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	<title>Ryan Babe&#187; The Stacks</title>
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		<title>A 1969 New York Times Retraction</title>
		<link>http://www.rbabe.com/the-stacks/a-1969-new-york-times-retraction/287</link>
		<comments>http://www.rbabe.com/the-stacks/a-1969-new-york-times-retraction/287#comments</comments>
		<pubDate>Tue, 08 Dec 2009 01:10:28 +0000</pubDate>
		<dc:creator>rbabe</dc:creator>
				<category><![CDATA[The Stacks]]></category>
		<category><![CDATA[humor]]></category>
		<category><![CDATA[new york times]]></category>
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		<guid isPermaLink="false">http://www.rbabe.com/?p=287</guid>
		<description><![CDATA[
A Correction. On Jan. 13, 1920, &#8220;Topics of the Times,&#8221; and editorial-page feature of the The New York Times, dismissed the notion that a rocket could function in vacuum and commented on the ideas of Robert H. Goddard, the rocket pioneer, as follows: 
&#8220;That Professor Goddard, with his &#8216;chair&#8217; in Clark College and the countenancing [...]]]></description>
			<content:encoded><![CDATA[<p><a href="http://www.rbabe.com/wp-content/uploads/2009/12/correction_vacuum.png"><img src="http://www.rbabe.com/wp-content/uploads/2009/12/correction_vacuum.png" alt="correction_vacuum" title="correction_vacuum" width="550" height="314" class="alignnone size-full wp-image-288" /></a></p>
<p>A Correction. On Jan. 13, 1920, &#8220;Topics of the Times,&#8221; and editorial-page feature of the The New York Times, dismissed the notion that a rocket could function in vacuum and commented on the ideas of Robert H. Goddard, the rocket pioneer, as follows: </p>
<p>&#8220;That Professor Goddard, with his &#8216;chair&#8217; in Clark College and the countenancing of the Smithsonian Institution, does not know the relation of action to reaction, and of the need to have something better than a vacuum against which to react &#8211; to say that would be absurd. Of course he only seems to lack the knowledge ladled out daily in high schools.&#8221;</p>
<p>Further investigation and experimentation have confirmed the findings of Isaac Newton in the 17th Century and it is now definitely established that a rocket can function in a vacuum as well as in an atmosphere. The Times regrets the error.</p>
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		<title>Halcion: It&#8217;s the Most Widely Prescribed Sleeping Pill in the World. But is it Safe?  (Newsweek, August 19, 1991)</title>
		<link>http://www.rbabe.com/the-stacks/halcion-its-the-most-widely-prescribed-sleeping-pill-in-the-world-but-is-it-safe-newsweek-august-19-1991/146</link>
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		<pubDate>Tue, 10 Nov 2009 18:20:45 +0000</pubDate>
		<dc:creator>rbabe</dc:creator>
				<category><![CDATA[The Stacks]]></category>
		<category><![CDATA[drugs]]></category>
		<category><![CDATA[halcion]]></category>
		<category><![CDATA[health]]></category>
		<category><![CDATA[newsweek]]></category>

		<guid isPermaLink="false">http://www.rbabe.com/?p=146</guid>
		<description><![CDATA[
SWEET DREAMS OR NIGHTMARE?
The most popular sleeping Pill in the world
faces a mounting challenge over its safety



When officer Reg Browne walked into the room, 83 year-old Mildred Coats was stretched out on her bed clutching a cheery birthday card in her left hand. Several towels had been placed gently around her head to absorb the [...]]]></description>
			<content:encoded><![CDATA[<p><a href="http://www.rbabe.com/the-stacks/halcion-its-the-most-widely-prescribed-sleeping-pill-in-the-world-but-is-it-safe-newsweek-august-19-1991/146/attachment/newsweek-cover" rel="attachment wp-att-148"><img src="http://www.rbabe.com/wp-content/uploads/2009/11/Newsweek-Cover.jpg" alt="Newsweek Cover" title="Newsweek Cover" width="199" height="266" class="aligncenter size-full wp-image-148" /></a></p>
<h1>SWEET DREAMS OR NIGHTMARE?</h1>
<h2>The most popular sleeping Pill in the world<br />
faces a mounting challenge over its safety</h2>
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<td><span style="font-size: large;">W</span>hen officer Reg Browne walked into the room, 83 year-old Mildred Coats was stretched out on her bed clutching a cheery birthday card in her left hand. Several towels had been placed gently around her head to absorb the blood spilling from eight gunshot wounds. Anticipating a heated domestic dispute, Browne had donned a bullet- proof vest before leaving the sheriff&#8217;s office in Hurricane, Utah. But he didn&#8217;t get a chance to use it. The old woman&#8217;s daughter, 57- year-old Ilo Grundberg, was waiting calmly to hand him a written confession. &#8220;I didn&#8217;t kill her because I didn&#8217;t love her,&#8221; Grundberg explained. &#8220;I love her very much.&#8221;Grundberg was arrested, charged with second-degree murder, jailed and then moved to a Salt Lake City mental hospital for psychiatric testing. But she never had to stand trial. After examining her, a pair of court-appointed psychiatrists testified that Grundberg had been involuntarily intoxicated when she killed her mother. Like more than 7 million other Americans, she had been taking the prescription drug Halcion to help her sleep. Though the drug is intended only for short-term use, her doctor had prescribed it for much of the preceding year, and she had grown increasingly agitated and paranoid while taking it. Because she had no clear motive for the murder and little memory of it, the experts concluded she hadn&#8217;t acted voluntarily. Prosecutors responded by asking the court to dismiss the case. On Feb. 7, 1989, Ilo Grundberg went free.</p>
<p>Out of custody and off the drug, Grundberg got herself a lawyer. In a $21 million civil suit, she and her daughter, Janice Gray, charged that Halcion is a &#8220;defective drug&#8221; and that Upjohn, its Michigan based manufacturer, failed to warn regulators and the public of its &#8220;severe and sometimes fatal adverse reactions.&#8221; The company responded that it was &#8220;in no way negligent&#8221; and that the murder was &#8220;in no way caused by the drug Halcion.&#8221; But last week, on the eve of a trial that would have brought a long, public airing of Halcion&#8217;s disputed safety record, Upjohn blinked. In a terse press statement, the company announced it had &#8220;reached a resolution&#8221; with Grundberg and that the &#8220;details of the resolution shall remain, confidential.&#8221; The settlement spares the company what could have been a bruising battle with an unhappy customer. But it won&#8217;t quiet the controversy surrounding the most widely prescribed sleeping pill in the world.</p>
<p>Sold in more than 90 countries, Halcion is Upjohn&#8217;s second biggest money-maker (after the closely related tranquilizer Xanax). The drug is marketed under the name Somese in South America, Singapore and Malaya. It has annual sales of $250 million-$100 million in the United States alone. US pharmacists fill roughly a half million Halcion prescriptions every month. The US Food and Drug Administration (FDA) declared Halcion safe and effective in 1982, and many doctors and patients obviously like it. The question raised by the Grundberg case-one that sleep specialists have debated bitterly for more than a decade-is whether the drug is more dangerous than other drugs in the benzodiazepine family, a group that includes Valium and Xanax and such popular sleep aids as Dalmane and Restoril.</td>
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<td>Halcion&#8217;s critics say there is no question it poses special hazards. They claim it is more likely than similar drugs to cause such nervous-system disturbances as amnesia, anxiety, delusions and hostility. And they charge that neither Upjohn nor the FDA has done enough to protect the pill-taking public. &#8220;This is a very dangerous drug,&#8221; says Dr. Anthony Kales, head of psychiatry at the Penn State University medical school. &#8220;No other benzodiazepine has such a narrow margin of safety. The only justification for keeping it on the market is to ensure the company&#8217;s profitability. From a public- health standpoint, there is no reason at all.&#8221;Upjohn, for its part, maintains that Halcion is no more likely than any other sleeping pill to cause adverse reactions. &#8220;I don&#8217;t think that we view the side-effect profile of this product as being any different from other benzodiazepines,&#8221; says pharmacologist Robert Straw, Upjohn&#8217;s director of project management. &#8220;The vast majority of studies back us up on that point.&#8221; Many sleep specialists who have studied and prescribed the drug share that view. &#8220;If used properly,&#8221; says Dr. Thomas Roth, chief of the division of sleep-disorders medicine at Detroit&#8217;s Henry Ford Hospital, &#8220;this is a very, very safe hypnotic.&#8221;</p>
<p>When the first benzodiazepines hit the market back in the early 1970s, they revolutionized the treatment of sleep disorders. These new agents were much less likely than the others then in use (the barbiturates) to cause death in overdose. But like the older drugs, they had a way of overstaying their welcome. People who took them at night were often too groggy to function efficiently, or drive safely, the next morning. The advent of Halcion seemed to solve that problem. Clinical trials showed that while it knocked people out in a hurry, it cleared the body so quickly that users experienced virtually no grogginess the next day. &#8220;Very reasonably, physicians jumped at the chance to have a benzodiazepine free of its major side effect,&#8221; says Dr. Wallace Mendelson, director of the Sleep/Wake Study Program at the State University of New York, Stony Brook.</p>
<p>Belgium and Holland approved Halcion at doses of up to a full milligram in 1977, but the drug soon ran into trouble. Dr. Graham Dukes, a drug-policy expert who was then vice chairman of Holland&#8217;s drug-regulatory agency, recalls that by early 1979 a handful of users had reported &#8220;peculiar psychiatric changes.&#8221; In television appearances and letters to medical journals, one Dutch psychiatrist, Dr. C. van der Kroef, described seeing some of his own patients become depressed or chronically anxious while taking the drug. He also described instances of amnesia, hallucinations, paranoia and verbal and physical aggression.</p>
<p>In August 1979 Dutch authorities suspended the drug&#8217;s license for six months to study the problem, and the reports kept mounting. By the end of the year Dutch doctors had reported 1,100 such reactions. In early 1980, the Dutch government reauthorized a quarter-milligram dose but permanently banned higher ones; Upjohn chose simply to leave the Dutch market (Halcion was reintroduced there last year). Researchers who had studied the drug rallied in support of the company. In a letter to the British medical journal Lancet, a dozen experts noted that in trials involving 5,000 Halcion recipients, &#8220;no symptom clustering similar to that described by van der Kroef was recorded.&#8221; <strong>No FDA comment:</strong> During these years, Halcion was making its way through the government-approval process in the United States. No one at the Food and Drug Administration is now talking about Halcion for the record, but publicly available documents reveal a long history of concern about the drug. In 1980 Dr. Theresa Woo, the medical review officer handling Halcion&#8217;s application, wrote a series of evaluations recommending against approval. Citing the Dutch experience and results from Upjohn&#8217;s own trials, she concluded that Halcion had a narrower margin of safety than other benzodiazepines (healthy young men were unable to tolerate as little as two milligrams) and was &#8220;associated with a greater number of adverse effects.&#8221; When Woo&#8217;s superiors decided to approve the drug despite her concerns, she argued for limiting the dose to a quarter of a milligram. But she eventually backed down, admitting that the &#8220;evidence for efficacy&#8221; was based primarily on the higher dose. Upjohn got its license in November 1982, and in early 1983 the half-milligram dose hit the American market.</p>
<p>Since new drugs don&#8217;t always reveal their full character in initial trials, the FDA maintains a system of &#8220;post-marketing surveillance.&#8221; Doctors and drug companies file brief reports, describing adverse reactions to the drugs they prescribe or sell, and experts within the agency monitor the reports for signs of unforeseen hazards. The spontaneous-reporting system is by all accounts a crude instrument. Many adverse reactions never get reported to the FDA, and those that do aren&#8217;t always caused by drugs. A drug&#8217;s record can also be skewed by such factors as its manufacturer&#8217;s reporting practices, the kinds of patients who happen to take it, even the amount of publicity it receives. For all their limitations, though, spontaneous reports provide a vital early-warning system.</p>
<p>Dr. Peter Mendelis, a researcher at the FDA, tracked Halcion&#8217;s adverse-reaction reports during its first year on the US market, and he perceived a troublesome pattern. The nervous-system side effects reported for Halcion &#8220;appear to have a singular intensity,&#8221; he wrote in an unpublished manuscript in early 1984. Americans were receiving only half the dose first approved in Holland. Yet their experiences- ranging from &#8220;purposeful activity without recall&#8221; to &#8220;personality changes,&#8221; &#8220;inappropriate emotional expression&#8221; and &#8220;unaccustomed aggression&#8221; had a familiar ring.</p>
<p>Alerted to these findings, Dr. Paul Leber, head of the FDA&#8217;s Division of Neuropharmacological Drug Products, requested a more extensive study. For the next few years FDA staffers Diane Wysowski and David Barash compared Halcion&#8217;s adverse-reaction reports with the reports for two other benzodiazepines, Dalmane and Restoril. The differences were startling. In a 1987 report, Wysowski and Barash noted that during its first three years on the US market, Halcion had racked up 8 to 30 times as many adverse-reaction reports as Dalmane and Restoril combined, even though it was still less widely used than either of them. Knowing how fallible the spontaneous reporting system can be, Wysowski and Barash had searched their data for biases. They corrected for differences in the companies&#8217; reporting habits, and they tested the possibility that different types of patients were receiving the different drugs. But they found nothing that could account for the patterns they were seeing.</p>
<p>Halcion&#8217;s high complaint rate wasn&#8217;t unique to the United States. Alarmed by similar reporting, French and Italian regulators forced the half-milligram tablet from their market in the spring of 1987. A few months later, Upjohn voluntarily lowered the recommended starting dose from a half milligram to a quarter in the United States. Under pressure from the FDA, the company also acknowledged in a revised package insert that &#8220;bizarre or abnormal behaviour, agitation and hallucinations&#8221; might possibly be dose-related responses, not simply freak occurrences. By the summer of 1988, Germany had joined France and Italy in blocking the sale of the half-milligram tablet, and Upjohn had decided to stop producing it at all. The idea, says Upjohn pharmacologist Straw, was simply to &#8220;strengthen the concept of lowest effective dose.&#8221;</p>
<p>The story might end there if a San Francisco novelist named Cindy Ehrlich had not received a prescription for Halcion in 1987. During the six months Ehrlich took the drug, she became depressed and anxious and ended up &#8220;convinced that the world was on the brink of nuclear war or invasion from space.&#8221; In the fall of 1988, in a two- part article for California magazine, she told her story and went on to question the FDA&#8217;s original approval of the drug. The piece prompted a flurry of publicity, plus yet another study of the adverse-reaction reports. At Leber&#8217;s request, a team of FDA epidemiologists took another look at the spontaneous-reporting system. The number of Halcion users reporting severe nervous-system side effects was still going up, despite the lower recommended starting dose. So Leber convened an outside advisory committee to consider official action.</p>
<p>On Sept. 22, 1989, the FDA&#8217;s Psychopharmacological Drugs Advisory Committee met outside Washington to hear the evidence. Dr. Charles Anello, the FDA official who&#8217;d overseen the latest review, explained that his team had examined six years&#8217; worth of reports on six different side effects: amnesia, anxiety, confusion, hostility, psychosis and seizures. Depending on the reaction, Halcion had generated 8 to 45 times as many reports as Restoril. Like Wysowski and Barash, Anello&#8217;s team had searched for factors that might have skewed -the results-and like Wysowski and Barash, they had failed to find any. There was nothing about the patients, nothing about the circumstances in which the drugs were prescribed, nothing about the reporting practices of the manufacturers that could account for Halcion&#8217;s higher rates.</p>
<p><strong>New labelling:</strong> The committee agreed that Halcion should carry a stronger amnesia warning (the label now states that amnesia &#8220;may occur at a higher rate with Halcion than with other benzodiazepine hypnotics&#8221;). But after hearing several Upjohn representatives dismiss the value of spontaneous reports and deny knowledge of any corroborating clinical evidence, the members voted not to require any other special measures. &#8220;Given the limitations of the information we had,&#8221; committee chairman Daniel Casey explained after the meeting, &#8220;we did not sense [Halcion] had a special problem with side effects.&#8221;</p>
<p>Naturally, Upjohn officials felt vindicated. &#8220;You&#8217;ve got to rely on science,&#8221; says Thomas Webber, the firm&#8217;s marketing director for central-nervous-system products. &#8220;Anecdotal evidence doesn&#8217;t cut it.&#8221; Straw adds that the firm has &#8220;not documented&#8221; unusual behavioural reactions in its large clinical trials. That&#8217;s true. But critics say the relevant studies were not designed to detect unusual problems. In 1984, for example, researchers analyzed results from 45 Upjohn trials and found that Halcion was no more likely than other treatments to cause &#8220;excessive adverse reactions.&#8221; But the analysts counted only the first side effect reported by any given patient (which, even with Halcion, is usually a morning hangover). By using that approach, says Dr. Frank Ayd Jr., one of the experts who defended Halcion during the 1979 Dutch controversy, the study failed to detect reactions that have since been &#8220;well documented.&#8221;</p>
<p>Aside from amnesia, the best-documented reactions are &#8220;rebound insomnia&#8221; and &#8220;rebound anxiety.&#8221; Any sedative can leave a person feeling wired as it wears off and the body continues to fight it. But several controlled studies have found that Halcion causes harsher rebound reactions than slower-acting benzodiazepines. Dr. lan Oswald of Edinburgh University found in 1982 that while a benzodiazepine called loprazolam left patients less anxious than usual by day, Halcion left them more so, especially after more than a week&#8217;s use. Since then, Kales and his colleague Dr. Edward Bixler have shown that Halcion causes more daytime anxiety than Doral (quazepam). Researchers in Wales have obtained similar results by comparing Halcion with a drug called chlormethiazole. And Oswald has advanced on his earlier study. After randomly assigning 120 patients to Halcion or the benzodiazepine lormetazepam, Oswald found that the Halcion takers &#8220;became more anxious on self ratings, were judged more often to have had a bad response by an observer, more often wrote down complaints of distress, and suffered weight loss.&#8221;</p>
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<td><a href="http://www.rbabe.com/the-stacks/halcion-its-the-most-widely-prescribed-sleeping-pill-in-the-world-but-is-it-safe-newsweek-august-19-1991/146/attachment/professor-ian-oswald" rel="attachment wp-att-150"><img src="http://www.rbabe.com/wp-content/uploads/2009/11/Professor-Ian-Oswald.jpg" alt="Professor Ian Oswald" title="Professor Ian Oswald" width="152" height="244" class="alignleft size-full wp-image-150" /></a><strong><em>Dr. Ian Oswald found<br />
that Halcion patients<br />
became more anxious<br />
than subjects on<br />
other sleep<br />
medications.</em></strong></td>
</tr>
</tbody>
</table>
<p>That doesn&#8217;t make Halcion a bad drug; some people no doubt prefer a little nervousness to the heavy hangovers other sedatives can cause. But if patients don&#8217;t expect some rebound anxiety, they may perceive it as their own problem and return to the medicine chest for relief. Cindy Ehrlich, the San Francisco novelist, recounts that after two weeks on Halcion, &#8220;my heart pounded and I was on the verge of tears much of the time. The slightest danger, such as having to make a left turn in traffic, put me in a sweat.&#8221; Her therapist, having heard only the good news about Halcion, never considered taking her off the drug. Instead, she added a prescription for Xanax, Halcion&#8217;s close chemical cousin.Delusions and strange behaviour are less common problems than amnesia or anxiety. As a result, they&#8217;re harder to study in controlled settings. No one has shown conclusively that Halcion users are more likely than people on other drugs to become paranoid or delirious or to wear overcoats in August. Upjohn may believe such reactions are flukes, no more likely with one benzodiazepine than another, but the company has never convincingly explained Halcion&#8217;s remarkable ability to generate weird stories. The stories abound, not only in FDA surveillance reports but in the medical journals and in doctors&#8217; private conversations.</p>
<p>In one 1987 case report, Dr. John Patterson of Columbia, Mo., describes episodes of delirium, sleepwalking and amnesia in five elderly hospital patients who were receiving as little as an eighth- of-a-milligram dose. One man was &#8220;found attempting to perform somersaults in his room.&#8221; Others wandered the wards or tried to flee the hospital in their pyjamas. None of them remembered their escapades in the morning. Dr. Philip Westbrook, director of the Sleep Disorders Center at Cedars-Sinai Medical Center in Los Angeles, thought his mother-in-law had Alzheimer&#8217;s disease until he learned she was using Halcion and martinis to help her sleep. &#8220;She became extremely anxious and confused, and her husband gave her more Halcion during the day to help her,&#8221; Westbrook recalls. &#8220;I thought for all the world she had a rapidly progressing dementia until I saw the pill bottles. We took her off it and she recovered beautifully.&#8221;</p>
<p>It probably isn&#8217;t a coincidence that so many of these anecdotes involve older people. Studies by Dr. David Greenblatt, a professor of pharmacology, psychiatry and medicine at Tufts University School of Medicine, show that age has a lot to do with people&#8217;s sensitivity to Halcion. In elderly patients, he reported recently, a given dose has roughly twice the effect it has on young adults. But Greenblatt sees no special risks to older patients as long as doctors prescribe the drug carefully.</p>
<p>If Halcion&#8217;s role in bizarre behaviour is still mysterious, its role in violent outbursts is more so. Drug-induced violence has never been documented in controlled, clinical studies. But Ilo Grundberg isn&#8217;t the first person to lash out while taking Halcion. Last year, when FDA analysts tallied the numbers of hostile acts reported in association with 329 different prescription drugs, Halcion ranked No. 1, followed by Xanax. In British Columbia a 63 year-old taxi driver with no history of mental illness ransacked a schoolhouse while taking Halcion. A San Diego man started setting fires. A woman in Virginia Beach, Va., shot her husband when he rebuffed her. And Ron Petty of Kalamazoo, Mich., a police officer with no criminal record, stabbed his wife in the heart, nearly killing her.</p>
<p><strong>Night rage:</strong> Petty recalls taking two half-milligram Halcion tablets (twice the dose his doctor had prescribed) at about 11 p.m. on Feb. 24,1984. He also recalls getting in his car at about 2 a.m. and driving 30 miles to the Battle Creek apartment where Jennifer Petty Bradley, then his wife, was staying while they were separated. But he says he has no recollection of breaking down the door with a tire iron, finding her with another man and attacking her. Petty was convicted of assault with intent to commit murder and sentenced to n. After seeing a television magazine show in which Cincinnati pharmacologist Martin Scharf described Halcion&#8217;s possible side effects, Petty grew more convinced that the drug had fueled his middle-of-the-night rage. He contacted Scharf, hired a lawyer, got a retrial and eventually won his freedom. He now works as an electrician.</p>
<p>Scharf, who has served as an expert witness in several such cases, has little doubt that the drug sometimes turns repressed anger into homicidal rage. Some users&#8217; actions are &#8220;completely unusual in contrast to their normal behaviour,&#8221; he says. But Scharf&#8217;s is a minority view. Most experts resist the notion that Halcion can steal a person&#8217;s volition. &#8220;I do believe that benzodiazepines can be dangerous drugs,&#8221; says University of Chicago psychiatry department chairman Dr. Stuart Yudofsky, a neuropsychiatrist who studies aggression. &#8220;They can affect memory. They can affect concentration. They can affect attention. They can affect mood. They can affect spatial perception and discrimination. But I don&#8217;t believe that they cause people to murder other people.&#8221; Far more people become violent on alcohol than on Halcion, Yudofsky says, but we don&#8217;t excuse their behaviour and blame the distilleries. If we did, he says, &#8220;the implications would be unimaginable.&#8221;</p>
<p>Upjohn&#8217;s critics have assumed wrongly that the only acceptable risk is no risk at all. Halcion may pose dangers not found with other drugs. But for many people, it has clear advantages over its longer- acting relatives. And horror stories aside, it&#8217;s far less dangerous than a barbiturate. &#8220;The general public is expecting a drug that doesn&#8217;t cause any side effects,&#8221; says Mark Mahowald, director of the Minnesota Regional Sleep Disorders Center at Hennepin County Medical Center and president-elect of the American Sleep Disorders Association. &#8220;If you take a medication, you are implicitly accepting a risk.&#8221;</p>
<p>Still, the FDA has been slow to ensure that users really understand the drug&#8217;s potential hazards. Nowhere does the label note that Halcion generates more adverse-reaction reports than any other benzodiazepine. Nowhere does it stipulate that the drug becomes largely ineffective after two weeks&#8217; use. The Public Citizen Health Research Group, a Washington-based consumer-interest organization, has petitioned the FDA to request those changes.</p>
<p>The question is whether doctors would even notice them. Many of Halcion&#8217;s horror stories involve patients who were prescribed excessive doses-and who were kept on the drug long after they should have been taken off. Halcion is approved, labeled and promoted only for the short-term management of insomnia. Yet Ilo Grundberg took it for months at a time, and her physician raised her dose when its effect dwindled. &#8220;These really bad cases result from doctors continuing to do something that&#8217;s damn stupid,&#8221; says one federal health official who insists on anonymity. &#8220;If a patient doesn&#8217;t do well on a medication, stop it.&#8221;</p>
<p>Upjohn, for its part, has also done less than it could have to promote caution. It has resisted labeling changes and has attacked unflattering research rather than face its possible implications. It has also worked assiduously to prevent full public disclosure of the data on reported side effects. As the Grundberg trial approached, the company tried to copyright and seal documents that it admitted contained no trade secrets. &#8220;It appears,&#8221; US District Judge J. Thomas Greene wrote in rejecting the move, &#8220;that Upjohn intended to use the copyright laws to thwart accessibility to the public of information &#8230; which may be offered into evidence in court proceedings.&#8221;</p>
<p>The lesson for consumers should be clear. Sedatives are powerful drugs-and Halcion, for all its advantages, is not the elixir its name implies. Neither Upjohn nor the FDA nor your doctor can guarantee it&#8217;s right for you. So think before you swallow.</p>
<p>Newsweek &#8211; August 19, 1991</td>
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		<title>Excerpt from Tim Donaghy&#8217;s book.  (FYI, the NBA is Rigged)</title>
		<link>http://www.rbabe.com/musings/excerpt-from-tim-donaghys-book-fyi-the-nba-is-rigged/99</link>
		<comments>http://www.rbabe.com/musings/excerpt-from-tim-donaghys-book-fyi-the-nba-is-rigged/99#comments</comments>
		<pubDate>Fri, 30 Oct 2009 07:38:30 +0000</pubDate>
		<dc:creator>rbabe</dc:creator>
				<category><![CDATA[Musings]]></category>
		<category><![CDATA[The Stacks]]></category>

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		<description><![CDATA[On gambling refs:
To have a little fun at the expense of the worst troublemakers, the referees working the game would sometimes make a modest friendly wager amongst themselves: first ref to give one of the bad boys a technical foul wouldn&#8217;t have to tip the ball boy that night. In the NBA, ball boys set [...]]]></description>
			<content:encoded><![CDATA[<blockquote><p><strong>On gambling refs:</strong></p>
<p>To have a little fun at the expense of the worst troublemakers, the referees working the game would sometimes make a modest friendly wager amongst themselves: first ref to give one of the bad boys a technical foul wouldn&#8217;t have to tip the ball boy that night. In the NBA, ball boys set up the referees&#8217; locker room and keep it stocked with food and beer for the postgame meal. We usually ran the kid ragged with a variety of personal requests and then slipped him a $20 bill. Technically, the winner of the bet won twice — he didn&#8217;t have to pay the kid and he got to call a T on Mr. Foul-Mouthed Big-Shot Du Jour.</p>
<p>After the opening tip, it was hilarious as the three of us immediately focused our full attention on the intended victim, waiting for something, anything, to justify a technical foul. If the guy so much as looked at one of us and mumbled, we rang him up. Later in the referees&#8217; locker room, we would down a couple of brews, eat some chicken wings, and laugh like hell.</p>
<p>We had another variation of this gag simply referred to as the &#8220;first foul of the game&#8221; bet. While still in the locker room before tip-off, we would make a wager on which of us would call the game&#8217;s first foul. That referee would either have to pay the ball boy or pick up the dinner tab for the other two referees. Sometimes, the ante would be $50 a guy. Like the technical foul bet, it was hilarious — only this time we were testing each other&#8217;s nerves to see who had the guts to hold out the longest before calling a personal foul. There were occasions when we would hold back for two or three minutes — an eternity in an NBA game — before blowing the whistle. It didn&#8217;t matter if bodies were flying all over the place; no fouls were called because no one wanted to lose the bet.</p>
<p>We played this little game during the regular season and summer league. After a game, all three refs would gather around the VCR and watch a replay of the game. Early in the contest, the announcers would say, &#8220;Holy cow! They&#8217;re really letting them play tonight!&#8221; If they only knew&#8230;</p>
<p>During one particular summer game, Duke Callahan, Mark Wunderlich, and I made it to the three-minute mark in the first quarter without calling a foul. We were running up and down the court, laughing our asses off as the players got hammered with no whistles. The players were exhausted from the nonstop running when Callahan finally called the first foul because Mikki Moore of the New Jersey Nets literally tackled an opposing player right in front of him. Too bad for Callahan — he lost the bet.</p>
<p>I became so good at this game that if an obvious foul was committed right in front of me, I would call a travel or a three-second violation instead. Those violations are not personal fouls, so I was still in the running to win the bet. The players would look at me with disbelief on their faces as if to say, &#8220;What the hell was that?&#8221;</p>
<p><strong>On star treatment:</strong></p>
<p>Relationships between NBA players and referees were generally all over the board — love, hate, and everything in-between. Some players, even very good ones, were targeted by referees and the league because they were too talented for their own good. Raja Bell, formerly of the Phoenix Suns and now a member of the Charlotte Bobcats, was one of those players. A defensive specialist throughout his career, Bell had a reputation for being a &#8220;star stopper.&#8221; His defensive skills were so razor sharp that he could shut down a superstar, or at least make him work for his points. Kobe Bryant was often frustrated by Bell&#8217;s tenacity on defense. Let&#8217;s face it, no one completely shuts down a player of Kobe&#8217;s caliber, but Bell could frustrate Kobe, take him out of his game, and interrupt his rhythm.</p>
<p>You would think that the NBA would love a guy who plays such great defense. Think again! Star stoppers hurt the promotion of marquee players. Fans don&#8217;t pay high prices to see players like Raja Bell — they pay to see superstars like Kobe Bryant score 40 points. Basketball purists like to see good defense, but the NBA wants the big names to score big points.</p>
<p>If a player of Kobe&#8217;s stature collides with the likes of Raja Bell, the call will almost always go for Kobe and against Bell. As part of our ongoing training and game preparation, NBA referees regularly receive game-action video tape from the league office. Over the years, I have reviewed many recorded hours of video involving Raja Bell. The footage I analyzed usually illustrated fouls being called against Bell, rarely for him. The message was subtle but clear — call fouls against the star stopper because he&#8217;s hurting the game.</p>
<p>If Kobe Bryant had two fouls in the first or second quarter and went to the bench, one referee would tell the other two, &#8220;Kobe&#8217;s got two fouls. Let&#8217;s make sure that if we call a foul on him, it&#8217;s an obvious foul, because otherwise he&#8217;s gonna go back to the bench. If he is involved in a play where a foul is called, give the foul to another player.&#8221;</p>
<p>Similarly, when games got physically rough, we would huddle up and agree to tighten the game up. So we started calling fouls on guys who didn&#8217;t really matter — &#8220;ticky-tack&#8221; or &#8220;touch&#8221; fouls where one player just touched another but didn&#8217;t really impede his progress. Under regular circumstances these wouldn&#8217;t be fouls, but after a skirmish we wanted to regain control. We would never call these types of fouls on superstars, just on the average players who didn&#8217;t have star status. It was important to keep the stars on the floor.</p>
<p>Allen Iverson provides a good example of a player who generated strong reaction, both positive and negative, within the corps of NBA referees. For instance, veteran referee Steve Javie hated Allen Iverson and was loathe [sic] to give him a favorable call. If Javie was on the court when Iverson was playing, I would always bet on the other team to win or at least cover the spread. No matter how many times Iverson hit the floor, he rarely saw the foul line. By contrast, referee Joe Crawford had a grandson who idolized Iverson. I once saw Crawford bring the boy out of the stands and onto the floor during warm-ups to meet the superstar. Iverson and Crawford&#8217;s grandson were standing there, shaking hands, smiling, talking about all kinds of things. If Joe Crawford was on the court, I was pretty sure Iverson&#8217;s team would win or at least cover the spread.</p>
<p>Madison Square Garden was the place to be for a marquee matchup between the Miami Heat and New York Knicks. I worked the game with Derrick Stafford and Gary Zielinski, knowing that the Knicks were a sure bet to get favorable treatment that night. Derrick Stafford had a close relationship with Knicks coach Isiah Thomas, and he despised Heat coach Pat Riley. I picked the Knicks without batting an eye and settled in for a roller-coaster ride on the court.</p>
<p>During pregame warm-ups, Shaquille O&#8217;Neal approached Stafford and asked him to let some air out of the ball.</p>
<p>&#8220;Is this the game ball?&#8221; O&#8217;Neal asked. &#8220;It&#8217;s too hard. C&#8217;mon, D, let a little air out of it.&#8221;</p>
<p>Stafford then summoned one of the ball boys, asked for an air needle, and let some air out of the ball, getting a big wink and a smile from O&#8217;Neal.</p>
<p><strong>On his fellow referees:</strong></p>
<p><strong>Dick Bavetta</strong></p>
<p>Crawford wanted the game over quickly so he could kick back, relax, and have a beer; [Dick Bavetta] wanted it to keep going so he could hear his name on TV. He actually paid an American Airlines employee to watch all the games he worked and write down everything the TV commentators said about him. No matter how late the game was over, he&#8217;d wake her up for a full report. He loved the attention.</p>
<p>I remember one nightmarish game I worked with Joe Crawford and Phil Robinson. Minnesota and New Orleans were in a tight game going into the last minute, and Crawford told us to make sure that we were 100 percent sure of the call every time we blew the whistle. When play resumed, Minnesota coach Flip Saunders started yelling at us to make a call. Robinson got intimidated and blew the whistle on New Orleans. The only problem was it wasn&#8217;t the right call. Tim Floyd, the Hornets&#8217; coach, went nuts. He stormed the court and kicked the ball into the top row of the stadium. Robinson had to throw him out, and Minnesota won the game.<br />
[...]<br />
Later that week, Ronnie Nunn told me that we could have made something up at the other end against Minnesota to even things out. He even got specific — maybe we should have considered calling a traveling violation on Kevin Garnett. Talk about the politics of the game! Of course the official statement from the league office will always read, &#8220;There is no such thing as a makeup call.&#8221;</p>
<p>That very first time Jack and I bet on an NBA game, Dick was on the court. The team we picked lost the game, but it covered the large point spread and that&#8217;s how we won the money. Because of the matchup that night, I had some notion of who might win the game, but that&#8217;s not why I was confident enough to pull the trigger and pick the other team. The real reason I picked the losing team was that I was just about certain they would cover the spread, no matter how badly they played. That is where Dick Bavetta comes into the picture.</p>
<p>From my earliest involvement with Bavetta, I learned that he likes to keep games close, and that when a team gets down by double-digit points, he helps the players save face. He accomplishes this act of mercy by quietly, and frequently, blowing the whistle on the team that&#8217;s having the better night. Team fouls suddenly become one-sided between the contestants, and the score begins to tighten up. That&#8217;s the way Dick Bavetta referees a game — and everyone in the league knew it.</p>
<p>Fellow referee Danny Crawford attended Michael Jordan&#8217;s Flight School Camp years ago and later told me that he had long conversations with other referees and NBA players about how Bavetta propped up weak teams. Danny told me that Jordan himself said that everyone in the league knew that Bavetta cheated in games and that the players and coaches just hoped he would be cheating for them on game night. Cheating? That&#8217;s a very strong word to use in any sentence that includes the name Dick Bavetta. Is the conscious act of helping a team crawl back into a contest &#8220;cheating&#8221;? The credo of referees from high school to the NBA is &#8220;call them like you see them.&#8221; Of course, that&#8217;s a lot different than purposely calling more fouls against one team as opposed to another. Did Bavetta have a hidden agenda? Or was he the ultimate company man, making sure the NBA and its fans got a competitive game most times he was on<br />
the court?</p>
<p>Studying under Dick Bavetta for 13 years was like pursuing a graduate degree in advanced game manipulation. He knew how to marshal the tempo and tone of a game better than any referee in the league, by far. He also knew how to take subtle — and not so subtle — cues from the NBA front office and extend a playoff series or, worse yet, change the complexion of that series.</p>
<p>The 2002 Western Conference Finals between the Los Angeles Lakers and the Sacramento Kings presents a stunning example of game and series manipulation at its ugliest. As the teams prepared for Game 6 at the Staples Center, Sacramento had a 3–2 lead in the series. The referees assigned to work Game 6 were Dick Bavetta, Bob Delaney, and Ted Bernhardt. As soon as the referees for the game were chosen, the rest of us knew immediately that there would be a Game 7. A prolonged series was good for the league, good for the networks, and good for the game. Oh, and one more thing: it was great for the big-market, star-studded Los Angeles Lakers.</p>
<p>In the pregame meeting prior to Game 6, the league office sent down word that certain calls — calls that would have benefitted the Lakers — were being missed by the referees. This was the type of not-so-subtle information that I and other referees were left to interpret. After receiving the dispatch, Bavetta openly talked about the fact that the league wanted a Game 7.</p>
<p>&#8220;If we give the benefit of the calls to the team that&#8217;s down in the series, nobody&#8217;s going to complain. The series will be even at three apiece, and then the better team can win Game 7,&#8221; Bavetta stated.</p>
<p>As history shows, Sacramento lost Game 6 in a wild come-from-behind thriller that saw the Lakers repeatedly sent to the foul line by the referees. For other NBA referees watching the game on television, it was a shameful performance by Bavetta&#8217;s crew, one of the most poorly officiated games of all time.</p>
<p>The 2002 series certainly wasn&#8217;t the first or last time Bavetta weighed in on an important game. He also worked Game 7 of the 2000 Western Conference Finals between the Lakers and the Trail Blazers. The Lakers were down by 13 at the start of the fourth quarter when Bavetta went to work. The Lakers outscored Portland 31–13 in the fourth quarter and went on to win the game and the series. It certainly didn&#8217;t hurt the Lakers that they got to shoot 37 free throws compared to a paltry 16 for the Trail Blazers.</p>
<p>Two weeks before the 2003–04 season ended, Bavetta and I were assigned to officiate a game in Oakland. That afternoon before the tip-off, we were discussing an upcoming game on our schedule. It was the last regular-season game we were scheduled to work, pitting Denver against San Antonio. Denver had lost a game a few weeks prior because of a mistake made by the referees, a loss that could be the difference between them making or missing the playoffs. Bavetta told me Denver needed the win and that it would look bad for the staff and the league if the Nuggets missed the playoffs by one game. There were still a few games left on the schedule before the end of the season, and the standings could potentially change. But on that day in Oakland, Bavetta looked at me and casually stated, &#8220;Denver will win if they need the game. That&#8217;s why I&#8217;m on it.&#8221;</p>
<p>I was thinking, How is Denver going to win on the road in San Antonio? At the time, the Spurs were arguably the best team in the league. Bavetta answered my question before it was asked.</p>
<p>&#8220;Duncan will be on the bench with three fouls within the first five minutes of the game,&#8221; he calmly stated.</p>
<p>Bavetta went on to inform me that it wasn&#8217;t the first time the NBA assigned him to a game for a specific purpose. He cited examples, including the 1993 playoff series when he put New Jersey guard Drazen Petrovic on the bench with quick fouls to help Cleveland beat the Nets. He also spoke openly about the 2002 Los Angeles–Sacramento series and called himself the NBA&#8217;s &#8220;go-to guy.&#8221;</p>
<p>As it turned out, Denver didn&#8217;t need the win after all; they locked up a spot in the playoffs before they got to San Antonio. In a twist of fate, it was the Spurs that ended up needing the win to have a shot at the division title, and Bavetta generously accommodated. In our pregame meeting, he talked about how important the game was to San Antonio and how meaningless it was to Denver, and that San Antonio was going to get the benefit of the calls that night. Armed with this inside information, I called Jack Concannon before the game and told him to bet the Spurs.</p>
<p>To no surprise, we won big. San Antonio blew Denver out of the building that evening, winning by 26 points. When Jack called me the following morning, he expressed amazement at the way an NBA game could be manipulated. Sobering, yes; amazing, no. That&#8217;s how the game is played in the National Basketball Association.</p>
<p>In a follow-up email to the referee staff and the league office, Crawford railed about the lack of respect players had for referees and the NBA&#8217;s failure to back him up. Then, in a direct shot at the league&#8217;s embracing of referees like Dick Bavetta, he fired a sharp rebuke:</p>
<p>&#8220;I also told [Stu Jackson] that the staff is an officiating staff of Dick Bavetta&#8217;s — schmoozing and sucking people&#8217;s asses to get ahead. Awful, but it is reality.&#8221;</p>
<p>Crawford also touched on the fact that he was being excluded from working the playoffs that year:</p>
<p>&#8220;Look on the bright side everybody, MORE playoff games for you guys and Dick, maybe you will get to be crew chief in the 7th game of the Finals, which is a travesty in itself you even being in the Finals.&#8221;</p>
<p><strong>Tommy Nunez</strong></p>
<p>My favorite Tommy Nunez story is from the 2007 playoffs when the San Antonio Spurs were able to get past the Phoenix Suns in the second round. Of course, what many fans didn&#8217;t know was that Phoenix had someone working against them behind the scenes. Nunez was the group supervisor for that playoff series, and he definitely had a rooting interest.</p>
<p>Nunez loved the Hispanic community in San Antonio and had a lot of friends there. He had been a referee for 30 years and loved being on the road; in fact, he said that the whole reason he had become a group supervisor was to keep getting out of the house. So Nunez wanted to come back to San Antonio for the conference finals. Plus, he, like many other referees, disliked Suns owner Robert Sarver for the way he treated officials. Both of these things came into play when he prepared the referees for the games in the staff meetings. I remember laughing with him and saying, &#8220;You would love to keep coming back here.&#8221; He was pointing out everything that Phoenix was able to get away with and never once told us to look for anything in regard to San Antonio. Nunez should have a championship ring on his finger.</p>
<p>Derrick Stafford and Jess Kersey</p>
<p>Of course, Stafford had some friends in the league, too. I worked a Knicks game in Madison Square Garden with him on February 26, 2007. New York shot an astounding 39 free throws that night to Miami&#8217;s paltry eight. It seemed like Stafford was working for the Knicks, calling fouls on Miami like crazy. Isiah Thomas was coaching the Knicks, and after New York&#8217;s four-point victory, a guy from the Knicks came to our locker room looking for Stafford, who was in the shower. He told us that Thomas sent him to retrieve Stafford&#8217;s home address; apparently, Stafford had asked the coach before the game for some autographed sneakers and jerseys for his kids. Suddenly, it all made sense.</p>
<p>Referee Jess Kersey was another one of Isiah Thomas&#8217; guys. They&#8217;d talk openly on the phone as if they had known each other since childhood. Thomas even told Kersey that he was pushing to get Ronnie Nunn removed from the supervisor&#8217;s job so that Kersey and Dick Bavetta could take over. This sort of thing happened all the time, and I kept waiting for a Knicks game when Stafford, Bavetta, and Kersey were working together. It was like knowing the winning lottery numbers before the drawing!</p>
<p><strong>Steve Javie</strong></p>
<p>And then there was the ongoing feud between Javie and 76ers superstar Allen Iverson. The rift was so bad that Philadelphia general manager Billy King often called the league office to complain about Javie&#8217;s treatment of Iverson during a game.</p>
<p>Iverson was eventually traded to Denver, and in his first game against his former team, he was tossed after two technicals. Afterward, Iverson implied Javie had a grudge against him, saying, &#8220;I thought I got fouled on that play, and I said I thought that he was calling the game personal, and he threw me out. His fuse is real short anyway, and I should have known that I couldn&#8217;t say anything anyway. It&#8217;s been something personal with me and him since I got in the league. This was just the perfect game for him to try and make me look bad.&#8221; The league fined Iverson $25,000 for his comments, but most of the league referees thought the punishment was too lenient and were upset he wasn&#8217;t suspended. As a result, we collectively decided to dispense a little justice of our own, sticking it to Iverson whenever we could.</p>
<p>Shortly after the Javie-Iverson incident, I worked a Jazz-Nuggets contest in Denver on January 6, 2007. During the pregame meeting, my fellow referees Bernie Fryer and Gary Zielinski agreed that we were going to strictly enforce the palming rule against Iverson. Palming the ball was something Iverson loved to do, but if he so much as came close to a palm, we were going to blow the whistle. Obviously, our actions were in direct retaliation for Iverson&#8217;s rant against Javie. True to form, I immediately excused myself and made an important phone call.</p>
<p>Sticking to our pregame pledge, each of us whistled Iverson for palming in the first quarter — we all wanted in on the fun. The violations seemed to affect Iverson&#8217;s rhythm and he played terribly that night, shooting 5-for-19 with five turnovers. After getting repeatedly whistled all night long, Iverson approached me in an act of submission.</p>
<p>&#8220;How long am I going to be punished for Javie?&#8221; he quietly inquired.</p>
<p>&#8220;Don&#8217;t know what you&#8217;re talking about, Allen,&#8221; I responded.</p></blockquote>
<p><a href="http://deadspin.com/5392067/excerpts-from-the-book-the-nba-doesnt-want-you-to-read">Source.</a></p>
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