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Emergency Department Visits Involving ADHD Stimulant Medications



 
 
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  #1  
Old September 26th 06, 10:49 PM posted to misc.health.alternative,alt.support.attn-deficit,misc.kids.health
Jan Drew
external usenet poster
 
Posts: 2,707
Default Emergency Department Visits Involving ADHD Stimulant Medications

https://dawninfo.samhsa.gov/files/TNDR09ADHDmeds.htm

Excerpts:

Emergency Department Visits Involving ADHD Stimulant Medications

a.. An estimated 7,873 drug-related emergency department (ED) visits
involved methylphenidate or amphetamine-dextroamphetamine, two medications
used to treat attention-deficit/hyperactivity disorder (ADHD).
b.. The most frequent reason for these visits was nonmedical use
(48%), followed by adverse reactions associated with medical use (34%),
accidental ingestion (10%), and suicide attempts (8%).
c.. The rates of ED visits involving methylphenidate or
amphetamine-dextroamphetamine for patients aged 12 to 17 were higher than
the rates for patients aged 18 or older.
d.. Over two thirds (68%) of the visits involving nonmedical use of
these two drugs also involved another substance, such as alcohol, an illicit
drug, or pharmaceutical.


Recent studies have indicated that as many as 7 percent of children and 4
percent of adults now meet the criteria for a diagnosis of
attention-deficit/hyperactivity disorder (ADHD).1,2,3 As a result, more
prescriptions are being written for the stimulants used to treat ADHD. More
prescriptions will likely lead to increases in medical side effects
associated with the use of these medications and, potentially, greater use
of these drugs for nonmedical purposes as well.4 A recent Food and Drug
Administration (FDA) advisory panel recognized the danger of side effects
for ADHD stimulants and recommended that they carry a warning of an
increased potential for cardiac problems, such as hypertension, cardiac
arrests, and stroke.5 The possibility of medical problems may be exacerbated
by using ADHD stimulant medications improperly or in combination with other
drugs.

The potential for greater access of these medications to persons without a
prescription is supported by research, which has shown that peers are a
common source of ADHD medications.6 Although the potential for diversion has
increased, estimates from the 2003 National Survey on Drug Abuse and Health
(NSDUH) indicate that nonmedical use of ADHD stimulant medications is still
relatively low: 0.3 percent of the population aged 12 or older reported
using such stimulants nonmedically during the past year. However, those aged
18 to 25 had a higher rate of nonmedical use than those who were younger or
older.7 College students, who may use these drugs as study aids because of
their stimulant properties, fall primarily in this 18-to-25 age group.

The Drug Abuse Warning Network (DAWN), which collects data from a national
sample of short-term, general, non-Federal hospitals,8 provides estimates of
drug-related emergency department (ED) visits. The findings presented in
this issue of The DAWN Report are based on ED visits related to two of the
pharmaceuticals commonly used to treat ADHD-methylphenidate and
amphetamine-dextroamphetamine. DAWN includes both generic and branded drugs,
including methylphenidate marketed as Ritalin© and Concerta© and
amphetamine-dextroamphetamine marketed as Adderal©. Based on DAWN data, this
report examines the reasons for the ED visits and the relative frequency of
these ED visits for different age groups. Finally, for the ED visits
involving nonmedical use, DAWN provides the ability to examine the drugs
used along with the ADHD drugs. DAWN, which observes drug-related morbidity
in ED visits, offers a different view of drug use than the NSDUH, which
measures prevalence of nonmedical use in the population at large.

Overview

In 2004, about 106 million ED visits occurred in short-term, general,
non-Federal hospitals in the United States.9 DAWN estimates that about 2
million ED visits in 2004 were drug related, and the ADHD drugs examined in
this report were implicated in about 1 percent of those drug-related visits.
Methylphenidate was involved in an estimated 3,601 ED visits, and
amphetamine-dextroamphetamine was involved in an estimated 4,272 ED visits.

Table 1. Estimated ED visits, by reason for ED visit and drug Reason for
visit Methylphenidate Amphetamine-
dextroamphetamine Total
ED visits % of visits ED visits % of visits ED visits % of visits
Totala 3,601 100% 4,272 100% 7,873 100%
Nonmedical use 1,541 43% 2,228 52% 3,769 48%
Adverse reaction (medical use) 1,322 37% 1,320 31% 2,642 34%
Accidental ingestion 390 11% 435 10% 825 10%
Suicide attempt 348 10% 289 7% 637 8%



more at link


  #2  
Old September 26th 06, 11:19 PM posted to misc.health.alternative,alt.support.attn-deficit,misc.kids.health
Rich
external usenet poster
 
Posts: 112
Default Emergency Department Visits Involving ADHD Stimulant Medications


"Jan Drew" wrote in message
m...
There is nothing worse than aggressive stupidity. Johann Wolfgang von
Goethe Excerpts:

Emergency Department Visits Involving ADHD Stimulant Medications

a.. An estimated 7,873 drug-related emergency department (ED)
visits involved methylphenidate or amphetamine-dextroamphetamine, two
medications used to treat attention-deficit/hyperactivity disorder (ADHD).


Considering the number of people who are prescribed these medications, this
is a rather low rate. The ER visits for acetaminophen, narcotic analgesics,
and even iron supplements are all much higher.


b.. The most frequent reason for these visits was nonmedical use
(48%), followed by adverse reactions associated with medical use (34%),
accidental ingestion (10%), and suicide attempts (8%).


Bear in mind that the "adverse reactions" are almost all transient
tachycardia which carries very little threat of injury or death in the young
population that is likely to be taking prescribed amphetamines.


c.. The rates of ED visits involving methylphenidate or
amphetamine-dextroamphetamine for patients aged 12 to 17 were higher than
the rates for patients aged 18 or older.


Well, duh. First, there are more 12-17 year-olds prescribed the medications
than those 18+. Second, a 12-17yo feeling ill is likely to be taken to the
ER by parents. An 18+ having an adverse reaction, especially if he is using
diverted drugs, or abusing his own, is more likely to wait for the effects
to subside.



d.. Over two thirds (68%) of the visits involving nonmedical use of
these two drugs also involved another substance, such as alcohol, an
illicit drug, or pharmaceutical.


Yes, people who abuse drugs often abuse more than one drug.





Recent studies have indicated that as many as 7 percent of children and 4
percent of adults now meet the criteria for a diagnosis of
attention-deficit/hyperactivity disorder (ADHD).1,2,3 As a result, more
prescriptions are being written for the stimulants used to treat ADHD.
More prescriptions will likely lead to increases in medical side effects
associated with the use of these medications and, potentially, greater use
of these drugs for nonmedical purposes as well.


True, but for every new abuser there are likely to be many more who are
enabled to lead productive lives with the help of the medication. It's a
good trade-off.


4 A recent Food and Drug Administration (FDA) advisory panel recognized
the danger of side effects for ADHD stimulants and recommended that they
carry a warning of an increased potential for cardiac problems, such as
hypertension, cardiac arrests, and stroke.


Yes, those things can happen, but they very seldom do in the younger
population.


5 The possibility of medical problems may be exacerbated by using ADHD
stimulant medications improperly or in combination with other drugs.

The potential for greater access of these medications to persons without a
prescription is supported by research, which has shown that peers are a
common source of ADHD medications.6 Although the potential for diversion
has increased, estimates from the 2003 National Survey on Drug Abuse and
Health (NSDUH) indicate that nonmedical use of ADHD stimulant medications
is still relatively low: 0.3 percent of the population aged 12 or older
reported using such stimulants nonmedically during the past year. However,
those aged 18 to 25 had a higher rate of nonmedical use than those who
were younger or older.7 College students, who may use these drugs as study
aids because of their stimulant properties, fall primarily in this
18-to-25 age group.


Amphetamines were a serious drug abuse problem in the '60's and '70's when
they were massively prescribed as "diet pills" and were available under the
counter at every truck stop. They are becoming a big problem again now, but
in the form of illegal methamphetamines ("ice" here in Hawaii), not Ritalin
or Adderal. The prescription-drug component of the amphetamine abuse problem
is a negligible fraction. And don't give me any bull**** about the ice-heads
"starting out" on prescription drugs unless you have some solid evidence
that the rate of occurance of that is significant.




The Drug Abuse Warning Network (DAWN), which collects data from a national
sample of short-term, general, non-Federal hospitals,8 provides estimates
of drug-related emergency department (ED) visits. The findings presented
in this issue of The DAWN Report are based on ED visits related to two of
the pharmaceuticals commonly used to treat ADHD-methylphenidate and
amphetamine-dextroamphetamine. DAWN includes both generic and branded
drugs, including methylphenidate marketed as Ritalin© and Concerta© and
amphetamine-dextroamphetamine marketed as Adderal©. Based on DAWN data,
this report examines the reasons for the ED visits and the relative
frequency of these ED visits for different age groups. Finally, for the ED
visits involving nonmedical use, DAWN provides the ability to examine the
drugs used along with the ADHD drugs. DAWN, which observes drug-related
morbidity in ED visits, offers a different view of drug use than the
NSDUH, which measures prevalence of nonmedical use in the population at
large.

Overview

In 2004, about 106 million ED visits occurred in short-term, general,
non-Federal hospitals in the United States.9 DAWN estimates that about 2
million ED visits in 2004 were drug related, and the ADHD drugs examined
in this report were implicated in about 1 percent of those drug-related
visits. Methylphenidate was involved in an estimated 3,601 ED visits, and
amphetamine-dextroamphetamine was involved in an estimated 4,272 ED
visits.

Table 1. Estimated ED visits, by reason for ED visit and drug Reason for
visit Methylphenidate Amphetamine-
dextroamphetamine Total
ED visits % of visits ED visits % of visits ED visits % of visits
Totala 3,601 100% 4,272 100% 7,873 100%
Nonmedical use 1,541 43% 2,228 52% 3,769 48%
Adverse reaction (medical use) 1,322 37% 1,320 31% 2,642 34%
Accidental ingestion 390 11% 435 10% 825 10%
Suicide attempt 348 10% 289 7% 637 8%


All in all, this article is interesting, but is not so scary as it is
intended to be.
--


--Rich

Recommended websites:

http://www.ratbags.com/rsoles
http://www.acahf.org.au
http://www.quackwatch.org/
http://www.skeptic.com/
http://www.csicop.org/


  #3  
Old September 26th 06, 11:57 PM posted to misc.health.alternative,alt.support.attn-deficit,misc.kids.health
Jeff
external usenet poster
 
Posts: 780
Default Emergency Department Visits Involving ADHD Stimulant Medications


"Jan Drew" wrote in message
m...
https://dawninfo.samhsa.gov/files/TNDR09ADHDmeds.htm

Excerpts:

Emergency Department Visits Involving ADHD Stimulant Medications

a.. An estimated 7,873 drug-related emergency department (ED)
visits involved methylphenidate or amphetamine-dextroamphetamine, two
medications used to treat attention-deficit/hyperactivity disorder (ADHD).
b.. The most frequent reason for these visits was nonmedical use
(48%), followed by adverse reactions associated with medical use (34%),
accidental ingestion (10%), and suicide attempts (8%).


Nonmedical use? The problem is that the patient is not taking the medication
as prescribed, not the drug itself.

c.. The rates of ED visits involving methylphenidate or
amphetamine-dextroamphetamine for patients aged 12 to 17 were higher than
the rates for patients aged 18 or older.


Gee, more kids than adults take the drug. What a surprise.

d.. Over two thirds (68%) of the visits involving nonmedical use of
these two drugs also involved another substance, such as alcohol, an
illicit drug, or pharmaceutical.


I doubt many many doctors prescribing these two drugs recommend the use of
alcohol, illicit drugs or other pharmaceuticals with the drugs.

Recent studies have indicated that as many as 7 percent of children and 4
percent of adults now meet the criteria for a diagnosis of
attention-deficit/hyperactivity disorder (ADHD).1,2,3 As a result, more
prescriptions are being written for the stimulants used to treat ADHD.
More prescriptions will likely lead to increases in medical side effects
associated with the use of these medications and, potentially, greater use
of these drugs for nonmedical purposes as well.4 A recent Food and Drug
Administration (FDA) advisory panel recognized the danger of side effects
for ADHD stimulants and recommended that they carry a warning of an
increased potential for cardiac problems, such as hypertension, cardiac
arrests, and stroke.5 The possibility of medical problems may be
exacerbated by using ADHD stimulant medications improperly or in
combination with other drugs.

The potential for greater access of these medications to persons without a
prescription is supported by research, which has shown that peers are a
common source of ADHD medications.6 Although the potential for diversion
has increased, estimates from the 2003 National Survey on Drug Abuse and
Health (NSDUH) indicate that nonmedical use of ADHD stimulant medications
is still relatively low: 0.3 percent of the population aged 12 or older
reported using such stimulants nonmedically during the past year.


0.3%? That means that in an average middle school, two students out of the
whole school used such stimulants nonmedically. WHile that is two too many,
that is probably much smaller than the numbre of students using other
illegal drugs, like cigarettes, put, marihuana or alcohol.

However, those aged 18 to 25 had a higher rate of nonmedical use than
those who were younger or older.7 College students, who may use these
drugs as study aids because of their stimulant properties, fall primarily
in this 18-to-25 age group.


The Drug Abuse Warning Network (DAWN), which collects data from a national
sample of short-term, general, non-Federal hospitals,8 provides estimates
of drug-related emergency department (ED) visits. The findings presented
in this issue of The DAWN Report are based on ED visits related to two of
the pharmaceuticals commonly used to treat ADHD-methylphenidate and
amphetamine-dextroamphetamine. DAWN includes both generic and branded
drugs, including methylphenidate marketed as Ritalin© and Concerta© and
amphetamine-dextroamphetamine marketed as Adderal©. Based on DAWN data,
this report examines the reasons for the ED visits and the relative
frequency of these ED visits for different age groups. Finally, for the ED
visits involving nonmedical use, DAWN provides the ability to examine the
drugs used along with the ADHD drugs. DAWN, which observes drug-related
morbidity in ED visits, offers a different view of drug use than the
NSDUH, which measures prevalence of nonmedical use in the population at
large.

Overview

In 2004, about 106 million ED visits occurred in short-term, general,
non-Federal hospitals in the United States.9 DAWN estimates that about 2
million ED visits in 2004 were drug related, and the ADHD drugs examined
in this report were implicated in about 1 percent of those drug-related
visits. Methylphenidate was involved in an estimated 3,601 ED visits, and
amphetamine-dextroamphetamine was involved in an estimated 4,272 ED
visits.

Table 1. Estimated ED visits, by reason for ED visit and drug Reason for
visit Methylphenidate Amphetamine-
dextroamphetamine Total
ED visits % of visits ED visits % of visits ED visits % of visits
Totala 3,601 100% 4,272 100% 7,873 100%
Nonmedical use 1,541 43% 2,228 52% 3,769 48%
Adverse reaction (medical use) 1,322 37% 1,320 31% 2,642 34%
Accidental ingestion 390 11% 435 10% 825 10%
Suicide attempt 348 10% 289 7% 637 8%



more at link



  #4  
Old September 27th 06, 04:58 AM posted to misc.health.alternative,alt.support.attn-deficit,misc.kids.health
Jan Drew
external usenet poster
 
Posts: 2,707
Default Emergency Department Visits Involving ADHD Stimulant Medications


"Rich" wrote in message
...

"Jan Drew" wrote in message
m...
There is nothing worse than aggressive stupidity. Johann Wolfgang von
Goethe



Nothing is more dangerous than active ignorance. -- Goethe
Posted in 2002 by me.

Excerpts:

Emergency Department Visits Involving ADHD Stimulant Medications

a.. An estimated 7,873 drug-related emergency department (ED)
visits involved methylphenidate or amphetamine-dextroamphetamine, two
medications used to treat attention-deficit/hyperactivity disorder
(ADHD).


Considering the number of people who are prescribed these medications,
this is a rather low rate. The ER visits for acetaminophen, narcotic
analgesics, and even iron supplements are all much higher.


b.. The most frequent reason for these visits was nonmedical use
(48%), followed by adverse reactions associated with medical use (34%),
accidental ingestion (10%), and suicide attempts (8%).


Bear in mind that the "adverse reactions" are almost all transient
tachycardia which carries very little threat of injury or death in the
young population that is likely to be taking prescribed amphetamines.


c.. The rates of ED visits involving methylphenidate or
amphetamine-dextroamphetamine for patients aged 12 to 17 were higher than
the rates for patients aged 18 or older.


Well, duh. First, there are more 12-17 year-olds prescribed the
medications than those 18+. Second, a 12-17yo feeling ill is likely to be
taken to the ER by parents. An 18+ having an adverse reaction, especially
if he is using diverted drugs, or abusing his own, is more likely to wait
for the effects to subside.


If there drugs were so not easy to get, 18 year olds couldn't get them.
This is the fault of doctors.



d.. Over two thirds (68%) of the visits involving nonmedical use
of these two drugs also involved another substance, such as alcohol, an
illicit drug, or pharmaceutical.


Yes, people who abuse drugs often abuse more than one drug.





Recent studies have indicated that as many as 7 percent of children and 4
percent of adults now meet the criteria for a diagnosis of
attention-deficit/hyperactivity disorder (ADHD).1,2,3 As a result, more
prescriptions are being written for the stimulants used to treat ADHD.
More prescriptions will likely lead to increases in medical side effects
associated with the use of these medications and, potentially, greater
use of these drugs for nonmedical purposes as well.


True, but for every new abuser there are likely to be many more who are
enabled to lead productive lives with the help of the medication. It's a
good trade-off.


In your opinion. The fact is they are given to very young kids. Which is
insane.
I was called a liar by your buddy, Mark Probert and others--when I posted
that
years ago. Now it is well proven
I was correct and not a liar.


4 A recent Food and Drug Administration (FDA) advisory panel recognized
the danger of side effects for ADHD stimulants and recommended that they
carry a warning of an increased potential for cardiac problems, such as
hypertension, cardiac arrests, and stroke.


Yes, those things can happen, but they very seldom do in the younger
population.


But, but,, but--Richey. Face the facts.


5 The possibility of medical problems may be exacerbated by using ADHD
stimulant medications improperly or in combination with other drugs.

The potential for greater access of these medications to persons without
a prescription is supported by research, which has shown that peers are a
common source of ADHD medications.6 Although the potential for diversion
has increased, estimates from the 2003 National Survey on Drug Abuse and
Health (NSDUH) indicate that nonmedical use of ADHD stimulant medications
is still relatively low: 0.3 percent of the population aged 12 or older
reported using such stimulants nonmedically during the past year.
However, those aged 18 to 25 had a higher rate of nonmedical use than
those who were younger or older.7 College students, who may use these
drugs as study aids because of their stimulant properties, fall primarily
in this 18-to-25 age group.


Amphetamines were a serious drug abuse problem in the '60's and '70's when
they were massively prescribed as "diet pills" and were available under
the counter at every truck stop. They are becoming a big problem again
now, but in the form of illegal methamphetamines ("ice" here in Hawaii),
not Ritalin or Adderal.


Is that right? Got any proof?

The prescription-drug component of the amphetamine abuse problem
is a negligible fraction. And don't give me any bull**** about the
ice-heads "starting out" on prescription drugs unless you have some solid
evidence that the rate of occurance of that is significant.


I love it *solid*. I that anything like--*Substantial* *real* *convincing*
*hard* *clear-cut* *reasonable*
*significant* *credibile* *compelling* *copious* *direct* *reliable*
*adequate* Used by your gang group.




The Drug Abuse Warning Network (DAWN), which collects data from a
national sample of short-term, general, non-Federal hospitals,8 provides
estimates of drug-related emergency department (ED) visits. The findings
presented in this issue of The DAWN Report are based on ED visits related
to two of the pharmaceuticals commonly used to treat ADHD-methylphenidate
and amphetamine-dextroamphetamine. DAWN includes both generic and branded
drugs, including methylphenidate marketed as Ritalin© and Concerta© and
amphetamine-dextroamphetamine marketed as Adderal©. Based on DAWN data,
this report examines the reasons for the ED visits and the relative
frequency of these ED visits for different age groups. Finally, for the
ED visits involving nonmedical use, DAWN provides the ability to examine
the drugs used along with the ADHD drugs. DAWN, which observes
drug-related morbidity in ED visits, offers a different view of drug use
than the NSDUH, which measures prevalence of nonmedical use in the
population at large.

Overview

In 2004, about 106 million ED visits occurred in short-term, general,
non-Federal hospitals in the United States.9 DAWN estimates that about 2
million ED visits in 2004 were drug related, and the ADHD drugs examined
in this report were implicated in about 1 percent of those drug-related
visits. Methylphenidate was involved in an estimated 3,601 ED visits, and
amphetamine-dextroamphetamine was involved in an estimated 4,272 ED
visits.

Table 1. Estimated ED visits, by reason for ED visit and drug Reason for
visit Methylphenidate Amphetamine-
dextroamphetamine Total
ED visits % of visits ED visits % of visits ED visits % of visits
Totala 3,601 100% 4,272 100% 7,873 100%
Nonmedical use 1,541 43% 2,228 52% 3,769 48%
Adverse reaction (medical use) 1,322 37% 1,320 31% 2,642 34%
Accidental ingestion 390 11% 435 10% 825 10%
Suicide attempt 348 10% 289 7% 637 8%


All in all, this article is interesting, but is not so scary as it is
intended to be.


Oh, dear--now you are in big trouble. Some on a.s.a.d. think DAWN is very
reliable.
--


--Rich



  #5  
Old September 27th 06, 06:40 AM posted to misc.health.alternative,alt.support.attn-deficit,misc.kids.health
Peter Bowditch
external usenet poster
 
Posts: 1,038
Default Emergency Department Visits Involving ADHD Stimulant Medications

"Jan Drew" wrote:

Nothing is more dangerous than active ignorance. -- Goethe


Start short-selling your irony meter futures. This didn't just blow
mine up but the one in the house next door as well.
--
Peter Bowditch aa #2243
The Millenium Project http://www.ratbags.com/rsoles
Australian Council Against Health Fraud http://www.acahf.org.au
Australian Skeptics http://www.skeptics.com.au
To email me use my first name only at ratbags.com
  #6  
Old September 27th 06, 07:01 AM posted to misc.health.alternative,alt.support.attn-deficit,misc.kids.health
Peter Bowditch
external usenet poster
 
Posts: 1,038
Default Emergency Department Visits Involving ADHD Stimulant Medications

Peter Bowditch wrote:

"Jan Drew" wrote:

Nothing is more dangerous than active ignorance. -- Goethe


Start short-selling your irony meter futures. This didn't just blow
mine up but the one in the house next door as well.


I just checked because I want to add it to the list of random
quotations on my site, and it seems that alternate words a "Nothing
is worse than active ignorance", which doesn't have quite the same
meaning.

Then, of course, there is "There is nothing more frightful than
ignorance in action", which is very probably just another different
translation from German of the same quotation but means something else
again in English.
--
Peter Bowditch aa #2243
The Millenium Project http://www.ratbags.com/rsoles
Australian Council Against Health Fraud http://www.acahf.org.au
Australian Skeptics http://www.skeptics.com.au
To email me use my first name only at ratbags.com
  #7  
Old September 28th 06, 02:02 AM posted to misc.health.alternative,alt.support.attn-deficit,misc.kids.health
Jeff
external usenet poster
 
Posts: 780
Default Emergency Department Visits Involving ADHD Stimulant Medications


"Jan Drew" wrote in message
m...

"Rich" wrote in message
...

"Jan Drew" wrote in message
m...
There is nothing worse than aggressive stupidity. Johann Wolfgang von
Goethe



Nothing is more dangerous than active ignorance. -- Goethe
Posted in 2002 by me.

Excerpts:

Emergency Department Visits Involving ADHD Stimulant Medications

a.. An estimated 7,873 drug-related emergency department (ED)
visits involved methylphenidate or amphetamine-dextroamphetamine, two
medications used to treat attention-deficit/hyperactivity disorder
(ADHD).


Considering the number of people who are prescribed these medications,
this is a rather low rate. The ER visits for acetaminophen, narcotic
analgesics, and even iron supplements are all much higher.


b.. The most frequent reason for these visits was nonmedical use
(48%), followed by adverse reactions associated with medical use (34%),
accidental ingestion (10%), and suicide attempts (8%).


Bear in mind that the "adverse reactions" are almost all transient
tachycardia which carries very little threat of injury or death in the
young population that is likely to be taking prescribed amphetamines.


c.. The rates of ED visits involving methylphenidate or
amphetamine-dextroamphetamine for patients aged 12 to 17 were higher
than the rates for patients aged 18 or older.


Well, duh. First, there are more 12-17 year-olds prescribed the
medications than those 18+. Second, a 12-17yo feeling ill is likely to be
taken to the ER by parents. An 18+ having an adverse reaction, especially
if he is using diverted drugs, or abusing his own, is more likely to wait
for the effects to subside.


If there drugs were so not easy to get, 18 year olds couldn't get them.
This is the fault of doctors.


It is not the fault of doctors that patients abuse drugs.




d.. Over two thirds (68%) of the visits involving nonmedical use
of these two drugs also involved another substance, such as alcohol, an
illicit drug, or pharmaceutical.


Yes, people who abuse drugs often abuse more than one drug.





Recent studies have indicated that as many as 7 percent of children and
4 percent of adults now meet the criteria for a diagnosis of
attention-deficit/hyperactivity disorder (ADHD).1,2,3 As a result, more
prescriptions are being written for the stimulants used to treat ADHD.
More prescriptions will likely lead to increases in medical side effects
associated with the use of these medications and, potentially, greater
use of these drugs for nonmedical purposes as well.


True, but for every new abuser there are likely to be many more who are
enabled to lead productive lives with the help of the medication. It's a
good trade-off.


In your opinion. The fact is they are given to very young kids. Which is
insane.


Really? It is insane to enable kids to pay attention and do well in school?

I was called a liar by your buddy, Mark Probert and others--when I posted
that
years ago. Now it is well proven
I was correct and not a liar.


In your opinion.



4 A recent Food and Drug Administration (FDA) advisory panel recognized
the danger of side effects for ADHD stimulants and recommended that they
carry a warning of an increased potential for cardiac problems, such as
hypertension, cardiac arrests, and stroke.


Yes, those things can happen, but they very seldom do in the younger
population.


But, but,, but--Richey. Face the facts.


Provide us with evidence that they happen often.

Jeff



5 The possibility of medical problems may be exacerbated by using ADHD
stimulant medications improperly or in combination with other drugs.

The potential for greater access of these medications to persons without
a prescription is supported by research, which has shown that peers are
a common source of ADHD medications.6 Although the potential for
diversion has increased, estimates from the 2003 National Survey on Drug
Abuse and Health (NSDUH) indicate that nonmedical use of ADHD stimulant
medications is still relatively low: 0.3 percent of the population aged
12 or older reported using such stimulants nonmedically during the past
year. However, those aged 18 to 25 had a higher rate of nonmedical use
than those who were younger or older.7 College students, who may use
these drugs as study aids because of their stimulant properties, fall
primarily in this 18-to-25 age group.


Amphetamines were a serious drug abuse problem in the '60's and '70's
when they were massively prescribed as "diet pills" and were available
under the counter at every truck stop. They are becoming a big problem
again now, but in the form of illegal methamphetamines ("ice" here in
Hawaii), not Ritalin or Adderal.


Is that right? Got any proof?

The prescription-drug component of the amphetamine abuse problem
is a negligible fraction. And don't give me any bull**** about the
ice-heads "starting out" on prescription drugs unless you have some solid
evidence that the rate of occurance of that is significant.


I love it *solid*. I that anything like--*Substantial* *real*
*convincing* *hard* *clear-cut* *reasonable*
*significant* *credibile* *compelling* *copious* *direct* *reliable*
*adequate* Used by your gang group.




The Drug Abuse Warning Network (DAWN), which collects data from a
national sample of short-term, general, non-Federal hospitals,8 provides
estimates of drug-related emergency department (ED) visits. The findings
presented in this issue of The DAWN Report are based on ED visits
related to two of the pharmaceuticals commonly used to treat
ADHD-methylphenidate and amphetamine-dextroamphetamine. DAWN includes
both generic and branded drugs, including methylphenidate marketed as
Ritalin© and Concerta© and amphetamine-dextroamphetamine marketed as
Adderal©. Based on DAWN data, this report examines the reasons for the
ED visits and the relative frequency of these ED visits for different
age groups. Finally, for the ED visits involving nonmedical use, DAWN
provides the ability to examine the drugs used along with the ADHD
drugs. DAWN, which observes drug-related morbidity in ED visits, offers
a different view of drug use than the NSDUH, which measures prevalence
of nonmedical use in the population at large.

Overview

In 2004, about 106 million ED visits occurred in short-term, general,
non-Federal hospitals in the United States.9 DAWN estimates that about 2
million ED visits in 2004 were drug related, and the ADHD drugs examined
in this report were implicated in about 1 percent of those drug-related
visits. Methylphenidate was involved in an estimated 3,601 ED visits,
and amphetamine-dextroamphetamine was involved in an estimated 4,272 ED
visits.

Table 1. Estimated ED visits, by reason for ED visit and drug Reason
for visit Methylphenidate Amphetamine-
dextroamphetamine Total
ED visits % of visits ED visits % of visits ED visits % of visits
Totala 3,601 100% 4,272 100% 7,873 100%
Nonmedical use 1,541 43% 2,228 52% 3,769 48%
Adverse reaction (medical use) 1,322 37% 1,320 31% 2,642 34%
Accidental ingestion 390 11% 435 10% 825 10%
Suicide attempt 348 10% 289 7% 637 8%


All in all, this article is interesting, but is not so scary as it is
intended to be.


Oh, dear--now you are in big trouble. Some on a.s.a.d. think DAWN is very
reliable.
--


--Rich





  #8  
Old September 28th 06, 03:30 AM posted to misc.health.alternative,alt.support.attn-deficit,misc.kids.health
Jan Drew
external usenet poster
 
Posts: 2,707
Default Emergency Department Visits Involving ADHD Stimulant Medications


"Jeff" wrote in message
ink.net...

"Jan Drew" wrote in message
m...

"Rich" wrote in message
...

"Jan Drew" wrote in message
m...
There is nothing worse than aggressive stupidity. Johann Wolfgang von
Goethe



Nothing is more dangerous than active ignorance. -- Goethe
Posted in 2002 by me.

Excerpts:

Emergency Department Visits Involving ADHD Stimulant Medications

a.. An estimated 7,873 drug-related emergency department (ED)
visits involved methylphenidate or amphetamine-dextroamphetamine, two
medications used to treat attention-deficit/hyperactivity disorder
(ADHD).

Considering the number of people who are prescribed these medications,
this is a rather low rate. The ER visits for acetaminophen, narcotic
analgesics, and even iron supplements are all much higher.


b.. The most frequent reason for these visits was nonmedical use
(48%), followed by adverse reactions associated with medical use (34%),
accidental ingestion (10%), and suicide attempts (8%).

Bear in mind that the "adverse reactions" are almost all transient
tachycardia which carries very little threat of injury or death in the
young population that is likely to be taking prescribed amphetamines.


c.. The rates of ED visits involving methylphenidate or
amphetamine-dextroamphetamine for patients aged 12 to 17 were higher
than the rates for patients aged 18 or older.

Well, duh. First, there are more 12-17 year-olds prescribed the
medications than those 18+. Second, a 12-17yo feeling ill is likely to
be taken to the ER by parents. An 18+ having an adverse reaction,
especially if he is using diverted drugs, or abusing his own, is more
likely to wait for the effects to subside.


If there drugs were so not easy to get, 18 year olds couldn't get them.
This is the fault of doctors.


It is not the fault of doctors that patients abuse drugs.


If there drugs were so not easy to get, 18 year olds couldn't get them.
This is the fault of doctors.

What part of that do you not understand?





d.. Over two thirds (68%) of the visits involving nonmedical use
of these two drugs also involved another substance, such as alcohol, an
illicit drug, or pharmaceutical.

Yes, people who abuse drugs often abuse more than one drug.





Recent studies have indicated that as many as 7 percent of children and
4 percent of adults now meet the criteria for a diagnosis of
attention-deficit/hyperactivity disorder (ADHD).1,2,3 As a result, more
prescriptions are being written for the stimulants used to treat ADHD.
More prescriptions will likely lead to increases in medical side
effects associated with the use of these medications and, potentially,
greater use of these drugs for nonmedical purposes as well.

True, but for every new abuser there are likely to be many more who are
enabled to lead productive lives with the help of the medication. It's a
good trade-off.


In your opinion. The fact is they are given to very young kids. Which is
insane.


Really?


Yes, really .

It is a fact that you knew already.

It is insane to enable kids to pay attention and do well in school?

That's debatabe, It was shown that they actually did worst on tests.

I was called a liar by your buddy, Mark Probert and others--when I posted
that
years ago. Now it is well proven
I was correct and not a liar.


In your opinion.


Nope. A proven fact (and you knew that also).



4 A recent Food and Drug Administration (FDA) advisory panel recognized
the danger of side effects for ADHD stimulants and recommended that
they carry a warning of an increased potential for cardiac problems,
such as hypertension, cardiac arrests, and stroke.

Yes, those things can happen, but they very seldom do in the younger
population.


But, but,, but--Richey. Face the facts.


Provide us with evidence that they happen often.

Jeff


Rich needs to face facts. Jeff--notkidsdoc--Jeffrey Peter, M.D--Jeff P.
Utz, MD.

5 The possibility of medical problems may be exacerbated by using ADHD
stimulant medications improperly or in combination with other drugs.

The potential for greater access of these medications to persons
without a prescription is supported by research, which has shown that
peers are a common source of ADHD medications.6 Although the potential
for diversion has increased, estimates from the 2003 National Survey on
Drug Abuse and Health (NSDUH) indicate that nonmedical use of ADHD
stimulant medications is still relatively low: 0.3 percent of the
population aged 12 or older reported using such stimulants nonmedically
during the past year. However, those aged 18 to 25 had a higher rate of
nonmedical use than those who were younger or older.7 College students,
who may use these drugs as study aids because of their stimulant
properties, fall primarily in this 18-to-25 age group.

Amphetamines were a serious drug abuse problem in the '60's and '70's
when they were massively prescribed as "diet pills" and were available
under the counter at every truck stop. They are becoming a big problem
again now, but in the form of illegal methamphetamines ("ice" here in
Hawaii), not Ritalin or Adderal.


Is that right? Got any proof?

The prescription-drug component of the amphetamine abuse problem
is a negligible fraction. And don't give me any bull**** about the
ice-heads "starting out" on prescription drugs unless you have some
solid evidence that the rate of occurance of that is significant.


I love it *solid*. I that anything like--*Substantial* *real*
*convincing* *hard* *clear-cut* *reasonable*
*significant* *credibile* *compelling* *copious* *direct* *reliable*
*adequate* Used by your gang group.




The Drug Abuse Warning Network (DAWN), which collects data from a
national sample of short-term, general, non-Federal hospitals,8
provides estimates of drug-related emergency department (ED) visits.
The findings presented in this issue of The DAWN Report are based on ED
visits related to two of the pharmaceuticals commonly used to treat
ADHD-methylphenidate and amphetamine-dextroamphetamine. DAWN includes
both generic and branded drugs, including methylphenidate marketed as
Ritalin© and Concerta© and amphetamine-dextroamphetamine marketed as
Adderal©. Based on DAWN data, this report examines the reasons for the
ED visits and the relative frequency of these ED visits for different
age groups. Finally, for the ED visits involving nonmedical use, DAWN
provides the ability to examine the drugs used along with the ADHD
drugs. DAWN, which observes drug-related morbidity in ED visits, offers
a different view of drug use than the NSDUH, which measures prevalence
of nonmedical use in the population at large.

Overview

In 2004, about 106 million ED visits occurred in short-term, general,
non-Federal hospitals in the United States.9 DAWN estimates that about
2 million ED visits in 2004 were drug related, and the ADHD drugs
examined in this report were implicated in about 1 percent of those
drug-related visits. Methylphenidate was involved in an estimated 3,601
ED visits, and amphetamine-dextroamphetamine was involved in an
estimated 4,272 ED visits.

Table 1. Estimated ED visits, by reason for ED visit and drug Reason
for visit Methylphenidate Amphetamine-
dextroamphetamine Total
ED visits % of visits ED visits % of visits ED visits % of visits
Totala 3,601 100% 4,272 100% 7,873 100%
Nonmedical use 1,541 43% 2,228 52% 3,769 48%
Adverse reaction (medical use) 1,322 37% 1,320 31% 2,642 34%
Accidental ingestion 390 11% 435 10% 825 10%
Suicide attempt 348 10% 289 7% 637 8%

All in all, this article is interesting, but is not so scary as it is
intended to be.


Oh, dear--now you are in big trouble. Some on a.s.a.d. think DAWN is
very reliable.
--


--Rich







  #9  
Old September 28th 06, 03:36 AM posted to misc.health.alternative,alt.support.attn-deficit,misc.kids.health
Rich
external usenet poster
 
Posts: 112
Default Emergency Department Visits Involving ADHD Stimulant Medications


"Jan Drew" wrote in message
m...

"Rich" wrote in message
...

"Jan Drew" wrote in message
m...
There is nothing worse than aggressive stupidity. Johann Wolfgang von
Goethe



Nothing is more dangerous than active ignorance. -- Goethe
Posted in 2002 by me.



Actually it's, "Es ist nichts schrecklicher als eine tätige Unwissenheit."
It loses something in translation.

YOUR active display of ignorance is legendary.



Excerpts:

Emergency Department Visits Involving ADHD Stimulant Medications

a.. An estimated 7,873 drug-related emergency department (ED)
visits involved methylphenidate or amphetamine-dextroamphetamine, two
medications used to treat attention-deficit/hyperactivity disorder
(ADHD).


Considering the number of people who are prescribed these medications,
this is a rather low rate. The ER visits for acetaminophen, narcotic
analgesics, and even iron supplements are all much higher.


b.. The most frequent reason for these visits was nonmedical use
(48%), followed by adverse reactions associated with medical use (34%),
accidental ingestion (10%), and suicide attempts (8%).


Bear in mind that the "adverse reactions" are almost all transient
tachycardia which carries very little threat of injury or death in the
young population that is likely to be taking prescribed amphetamines.


c.. The rates of ED visits involving methylphenidate or
amphetamine-dextroamphetamine for patients aged 12 to 17 were higher
than the rates for patients aged 18 or older.


Well, duh. First, there are more 12-17 year-olds prescribed the
medications than those 18+. Second, a 12-17yo feeling ill is likely to be
taken to the ER by parents. An 18+ having an adverse reaction, especially
if he is using diverted drugs, or abusing his own, is more likely to wait
for the effects to subside.


If there drugs were so not easy to get, 18 year olds couldn't get them.
This is the fault of doctors.


No, it's not the fault of doctors when prescription drugs are abused.



d.. Over two thirds (68%) of the visits involving nonmedical use
of these two drugs also involved another substance, such as alcohol, an
illicit drug, or pharmaceutical.


Yes, people who abuse drugs often abuse more than one drug.





Recent studies have indicated that as many as 7 percent of children and
4 percent of adults now meet the criteria for a diagnosis of
attention-deficit/hyperactivity disorder (ADHD).1,2,3 As a result, more
prescriptions are being written for the stimulants used to treat ADHD.
More prescriptions will likely lead to increases in medical side effects
associated with the use of these medications and, potentially, greater
use of these drugs for nonmedical purposes as well.


True, but for every new abuser there are likely to be many more who are
enabled to lead productive lives with the help of the medication. It's a
good trade-off.


In your opinion. The fact is they are given to very young kids. Which is
insane.
I was called a liar by your buddy, Mark Probert and others--when I posted
that
years ago. Now it is well proven
I was correct and not a liar.


You are correct that the medications are prescribed for younger patients
than in the past. That this practice is "insane" is your opinion, and in my
opinion you are wrong.





4 A recent Food and Drug Administration (FDA) advisory panel recognized
the danger of side effects for ADHD stimulants and recommended that they
carry a warning of an increased potential for cardiac problems, such as
hypertension, cardiac arrests, and stroke.


Yes, those things can happen, but they very seldom do in the younger
population.


But, but,, but--Richey. Face the facts.


The fact is that healthy young hearts tolerate amphetamine induced
tachycardia very well. Those of any age with cardiac disease, particularly
tachyarrhythmias do not fare as well. Since ADHD medications are used
primarily by young people, and hardly at all by the elderly population in
which most of the cases of cardiac diseases occur, hypertension, cardiac
arrests, and stroke resulting from ADHD medications are rare events. In all
my years as an ER nurse, I've never seen one. (Actually I've only seen four
or five ER admissions related to ADHD meds, and with one exception all that
I can recall were simple panic attacks which resolved and the patients were
discharged home from the ER. The exception was a young lady (I can't recall
her age) who took her son's Ritalin because she thought it would help her
lose weight. Her tachycardia persisted, and she was admitted to the ICU. The
next day, the problem resolved and she was discharged. The cardiolgist told
us later that she had previously undiagnosed Wolf-Parkinson-White disease,
one of the above mentioned tachyarrhythmic disorders. Even with that, she
did not suffer hypertension, cardiac arrest, or stroke.



5 The possibility of medical problems may be exacerbated by using ADHD
stimulant medications improperly or in combination with other drugs.

The potential for greater access of these medications to persons without
a prescription is supported by research, which has shown that peers are
a common source of ADHD medications.6 Although the potential for
diversion has increased, estimates from the 2003 National Survey on Drug
Abuse and Health (NSDUH) indicate that nonmedical use of ADHD stimulant
medications is still relatively low: 0.3 percent of the population aged
12 or older reported using such stimulants nonmedically during the past
year. However, those aged 18 to 25 had a higher rate of nonmedical use
than those who were younger or older.7 College students, who may use
these drugs as study aids because of their stimulant properties, fall
primarily in this 18-to-25 age group.


Amphetamines were a serious drug abuse problem in the '60's and '70's
when they were massively prescribed as "diet pills" and were available
under the counter at every truck stop. They are becoming a big problem
again now, but in the form of illegal methamphetamines ("ice" here in
Hawaii), not Ritalin or Adderal.


Is that right? Got any proof?


http://www.narconon.org/druginfo/met...mine_hist.html
http://www.nida.nih.gov/Infofacts/methamphetamine.html
http://www.addictionsearch.com/featuredtopic.php
http://www.dea.gov/pubs/cngrtest/ct080204.html

Want more? There's lots.



The prescription-drug component of the amphetamine abuse problem
is a negligible fraction. And don't give me any bull**** about the
ice-heads "starting out" on prescription drugs unless you have some solid
evidence that the rate of occurance of that is significant.


I love it *solid*. I that anything like--*Substantial* *real*
*convincing* *hard* *clear-cut* *reasonable*
*significant* *credibile* *compelling* *copious* *direct* *reliable*
*adequate* Used by your gang group.


These are all perfectly useful words. Your contempt for them implies you
prefer that evidence be insubstantial, imaginary, unconvincing, soft, vague,
unreasonable, insignificant, incredible, noncompelling, scant, indirect,
unreliable, and inadequate.







The Drug Abuse Warning Network (DAWN), which collects data from a
national sample of short-term, general, non-Federal hospitals,8 provides
estimates of drug-related emergency department (ED) visits. The findings
presented in this issue of The DAWN Report are based on ED visits
related to two of the pharmaceuticals commonly used to treat
ADHD-methylphenidate and amphetamine-dextroamphetamine. DAWN includes
both generic and branded drugs, including methylphenidate marketed as
Ritalin© and Concerta© and amphetamine-dextroamphetamine marketed as
Adderal©. Based on DAWN data, this report examines the reasons for the
ED visits and the relative frequency of these ED visits for different
age groups. Finally, for the ED visits involving nonmedical use, DAWN
provides the ability to examine the drugs used along with the ADHD
drugs. DAWN, which observes drug-related morbidity in ED visits, offers
a different view of drug use than the NSDUH, which measures prevalence
of nonmedical use in the population at large.

Overview

In 2004, about 106 million ED visits occurred in short-term, general,
non-Federal hospitals in the United States.9 DAWN estimates that about 2
million ED visits in 2004 were drug related, and the ADHD drugs examined
in this report were implicated in about 1 percent of those drug-related
visits. Methylphenidate was involved in an estimated 3,601 ED visits,
and amphetamine-dextroamphetamine was involved in an estimated 4,272 ED
visits.

Table 1. Estimated ED visits, by reason for ED visit and drug Reason
for visit Methylphenidate Amphetamine-
dextroamphetamine Total
ED visits % of visits ED visits % of visits ED visits % of visits
Totala 3,601 100% 4,272 100% 7,873 100%
Nonmedical use 1,541 43% 2,228 52% 3,769 48%
Adverse reaction (medical use) 1,322 37% 1,320 31% 2,642 34%
Accidental ingestion 390 11% 435 10% 825 10%
Suicide attempt 348 10% 289 7% 637 8%


All in all, this article is interesting, but is not so scary as it is
intended to be.


Oh, dear--now you are in big trouble. Some on a.s.a.d. think DAWN is very
reliable.


I never said it wasn't. I'm just saying that this article is not something
to get your panties in a twist about.
--


--Rich

Recommended websites:

http://www.ratbags.com/rsoles
http://www.acahf.org.au
http://www.quackwatch.org/
http://www.skeptic.com/
http://www.csicop.org/


  #10  
Old September 29th 06, 03:48 AM posted to misc.health.alternative,alt.support.attn-deficit,misc.kids.health
Jeff
external usenet poster
 
Posts: 780
Default Emergency Department Visits Involving ADHD Stimulant Medications


"Jan Drew" wrote in message
...

"Jeff" wrote in message
ink.net...

"Jan Drew" wrote in message
m...

"Rich" wrote in message
...

"Jan Drew" wrote in message
m...
There is nothing worse than aggressive stupidity. Johann Wolfgang von
Goethe


Nothing is more dangerous than active ignorance. -- Goethe
Posted in 2002 by me.

Excerpts:

Emergency Department Visits Involving ADHD Stimulant Medications

a.. An estimated 7,873 drug-related emergency department (ED)
visits involved methylphenidate or amphetamine-dextroamphetamine, two
medications used to treat attention-deficit/hyperactivity disorder
(ADHD).

Considering the number of people who are prescribed these medications,
this is a rather low rate. The ER visits for acetaminophen, narcotic
analgesics, and even iron supplements are all much higher.


b.. The most frequent reason for these visits was nonmedical
use (48%), followed by adverse reactions associated with medical use
(34%), accidental ingestion (10%), and suicide attempts (8%).

Bear in mind that the "adverse reactions" are almost all transient
tachycardia which carries very little threat of injury or death in the
young population that is likely to be taking prescribed amphetamines.


c.. The rates of ED visits involving methylphenidate or
amphetamine-dextroamphetamine for patients aged 12 to 17 were higher
than the rates for patients aged 18 or older.

Well, duh. First, there are more 12-17 year-olds prescribed the
medications than those 18+. Second, a 12-17yo feeling ill is likely to
be taken to the ER by parents. An 18+ having an adverse reaction,
especially if he is using diverted drugs, or abusing his own, is more
likely to wait for the effects to subside.

If there drugs were so not easy to get, 18 year olds couldn't get them.
This is the fault of doctors.


It is not the fault of doctors that patients abuse drugs.


If there drugs were so not easy to get, 18 year olds couldn't get them.
This is the fault of doctors.

What part of that do you not understand?


Doctors are not police. One alternative is to have a pharmacist in each
school and college, giving out pills one-by-one. For about $80k per year per
school.

Do you have a workable alternative?

People take other people's antibiotics. But that is not the fault of
doctors, either.





d.. Over two thirds (68%) of the visits involving nonmedical
use of these two drugs also involved another substance, such as
alcohol, an illicit drug, or pharmaceutical.

Yes, people who abuse drugs often abuse more than one drug.





Recent studies have indicated that as many as 7 percent of children
and 4 percent of adults now meet the criteria for a diagnosis of
attention-deficit/hyperactivity disorder (ADHD).1,2,3 As a result,
more prescriptions are being written for the stimulants used to treat
ADHD. More prescriptions will likely lead to increases in medical side
effects associated with the use of these medications and, potentially,
greater use of these drugs for nonmedical purposes as well.

True, but for every new abuser there are likely to be many more who are
enabled to lead productive lives with the help of the medication. It's
a good trade-off.

In your opinion. The fact is they are given to very young kids. Which
is insane.


Really?


Yes, really .

It is a fact that you knew already.


It is your opinion. Not that I think it is a good idea to give these drugs
to young kids. But, they are not licensed for this either, by the FDA.

It is insane to enable kids to pay attention and do well in school?

That's debatabe, It was shown that they actually did worst on tests.


References, please. Again, if you don't back your claims, you lose. Backing
your claims is your homework, not mine.

I was called a liar by your buddy, Mark Probert and others--when I
posted that
years ago. Now it is well proven
I was correct and not a liar.


In your opinion.


Nope. A proven fact (and you knew that also).


No, I have not seen any evidence that makes me think Probert is a liar. If
you think I knew what you say, prove you can read minds. Of course, you may
believe it and may have said it a million times, but I usually ignore
garbage, so I ignore most of what you type.




4 A recent Food and Drug Administration (FDA) advisory panel
recognized the danger of side effects for ADHD stimulants and
recommended that they carry a warning of an increased potential for
cardiac problems, such as hypertension, cardiac arrests, and stroke.

Yes, those things can happen, but they very seldom do in the younger
population.

But, but,, but--Richey. Face the facts.


Provide us with evidence that they happen often.

Jeff


Rich needs to face facts. Jeff--notkidsdoc--Jeffrey Peter, M.D--Jeff P.
Utz, MD.


In other words you are unable or unwilling to back your cliams.

You lose again.

When you are able to say something intelligent, I will respond. Until then,
I will not respond to anything else you write in this thread.

Jeff
...


 




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