By PETE YOST
AP
WASHINGTON (Jan. 5) - A physician at the U.S. Capitol prescribed a powerful sleep aid for William Rehnquist for nearly a decade while he was an associate justice of the Supreme Court , according to newly released FBI records.
The records present a picture of a justice with chronic back pain who for many months took three times the recommended dosage of the drug Placidyl and then went into withdrawal in 1981 when he abruptly stopped taking it.
Rehnquist checked himself into a hospital, where he tried to escape in his pajamas and imagined that the CIA was plotting against him, the records indicate.
Although Rehnquist's drug dependency was publicly known around the time he was hospitalized in 1981, the release of the FBI records provides new details.
The justice was weaned off Placidyl in early 1982 in a detoxification process that took a month, according to the records. The hospital doctor who treated Rehnquist said the Capitol Hill physician who prescribed Placidyl for Rehnquist was practicing bad medicine, bordering on malpractice. Both doctors' names were deleted from the documents before they were released.
The FBI documents were prepared in 1986 when Rehnquist - who began serving on the court on Jan. 7, 1972 - was nominated for chief justice, years after his problems with the drug had ended. They were released by the agency in response to requests under the Freedom of Information Act. The agency said one of the seven folders of Rehnquist documents could not be found.
A psychiatrist told the FBI that Rehnquist's family in 1981 noted "long-standing slurred speech which seems to coincide with administration of Placidyl," one FBI interview report stated. The psychiatrist also indicated that Rehnquist's chronic back pain led to his heavy use of such substances as Darvon and Tylenol 3, which the psychiatrist said also played a part in Rehnquist's condition.
An attending physician at the U.S. Capitol detailed Rehnquist's problems with Placidyl for the FBI, saying that prior to his seeing the justice in 1972, Rehnquist was prescribed the drug by another doctor for relief from insomnia. The attending physician told the FBI he continued to prescribe Placidyl for the entire 10-year period that he treated Rehnquist.
The physician said that Rehnquist had been prescribed 500 milligrams of Placidyl per evening, but that Rehnquist was actually taking 1,500 milligrams each night. The doctor said this increased consumption may have coincided with Mrs. Rehnquist's illness and treatment for cancer.
Rehnquist had told the physician that he was taking one pill before going to bed and he would take other pills if he awakened during the night.
The physician indicated that he decided to discontinue the drug's use and to try another medication. Rehnquist said the new medication was not strong enough, an FBI interview report stated. The physician said he then prescribed a substitute and then another, at which point Rehnquist went into the hospital..
The hospital doctor who successfully weaned Rehnquist from the drug told the FBI that the toxicity of Placidyl causes blurred vision, slurred speech and difficulty in making physical movements. Once a patient stops taking the drug, the withdrawal symptoms of delirium begin, which is what happened to Rehnquist at the hospital.
The doctor who helped Rehnquist get off the drug said the justice's wife was highly upset and felt that the prescribing physician and the pharmacist who filled the prescription were probably intimidated by such high-ranking officials as Supreme Court justices and senators and probably would have agreed to almost any request.
Copyright 2007 The Associated Press. The information contained in the AP news report may not be published, broadcast, rewritten or otherwise distributed without the prior written authority of The Associated Press. All active hyperlinks have been inserted by AOL.
2007-01-05 10:40:48
1 comment:
A LETTER TO THE DIRECTOR OF FDA
Dear Dr von Eschenbach.
We are the Swedish couple - drs Ulf and Birgitta Jonasson – “experts on Propoxyphene” - and we are two of four signers of the Public Citizens petition to FDA about banning Darvon. Wewould like to add some more information and background about Propoxyphene or Dextropro-poxyphene (DXP) as we call the substance in Europe. Our background: We have written and published eight scientific articles about (DXP) . Afterthat, we wrote and defended two doctorial dissertations – in 2000 and 2001. To get the aca-demic results known outside the academic world we wrote a popular science version of our research. The book was also translated into English and the title was “ Fatalities due to useor misuse of painkiller”. Main results: Our main-result was that 200 persons were poisoned to death every year duringthe investigated years 1992-1999 (eight years) – where DXP caused or contributed to thedeath. During these years the population of Sweden was about 9 million inhabitants. There were 1 572 fatal deaths in the medico legal world during 1992-1999 where DXP caused orcontributed to the death during the 8 years. During the years 1992-1996 (five years) therewere 956 fatalities due to DXP and the manner of death was recorded as accident in 49 cases (5 %), suicidal in 542 cases (57%) and undetermined in 365 cases (38 %).We also publish a follow up study. You will find a summary here http://www.rmv.se/pdf/dxpsummary.pdf and the report: http://www.rmv.se/pdf/dxp-report.pdf The follow up-report wasabout the years 2000-2002 and was published 2004. The report was written on behalf of Na-tional Board of Forensic Medicine, Medical Product Agency in co-operation with National Social Insurance Board and Swedish Poisons Information Service – all in Sweden. Consumption of DXP. Thanks to INCB - The International Narcotic Control Board in Vienna – we have figures on the consumption of DXP since 1982 for some countries; US, UK,France – they are big consumers - and Sweden, Norway and Denmark – all three have restrictions when DXP is to be prescribed. We have all the countries in the world from 1995 – 2003http://www.incb.org/pdf/e/tr/nar/2004/narcotics_part4_tables.pdf (US-figures at page219, or nr 60 of 116 are from 1999 to 2003, the rest of the figures I have from a special e-mail)
The US figures are as follows: From 1982 – 2003 (22 years) US consumed 1 921 915 kgDXP. It makes 87 360 kg/year. If we compare – with Sweden - the years 1982 - 2003, theconsumption was 47 170 kg, that makes 2 144 kg every year. Some “Golden standards” for Sweden: According to our research 1 592 persons were poi-soned to death - where DXP caused or contributed to the death - during the investigated years1992-1999 (eight years). That makes 199 fatalities per year.
During the same years the consumption of DXP in Sweden was totally 19 154 kg, that is 2 394 kg every year. If you say thatthese 2 394 kg/year caused 199 fatalities, it “took”12,03 kg for every fatalities. If it “took” 12 kg of DXP for every fatalities in Sweden, maybe it also “took” 12 kg DXP forevery fatalities in the US. The consumption – during the years 1982-2003 was 1 921 915 kg,and we divide that with 12 kg = 160 160 persons. That is 7 280 persons every year that were poisoned to death. Do you know anything that would contradict this statement? I think the American people and the Swedish people in many ways are quite the same. If we use the Swedish figures as “Golden standards” and compare them with some other countries you will get some interesting figures: This time I compare the years 1996-2000. You get the quota= DXP kg ( the average consumption during the years 1996-2000)/population x 100. Sweden – average consumption in kg – 2 847 kg, quota – 32.0 and fatal deaths per year200. Norway – 394 kg – 9,0 – 28 fatal deaths, Denmark – 349 kg – 6,6 – 24 fatal deaths, UK –49 641 kg – 100,7 – 3 452 fatal deaths, France – 44 940 kg – 76,4 – 3 151 fatal deaths andfinally US 101 687 kg, 37,1- and 7 136 fatal deaths. There are different ways to estimate thefatal poisonings in different countries. We have all figures for Sweden, and we have two figures for the other countries. It needs a simple equation to get the third number.More US-figures: In the case above mentioned, I have figures from the years 1982 – 2003. I do know that the consumption of Propoxyphene probably was the highest during the mid60th, but I do not have those figures . During these years Propoxyphene drugs were the mostsold in the whole of US. In the report Propoxyphene – Oversight, Hearing before the Subcommittee on healthand the environment of the Committee on Interstate and Foreign Commerce Houseof Representatives, ninety-sixth congress, May 21, 1980. Serial No.96-80. In this hearing Dr Sid Wolfe from Public Citizen was one witness and he mentioned among otherthings that 11 000 death in the US since 1972 (to 1979 or 1980). 11 000 fatal deaths in 8 or 9years, that makes 1200 – 1350 every year. In 1982 the consumption of DXP in the US was 47 812 kg, and that increased to 110 041 kg in 2002, 2,3 times more. Maybe the fatalities couldbe 2,3 more – 2760- 3100 per year. There are quite different medico legal systems comparing Swedento US. How could wetrust the Swedish figures and not the American in this research. The most important thing is the organisation of the medico legal system in Sweden comparedwith US. We have fresh, updated data in Sweden, we have studied the problem since 1993,nobody has studied in the way we do in the US. I have been told there are no data at all from the last years about propoxyphene in your country. The circumstances are not there to findimportant data in your country. In Sweden we have just one law for the whole medico legal organisation. And this includesall the four branches of the medico legal world; the forensic medicine, the forensic toxicology, the forensic psychiatric medicine and the forensic genetic medicine. In the forensic medicine world in Sweden all doctors are MDs, almost everyone has a PhD, and to be a spe-cialist in medico legal medicine you have to have 3-5 years of special training. When a person dies - so to say outside the hospital - or the cause of death is unknown, youwill be transported to one of the six medico legal stations in the country – and an autopsy willbe done. Even more important is that a blood sample is taken on 95 per cent of the dead persons – and this blood-sample screens for all legal drugs – like propoxyphene - and even ille-gal drugs if the police or the district attorney wants that. This is why we find DXP in Sweden.It is quite simple with one law for the whole medico legal things. In US you have two different systems – as you well know, the coroner system and the medi-cal examiner system. There are about 60 per cent with the coroner system, and the coronersare more like investigators – no MDs. With all respect for all skilled medical examiners, they are MDs, but most of them are not PhDs and just some of them have special training formedico legal purposes. The coroner system and the medical system in US are based on State-laws, that differs a lotbetween many states, and the most import thing is that the power to test a blood samples isdecided on county-level and there are some 3 200 counties in US. And if you by some reason take a blood sample, you are mostly not looking for propoxyphene. Of the states with a coro-ner system, they are elected in 21 states, only 4 states requires the coroner to be a physician, 7requires certain limited training. Today only 300-400 forensic pathologists employs full time in the US today. Only about 30 are specialists in forensic pathology. Today 38 states havesome form of medical examiners system in state, county or district In this special DXP-case, I think that the Swedish – and partly even Norway and Denmark –
have a very good organisation of the medico legal systems. In our system we find lots ofthings in the blood samples-that you do not find in your country. To put it short. We am quite convinced that you don’t find the problem - propoxyphene in theblood samples – in your country and that’s very sad. If we look at the consumption - figuresfrom INCB – that is an organisation within the WHO, it is easy the see what this drug does to people I do hope you will get some more understanding to the Swedich data that we present,and we do hope this will help you to a decision about banning propoxyphene
Kind regards
Ulf Jonasson, Doctor of Public Health
Birgitta Jonasson, Ph D
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Ulf Jonasson Doctor of Public Health (DrPh),Journalist Lövdalsvägen 5, SE-640 20 Björkvik, Sweden Phone: +46(0)155-714 55 Cellphone: +46-0730 23 26 00 http://www.folkpartiet.se/ulfjonasson
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