Stuart Jeanne Bramhall's Blog: The Most Revolutionary Act , page 1372

The Me-Too Drug Ripoff

In addition to the billions of health care dollars drug companies waste on disease mongering (see earlier posts), billions more are wasted on developing and marketing hundreds of “me-too” drugs. By definition, a “me-too” or “copycat” drug is a very slight variation of a drug already on the market.

The main downside of me-too drugs that they drive up health care costs  – the exorbitant cost of medical care is the main reason millions of Americans can’t afford a doctor when they’re ill. Other drawbacks of Big Pharma’s fixation with copycat drugs include the neglect of hundreds of potentially treatable illnesses and hundreds of cases of premature death and/or permanent disability related to inadequate safety profiling. Nearly all the major drug recalls in the last few years have involved copycat drugs that were assumed safe because they were chemically similar to medications already on the market.

An Issue First Raised by Ralph Nader

To the best of my recollection, Ralph Nader was the first to raise the issue of “me-too” drugs in his 2000 presidential campaign. Dr Marcia Angell, Harvard Senior Lecturer in Social Medicine, also covers the subject extensively in The Truth About the Drug Companies: How They Deceive Us and What To Do About It (2004) and in “Excess in the pharmaceutical industry” in the Canadian Medical Association Journal

According to Angell, it’s quite common for a drug company to manufacture their own copycat drugs when their patent is about to expire. The idea is to persuade doctors not to opt for cheaper generics when brand named drugs lose their patent protection. She gives the example of AstraZeneca reformulating the ulcer drug Priloxec to bring out Nexium, a nearly identical replacement. The company also shrewdly increased the price of Prilosec to get people to switch.

Three virtually identical cholesterol lowering drugs, Provochol, Zocor and Lipitor were introduced soon after Lipitor (introduced in 2002) became the best selling pharmaceutical in history . The latter was the first statin, a class of drugs that inhibits cholesterol formation in the liver. There are now eight virtually identical statin medications, excluding combination medications that contain it.

Billions Spent on Marketing Identical Drugs

OF all the drugs the FDA approved between 1993 and 2003, 78% were similar to already marketed drugs. Even more shocking, 68% weren’t even new compounds but a reformulation (change from capsule to tablet, short to long acting, etc) or a recombination of existing drugs.

Angell also laments the billions of dollars drug companies spend persuading doctors (and now patients through direct-to-consumer advertising) that their new me-too drug is more effective or safer than the older versions on the market. In most cases, they do this without a shred of scientific evidence. The FDA only requires pre-approval trials to compare me-too drugs to placebo and not to existing medications.

Big Pharma’s View on Me-Too drugs

Pharmaceutical companies want us to believe that me-too drugs enhance health care delivery. They allege that copycat drugs lower prescription costs by increasing competition. They also assert that doctors need a range of back-up drugs when the first-line medication doesn’t work or isn’t tolerated.

The claim about lowering prescription costs is utter rubbish. Copycat drugs are always priced the same or higher than the older drugs they supposedly compete with. And drug companies never, ever market their me-too drugs to doctors or patients on the basis of cost savings. As the price for brand name prescription drugs soars through the roof, only the easy availability of quality generics keeps prescription costs affordable for patients.

To justify the value of providing doctors a range of similar drugs to choose from, drug industry analysts give the example of the numerous copycat SSRIs available for treating depression. In doing so, they claim that some patients who fail to respond to Prozac, may respond to Paxil, Zoloft, Celexa, Priligy, Lexapro, Zelmid, Viibyrd or Upstene.

This is yet another marketing claim unsubstantiated by scientific research. After prescribing SSRIs for 25 years, I, like most of my colleagues, have never found a differential response to different brands. In fact my clinical experience coincides very closely to a recent literature review of SSRI effectiveness. This meta analysis revealed that only 35-38% of patients (only slightly higher than the rate of placebo response) get a positive response to any SSRI. The other 60+% fail to improve or experience horrible side effects.

What the Congressional Budget Office Found

In 2004, Angell could only estimate what drugs companies were spending on marketing, as this is considered proprietary corporate information. However in 2008, the Congressional Budget Office investigated and came up with the following findings:

Drug companies spent approximately $20.5 billion on promotional activities (10.8% of total revenue) in 2008.
Drug marketing costs, which grew rapidly between 1988 and 2006 had slowed and had been steady for three years at 10-11%. The CBO felt this was directly related to decreased rate of new drugs coming to market.
In 2008 drug companies spent only slightly more on promoting new drugs than they did marketing copycat drugs.

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Medicalizing the Menstrual Cycle

I have blogged previously (see Menopause: Made in the USA) about the negative effects of the “corporatization” of health care in the US. “Disease mongering” is a particularly nasty one. This occurs when pharmaceutical companies “medicalize” common conditions in order to market drugs that supposedly treat them.

Thanks to skillful marketing, Eli Lilly has turned premenstrual syndrome (PMS) into a profit-making commodity nearly as lucrative as menopause and “childhood bipolar disorder” (see Drug Companies: Killing Kids for Profit).

In 1994, the American Psychiatric Association (APA) included premenstrual dysphoric disorder (PMDD) in their diagnostic manual “as a possible mental disorder requiring more research.” They have continued the diagnosis in DSM V. Although DSM IV lists PMDD as a strictly “research” diagnosis, Eli Lilly immediately seized on it as a genuine disorder and devised a marketing strategy to profit from it.

The Difference Between PMS and PMDD

Approximately 80-90% of women worldwide report physical and emotional changes in the 7-10 days prior to the onset of menstruation. For most women, these consist of minor physical changes similar to those of early pregnancy (water retention, breast swelling and tenderness and abdominal bloating).

Approximately 1/3 of women note mental and emotional changes (aka PMS) – depression, anxiety, fatigue, irritability, insomnia, difficulty concentrating – that have a minor impact on their daily functioning.

Although the APA has yet to agree PMDD even exists as a disorder, there are numerous claims in psychiatric and women’s health literature that approximately 3-8% of women suffer from it. By definition, a woman can only qualify for a PMDD diagnosis if they experience a “marked” decrease in normal functioning due to premenstrual mood changes. A rigorous Swedish study ascertained that the true percentage of women experiencing a “marked” decrease in functioning before their period closer to 1.3%.

A Golden Marketing Opportunity for Eli Lilly

Once the patent on a drug expires, other manufacturers are free to produce cheaper generic versions, resulting in plummeting sales of the original brand name drug. In 1999 Lilly, facing the expiration of its patent on Prozac, exploited the new “diagnosis” of PMDD by re-branding Prozac as a feminine pink and purple tablet called Sarafem.

In 2001, the FDA approved Sarafem for “PMDD,” on the basis of double blind studies involving several hundred women. Lilly reported a 60% response rate in women who took it for five cycles, with greater effectiveness in women who took it continuously throughout the month (as opposed to 7-10 days before their period).

Hopefully psychiatrists aren’t quite so gullible as the FDA, given Prozac’s limited effectiveness in treating depression. Thirty years of double blind studies reveal that depressed patients who take Prozac have an average response rate of 38-40%. In fact, statistical analysis of all randomized controlled trials reveal that all SSRI’s (i.e. Prozac, Zoloft, Paxil, citalopram, etc) are only slightly more effective than a placebos, which works 33-37% of the time.

Skillful Marketing Adds Billions to US Health Care Bill

Charging three dollars per dose for their pink and purple Sarafem tablets (in contrast to 41 cents per dose for generic fluoxetine), Lilly launched a massive marketing campaign to convince women they suffered from PMDD. In 2001, the year Serafem came out, nearly 100,000 prescriptions were sold, reaping Lilly $85 million in profits.

Given the soaring cost of health care in the US (the main reason millions of Americans go without medical care), it strikes me as unethical and immoral to trick doctors and women into wasting nearly a billion dollars on pink and purple pills with a fancy name, when generic fluoxetine would have been equally effective at 1/9 the cost.

Research Evidence for “Natural” Treatments

What I find really fascinating about the PMS/PMDD controversy is that it’s one of the few women’s health “conditions” in which there are more double blind placebo trials of “alternative” or “natural” treatments than medication trials. The three “alternative” treatments that have shown clear effectiveness in randomized controlled trials are omega 3 supplements, Vitamin D and the chaste tree berry or chasteberry. In fact, much of this research suggests that PMS-related mood changes may actually represent a nutritional deficiency of omega 3 and/or Vitamin D.

Omega 3 oil is the most studied in PMS-related mood changes, largely owing to its proven efficacy in depression and large cross cultural studies revealing that populations (for example Asians and Norwegians) consuming large amounts of fish (a primary source of omega 3) in their diets have an extremely low incidence of depression.

Vitamin D, has also proved helpful for depression in double blind studies, especially in elderly depressives suffering from documented Vitamin D deficiency. Other studies show that 1,000 – 2,000 international units of Vitamin D is helpful in alleviating premenstrual symptoms.

This finding correlates with an extremely low incidence of PMS in Asian women. The same oily fish that are a rich source of omega 3 are the only natural food source of Vitamin D (the majority of us derive Vitamin D from exposure to sunlight).

Three double blind studies in the British Medical Journal, the Archives of Gynecology and Obstetrics and the Journal of Women’s Health and Gender-based Medicine reveal that chasteberry helps approximately 52% of women with PMS. Chasteberry is an herbal remedy used by Hippocrates in ancient Greece for pre-menstrual symptoms. It’s believed to work by lowering prolactin (a pituitary hormone influencing milk production). High prolactin levels are a recognized, but infrequent, cause of depression.

Take Home Message: Try Natural Remedies First

In light of all the above studies, common sense would dictate that women who suffer from PMS should try a combination of omega 3 and 1,000-2,000 IU of Vitamin D for a minimum of six months before resorting to either Sarafem or generic fluoxetine. Both have potentially serious long term side effects. Owing to their effect on serotonin receptors in the brain, SSRI’s can be very difficult to stop. Moreover they are associated with a loss of bone density, which increases the risk of osteoporosis and hip fracture in later life, and possibly linked to breast and ovarian cancer

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Letter from a Modern Day Mandela

photo credit: http://www.freeocalan.org/

Open Letter to the Guardian

Guest post by Abdullah Ocalan

On Thursday 5 December 2013, the Guardian published an editorial article on the occasion of Nelson Mandela’s death. The article included a significant(!) comparison between Mandela and some other names like Jawaharlal Nehru, Aung Sang Suu Kyi, and me.  As long as they approach the issue with a hegemon’s mindset, the potentates will certainly continue to make such comparisons among those figures wining the affection of their peoples. However, any comparison has its own inner problems.

The time of the struggles, varying geographic and political conditions and even the characteristic differences between the figures will render such comparisons problematic. First of all, for me, being remembered together with a leader for whom all the world shed tears shows the extent to which our struggle line has taken universal dimensions. It also demonstrates the fact that our case couldn’t be explained as a struggle only against an unjust treatment.

Writing on the capabilities of a leader with exemplary methods of struggle and negotiation just after his death needs some more pondering on the history and politics of risk-takers, in order to get a better understanding of the conditions of those who haven’t been afraid of struggling in the front line throughout history.

There are clear-cut differences between the front-line strugglers and deskbound analysts. The greatest difference is to witness the death of your comrades and your people, live the experience moment to moment, and do right and wrong.  Restricting the esteem and dignity of such an important leader with ‘the prison’ is a beleaguered approach which holds in contempt the self-realized political struggle of a people with over 40 million population voluntarily approving this leader as the representation of their own will.  How objective and just would it be to turn a blind eye on the national identity the Kurdish people have achieved after a 40-year-long freedom struggle, and on our peace efforts for a democratic solution to the Kurdish question.

Comparing me with Nelson Mandela in your article, you had referred to me as “feared and worshiped”. Here, not only can I see more easily the writer’s desire to be the state chronicle of a history which tramples on the world’s oppressed, but also I discern the codes of the purposive enmity harbored against both of the compared figures, whose only resource for facing the enslaving, massacre and denial policies is their own self-belief.

It is too evident to need proof that a person who has spent the last 14 years of his life in a prison-island alone and under solitary confinement can be a “source of fear” only for those who have put him into chains. The chains speak for themselves ….

In reply to those who, instead of analyzing the fear spread by the hegemons, are busy giving advice and teaching lessons to those struggling against these hegemons, I should say, in all modesty, that Dear Madiba and me have more parallels than contrasts.

Everybody knows that the ordeal succeeded in facing the Apartheid regime was an accomplishment of not only the South African people, but at the same time of the leader in whom they had unsuspectedly confided their fate.  No matter their numbers, the many ludicrous comments made on Mandela’s credibility come from the quarters which  adopt a remote and trivial approach to the ‘struggle of the oppressed’ rather than making a close and reasonable analysis.

The self-organization processes of the communities subjected to suppression and discrimination would differ from the common practices, especially when they begin to make a true analysis of the notion of capitalist modernity. Traditionally, the organizational options of ‘the book’ are already known. But time proceeds forward and circumstances change, in company with historical determinism. Changing conditions will bring about changes in the behavior and attitude of individuals and organizations, either captive or free. When it comes to the PKK, instead of bringing about pragmatic progress, these changes have led to the political and ethical progress for a movement which has transformed itself on the basis of the struggle for democratic modernity and the developing direct democracy examples in the world.

The 12 September 1980 fascist coup followed by many organized coups against our community as well as the international conspiracy act against me and our movement share one thing in common with other interferences in other struggles of the oppressed; and that is the silence of the international community in the face of these interventions.  Despite the progress in the international democratic standards in the 21st century, due to the state propaganda characteristic of the international conspiracy, the dehumanization of the struggling leaders held captive still continues, based on poor intellectual standards.

How odd it is that a credible newspaper in Britain has not noticed the recent democratization progresses that we have made in Mesopotamia. As far as the approach is concerned, I hope it to be only ‘odd’, not more. Looking at the general approach of the article, what I see is not only the “oddness”; rather, every line is a dead giveaway to a hierarchic and ‘from above’ viewpoint.

Here, those opposing peace are accusing us of starting negotiations, are dehumanizing me in the eyes of the new generations and defaming our movement which has adopted peace and settlement as its main principle.  They are running and organized activity to blacken the reputation of our efforts for democratic modernity.  How odd it is that racist notions and old propaganda rhetoric which have even lost their reputation in Turkey are still being repeatedly covered in the international press.

The only topic to be discussed after Mandel’s demise should be Apartheid, a regime which history would remember only with shame. Nobody would keep a memoir of Apartheid and its leaders; nobody would shed tears for them; whereas Mandela has become a shining star for the peoples of Africa.  Our historical mission is to ensure the ever brilliance of this star for the peoples of the Middle East. The friendship developed on the basis of principled and political integrity between the peoples’ movements and particularly our movement, relies on the changing dynamics and the horizontal nature of their policies.  To believe that these laws of goodwill and friendship have been developed on the basis of fear can only be explained by having no knowledge about the metamorphosis eras the Kurdish political movement has undergone and failing to observe its democratic inner reflections of the peaceful and negotiating perspective of this movement.

Likewise, negotiation and struggle are both important processes in determining the future of peoples’ movements and those leading these processes are figures winning the confidence of the peoples, not ‘feared’ ones. If not so, it wouldn’t be possible for these movements to be represented both in the parliamentary system and the local politics , as it wouldn’t have been possible to succeed in the years-long armed struggle.

My recommendation to the editorial board of the Guardian is to do more research and analysis on the role of the women in our political movement and the resulting transformative effects. Then, they would certainly encounter such an infinite experience so as to take off their colonialist hat, though ashamedly.

Abdullah Ocalan

The Prison Island of Imrali

Abdullah Öcalan Apo, is one of the founding members (1978) of the Kurdistan Workers’ Party (PKK) in Turkey. Like the early ANC, the PKK is labeled as a “terrorist” organization by the US and its allies. Link to “Free Ocalan” website: http://www.freeocalan.org/

Menopause: Made in the USA

(Part II of a two part series about the dangerous campaign by Wyeth pharmaceuticals to medicalize menopause for profit).

Historically 80% of Premarin and Prempro sales have occurred in the US. Even in the US, the cessation of menstruation is a non-event in 75% of women, who experience no symptoms whatsoever. Most languages and cultures have no word for menopause. In Chinese medicine, so-called menopausal symptoms are considered a manifestation of “imbalance” and disappear with a few days of herbal treatment. Even untreated, the hot flashes, night sweats, mood swings and insomnia some women experience rarely last longer than a few months. It’s actually quite common for women to experience improvement in their health and well-being when they stop having periods.

There are interesting cross cultural studies of the “menopause” phenomenon. Non-western cultures typically view the cessation of monthly cycles as a milestone signaling transition to the role of community elder. The Filipino women Berger and Wenzel studied in Women, Body and Society: Cross-cultural Differences in Menopause were extremely pleased with their freedom from the inconvenience of menstruation. They saw it as an initiation into the joys of old age: better sex (estrogens suppress a woman’s sex drive, which is regulated by testosterone and oxytocin) and improved energy and mood.  Most of all they appreciated the new love and respect they enjoyed as elders.

As Berger and Wenzel’s and other cross cultural studies note, attitudes in the US and other English speaking countries are heavily influenced by a multibillion dollar PR industry that bombards women with messages glorifying youth, thinness and sexual attractiveness – and engendering frank terror of gray hair, facial wrinkles, weight gain and cellulite. Aggressive marketing preys on these insecurities to sell billions of dollars of plastic surgery, botox, wrinkle removing creams and lotions, age concealing make-up, hair coloring and diet products and programs.

Six Decades of False and Misleading Marketing

As revealed in internal documents uncovered in a few of the 5000+ lawsuits filed against Wyeth, the company’s culpability goes far beyond neglecting to inform menopausal women of cancer risks. They paint a very ugly picture of an aggressive public relations campaign to convince women and their doctors that estrogen replacement was the secret to eternal youth.

It was a win-win campaign. By 1992, Premarin was the most commonly prescribed drug in the US. Thanks to decades of marketing about the horrors of aging, post menopausal women were terrified of losing their sexual attractiveness without estrogen replacement. And because health “experts” were recommending it in medical journals, doctors were more than happy to overlook increasing evidence that it caused cancer.

By the mid-nineties, ironically, even the corporate media was reporting on studies linking estrogen replacement to cancer. In 1995 Time magazine ran a feature on it: Wallis, C. “A Risky Elixir of Youth” Time. (26), 46-56, 1995. In 1999, Tom Brokaw featured Medicine/Breast Cancer and Estrogen  on NBC Evening News.

The NIH Shuts Down the WHI

Seventy percent of American women taking estrogen replacement when the National Institute of Health shut down the Women’s Health Initiative (WHI) study in 2002 (see Wyeth and the Multibillion Dollar Menopause Industry). This resulted in a 7% decrease in the first year alone of new breast cancer cases – a total of  14,000 women spared the agony of a potentially fatal breast cancer diagnosis.

The study findings have also resulted in 5000+ cancer lawsuits against Wyeth for misrepresenting earlier cancer research to doctors – and their failure to inform women of the significant cancer risks associated with HRT.

Wyeth’s response was to initiate a massive PR campaign discrediting the WHI study. They started with a letter to 500,000 doctors attacking the study, complaining that the women in the Premarin arm had other reasons for developing cancer – they were too old, too menopausal or weren’t checked for pre-existing heart disease.* This was followed by articles attacking the study in numerous medical journals. All were ghost written by the company and published under the names of doctors specializing in women’s health

Many of these doctors were affiliated with the notorious Council on Hormone Education at University of Wisconsin that Wyeth founded in response to the 2002 WHI study. In 2006 the Council was still offering a continuing medical education course promoting estrogen replacement called “Quality of Life, Menopausal Changes and Hormonal Therapy.”

Filing Suit: the Only Consumer Protection Against Big Pharma

Wyeth’s massive campaign to discredit the 2002 WHI study, at the expense of tens of thousands of women who would start or continue estrogen replacement, has clearly harmed their defense in the dozens or so of the 5000+ lawsuits that have made it through the courts.

The pharmaceutical company has yet to win a single lawsuit brought by women (or families of deceased women) who developed reproductive cancers as a result of taking Premarin or Prempro. Moreover there are still active information websites for affected women and/or families who have yet to file suit. If you or a loved one has developed breast, uterine or ovarian cancer as a result of taking Premarin or Prempro click here.

*Unbelievable. Part of the reason the WHI was stopped was because women on estrogen had higher rates of heart disease. Yet in 2002 Wyeth was still aggressively promoting Premarin as a way to prevent heart disease.

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Wyeth and the Multibillion Menopause Industry

(Part I of a two part series on the dangerous and cancer causing campaign by Wyeth Pharmaceuticals to “medicalize” menopause for profit),

I have written previously (see The Multibillion Dollar Depression Industry and Drug Companies: Killing Kids for profit)  about the ingenious – and deadly – strategy by pharmaceutical companies of inventing fictitious illnesses to market highly profitable drugs that allegedly “treat” them. The technical terms for this are “medicalizing” or “disease mongering.” In her 2004 The Truth About the Drug Companies: How They Deceive Us and What To Do About It, Dr Marcia Angell talks about “generalized anxiety disorder,” “erectile dysfunction,” “premenstrual dysphoric disorder,” and “gastro-esophogeal reflux disorder (heartburn).” These are other common complaints that drug companies have reinvented as chronic illnesses requiring lifelong treatment.

Estrogen Deficiency Syndrome

Based on 30 years of research linking it to reproductive cancers, the marketing of so-called “estrogen deficiency syndrome” has been far more lethal. The condition is known as “menopause” in English-speaking countries. Other cultures have no word for it. The number of premature deaths from the so-called treatment – “hormone replacement therapy (HRT)” – is the millions.

In this case the culprit is a single company, Wyeth, which manufactures Premarin (conjugated estrogens extracted from pregnant mare urine) and Prempro, a combination of estrogen and progesterone (a second female hormone).

Estrogen, a hormone regulating the development and function of the female reproductive system, was first discovered in 1925. In the 1930s, the drug company Wyeth developed a process to extract conjugated estrogens from the urine of pregnant mares. They patented their product as the drug Premarin (PREgnantMAresurINe), which first appeared on the market in 1942.

From the beginning Wyeth marketed Premarin, not for temporary relief of menopausal symptoms, but as a lifelong treatment to help all women maintain “healthy” estrogen levels in later life. Obviously this is nonsense. A “healthy” or natural estrogen level in a post-menopausal woman is virtually zero.

Although the medical community (and Wyeth) have been aware of links between estrogen replacement and breast, uterine and ovarian cancer since the 1970s, this research was effectively concealed from the public. Until the frightening results of the Women’s Health Initiative (WHI) study hit the front page in 2002. Between 1993 and 1995, the National Institutes of Health enrolled 161,809 women in the double blind WHI study. In 2002 the NHI shut down the study. Although it was originally scheduled to finish in 2005, it was painfully obvious that the women taking HRT were experiencing a 26% increase in breast cancer (with the risk doubling after five years), a 41% increase in strokes and a 29% increase in heart disease.

1975: the First Study Linking Premarin with Cancer

The first study linking Premarin with uterine cancer appeared in 1975. It was replicated by other researchers in 1977 and 1979. Wyeth responded to these worrisome studies by promoting a small 1980 study that taking progesterone, a second female hormone, reduced the risk of uterine cancer with estrogen replacement.

Sadly, most doctors fell for Wyeth’s slick PR campaign. Thanks to all the free pens, watches, clocks, lunches and trips to overseas conferences, they conveniently overlooked the failure of Wyeth’s 1980 study to at cancer rates in women who took no hormone replacement or to study the possible role of combined treatment in inducing other hormone sensitive cancers, such as breast and ovarian cancer. Wyeth’s success in selling doctors on combined treatment would lead them to launch Prempro, a combination of Premarin and progesterone, in 1995.

The earliest studies linking Premarin with breast cancer appeared in early 1980. According to Nik Ismail in “Hormone Replacement Therapy and Gynaecological Cancers,” between 1975 and 1995, there were at least fifty studies linking estrogen replacement (also known as HRT) with breast and uterine cancer. Some were cross cultural studies revealing American women had more than ten times the incidence of breast cancer than Asian women, who don’t take estrogen replacement.

The Multibillion Dollar Wyeth Cover-up

Wyeth responded to the breast cancer studies with a new PR blitz. In addition to flooding doctors’ offices with literature claiming studies linking Premarin to cancer were “contradictory,” they promoted numerous company-funded studies allegedly showing that estrogen replacement prevents osteoporosis and hip fractures, dementia and heart disease. The spin Wyeth gave doctors was that the effect of reducing cardiovascular disease (heart disease and strokes) — the most common cause of death in Americans – outweighed the somewhat lower risk of developing breast cancer.

Ultimately the claim that Premarin and Prempro reduce elderly women’s risk of cardiovascular disease proved to be false. This was one of the main reasons the WHI study was stopped: the women in the Premarin/Prempro arm of the study were developing significantly more heart attacks, strokes and dementia.

The WHI points to some role for estrogen replacement in reducing osteoporosis. However no studies have ever controlled for long term fluoride ingestion or epidemic Vitamin D deficiency in elderly Americans – which both have a documented role in high US rates of osteoporosis and hip fracture.

The marketing blitz aimed at doctors was accompanied by an even more powerful PR campaign in Harper’s Bazaar, the Ladies Home Journal and other women’s magazines. The goal was to appeal to American women’s (largely manufactured) terror of aging by emphasizing the value of estrogen replacement in preserving sexual attractiveness by preventing the skin changes and vaginal drying associated with aging.

To be continued.

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Drug Companies: Killing Kids for Profit

(Thanks to the corporatization of health care, Americans pay double what other countries pay for health care but have much worse health. The recent Obamacare roll-out has heightened public awareness about the role of private insurance companies in sucking billions of health dollars out of the health care system. There is far less scrutiny of the role of Big Pharma in driving up health care costs.

This is the second of several posts on “disease mongering” by pharmaceutic companies  – i.e. the invention of fictitious diseases to market drugs that supposedly treat them.)

Practicing psychiatry for eight years in New Zealand has given me a unique perspective on childhood bipolar disorder. Also known as pediatric bipolar disorder (PBD), this is a condition virtually unknown outside of the US. Australian psychiatrist Dr. Peter Parry has undertaken detailed research into this condition, and a “conspiracy” by Eli Lilly and other drug companies to promote off-label use of antipsychotic drugs to children under 12. Yet another example of “disease mongering” by Big Pharma (see link) to encance their profits.

As well as publishing numerous papers on the PBD controversy, Parry also has a Powerpoint presentation he gives at grand rounds and conferences around the world. It includes internal Lilly and Janssen memos (available from his Healthy Skepticism website) about their innovative campaign to “medicalize” children’s misbehavior.

Thanks to their aggressive marketing of PBD to US doctors and parents, American children as young as two are being started on antipsychotics for extreme anger and behavioral problems

Breaking the Law: Good Business Practice

Prescribing “off-label” refers to using medication for an indication that hasn’t been approved by the FDA. As yet no antipsychotics have been approved for use in children. Moreover, it violates federal law for drug companies to market medications to doctors or the public for “off-label” uses. Yet because the fines imposed are minuscule, compared to the massive profit potential of off-label marketing, it’s considered good business practice to pay the fine and keep on doing it anyway.

Diagnostic Criteria for Bipolar Disorder

Parry’s slideshow starts with studies comparing US attitudes about BPD in the UK, Germany, New Zealand and Australia. Most foreign psychiatrists either don’t recognize pediatric bipolar disorder as a diagnosis or regard it as extremely rare. According to Parry, the discrepancy revolves mainly around an insistence (outside the US) that both children and adults manifest symptoms of true mania to be diagnosed bipolar. Over the past 10-15 years, an increasing number of industry-funded psychiatric researchers have been claiming that extreme temper outbursts, rages and rapidly changing moods are a “manic” equivalent in children.

They also claim that children with extreme mood swings will go on to develop true bipolar illness in adulthood, making early treatment essential. This despite studies showing that most kids with PBD  “outgrow” it as adults. (Although it seems more likely they never had it to begin with.)

What Parry finds particularly horrifying is that American child psychiatrists are diagnosis kids bipolar and starting them on antipsychotics without taking a developmental history to rule out the most common cause of extreme anger and behavioral problems – namely child abuse and attachment difficulties.

Putting Psychiatric Experts on the Payroll

That being said, he puts the blame for the dangerous fad of prescribing unapproved antipsychotic drugs for children squarely where it belongs: on multinational drug companies. In the US, most child psychiatrists are naturally uneasy prescribing dangerous antipsychotic medication for kids. They have to be egged on by esteemed researchers issuing stern warnings about ruining a child’s future life by “missing” a the diagnosis of bipolar disorder.

Too bad these self-proclaimed PBD experts are so careless about disclosing conflicts of interest, in the form of hundreds of thousands of dollars in of drug company research grants and consultant fees. This has only come out in subsequent lawsuits and ethical investigations.

Death and Other Dangerous Complications

The complications of antipsychotic treatment in children fall into four broad categories: death, severe medical complications, social exclusion and delayed emotional development.

1. Death

15 years of FDA adverse incident reports (which typically capture only 1% of adverse drug events) directly implicates antipsychotic use in children with scores of deaths:

2000-2004: 45 deaths (source)

2006: 29 deaths (source)

2.  Severe Medical Complications

Antipsychotics tend to cause massive weight gain – often as much as 100 pounds – a common cause of diabetes. In addition a disfiguring neurological disorder called tardive dyskinesia that occurs in 6-9% of children who take antipsychotics. The tics and writhing movements associated with tardive dyskinesia often persist permanently, even after the medication is stopped.

3. Social exclusion

Labeling a child with a mental illness, particularly if they are taking a medications that cause sedation, extreme weight gain and/or tics has an extremely detrimental effect on social relationships that are absolutely vital to normal child development.

4. Delayed emotional development

Sedating a child who has difficulty regulating anger and extreme moods only further delays the process of learning to regulate their emotions themselves.

Below a video from a mom whose son died from antipsychotic complications:

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The Multibillion Dollar Depression Industry

(Thanks to the corporatization of health care, Americans pay double what other countries pay for health care but have much worse health. The recent Obamacare roll-out has heightened public awareness about the role of private insurance companies in sucking billions of health dollars out of the health care system. There is far less scrutiny of the role of Big Pharma in driving up health care costs.

This is the first of several posts on “disease mongering” by pharmaceutic companies  – i.e. the invention of fictitious diseases to market drugs that supposedly treat them.) 

Marketing Serotonin Deficiency

With the release of Prozac back in 1987, the pharmaceutical industry began systematically indoctrinating doctors with the theory that depression is caused by a genetic deficiency in a brain neurotransmitter called serotonin. Big Pharma then spent the next 25 years reaping billions of dollars from marketing high-priced SSRIs to treat this so-called deficiency.

There are several obvious flaws in the theory that depression is a genetic brain disorder. The first is the skyrocketing increase in depression and suicide triggered by the 2008 meltdown. The prevalence of a genetic illness should follow the same predictable growth curve as population. The second is the total absence of so-called “serotonin deficiency” in lower mammals. The third and most obvious is the extremely low response rate to SSRIs and other antidepressants. Only 50% of patients who take them ever achieve full recovery.

The Learned Helplessness Model of Depression

The absence of “serotonin deficiency” in lower animals means that depression has to be artificially created to research prospective antidepressants. Most of this animal research is based on the “learned helplessness” model. In a common experiment, mice are dropped into a large vat of water and the researcher times how long they keep swimming before they give up. After taking a dose of Prozac, they swim longer before giving up.

There is something incredibly sad about the drug companies’ persistence in torturing small animals. If the medical profession is serious about addressing the immense suffering caused by the costly and disabling condition, surely they need to start addressing some of the other known causes – for example, nutritional deficiency, derangements in intestinal bacteria and the total degradation of family and community life.

Depression Caused by Poverty and Malnutrition

Doctors have known for half a century that specific nutritional deficiencies can cause depression. Western countries are particularly known for depression-linked deficiencies in omega 3 and Vitamin D. Cross-cultural research shows that Asian and Scandinavian countries consuming quantities of fish (which contains both omega 3 and Vitamin D) have extremely low rates of depression. The phytonutrients found in fresh fruits and vegetables also seem important in preventing depression, though the evidence is less strong.

Owing to recent skyrocketing food costs, I feel a little silly advising low income patients to eat more oily fish and fresh vegetables. I also feel angry and disgusted about a corporate-driven health policy whereby Medicaid, Medicare and Obamacare happily pay for a Prozac prescription (to help their friends at Big Pharma) but not to subsidize fresh, organically grown food for low income patients with obvious nutritional deficiencies.

Depression Caused by Unhealthy Gut Bacteria

Pioneering gastroenterology research suggests that the microbiome (the resident bacteria in our intestines) also plays a major role in brain function. The overuse of antibiotics, in medicine and factory farming, has killed off normal bowel flora in a large segment of the industrialized world. This, in turn, has led to a near epidemic levels of irritable bowel syndrome and inflammatory bowel disease. Surprisingly both conditions have links to arthritis, obesity, autoimmune diseases, and so-called “brain” diseases, such as depression, anxiety, migraines, and even autism.

Recent studies suggest that treating this type of depression can be as simple as taking probiotics or eating fermented foods, such as yoghurt and sauerkraut. Yet because these treatments aren’t medication-based, they aren’t covered by health insurance, Medicare or Medicaid.

Human Misery, Stress and Social Isolation

Obviously the worsening depression, along with epidemic levels of foreclosures, bankruptcies and evictions, is a far bigger culprit than nutritional deficiencies or gut bacteria in the recent exponential increase in depression and suicide. The best way to trigger depression in higher mammals is through massive, unrelenting environmental stress. Surely the pharmaceutical companies know this, or they wouldn’t be using learned helplessness in their animal research, would they?

It’s also striking that the current economic depression has hit people a lot people harder than the Great Depression of the 1930s. This seems to relate to the overall breakdown of family and community life. Prior to World War II, the family and social networks people belonged to exerted a protective effect during stressful times. Human beings, like other primates, such as apes, monkeys and gorillas, are fundamentally social beings. We are all hard wired to have strong social needs and function very poorly when they go unmet.

Recent neurophysiologic research shows that the human brain produces specific “feel good” neurochemicals (e.g. oxytocin, endorphins, and dopamine) to reward people for social activity. Social isolation appears to produce a deficit in these chemicals.

The Absence of Social Needs Research

Research into non-pharmaceutical treatments for depression is unlikely to occur in the US, where Big Pharma oversees the vast majority of medical research. For obvious reasons, drug companies have no incentive to investigate treatments that don’t involve a product they can sell for profit. It hasn’t helped that Obama has slashed research budgets for National Institutes of Health and National Institutes of Mental Health.

photo credit: Tidewater Muse via photopin cc

The CIA Role in the Arab Spring

(more from my research for A Rebel Comes of Age)

L’Arabesque Americaine (French edition – not available in English yet)

by Ahmed Bensaada (2011 Michel Brule)

Book Review

The current military junta in Egypt supports growing suspicions that the Arab Spring revolutions of 2011 were simply “color revolutions” – like the so-called “color revolutions” George Soros and CIA-linked foundations orchestrated in eastern Europe a decade ago.

Despite a few autocratic dictators being deposed, in each country the rich keep getting richer, the poor keep getting poorer, and US corporate and foreign policy interests continue to take precedence over labor rights and public welfare.

In Arabesque Americaine , Ahmed Bensada assembles a wealth of data  suggesting that the “Arab Spring” was first and foremost a destabilization/regime change operation, funded and orchestrated by the CIA, State Department and historic CIA-funded foundations. His book is unique in that it provides a carefully researched and referenced account of each of the “democracy exporting” foundations, along with the totals it gave each country and group in 2009.

Bensaada, a French Canadian who was born and received his early education in Algeria, devotes special attention to the Egyptian revolution – and the role played by Google’s star employee Gael Ghonem.

A brief outline of the topics covered:

Chapter 1 — the secret American funding and orchestration of the so-called “color revolutions” in Eastern Europe , with particular focus on Serbia (2000), Georgia (2003), Ukraine (2004) and Kirghizistan(2005). In each case, pro-Soviet governments were overthrown by mobilizing disaffected, pro-Western young people — financed by the CIA, State Department, and Pentagon linked “democracy manipulating” foundations. The latter include National Endowment for Democracy (NED), National Democratic Institute for International Affairs (NDI), the International Republic Institute (IRI),Freedom House (FH), the Albert Einstein Institution, the Center for Non Violent Action and Strategies (CANVAS), the United States Agency for International Development (USAID) — and George Soros’ Open Society Institute (OSI). Several “color revolution” veterans were used to help organize Arab Spring protests. The uncanny similarity in protest symbolism (see video below) was no coincidence.

Chapter 2 — detailed discussion of the above think tanks and foundations, which includes a description of the their government funding, as well as the subversive activities (espionage, election rigging, an popular destablization activities) they have promoted in countries like Venezuela, Bolivia, Cuba and Iran that oppose America’s pro-corporate agenda.

Chapter 3 — the promotion, by the State Department and these think tanks and foundations, of new technologies in Middle East destabilization campaigns. The Tor Project, developed by Google, the US Naval Research Lab and State Department-linked Human Rights Watch, is an example. Tor supposedly permits anonymous navigation of the Internet in countries (with the exception of the US) with heavy Internet censorship. Bensaada also explores the role of Movements.org and the Alliance of Youth Movements in promoting social media to international youth activists. Movements.org is run by Jared Cohen, the director of Google Ideas and a former adviser to both Condolizza Rice and Secretary of State Hillary Clinton, and Jason Libman, another Google employee formerly employed by both the State Department and the Pentagon. AYM executive director David Nassar was formerly employed by NDI, USAID and IRI. In 2008 the State Department brought future Arab Spring activists to the US to teach them to use Facebook and Twitter, with the assistance of Sherif Mansour from Freedom House, Larry Diamond from NED, and national security adviser Shaarik Zafar.

Chapter 4 — focuses on Egypt, with particular attention to the role played by Google employee Gael Ghonem. Ghonem, who was given paid leave from his job to participate in the Tahrir Square uprising, created the Facebook page “We are all Mohamed Bouazizi” after the Tunisian fruit seller set himself on fire. In 2009, Ghonem also set up a Facebook page for Egyptian exile Mohammed El-Baradei. This was in advance of El-Baradei’s February 2010 Cairo visit to explore. The visit, according to Wikileaks cables, was organized through the US embassy. This was a full year before the Tahrir Square protests.

Chapter 5 — the pro-democracy organizations in other Arab countries (Algeria, Bahrain, Egypt, Jordan, Kuwait, Lebanon, Libya, Morocco, Palestine, Tunisia, Yemen, and Syria) financed by the State Department and specific “democracy manipulating” foundations.

Chapter 6 — summation and analysis that explores the ethical dilemma faced by many Egyptian activists on learning the non-violent manuals they were using were the creation of CIA and State Department Funded think tanks and Foundations.

Below a video illustration of the “color revolution” symbols that were incorporated into the Arab Spring revolutions.

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In A Rebel Comes of Age, seventeen-year-old Angela Jones and four other homeless teenagers occupy a vacant commercial building owned by Bank of America. The adventure turns deadly serious when the bank obtains a court order evicting them. Ange faces the most serious crisis of her life when the other residents decide to use firearms against the police SWAT team.

$3.99 ebook available (in all formats) from Smashwords:

https://www.smashwords.com/books/view/361351

How the CIA Promotes Nonviolence

(More from my research for A Rebel Comes of Age)

As Ward Churchill (in Pacifism as Pathology) and Peter Gelderloos (in How Nonviolence Protects the State) suggest, white middle class activists have very complex psychological reasons for their dogmatic attitude towards political violence. However it’s also important to look at the role played by the US government and the corporate elite in institutionalizing the nonviolent movement.

The International Center for Nonviolent Conflict (ICNC)

In 2007, Australian journalist and research Michael Barker published a fascinating expose in Green Left Weeklys regarding the role played by the International Center for Nonviolent Conflict (ICNC) and similar Left Gatekeeping Foundations* in promoting a de facto taboo against violent protest in North America.

The role the ICNC and sister foundations have played in galvanizing the “color” revolutions in the Eastern Europe, the Philippines, Nicaragua, Chile, Haiti (and more recently the Middle East and North Africa) was first identified in William I. Robinson’s groundbreaking 2006 Promoting Polyarchy. Robinson defines “polyarchy” as “low intensity democracy” – a form of government that replaces violent coercive control with the type of ideological control (i.e. brainwashing) that Noam Chomsky describes in Manufacturing Consent.

In Promoting Polyarchy, Robinson describes how Church Committee reforms of the late seventies forced the CIA to cut back on many of their more repressive covert activities (i.e. domestic spying and clandestine assassination). Their response, in 1984, was to create the National Endowment for Democracy. NED works closely with the CIA, the US Agency for International Development (USAID is another well-documented conduit for CIA funding), and other “democracy manipulating” foundations, such as US Institute for Peace, the Albert Einstein Institute, the Arlington Institute, Freedom House and the International Republican Institute.

Robinson also provides detailed outlines how these US-based “democracy manipulating organizations” orchestrated “non-violent” revolutions in the Philippines and Chile to prevent genuinely democratic governments from coming to power. As well as sabotaging democratically elected governments in Nicaragua and Haiti (where they caused the ouster of the Sandinista government and the populist priest Jean Bastion Aristide).

According to Robinson, the Left Gatekeepers deliberately infiltrate and “channel” (i.e. co-opt) the genuine mass movements that form naturally in countries dominated by repressive dictators. The goal is to make sure they don’t go too far in demanding economic rights (for example, labor rights or restrictions on foreign investment) that might hurt the interests of multinational corporations.

The ICNC’s PBS Documentary

Barker’s work goes even further than Robinson’s in examining the ICNC’s efforts to influence the US progressive movement. Specifically Barker points to the phenomenal influence of the 2000 book and PBS documentary (and now computer game) A Force More Powerful: A Century of Nonviolent Change.

The ICNC is naturally defensive about research by Barker and others linking them to the NED and other “democracy manipulating” foundations. Their website devotes an entire page Setting the Record Straight to refuting these studies. Their argument, that they receive no NED or government funding, is totally factual. The ICNC receives all their funding from co-founder Peter Ackerman, a member of the Council on Foreign Relations, and his wife Joanne Leedom-Ackerman. Ackerman earned his fortune as a specialist in leveraged buyouts, the second highest paid in Wall Street history (Michael Milken made more but went to jail for it.)

Why Did the ICNC Seek to Oust Hugo Chavez?

Barker refers to the argument over the source of their funding as whitewashing, especially given the collaboration between the ICNC and the Albert Einstein Institution in training the conservative Venezuelan opposition who fronted the 2002 coup against democratically elected Hugo Chavez.

As Barker points out, both Ackerman and his wife and ICNC co-founder Jack Duvall have a long history of working for and with the other “democracy promoting” foundations. In addition many of the vice presidents and other officers involved in running the ICNC have links to US or foreign military/intelligence operations or other “democracy promoting” foundations.

This is clear from the following diagrams summarizing the Ackermans’ links to “democracy manipulating” and military intelligence entities:

Groups to which Peter Ackerman is connected (past and present) 

from http://quotha.net/node/1606)

Groups to which Joanne Ackerman is connected (past and present)

from http://quotha.net/node/1606):

Jack Duvall, the other ICNC co-founder, has similar intelligence and “democracy manipulating” links. According to Sourcewatch, he helped former CIA director James Woolsey co-founded the The Arlington Institute. The latter is a non-profit intelligence gathering think tank which boasts:

“We will be able to anticipate the future, thanks to the interconnection of all information to do with you. Tomorrow we shall know everything about you.” [link]

More on the background of other ICNC officers at the Nonviolent Military Industrial Complex and The Velvet Slipper and the Military-Peace Complex

*Left Gatekeeping Foundations oundations are non-profit foundations seeking to limit the acceptable range of leftist debate and political activity within the US and in client states. They usually receive most or all of their funding from the CIA, Pentagon, State Department and/or right wing think tanks and foundations. See Does the CIA Fund Both the Right and the Left and The Cointelpro Role of Left Gatekeeping Foundations

***

In A Rebel Comes of Age, seventeen-year-old Angela Jones and four other homeless teenagers occupy a vacant commercial building owned by Bank of America. The adventure turns deadly serious when the bank obtains a court order evicting them. Ange faces the most serious crisis of her life when the other residents decide to use firearms against the police SWAT team.

$3.99 ebook available (in all formats) from Smashwords:

https://www.smashwords.com/books/view/361351

1968

(More from my research for A Rebel Comes of Age)

1968: The Year that Rocked the World

by Mark Kurlansky (Vintage 2005)

Book Review

1968 was a year for citizen uprisings around the world. Kurlansky comprehensively reviews 19 of them.* Student activists and workers on both sides of the Iron Curtain learned from and copied one another and supported each other’s liberation struggles.

The most eye-opening section discusses the importance of violence in attracting media attention. No one understand the importance of the media in movement building better than Mohandas Gandhi, who went to great lengths to obtain Indian, British, and American coverage of every protest he organized. He also spoke and wrote about the value of British violence in enticing the media to cover the Quit India movement.

According to Kurlansky, Martin Luther King also understood the role of police violence in drawing national media attention – which would be essential in pressuring Attorney General Bobby Kennedy to enforce federal civil rights laws. Kurlansky talks about a police chief in Albany, Georgia who thwarted King’s organizing efforts by studying his nonviolent tactics and countering them with nonviolent law enforcement. Because there was no police violence in Albany, it received no national media attention. .

After Albany, King and other civil rights leaders deliberately targeted towns with hothead police chiefs and angry, volatile mayors. In a 1965 incident, a King protester named Annie Lee Cooper punched the sheriff. and then dared him to hit her. The photo of Sheriff Clark clubbing a defenseless woman made the front page of every mainstream newspaper.

The 1968 Democratic Convention

At August 1968 Democratic Convention, yet again it was police violence by Mayor Daley’s goons that drew national media attention to what was essentially a harmless prank by Abbie Hoffman, Jerry Rubin, Phil Ochs and other Yippies (Youth International Party). Featured events at the Yippies’ Festival of Light included snaking dancing, poetry, mantras, the Yippie Olympics, a Miss Yippie Contest and Pin the Rubber on the Pope.

The police riot magically transformed the Yippies non-violent prank into front page news. Ironically, however, they had to share the limelight with the Soviet invasion of Czechoslovakia. Violent Soviet repression of Dubcek’s freedom movement also made the front page..

Prague Spring

It’s quite common for the ruling elite and corporate media to attribute the collapse of the Soviet Union to the Soviet invasion and occupation of Afghanistan, which ultimately bankrupted their economy. Obama’s mentor Zbigniew Brzezinski still talks about ingeniously “luring” them into an unwinnable war by training and arming the Mujahideen freedom fighters.

Kurlansky believes the 1968 Soviet’s invasion of Czechoslovakia marks the beginning of the end of the Soviet empire. The student/intellectual protest movement that brought Alexander Dubcek to power in January 1968 became less public but didn’t disappear in the government crackdown that followed the August invasion .It also served to strengthen reform movements in other Soviet Bloc countries – especially Romania and Poland – where government leaders were under pressure to condemn the invasion. In Kurlansky’s view the appearance of Soviet tanks on Czech streets killed the dream of eastern block reformers that socialism could be made more democratic.

His description of the background and personality of Alexander Dubceck, the father of “Prague Spring” is especially illuminating. Dubcek was no wild-eyed radical seeking to overthrow communism. In every respect he was the ultimate communist bureaucrat:  blindly loyal, dutiful, and deeply pro-Soviet. Dubcek and his subordinates, who considered the Soviets their friends and protectors, never dreamed they would invade.

In this respect, Czechoslovakia was unique among eastern bloc countries in voting in a communist government at the end of World War II (rather than having it forced on them).

Parallels Between Dubcek and Nixon

Dubcek, who was far more moderate than the students and intellectuals in the street, was actually somewhat dismayed at his sudden rise to power in January 1968. The student protest and Slovak nationalist movement had erupted simultaneously in late 1967, and Dubcek’s predecessor had been unable to quell the civil unrest.

Unlike many Communist Party officials, Dubcek who was deeply principled, viewed violent suppression of the protests as unthinkable. Aside from his refusal to invoke military force against the students, his situation parallels that of Richard Nixon’s in some ways. Nixon was also forced to enact a number of progressive initiatives  (e.g. the Clean Air Act, and legislation creating of the Environmental Protection Agency, the Occupational Health and Safety Administration, the National Endowment for the Humanities, and Social Security Supplemental Income for the disabled) in response to a large and militant protest movement.

Dubcek had no real platform until April 1968, when he issued an Action Program with three planks: 1) commitment to Czechoslovakia’s socialist political/economic system, 2) ending secret police repression of personal and political beliefs, and 3) ending the monopoly of power by the Communist Party.

The immediate result was liberalization of foreign travel, increased access to foreign periodicals, and media exposes about Czech and Soviet corruption and Stalin’s notorious purges. Freedom of artistic expression also increased, as Czech students and everywhere wore blue jeans and long hair, listened to rock and jazz, displayed psychedelic posters and even held an international film festival.

Soviets Forced to Keep Dubcek in Power

Brezhnev, one of Stalin’s henchmen in several purges, put extreme pressure on Dubcek to crack down on these “excesses.”  However even as Russian tanks rolled into Czechoslovakia Dubcek, who was profoundly antiwar, explicitly ordered a robust, well-trained and armed Czech military not to fire on them. As in Tienanmen Square in China, the only opposition to the tanks was tens of thousands of unarmed civilians.

Kurlansky writes at length about an unsung hero named General Ludvik Svoboda, who the Soviets attempted to install in a puppet government after imprisoning Dubcek and three members of his cabinet. Though forced to agree to Soviet demands to gradually reinstate censorship and foreign travel restrictions, Ludvik released Dubcek and allowed him to remain in power until April 1969.

*Countries experiencing mass uprisings in 1968:

France
Czechoslovakia
Poland
Yugoslavia
Romania
Italy
West Germany
East Germany
Spain
UK
Russia
Nigeria
Palestine
Mexico
Brazil
Ecuador
Chile
Uruguay
US

***

In A Rebel Comes of Age, seventeen-year-old Angela Jones and four other homeless teenagers occupy a vacant commercial building owned by Bank of America. The adventure turns deadly serious when the bank obtains a court order evicting them. Ange faces the most serious crisis of her life when the other residents decide to use firearms against the police SWAT team.

$3.99 ebook available (in all formats) from Smashwords:

https://www.smashwords.com/books/view/361351