Wednesday 18th of September 2019

non-diseases to profit big pharma...

trouble

The most common chronic disease after obesity, afflicting 84 million Americans and more than 1 billion people worldwide, was born as a public relations catchphrase. In 2001, the PR chief of the American Diabetes Association (ADA) approached Richard Kahn, then the group's chief scientific and medical officer, for help with a vexing problem, Kahn recalls. ADA needed a pitch to persuade complacent doctors and the public to take seriously a slight elevation in blood glucose, which might signal a heightened risk of type 2 diabetes. Raising the alarm wasn't easy, given the condition's abstruse name, impaired glucose tolerance, and lack of symptoms.

Kahn invited half a dozen diabetes thought leaders to brainstorm at a National Institutes of Health cafeteria in Bethesda, Maryland. Surrounded by hungry federal employees, many enjoying the kinds of fatty foods and sugary drinks tied to the diabetes epidemic, they landed on a then–little-used term that seemed sure to scare patients and doctors into action: prediabetes.

“We went back to the ADA office right after lunch and started the change. Within a relatively short period of time we … eliminated ‘impaired fasting glucose’ and ‘impaired glucose tolerance’ and substituted ‘prediabetes’ in all of our literature,” Kahn says. Soon, the term was enshrined in the Arlington, Virginia, group's standards of care—widely regarded as the bible of diabetes. ADA and the Centers for Disease Control and Prevention (CDC) in Atlanta declared war against prediabetes, with CDC diabetes prevention chief Ann Albright, an ADA board member from 2005 to 2009, leading the charge. The two groups labeled prediabetes a first step on the road to diabetes, which can lead to amputations, blindness, and heart attacks.

In medicine, prevention is usually an unalloyed good. But in this case, other diabetes specialists argue, medical and epidemiological data give weak support, at most, for increasingly dire prediabetes admonitions. “Nobody really thought at the time, how ‘pre’ is prediabetes for all these people?” says Kahn, who left ADA in 2009 and is now at the University of North Carolina in Chapel Hill. The World Health Organization (WHO) in Geneva, Switzerland, and other medical authorities have rejected prediabetes as a diagnostic category because they are not convinced that it routinely leads to diabetes or that existing treatments do much good. John Yudkin, a diabetes researcher and emeritus professor of medicine at University College London, describes the ominous warnings about prediabetes from ADA and CDC as “scaremongering.”

 

Dubious diagnosis

Charles Piller*

 

Read more:

 

SCIENCE MAGAZINE

fake sciences...

Fake news is a challenge being faced by the media, politics and business alike, but it seems the scientific community too is now facing up to this too.

This week, the World Conference of Science Journalists is being held in Lausanne in Switzerland.

Bad information, misleading scientific claims and outright fakes are being put to the assembled science journalists to grapple with.

 

Hear more:

https://www.abc.net.au/radionational/programs/breakfast/science-with-jon...

creating addictions to big pharma...

Debbie Thompson is a grandmother of five who likes to crochet in her spare time. The 64-year-old is also an addict.

Key points:
  • Pain specialist says Mundipharma distributed misleading brochure on strong pain medications to GPs
  • The company avoided scrutiny because it opted out of Australia's self-regulatory system
  • The Therapeutic Goods Administration can't act because false advertising laws exclude marketing to GPs

 

The former curtain shop manager remembers the first time her GP prescribed a mild painkiller to relieve ankle pain from a slip at work. 

"The pain was like shards of glass," Ms Thompson said.

"He didn't tell me anything just 'well, this should help with pain'."

For Ms Thompson, this was the start of a two-decade "rollercoaster" that would see her taking double the recommended dose of the strong painkiller oxycodone. 

"From then on, operations, pain, meds, 19 years and I'm still suffering," she said. 

One Australian GP believes misleading practices by one global pharmaceutical company are contributing to patients like Ms Thompson becoming hooked on opioids. 

He wants the Federal Government to crack down on them. 

Pain specialist Simon Holliday said a massive loophole was allowing pharmaceutical companies to falsely advertise the purported benefits of their products to general practitioners.

He has evidence pharmaceutical giant Mundipharma has been misrepresenting the position of two major doctors' groups on how to prescribe pain medicines to those with chronic pain in order to promote their drugs.

Mundipharma is the Australian arm of Purdue Pharma, the United States company behind Oxycontin, which is facing multi-million-dollar legal challenges because of allegedly deceptive marketing practices.

Those practices have been blamed for contributing to the opioid crisis in that country.

 

Read more:

https://www.abc.net.au/news/2019-07-10/opioid-maker-linked-to-sackler-fa...

 

 

Read from top.

a wake-up call or over-servicing?

John Pahos had always eaten well and exercised daily, so when he found out he had type 2 diabetes, it came as a surprise.

Key points:
  • More than one third of hospital patients have diabetes, research suggests
  • Half a million Australians are thought to have the condition without realising
  • Diabetes Australia says Australia needs a "wake-up call" in treating the disease

 

"It was a bit of a shock because my lifestyle's reasonably good, so I thought if it can happen to me, it can happen to anybody," he said.

He did not have any noticeable symptoms and his diagnosis was detected by doctors at Melbourne's Austin Hospital as part of a program to reduce the disease.

Research conducted through the program shows Mr Pahos is not alone. An average of 34 per cent of patients at the hospital had diabetes — and 5 per cent of those had undiagnosed type 2 diabetes which was only discovered as part of the study.

It is estimated about 500,000 people across Australia may have the disease without knowing.

"One of the wicked problems with type 2 diabetes is it's often silent," Diabetes Australia chief executive Greg Johnson said.

 

Read more:

https://www.abc.net.au/news/2019-07-14/diabetes-the-silent-killer-overwh...

 

Read from top.

 

 

Meanwhile at drug pricing headquarters...:

 

JACQUELINE LUQMAN Hi. This is Jacqueline Luqman with The Real News Network.

 One of the Trump administration’s key campaign promises leading up to 2020 is to reduce prescription drug prices. The idea is really popular among even GOP voters who are just as opposed to giant pharmaceutical companies price gouging prescription drugs as the progressive left is, but Trump has had some trouble getting his much-touted plans off the ground as of late. And that might be an inroad for the Democrats to seize on in 2020. So joining me now to talk about this is Wendell Potter. Wendell is a former health insurance executive, serving as head of corporate communications for Cigna before leaving in 2008 after a crisis of conscience. And now, he’s a consumer advocate and author. His newest project is Tarbell.org, which examines how money and politics impacts millions of Americans. Wendell, thank you for joining me.

WENDELL POTTER My pleasure, Jacqueline. Thank you.

JACQUELINE LUQMAN So let’s talk about Trump’s plan for transparency in prescription drug pricing because that’s what he called it. What was this plan, and what would it have meant for consumers?

WENDELL POTTER Well among the various things that he said he would be doing along the lines of transparency, one was to require drug companies in their TV advertising to list the prices of those medications, and that’s not going to happen. There’s been a ruling that says that drug companies don’t have to do that. It’s not constitutional to require them to do that. And so, it’s not going to happen. It would have been probably meaningless in the first place. I think there’s some merit certainly in us knowing how much drug companies are charging for their medications, but the reality is that we pay varying amounts. There’s no one charge. There might be an ultimate list price for some medications but regardless of—Because so many of us have different kinds of health insurance plans. Some of us have to pay a lot out of our own pockets before our coverage kicks in. Some of us are uninsured. It’s almost a meaningless number anyway, but it’s not going to happen. That’s one thing.

JACQUELINE LUQMAN So basically, this plan that Trump touted that would drive prescription drug prices down—And as a matter of fact, he said, or one of his Health and Human Services Department officials said, that forcing pharmaceuticals to publish their prescription drug prices would shame the pharmaceutical companies into reducing their prices. So you’re saying that wouldn’t have happened, even if this ruling went in Trump’s favor?

WENDELL POTTER Oh, absolutely not. Again, there is merit in transparency and knowing how much they actually are trying to get away with and gouge us. But the reality is, they could have done it in a way that—Say for example, you actually need a medication that’s being advertised, and you want to make sure that you’re presumably getting the best medication that’s available for your treatment. A lot of people would say, well, that one that cost $50,000 is better than the one that cost $20,000. Well, I want that $50,000 drug. So, you know, we just have to keep in mind the psychology of so-called consumers or patients. So I’m not sure it would have had the intended effect. In fact, it could have been counterproductive, to tell you the truth.

JACQUELINE LUQMAN Counterproductive in what way?

WENDELL POTTER In that, they could do the advertising in such a way to say, look, our new drug or this new version of a drug, it may cost a lot of money, but it’s far superior than a competitor or a generic. And so people would probably then go to their doctor and say, look, I want the high-priced Cadillac drug, if you will, because it’s my health and my life’s on the line. So I’m not sure that that would actually serve to bring prices down, and I don’t know that—You know, the drug companies have demonstrated they’re not shamed. They can’t be shamed all that much. We’ve seen them get away. There’s been a lot of publicity about the money that they’re taking in, and the prices they’re charging for drugs that just have no bearing in reality in terms of value. It’s just, they just price them based on what they think the market can bear. So there’s been no shortage of publicity. It’s one of the reasons why Americans are outraged, but that outrage hasn’t translated into any changes in terms of pricing by the big drug companies.

 

Read more:

https://therealnews.com/stories/pharma-companies-win-case-against-drug-p...

 

Read from top.

 

Makes the price of red-ned worth the headaches...

escaped bioweapon from cold war?...

...

...a year later, Bullough began to experience sudden seizures and muscle weakness, leaving him with severe difficulties walking. Over the past three years, his condition has rapidly deteriorated, leaving him unable to see, permanently bed-bound and often suffering multiple seizures at a time.

“Last May, he had a massive seizure and then his whole body was convulsing,” says Angela. “That’s the day he went blind and has never walked or seen since. He then started having back-to-back seizures; he’s in hospital once a month because they just won’t stop, regardless of how many drugs they give him. One weekend, he had 40 seizures.”

Bullough was eventually diagnosed with Lyme disease, an illness caused by various species of bacteria in the genus Borrelia that live in the guts of ticks. Once transmitted to humans, it can attack the immune system and lead to serious health complications such as arthritis, meningitis, neurological problems, even heart failure. While Lyme disease can sometimes be treated with antibiotics if detected early, not everyone responds and for patients such as Bullough who have developed chronic symptoms, there is currently no cure.

This is particularly concerning as Lyme disease appears to be on the rise, something scientists have attributed to climate change, creating conditions in which tick populations can thrive. While the disease is currently estimated to affect between 2,000 and 3,000 new people every year in the UK, the National Institute for Health and Care Excellence (Nice) suspects the real figure is far higher.

But for scientists, one of the most tragic aspects of Bullough’s story, as with those of many other patients, is that it could potentially have been avoided. In the late 1990s, the first preventive human vaccine, called LYMErix, was developed and 1.4m doses had been administered by the end of 2001. The data suggests it was highly effective, protecting against the disease in almost 90% of cases.

LYMErix wasn’t perfect. It was relatively expensive, did not work in young children, only protected against one strain of Lyme disease and was only available in the US. But it appeared to be the first step towards eradicating the disease for good. Anti-vaccine fear saw it vanish from the market, however, and with that, all scientific research and investment in the field ceased.

 

Read more:

https://www.theguardian.com/science/2019/jul/20/lyme-disease-is-solution...

 

BUT:

 

US Pentagon is told to investigate claims that Lyme disease is escaped bioweapon from cold war

 

BMJ 2019; 366 doi: https://doi.org/10.1136/bmj.l4784 (Published 19 July 2019)
Cite this as: BMJ 2019;366:l4784 
The US House of Representatives has ordered the Pentagon’s inspector general to conduct a review of whether the defence department “experimented with ticks and other insects regarding use as biological weapons between 1950 and 1975.”1

The demand for a review, proposed by Chris Smith, a New Jersey Republican, passed easily among a raft of other late amendments to a House bill on defence spending. It must still be “reconciled” with the Senate’s version of the spending bill, but Smith said that he was confident of Senate support.

He told the House that his amendment had been “inspired by a number of books and articles suggesting that significant research had been done at US government facilities including Fort Detrick, Maryland, and Plum Island, New York, to turn ticks and other insects into bioweapons.”

Biological research

Plum Island, a secure government biological research site since 1945, lies directly across a narrow stretch of water from Lyme, … 

View Full Text
https://www.bmj.com/content/366/bmj.l4784.full

REad from top.

fighting borrelia burgdorferi...

Months after a U.S. Congress–mandated advisory group sounded the alarm about tickborne illnesses and urged more federal action and money, the National Institutes of Health (NIH) is readying its first strategic plan for these diseases. Last week it also, serendipitously, issued a rare solicitation for prevention proposals in tickborne diseases. The new pot of money for those efforts, $6 million in 2020, represents a significant boost to the field; NIH spent $23 million on Lyme in 2018, by far the most common tickborne illness, with $56 million devoted to tickborne diseases overall. Cases of Lyme disease have roughly tripled since the 1990s, to more than 300,000, as ticks carrying the bacterium Borrelia burgdorferi have spread. Scientists still hope for more money for diagnostics and treatment research.

 

Read more:

https://science.sciencemag.org/content/364/6437/221

weaponising insects...

JACQUELINE LUQMAN: Hi, I’m Jacqueline Luqman with The Real News Network.

A new book published in May has raised questions about the origins of Lyme disease, which affects 400,000 Americans each year. And this book has caught the attention of Congress, prompting some to ask the question, did the Pentagon weaponize ticks and unleash them on an unsuspecting public? Here to talk about this is Kris Newby, the author of Bitten: The Secret History of Lyme Disease and Biological Weapons. Kris is an award-winning science writer at Stanford University and the Senior Producer of the Oscar shortlisted documentary on Lyme disease, Under Our Skin. Thank you so much for joining me today, Kris.

KRIS NEWBY: Thank you for the invitation.

JACQUELINE LUQMAN: So Lyme disease is not a new phenomenon, right? It’s not new. It’s been around for a long time. But what is it about Lyme disease that has turned more attention on this issue now?

KRIS NEWBY: The Lyme disease bacterium was discovered or announced that it was discovered in ’81, and the tick-borne disease problem has just continued to increase since that time. What my book shows is not that the Lyme disease bacterium is a bio weapon, but the epidemic of tick-borne diseases. There was three new tick-borne diseases sort of noticed in 1968, and those may be related to a biological weapons accident associated with the weaponization of ticks that may have had multiple germs inside of them.

JACQUELINE LUQMAN: Now, that’s the secret history of Lyme disease that you talk about in your book— that people obviously don’t know anything about— that ties Lyme disease to the Pentagon and the creation of bio weapons or using ticks and other insects as bio weapons possibly. Can you explain for us what that alleged program was about?

KRIS NEWBY: Well, ticks were used as basically eight-legged soldiers. And the military, the bio weapons headquarters in Fort Dietrich, Maryland, figured out how to put dangerous diseases inside the ticks. And then they had a program where they would drop those ticks on enemy territory from a plane, and then those ticks would be like stealth soldiers and it would be hard to protect yourself from them and they would bite people. And they would either transmit fatal or incapacitating diseases to the local population that would make it easier for an invading army who had been vaccinated to take over the area and less destructive than traditional bombs.

JACQUELINE LUQMAN: Now, I know that for some people watching this, they may say, “Okay, this sounds really ridiculous. Weaponized ticks? Come on now.” But there is a key figure referenced in your book who actually lends credence to this idea because this is not something, from what I understand, that you discovered. This was something that you were given information on from this key figure. So who was this person and why is he important to not just this program of weaponized ticks and insects, but also to the history of Lyme disease? Who was this person?

KRIS NEWBY: This person was Willy Burgdorfer, a medical zoologist who came over from Switzerland in 1951, landed in the Public Health Service in Hamilton, Montana— that was the number one spot for tick research—and he was very shortly enlisted in the biological weapons program headquartered in Frederick, Maryland. His job was to weaponize fleas, ticks, and mosquitoes by putting dangerous diseases in them so that they could be dropped on the enemies. Now, in 2013, he told a filmmaker and me pieces of the story where he admitted that he had been in the biological weapons program for over 10 years and no one had known that. And he’s also the discoverer of Lyme disease, and that’s what really made him world-renowned. So for him to say that, that he had been covering this up for so many years, makes it somewhat credible.

JACQUELINE LUQMAN: Now, the Representative from New Jersey, Chris Smith, who is a Republican and has introduced an amendment to have the Department of Defense’s Inspector General investigate whether this program actually did exist and whether the Pentagon has weaponized ticks and other insects and unleashed them on the public, has just been voted on and it was proved to be – I think the next step is that it would be reconciled to the Senate bill and it may not make it through the full and final defense budget, but it is true that there has been a rise in Lyme disease cases over the past decade or so.

So these two events have coincided, the release of your book and also the rise in Lyme disease cases, which for some people does cause some alarm. As a matter of fact, the CDC has documented this rise in their recent study called “Lyme and Other Tick-Borne Diseases Increasing.” Now, they cite that the new germs contributing to Lyme disease and other tick-borne diseases have been identified. The geographic range of the tick population is expanding, and that can be contributed to over-development of wooded areas, destroying the ecosystems of insects and also climate change. But can those contributing factors account for the entirety of the rise in Lyme disease cases? I guess what I’m asking is, can we rule out the possibility that the Pentagon may have unleashed weaponized ticks and other insects onto the American public or in some areas and it got out of hand?

KRIS NEWBY: I think it’s absolutely proven that there was a tick weapons program. The outstanding question is, was there an accident where some of the infected ticks got out? And maybe they didn’t know they were infected and they were. And there was also aerosolized programs where germs that can be caused by ticks were sprayed over in open air conditions, and did that enter the ecosystem that way? So it can’t be ruled out. And there has been a mystery as to why these three new dangerous virulent tick-borne diseases showed up around Long Island Sound. That’s New Jersey, New York, Connecticut, Rhode Island, and Massachusetts, in 1968, around 1968. And so, in nature, it would be highly unusual for three brand new pathogens to just show up unless there was some sort of manmade intervention.

So that’s the hypothesis of my book. And I go through and present evidence of the development of the tick-borne research program, tick-borne disease research program, accidents that have happened in the past with the ticks, and then Willy’s confession and supporting information to that admission that he thought the outbreak was due to a bio weapons release. He never said it was the Lyme bacteria per se. He intimated it was a different bacterium. But that may be why it’s been confusing to scientists and we need to look into it now with this new information, and that would speed up our development of diagnosis, treatment and cures.

JACQUELINE LUQMAN: So you’re saying that people are kind of conflating ideas. People are saying, or making the, I guess accusation, that you’re saying that Lyme disease itself was the result of a weaponized tick program from the Pentagon. But you’re saying that there were other pathogens that were discovered at the same time that the Lyme pathogen was discovered and in a scientific process, that’s unheard of. So these other-

KRIS NEWBY: Unlikely. Unlikely.

JACQUELINE LUQMAN: Unlikely. So the appearance of these other pathogens at the same time that are related, point to something outside of just a natural occurrence.

KRIS NEWBY: Right. And also, strange new species of ticks out of their natural habitat. For example, the Lone Star tick, which is very aggressive and man-biting and spreads disease faster than the traditional native ticks in and around Long Island. So there are documented reports about Lone Star ticks being released in Norfolk, Virginia on the coast, and a year after those experiments, they’re around Long Island. And so it appears that birds helped spread them farther north.

JACQUELINE LUQMAN:  Now, the interesting thing about this story is that as fast as it has come out and there has been attention given to it, some in the more established media circles have already come out and tried to discredit, not necessarily your book. They have not tried to do that directly, but they’ve tried to discredit interestingly enough, Dr. [Burgdorfer]. In a Washington Post article, they quote a scientist who says this of Dr. [Burgdorfer]. The scientist is Michael T. Osterholm, the Director of the Center for Infectious Disease Research and Policy at the University of Minnesota. And he said of Dr. [Burgdorfer] that there’s just no credible evidence behind the stories about weaponizing ticks … or Burgdorfer’s … I’m sorry, I mispronounced his name … Dr. Burgdorfer’s involvement with such a project. What do you say to this claim that there is no credible evidence behind the man who you admitted, you said yourself identified the Lyme pathogen, also saying that the Pentagon was weaponizing ticks with not just that pathogen but others?

KRIS NEWBY:    Well, I have him on video saying he weaponized ticks and I have a plethora of documents confirming that, including a progress report to the NIH Director saying Willy Burgdorfer is an outstanding employee and he’s been for three years working on classified programs for the Army that involves ticks. So I would say to Dr. Osterholm, I hope you read the book and then perhaps you’ll be convinced.

JACQUELINE LUQMAN:  So you have a paper trail proving that Dr. Burgdorfer was an employee of the Department of Defense and that he was a part of this program and worked on this program.

KRIS NEWBY:   He was an employee of the NIH, but he had contracts from Fort Dietrich, Maryland to do many, many biological weapons experiments. So I have quite a long paper trail to that, and it’s all posted publicly on the various archives.

JACQUELINE LUQMAN: And it’s all in your book?

KRIS NEWBY: Yeah, I mean, the key evidence. There’s much more, as you can see behind me. It’s all there.

JACQUELINE LUQMAN: So ultimately, let’s go back to this amendment that representative Chris Smith has introduced, which he says is partially inspired by your book, not entirely, but partially inspired by your book and other articles on this subject. As I said, this amendment has to be reconciled to the Senate defense bill. It may not make it into the final approved bill for the Department of Defense, and if that doesn’t happen, if there’s no investigation into this issue, what do you want people to understand about this issue? Is this just another one of those kind of general, “Don’t trust the government,” conspiracy theories or is there really something here that we should take very seriously?

KRIS NEWBY: Well, I’ve been working on this book for five years and then through the documentary that’s another five years, I can say with some authority that the tick-borne epidemic in the US is reaching really serious levels, and the CDC certainly has come out this year to support that premise. I think everybody now knows somebody who has Lyme disease and they have a horror story. And so this denialism—I have to be really clear, it’s not just Lyme disease. It’s the co-infections, too. So when you have the Lyme bacteria plus the co-infections, which may or may not have bio weapons’ ancestry, you get this really bad chronic disease. We need to quit denying that this is a problem and start trying to understand what’s in the ticks, where are they spreading, and we need to develop treatments for the people with the chronic forms of tick-borne diseases. I mean, for Lyme disease alone, there’s only been I think five to seven randomized treatment trials. The last one was 18 years ago, and that’s not good enough for the rate at which these diseases are spreading.

JACQUELINE LUQMAN: So people are suffering from a disease that is spreading far rapidly than the research for the treatment or even the attention that the medical community should be paying to it, is keeping pace with it.

KRIS NEWBY: Right. I think there’s been a hyper focus on Lyme disease only and the scientists who have all the grants to study it are saying, “Oh, Lyme disease is easy to treat, easy to cure, and if you have lingering symptoms, then you’re a hypochondriac or you have an autoimmune disease.” And I’m hoping that the book opens their eyes to look at the co-infections that might be worsening the original Lyme infection in these people.

JACQUELINE LUQMAN: Well, we will be fascinated to see what will happen with this amendment that has been introduced by Representative Chris Smith that was partially inspired by the book Bitten: The Secret History of Lyme Disease and Biological Weapons that was written by Kris Newby. Thank you so much, Kris, for joining me to talk about your book and this issue today. It was a wonderful conversation and fascinating.

KRIS NEWBY:    Thanks so much.

JACQUELINE LUQMAN:  And thank you for watching. This is Jacqueline Luqman and this is The Real News Network in Baltimore.

 

 

Read more:

https://therealnews.com/stories/is-the-rise-in-lyme-disease-due-to-weapo...

 

 

 

Read above and from top.

health vampires...


Our Frankenstein’s monster of a health care system has created an abundance of “rent-seekers,” the term economists give to firms that exploit highly regulated markets and make profits they otherwise couldn’t. And PBMs like CVS are the worst of the bunch. They use monopolistic conditions, secrecy, and deception to inflate their profits at the expense of consumers, exploiting their role in America’s decidedly non-market health care system. As Republican Congressman Doug Collins once said, “they act as monopolistic terrorists on the market.”

CVS Caremark, Express Scripts, and OptumRx are some of the worst rent-seekers in the American economy. In a 2018 article, The Economist argued that PBMs, not drug manufacturers or insurers, were the recipients of the greatest excess profits in the U.S. health care system. According to the magazine, “excess profits from healthcare firms are equal to $200 per American per year” and “middlemen capture $126 of excess profits a year per American.” 

One of the main ways that PBMs seek rent is through their negotiation of rebates from drug manufacturers. And generally, to retain a PBM’s favor, drug manufacturers will readily cough them up. In turn, PBMs split the dough between themselves and the insurance company—placing the majority of it in their own pockets, of course.

Just how much, then, do they make off these rebates? Since the payments are kept strictly confidential, it’s hard to pin down the exact number. But considering the fact that insurers received $89 billion in rebates from PBMs in 2016, it’s safe to say they make a lot.

 

Read more:

https://www.theamericanconservative.com/articles/how-pill-middlemen-like...

 

 

 

Read from top.