team and we did some negotiation and got the cost down a little bit. We wrote a contract between our university and Duke University that would enable us to have access. Then, at the last minute, they said, “Actually, we’ve gone to our ethics committee and we can’t give you those documents because they can’t be sufficiently redacted to protect the identity of the patients.” This was clearly untrue because I had already provided the same documents to Columbia University in an earlier analysis of suicide and antidepressant trials.

    What was equally interesting was that we went to our university and said, “Please support us in enforcing this contract that Duke has already entered into.” But our university wouldn’t do that. We got an American law firm to support us but again, our university wouldn’t let us pursue a legal means. Then when we wrote the whole thing up, our university wouldn’t let us publish any of the correspondence that we’d had with them about it.

    One of the things that we do go on about in our book and in the opinion paper is the way in which academic institutions have sold out to industry more generally, and how concerning that is.”


    This strikes me as indicative of a kind of “out of touch” group think. Except I think the people doing this are and should be described as out right bullies.

    However, as a former member of a very successful grass roots organization and also someone who really had this knack for political STRATEGY, I can only say that, when large entrenched institutions like this develop these types of tactics, changing it is going to take more than merely complaining about it or listing the behaviors, for people to passively gasp in horror about it.

    Actually, our media is full of people whining about comparatively trivial injustices compared to this kind of thing, non-stop all the time in such a way that is exactly like crying wolf. By the time you read about institutions engaging in these kinds of skullduggery tactics re: Big Pharma, you’ve heard so much else, it’s like you’ve been lulled into complacency and into accepting this notion that things never change, never can be changed.

    But that’s not true. Things CAN change. You just have to know how to go about it right. Tocqueville mentioned many many times that, when a people is deprived of political freedom for too long, they lose even the ability to know how to exercise political freedom if they ever had it given back to them.

    Anyway, when I hear about such tactics, it strikes me that those interested in combatting this kind of stuff should read two books I and others read when involved in this successful grassroots political organization. One an old Chinese book titled “The Art of War” and the other book, “Rules for Radicals.”

    I would say reading such books helps provide inspiration for the approach one should take, or even the attitude one should have, when seeking to change these kinds of things. Even while I’ll say this is something that is an art where you just have to do what you feel is right sometimes.

    I personally feel that humiliation and shaming is what is necessary for officials in academic institutions who engage in that kind of behavior. And I mean it. The kind of humiliation that is ugly, like ugly name calling, as if they have gone so far that it really would take something as severe as that to give them a dash of cold water they need to wake themselves up.

    Sometimes you can’t be nice. Sometimes the world is about dominance and submission, and when some people are way too uppity or outrageously asserting too much privilege over others, you just need to out dominance them and do whatever it takes to do that.

    I should note, I have sometimes been “bad,” you might say or had “adventures.” I’ve dealt with academic bureaucrats who are just like that, and I have also dealt with the kinds of dregs of society drug dealer types who hang out in Dorchester, MA, fields corner, or outside the Pine Street Inn Homeless Shelter in Boston.

    But that’s how it goes. Those who have too much of a reputation for being “nice” and “respectable” can end up devolving to levels of criminality and sleaziness that far outweigh those with reputations for criminality and low-classness and sleaze. It’s really true and I’ve dealt with a diverse array of people, unlike most people, so I know.

    It’s bad when you are told you are “nice” or are part of the “upper classes,” and then told there are so many people out there who are beneath you, and you never deal with them so you don’t know any better. It’s like being spoiled. And how do children who are spoiled behave? Badly, right?

    Bottom line is, we are a society where people need to be put in their place sometimes. And this sometimes means classes of people as well. In this case, I’d describe psychiatry as a big part of the “White Establishment.”

    Actually, I think no one has ever pointed this out, but although I have never been to such meetings of all the psychiatric movers and shakers, I am right if I guess that all the movers and shakers in this industry who are “part of the problem” are 100% white, and that’s not even rounding up.

    See, when I had my own issues with corruption at Harvard, and it is somewhat tangentially tied to this issue, I was a musician who played the pipe organ and I had my own problems with the organ world as a result. The organ world then, which was very well ensconced in all sorts of academic institutions all over America, also happened to be 100 percent white. And I mean that. 100 percent. Well, ok Asians were allowed. But zero blacks.

    I can be even more precise about it. I played the organ starting in the late 80’s. And I was very talented and all that. So, from the late 80’s until maybe 2016 or 2017, I never met, heard, or saw — or even heard OF a black organist. With one exception. I once mentioned to Murray Somerville of Harvard something about how I noticed, some black people seem to have an amazing musical skill that really would lend itself so well to the organ, so why aren’t there black organists. And I think I even said that part of what makes my skill so special is that I’m similar to blacks in that way. He told me that he agreed with me, and even told me he knows of one black organist, and “his playing is very special like that” or something like that.

    I should note, eventually when I had my problems with Harvard, they tarnished me with all the same Jim Crow stereotypes directed against black men. And, later on, I’d get stalked and harassed by people, who always would insult me using terms of poor mental health. E.g., it’s as if the mental health system, they viewed, was put in place to marginalize people they didn’t like or who they felt jealous of in some sense. So, if I had a problem with Harvard, that meant I was “crazy.”

    It’s kind of like a “I bet those grapes are sour” wanting to stigmatize someone they feel jealous of as “mentally ill” in this arbitrary and capricious way which reflects more the kind of ostracism you might see on the school yard. And, true to form, blacks really are diagnosed schizophrenic at a rate four times that of whites, meaning the degree of bias that must permeate the mental health system, just based on that fact alone, is horrifying.

    And, here’s the thing. I’ve always noticed that I seem to have much more affinity for black people than most other whites, especially those types of whites I have had such above mentioned problems with. And I do feel it’s my expressive style and all that — those same traits that inspired all those problems in the first place — that is why I get along with black people as well as I do.

    But, here’s the thing, what do you do with bullies? How do you handle bullies? You cannot try to reason with them in a wishy washy way and get anywhere. They will not listen to reason, and if you try to reason with them, they will laugh at you and have no respect for you, because you are naive enough to actually think they are capable of listening to anything but outright force and dominance, as opposed to a polite request to voluntarily abide by rules of right versus wrong. They know only dominance and submission. You either out dominance them, or you don’t. That DOES mean you have to be tough — or, another way of putting it is: mean.

    That, by the way, is exactly how you have to deal with drug dealing riff raff hanging out in bad areas of town too.

    As an afterthought, I should even mention that, when I was victimized by the mafia in connection to Harvard, I was living in Dorchester then, in an alleged “bad neighborhood.” Well, I was not menaced even once by a single black “hoodlum.” However, after being date rape drugged by a bar in Boston, and involuntarily drugged other times, many incidents occurred involving gay men DRIVING DOWN from hoity toity neighborhoods like Boston’s South End, Cambridge, Melrose, etc., to do all sorts of bad and criminal things to me.

    The only reason perpetrators wanted me to live in that neighborhood was not because residents were especially criminal compared to anyone else, but because residents were poor enough and easily intimidated enough so the perpetrators could get people from “nicer” areas like Cambridge to come down and do bad things to me, and they trusted the neighboring residents would be too INTIMIDATED to talk or come forward as witnesses admitting they’d seen things untoward happening.

    I realize, I should point that out, because it flies so far in the face of typical societal stereotypes regarding who is behind most crime, The kinds Republicans use to justify their “tough on crime” stance. I realize I need to actually explain this or else people just won’t on their own guess that this was true. In my case, all perpetrators were either white or Asian.

    And it just couldn’t be any other way.

    One reason for the race disparities in Mass Incarceration, I believe, is to help it so whites only can monopolize these areas of crime, as they are quite lucrative and also come with valuable “party privileges.”

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  6. The mental health industry is actually like the canary in the coal mine, indicting the whole medical/pharmacuetical system. Sadly, what we see in the mental health system is running rampant amongst all medical systems in the “developed world.” Yes, it would seem nice to eradicate the mental health system, but we would still have Big Pharma poisoning people through traditional medicine. The healthcare/medical system, including psychiatry and mental health is like your alcoholic out of control uncle in the back seat of your car driving you crazy on a long distance trip across the country. However, like your alcoholic out of control uncle, this system must break down or nearly break down before it can be saved to the point that it benefits people in all the nations. Please remember medicine has been on its downward slope since healthcare tried to become a science, rather than an art practiced by those known as “true healers.” Thank you.

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  7. I agree with other commenters that these issues are rampant not just in psychiatry but throughout the medical system. Psychiatry does have certain things that make it more catastrophic. Forced treatment, extreme social pressure for people labelled as “mentally ill” to “comply”, a legal system that has no protections for “people who don’t know what’s good for them” and “people who society needs protection from”.
    After losing everything, after decades of “help” that all I managed to do was survive through while losing my condo, my job, and my health, my ability to”pass for normal” (as one wonderful former friend used to encourage me to do), I finally removed myself from psychiatry and got off the last of the drugs at age 52. I’m aware I will need to spend the rest of my life watching what I say to people and how I appear, lest someone decide that I’m someone “in need of help”. No family, no friends, not even an emergency contact. I’ll be hiding from this wonderful system for the rest of my life.

    I’m torn about interviews like this, because while I recognize and admire the tenacity and bravery it requires for people working in this system to tell the truth about what’s been happening and who really benefits and who pays the price, I don’t sense the urgency. I realize that screaming and shouting and accusing people and institutions of fraud and worse doesn’t change anything, but knowing, as I do, first hand, the suffering that has been caused by these practices, and also sensing that it’s just not a priority for the powers that be to put a stop to all of it, and then also getting the sense that we’re not even going in the right direction (forced treatment of the homeless, snarky magazine articles mocking the new SSRI study as in Rolling Stone, a NY Times comment section where invariably the people pushing psych drugs and forced treatment get the most upvotes), it leaves me feeling sickened and hopeless.

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  8. I wish people who had influence (rather than someone like me, a disabled former patient with nothing to show for my life) would do more to combat the psychiatric party line that gets repeated so often in so-called reputable publications like the New York Times.

    This article by Jane Brody was published in 2019 and is a veritable case study in psychiatric propaganda being presented as accepted and proven fact. It contains all the usual gems, like the “fact” that effective treatments for severe mental illness exist and it’s only a matter of getting patients to comply, since they don’t know they’re sick.

    Sure, I can write a decently-worded comment in response to this article or another like it (there are many) but if I identify myself as someone who was labeled as severely mentally ill and who is currently not in treatment, who has rejected treatment, including “medication”, I’m not going to get very far. The only people I have a chance of convincing are other people who have been directly harmed by the system.

    When Mental Illness Is Severe

    The following quote from Brody’s article relates directly to the issue of “evidence-based medicine.”. How did these myths become accepted fact that get printed and spoken again and again and go unchallenged again and again, and what will it take to disabuse the general public of the notion that any of this is factual?

    If people believe that the statement below is true, they are most likely going to applaud any psychiatrists who participate in a pharma funded study of a new psych drug, and they’re going to applaud the pharmaceutical company as well. And more patients will be harmed and then disbelieved.

    “…the‌ ‌issue‌ ‌is‌ ‌that‌ ‌treatments‌ ‌known‌ ‌to‌ ‌be‌ ‌effective‌ ‌are‌ ‌underfunded‌ ‌or‌ ‌wrongly‌ ‌dismissed‌ ‌as‌ ‌ineffective‌ ‌or‌ ‌too‌ ‌dangerous; ‌basic‌ ‌research‌ ‌in‌ ‌university‌ ‌and‌ ‌government‌ ‌laboratories‌ ‌into‌ ‌new‌ ‌and‌ ‌better‌ ‌drugs‌ ‌is‌ ‌limited‌ ‌and‌ ‌also‌ ‌underfunded; ‌and‌ ‌pharmaceutical‌ ‌companies‌ ‌have‌ ‌shown‌ ‌little‌ ‌interest‌ ‌in‌ ‌developing‌ ‌and‌ ‌testing‌ ‌treatments‌ ‌for‌ ‌severe‌ ‌mental‌ ‌illness. ‌ ‌”

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        • That’s a bloody understatement! He was fired from his job and treated with such derision that he eventually went mad with frustration – he had proven his point beyond all doubt, and yet was punished for it! I believe he ended his life in a mental institution. There is some question of whether he belonged there or was put there by his enemies. It is a story of arrogance, bias and mutual backscratching allowing the death of thousands and thousands of women in the face of absolute proof of the medical profession’s wrongheadedness.

          Does that sound familiar to any of us?

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          • “I believe he ended his life in a mental institution.”

            Always sketchy when these places are “editing” realities but,….. from what I remember, he died as a result of an infection caused after a beating by the staff of a mental institution.

            “Does that sound familiar to any of us?”

            Maybe, as long as I’m not going to be drugged and snatched out of my bed if I DO say I recognise the pattern lol A ‘conditional’ yes.

            Kind of bizarre looking back, that if I disagreed with my wife I had to go and have my decision confirmed at a cost of $200 a time, every time (she did want me to speak to the psychiatrist at $600 a time, but I said he was the pill man and what the fuk does he care about my decision to dislike broccoli for dinner? All that business was over when I left the service).

            Mind you, the family disagreement was about the right of the nephew to beat his girlfriend senseless in front of her children (after a night or two on the meth and gambling his, and his fathers, money away), and make threats to my wife. On these issues we disagreed. And there was nothing about the ‘assessment’ which wasn’t related to these issues, and why the fuk I have to be dragged out of my bed to speak to a psychiatrist about them still to this day eludes me. And there is nothing else in the documentation except the fabrications for others to utter with to conceal the offending.

            It must have been quite a blow to the ego of a psychologist with a Masters degree to know that my opinion of her was that she was like most of the 2nd year College students I had met. But with a psychiatrist as a husband, I guess taking no for an answer didn’t really enter the equation. The methods of arbitrarily detaining and torturing citizens exposed, and what they actually do when it is, even more interesting. Not just the “editing”.

            I’m not paying someone $200 a time to discuss if my decisions regarding how I live my life are correct. I didn’t survive this long by making reckless decisions.

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          • “It was a horrific tragedy, and possibly not an accidental one.”

            and I quote

            “Does that sound familiar to any of us?”


            Of course, if no one looks at the unredacted documents, then they won’t see the motive, and if they don’t see the motive, then “they wouldn’t do that” and “it never happened” are perfectly reasonable responses to my claims regarding the events which unfolded in the E.D.

            I kind of knew what you meant Steve, but it does show the double entendre.

            I realised earlier today that by reversing the ‘redacted’ documents I was provided by the FOI Officer which caused all the problems between me and my wife, and that Police needed to get back before the “edited” version was provided to the Law Centre, it becomes clear what it was ‘they’ were REALLY trying to conceal. Turn the ‘cards’ over 180 degrees and it all becomes apparent.

            The rather nasty way they turned me against my own wife rather than allow us to figure out what they had done (shame she didn’t trust my legal representatives enough to tell them what had occurred…. though would they simply have tried to ‘outcome’ the pair of us?) ……… What God has put together, let no man (or woman) put asunder.

            It was for the benefit of the State in concealing arbitrary detentions and acts of torture…… smashing peoples marriages to pieces because of a need to conceal misconduct and keep criminals operating within the hospital system? Good news is I know I’m not the only one that knows what she has been doing in her position of trust (that is “editing” legal narratives and then poisoning peoples relationships to push them to suicide. Their families thinking it was the ‘illness’ or the lack of drugs.
            I wonder what the redundancy package from the State looks like?. Fortunately the State doesn’t do body counts when it comes to such corrupt public officers viciously attacking vulnerable people at a time when they find themselves isolated and alone. And they will tell you they did try to ‘help’, whilst stabbing you in the back repeatedly.

            Giving me the documents redacted, and showing the ‘spiking’ and the claim that my wife was calling me a wife beater behind my back (a lie she told me, which fitted with my reality that I had been a good husband that she didn’t want to leave) really caused some problems between us……… Cover those ‘revelations’ and leave only the stuff they redacted and you can see quite clearly the attempt to pervert the course of justice by the FOI Officer.

            The Community Nurse calling police and telling them I was an “Outpatient” of his hospital (a criminal offence) when it was clear from the other redactions that I wasn’t? Naughty naughty….. and there is the motive for a “horrific tragedy, and possibly not an accidental one”. Especially when the Private Clinic Psychologist wasn’t aware of exactly what was contained in the documents relating to her conspiracy with ‘others’. And could she afford to have Police look and see? Not while they thought I was an “Outpatient” …. but that window of opportunity was closing, and fast.

            Mind you, all of my friends would have been aware that it wasn’t what I would have done……. because one of the reasons I never took heroin was because of a needle phobia…. so had I died as a result of ‘morphine from an unknown source’ and the “edited” documents handed to the Coroner……. they also have families that the police could threaten so…….and now that we have Euthanasia Laws and the ability to “edit” legal narratives as FOI Officers in hospitals before anyone else gets to look?

            Schlachthof funf

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          • Do you know, this reminds me of when I was victim of the mafia. It started many years prior with Harvard University first engaging in wrong-doing and then, when I ask for an investigation, engaging in years of reprisals and intimidation, all of it targeting me for daring to implicate them in exactly what they did or were doing, which was criminal to start with, though less obviously criminal than things became later, when I drop out of Harvard and later on the gay community is “handed the reins” by Harvard and starts abusing me even more viciously than I had been abused at Harvard, and this gay community abuse started in this chatroom where a weirdly large number of “regulars” were gay Harvard employees, and they and others in the gay community made it clear in no uncertain terms that they were abusing me on behalf of Harvard.

            Eventually, I am told that, if you are gay and want to be part of the “party scene,” e.g., be able to party with illegal drugs like crystal meth and get away with it and also be safe, you HAVE TO abuse and intimidate victims of the mafia like me in this way. As well as shun them except for those few instances where you might be allowed to “hook up” with them, but it’s some kind of assignment where you are given instructions as to how to treat them. And, if you don’t agree to go along with this criminality, you will not be able to do illegal drugs without having “problems.” And, apparently, the way it works, even gays who don’t do drugs can still have problems at work, and also be turned into incels by the rest of the gay community, if they fail to toe the line exactly on victims of the mafia like me. So pretty much everyone agrees to let a certain portion of the gay community be experimented on in vicious ways by corporations. And they all know it happens and they all keep quiet like docile subjects. The gay activist “movement” actually gets money from these corporations, and also it’s obvious they neglect so many issues that SHOULD be important to gays, like for instance I eventually found out that life for HIV positive gay men can be absolutely horrible, because they get forced on SSI and must live on only 800 a month income, and if they try to work and make more money than that, they will lose their health insurance, and they will have to stop taking their HIV medication because the medication alone costs $40,000 a year, so they’ll die. In my case, two or three of the perpetrators were HIV positive gay men in just that same position. Forced into it because of their dire financial straits.

            Another perpetrator was this Jewish guy who clearly was from a compromised family and was a victim of some kind of unethical medical experiment himself, and lawyers were refusing to let him sue the doctors. He was in excruciating pain all the time because the bad medical care had left him with osteoporosis causing him to eventually break his back. Medical doctors forced him to work for the mafia by under treating his pain, forcing him to turn to the “gay drug scene” for heroine to help get the pain under control which doctors were refusing to help with. And, one of the requirements for continued heroine was the “job” he did with me, working for the mafia. So, I mean, a lot of other gays are victims too.

            Later on, when several date rape druggings and rapes happened, and police started stalking me and framing me a few times, first of all there were a couple of incidents that were staged in order to make it clear that Harvard was involved in all of it. But, then, my own attorneys went and intimidated me themselves. They simply refused to do their jobs right. Two attorneys. However, it was in private and they were sneaky enough so, if I eventually died, they could probably blame me or make it look like some kind of invented guilt on my part was responsible for failure to aggressively prosecute the case.

            At the same time the attorneys refused to help and also the Boston Area Rape Crisis Center and associated police not only refused to help but outright joined in on the intimidation, I ended up being date rape drugged several more times, more rapes and other incidences, some merely violent and not “rape,” I end up getting intimidated so badly as to develop a kind of stockholm syndrome or patty hearst syndrome. Except it was more that the things done to me were so extreme as to cause the fear centers of my brain to just completely make me so terrified of implicating the mafia or Harvard in anything that all I could do was act like and say that I only wanted to make a deal with the mafia to cover things up, and not only say that but engage in a pattern of withholding of information and even altering of facts just right so as to do a very good job — and I’m smart and knew how to do it right — of actually making it genuinely look like nobody else had done anything wrong, and that maybe the only motives behind my desire to “cover things up” were guilt based on some implied wrong doing on my part, and surely not extreme abuse so extreme, there has never been a legal case anywhere in this world ever publicized which involved whole communities of people ganging up on a victim as badly as that, so as to traumatize them this badly.

            It was after I’d been intimidated this badly that the second lawyer I got handled everything just right so I could be pressured and intimidated into putting myself in the situation that let them try to murder me with rat poison, which probably would have been faked as an accident or suicide. But I believe, had I not survived, that Harvard and members of the gay community and the police could have all DENIED the extreme abuse that had gone into forcing me to change my stance from one where I originally was demanding criminal prosecution of all perpetrators to one where I “only wanted to make a deal with the mafia and cover things up.” They could instead say some kind of hidden guilt resulted in blackmail pressure getting me to say all that. As if a genuine criminal investigation might have uncovered something about myself, and that’s why I didn’t want one.

            And I think, based on how viciously I was treated and what they told me, that then the perpetrators themselves, including the very same gay people who’d abused me so badly, could have BRAZENLY and aggressively played the victim themselves, and gone and accused me of having been menacing and “difficult” with all of them, and — well, you know what happened with the Matthew Shepard murder. But it’s pretty much exactly how lynchings would happen in the south, where it wasn’t the black man lynched who was the victim, it was instead the white woman who instigated it who was the victim.

            I am still angry that a group of people would have the gall to think they could be that vicious towards someone, arrange that person’s corruptedly rigged death, meant to be covered up with a false narrative and faked forensics, they immediately afterwards go and get on their high horses, playing the victim themselves, and probably act super aggressive and outraged and self righteous, not merely denying responsibility for all the things done to me — which they did for money and drugs — but take it even further and claim that THEY were victims of ME. Or some such lies meant to damage and discredit me.

            However, at the same time, I was told by one of the perhaps not quite a perpetrator but someone “on the inside,” that what was happening to me was something this “group of people” within the crystal meth scene does to victims all the time. His name was Loi and he said he absolutely hated them, and that they were always ganging up on someone and starting trouble with someone, and they always cover it up using crooked police and, well, he didn’t say murder but I think that’s also what they do. If a victim doesn’t back down.

            In other words, they enjoy this permanent impunity from accountability, all the while being used to going to extremes of viciousness. They are untouchable, and whenever they have a problem with someone, it’s the victim who is to be blamed, while they always get off scott free. That’s what the rules are in this world. And the police and the medical system and mental health system collude with this requirement.

            The punishment for taking on this group can be to be framed by police, or falsely diagnosed schizophrenic or with a “drug problem” by psychiatrists, or murdered in some way that’s usually sneaky, usually “a drug overdose” or a rigged accident, where they again blame you for it.

            When I was almost murdered via rat poison, someone broke in and trashed my hotel room and broke my laptop in half, all in a way so they could say I did it myself, like Charlie Sheen, in some drug induced psychotic rage — perfect so all other perpetrators of viciousness against me could have gone and acted like, I don’t know, that while spectre of the damsel in distress intimidated woman, terrified by the menacing man who is so big, strong, and scary. This was gay men, of course, but I know they were going to cop to that “explanation” for why a problem happened with me, because they were all reminding me non-stop about such intentions.

            Oh, here is one example of such a “reminder” regarding how the gay community would collude with a cover up of their crimes against me — by blaming ME for being “difficult.” You can read it. It’s obvious, they all learned the same lesson as to “this is how we cover things up.” Only problem is, I documented this and all other instances of such “reminders” for years.


            After I hire the second attorney — and was almost murdered with rat poison a few months after — I remember sending an email to someone explaining that I “now have about 8000 files saved over the course of a five years, documenting the non-stop harassment and bullying.”

            If you look at these print screens, you can kind of get an idea. But, yes, gay community harassment and hate directed against me over the course of maybe five years eventually took up nearly 8000 files, as you can see here.


            But, just note the sense of entitlement they have or had.

            Let me quote:

            “Since you are a lawyer you’d realize the significance of the attached document

            Damian Schloming
            to bbixby
            show details Jun 24 (6 days ago)
            Showing the massive amounts of documentation I have on ALL of the various games so many gay guys played on me, mostly online conversations, since I began talking to Stefano. I call it a massive outpouring of hate, because that’s what it is. And, again, when you start noticing large amounts of total strangers suddenly contacting you and you start to get all sorts of people saying weird things, doing weird things, just a ton of weirdness, what else would the prudent thing be to do other than to start to compulsively document everything? Now, remember, I did not document EVERYTHING that happened because I couldn’t. Just impossible to. I only only document or save a conversation like that when the person behaved too weirdly for me not to think something was fishy about it. So I decided to open the bulk of the folders that show the various files constituting the bulk of the papertrail, just so you can see the file names. Then I hit “print screen” and pasted to MS word. Just so you can see the file names. Now imagine if you opened each and every file, and read everything in it? But, just open this MS word document, and just browse over the file names alone. Look at what I have been having to deal with over a long stretch of several years. Look at some of the file names. Is this the life of an ordinary person that I am living? Furthermore, now when I email mafia people, I keep on telling them I will keep quiet, and be good, I just want to be able to live a normal life from now on — and all I get are taunts and hate and vicious and sadistic games played on me. At the same time they are so dismissive of my requests to be allowed to live a normal life, I cannot even mention the idea that maybe some of these people who perpetrated these wrong-doings should possibly be criminally prosecuted or, in anyway, be anything but rewarded for they did to me, or I am made to feel like I have committed a terrible social faux paux.

            I think I will go through that word document, and just list a sampling of the file names. Most of them deal with criminal harassment, vicious behavior, mind games, death threats, rapes, poisonings, the mafia, the FBI, hits on life, “it will all be over soon,” and you also see how it impacted every single aspect of my life, like I was boxed in and could go nowhere without it being present and a factor. What you don’t see from this are the files showing massive amounts of the same sort of thing occurring at two different workplaces, three apartments I lived in, and then there seems to be no place in the world I can travel without it following me. Incidents have happened in Massachusetts, New York City, Connecticut, Provincetown, Rhode Island, New Hampshire, Maine. This is a high tech stalking of me using the mafia. An attempt to stalk me, torment me, and eventually murder me. Think of what certain serial killers do — torment their victims for maybe hours or days before killing them. But look at what this is — years and years and years of abuse, torment, and being put in situations of the most wretched pitiful condition you could possibly imagine on a human being. In particular, what you sometimes see is a need for me to document that someone said something or whatever, just because when you have that many people doing things like that to you, you have to document it or otherwise you end up with a story that is so beyond the realm of human imagination that it is impossible to tell it and have people believe it could possibly be true. And then there are a few where it appears the people who have organized this campaign against me are starting to realize just what they have done, so you start to get file names showing massive amounts of placating, flattery, sweettalking, and guys contacting me from all over the world doing that. This is unreal, yet I am not making it up.”


            They really were like children who have a sense or entitlement and think they are entitled to get away with this kind of stuff.

            Let me quote from other emails I sent to my attorney, which capture perfectly the sense of entitlement, these groups of people had who were all being bribed with money and drugs.

            “to bbixby, bcc: MalenaSD@, bcc: has
            when, in particular, you read what I said to Cockwatch, and realize how true it is, I guess it should only take just a bit of thinking — thinking done in the absense of hearing peer pressure from all the perpetrators who want to avoid being held accountable for what they did — to realize, hold on, I’m being way too nice to people. People did things. They should get what they deserve. We live in a certain kind of world. Those are the rules, nobody is exempt from them, even if obviously all bad people who eventually get in trouble got into trouble because they did something they thought they would get away with. It just doesn’t matter. There is such a thing as right versus wrong, it is not political, it is not a democracy, right versus wrong. It doesn’t matter how psychopathic my parents were, or how good they were at getting a huge coalition of people to jump on the bandwagon with respect to their abuse of me. As horrific as it was, and as huge as the multitude was of people who were involved in the abuse, there is such a thing as right versus wrong and there is such a thing as the truth. There is no way around the truth. It doesn’t matter how vociferously the perpetrators can get multitudes of people to lobby for their cause. It’s a matter of right versus wrong, and how strongly I was able to prove it and me being able to escape through even the most cunning of traps. It simply doesn’t matter how rich someone is who does wrong, or how clever or manipulative my parents were. I am a lot more clever, and that counts for something. Those people who did sick and twisted things to me need to pay, and so do my parents. I suggested those people who engaged in the manipulation that started this problm should get in trouble wiht the law, get caught for doing drugs, I was treating to a bunch of sermonizing a felt like I was sitting in some pew listening to some evangelical minister preach to me about how bad I am. Well, you know what? Maybe I should stop caring about people trying to tell me I am bad. OK fine, I am bad — so that means they shouldn’t have picked on me, because of what sort of hell I am going to unleash because they did. Fine, let people denounce me, I don’t care. I am going to get what I want and live the kind of life I want to live, and everyone else can go to hell.”
            Damian Schloming
            Oh yes and this email. This really captures it. What else can I say when I read this but yuck!!! And what I am talking about — this is how EVERYONE treated me. But look at what it shows, regarding what kind of people they are.
            Damian Schloming
            Damian Schloming
            Feb 10, 2011, 12:43 AM
            to MalenaSD, bcc: bbixby, bcc: bootjockstud
            And, maybe now isn’t a bad time for me to point out, when I was suggesting those individuals be punished, that small handful of individuals who wove this web of lies which, combined with my parents’ lies, allowed Stefano to sic the mafia on me so he could abuse me in some of the sickest and most twisted ways imaginable, the answers I was receiving did not indicate any respect or recognition of what happened to me, or appreciation for what was done to me. “People just don’t want to be involved in that” and this whole idea that, apparently, not everyone on this earth has an equal right to be protected from crimes of this nature. E.g., if you are an important and powerful person, merely being annoyed is enough for these people to be punished real badly. But I, at least according to what some have implied, am some of different category of person where nobody cares that the sickest and most twisted crimes imaginable were committed against me, and so these people should just get away with it. “Sometimes people just get away with it,” I was told, in the most disrespectful and hurtful manner possible. The message is the same message my parents had for me all my life “you’re nothing, people can abuse you however they like and get away with it, because you are nothing.”
            All you can do, when in some situation like that, is just take it and take it and take it, but plan very meticulously to ensure that a day will come when you won’t have to take it anymore. And, when that day comes, yeah that’s a huge number of guilty people who cannot avoid accountability for their actions anymore. Because, usually, when one crime is committed against someone, their family intervenes to put a stop to it. Not in this case — my family intervened and only sought to perpetuate it and incite others into going to extremes in the things they did to me combined with the numbers of individuals they involved. It is my business that the perpetrators be brought to justice. This is not a democracy. The perpetrators need to be brought to justice, and it does not matter who they are, how many of them they are, or how rich they are. What matters is what they did. This all started with a small handful of individuals inciting other people into abusing me. Everyone had a choice about it, and they made it. On top of it, it is wrong to treat someone in a manner that flippantly fails to acknowledge or validate the seriousness of the crimes that were committed against him. This is all about picking on someone because you think you can get away with it. Just because you can doesn’t make it right, and doesn’t mean you have to. If you pick on someone because you think you can get away with it, even if you don’t have to, well, you deserve to learn later you miscalculated.
            Nobody showed me any mercy. I don’t need to show anyone else any mercy. I just need to show myself mercy, since I’m the only one doing that here. I don’t like being treated like I am nothing, like people who commit crimes of that seriousness just “get away with it.” I don’t like people lecturing me, trying to tell me these people should get away with it, and trying to tell me that it is wrong of me to want them punished. So now, I can prove everyone is guilty. Everyone else should start thinking, how important is it to them that these people get away with it? I am sick of feeling like I am sitting in a pew in some evangelical church, listening to some fire and brimstone sermon from someone in the mafia acting like a preacher disapproving of me because I am saying, no, these people are not going to get away with it, and if you think they should, you are sick. Is this something everybody really and truly believes in? How important is it to them that these people get away with it? Is this a deep rooted belief so strong they are willing to go to jail for it? If so, I can help give them an opportunity to prove this is something they really and truly mean — and not something they are merely saying to me simply because they think they can get away with it.”


            I think, though, that if you look at what happened in Iraq, I think there is a connection between these groups of people with that sense of entitlement, thinking only about their bribe money and their drug privileges, and these horrible atrocities you can read about here.


            Actually, I KNOW there is a connection because this group of people who abused me like this were doing it as part of a program where I was used as a guinea pig for unethical nazi style medical experiments. And, I have been repeatedly told that the underlying motive for the wars in Afghanistan and Iraq were to enslave those populations for the purpose of such medical experiments.

            And it’s these same constituencies in the United States as who abused me who are the ones whose jobs (or other privileges) they owe to the fact that so many of this medical research is done using the mafia, rather than done honestly and aboveboard. And money talks, and some of these drugs talk even louder. Hitler used crystal meth to control the Nazis and get them to do all that horrible stuff. You should try it sometime. You will see.

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  9. Psychiatric drugging is very common now. A large portion of the population is kept medicated.

    It is very common and even more so in CA. We have prop 63 2004, Mental Health Services Act, gotten passed by now Sacramento Mayor Darrell Steinberg. They did polling and found that the electorate would go for a 1% Millionaires Tax. And then they ran 1 week of statewide TV ads and it passed by 53%. It has since raised $30 billion, and is now up to $8.3 billion per year. And all that this money is used for is putting people on drugs.

    The Democrats have the 2/3rds in both houses, so they could overturn ballot box propositions, and they could even amend the state constitution. But instead they and Republicans are doing more stuff like this to make it worse.

    Darrell Steinberg had put his daughter in an out of state mental hospital at the age of 13 years. As far as I am concerned, there is not anything else one needs to know about him.

    The girl now in her 20’s goes along with it, “I have mental illness”, and her father continues to build his entire political career around mental health.


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