Naltrexone funding rejected

13/Jan/2009

Comments: 42 readers have left a comment

Dr George O’Neil. Dr George O’Neil.

THE State Government has rejected a funding request of $3 million over three years for Naltrexone advocate Dr George O’Neil’s Subiaco-based Fresh Start Recovery Program, because the treatment is still experimental.

Mental Health Minster Graham Jacobs said the Drug and Alcohol Office had provided more than $8 million to the program over the past eight years, including $1.153 million in the 2008-09 financial year, but rejected the extra request because Naltrexone implant treatment was not registered by the Therapeutic Goods Administration.

“It is not the responsibility of the State Government to fund the prescription or administration of medications by practitioners in private practice,” Mr Jacobs said.

Dr O’Neil has appealed the decision to Premier Colin Barnett, who has agreed to a meeting at the end of this month.

Dr O’Neil claimed that doctors from the Government’s Next Step Drug and Alcohol Services were against Naltrexone treatment, creating a conflict of interest in considering his funding request.

The doctor, his family and friends have always funded the Naltrexone implants, which cost about $2 million a year, and have sold properties in the past to cover costs.

“We have had to sell properties to keep the clinic open and previously I’ve done it quietly, but not this time because it’s a ridiculous situation,” Dr O’Neil said.

“It costs about $6 million a year to run the clinic – $2 million on the implants, about $2.5 million in staff costs and another $1.5 million for running 10 houses and feeding people.

“Eight years ago, we had skeleton staff. Now we have 40 staff and about 200 volunteers, but have not seen an increase in funding.”

Mr Jacobs said the clinic received about $1 million annually for assessment, counselling and patient support services, which adequately covered these services.


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What everyone else is thinking

Rex

03/07/2010

I have been on NAL for two months now for alcohol addiction.It works,just the same as it works for my brother,who uses it for heroin addiction.What we are talking about here is firstly the real desire to stop these habits that destroy our lives.I have read many forums and there are always those that knock this treatment.The figures are there to support its success with many people if you make the effort to find them.There is no 'get out of jail free' it takes effort on your part,so for those who dont believe,cool dont,but your negative views could well be stopping others from finding real help.
What happens with NAL is referred to as Pharmaceutical Extinction which gives the user time to make important changes in there habits.
I agree that implants are possibly dangerous but I see no real need for them as it is simply a matter of taking a tablet every day.Thats something you dont forget to do each day if youre really serious.To those who are on this treatment,hang in there.

Karin

04/06/2010

Just a month ago I came back from Israel where Dr Andre Weisman the Dr that INVENTED this method (It's called ANR) performed the procedure. He came to Australia to teach the method, but left disappointed, because our Drs wanted to make changes to it. Then they had the nerve to "copy"what they half learnt, and called it "Rapid detox". BUT they do not know how to perform the procedure here & they don't asess each patient. ANR is a way where they "clean"your endorphines, then they reproduce 60% of them! It is remarkable! And it DOES DEFINATELY work!!! Dr Weisman does NOT believe in IMPLANTS!! Naltrexone should be taken daily in tablet form. I believe all these deaths & fatalities are due to implants that obviously release the wrong amount of the drug, or not inserted correctly.. Who knows!
Wanna know more? Google ANR Clinic. And GIVE DR O'NEILL HIS FUNDING!!!!

Jason

05/05/2010

wow this is still going on in regards to naltrexone treatment etc , well from personal experience and being 1 of the 1st in the original trials in 1997 which nearly killed me and took a huge toll on my mind and body im still to yet get over i think i smell a rat i love dr George but i think paying for naltrexone any more than $400 dollars is a rip off it will only work for the very highly motivated individuals that are really keen to change there life the naltrexone isnt the miracle drug cure its made out to be it wont help someone that cant help themselves it didnt cure me but i bet every measly dollar i own im on the cured list it was the begining of the end for me i havent used heroin for 7 years but are on the parole i call it case of going to the chemist every 2nd day for a dose subutex wich i think is far better than naltrexone though the handcuffs the medical profesion puts on it has ruined my life totaly i was a happy recovered addict upto 6 years ago now im bitter as hell

treena

11/04/2010

After 7yrs of heavy smack use, I was desperate for it to be over. Iwas on methadone most of that time too but still using every chance I got. stealing, scamming, the usual. I flew to sydney for a rapid detox and implant. $5,900. but they told me I wouldnt remember a thing. LIES. No doctor, so the nurses could only give what they had been ordered. A few mogadon and valium does not knock out a junkie. I spent the whole process eyes wide open, throwing up, spasming and aching in parts I never knew I had. Came out after 24 hours still withdrawing. I know naltrexone works for some. But do your research if you intend to get it done. Within 2 days I became extremely voilent, not my usual behaviour at all. its been 10 days now, I dont want to be near anyone, their concern just makes me angry, Im depressed and I feel like there is no space in the world that I feel comfortable occupying.

Alecia.b

17/03/2010

I have been getting implants for 8yrs now& I would rather have an implant than opiate replacement.I am a 3rd generation addict who would still be using if not for the Oneil implant.give George his funding so it's sucsess can be proven.it may not work for everyone but it works for me&i am now in debt because I choose naltrexone not methadone which is only chosen by people who don't want to be hanging out between shots of heroin.how can he prove it works if he cannot afford to give the tga the results they are asking for?george has saved my life& the lives of many others&i hope he gets the funding he's asking for cause if the naltrexone don't get approved soon I'll probably end up just another dead junkie Whos a drain on the public health system for the rest of my short life.George is a saint who deserves a medal

ross dalrymple

07/03/2010

i tried the (cure) about ten years agot. If i had known I'd be declared a drug addict i wouldnt have touched it or even entertained the thought.since then i cant get work ect...if you break a bone and go to hospital dont expect to get any painkillers,no doctor will want to know you and the list goes on & on. I went from a company director with the world at my feet to living in a bedsit with no friends or family. depressed would be the word.

james

25/02/2010

I just want to say that I have had my implant for a week and I am suffering from severe depression.

I feel as though natlrexone has taken away all my natural highs and I feel like a zombie without a soul and can't seem to find joy in anything. I came off suboxone two weeks before my implant and I was just starting to feel alive again, I was going to the gym and I felt my brain chemistry was getting back to normal.

After my implant all my passions all my desires are gone. I feel like an empty shell of a man. All I think about day in and day out is how horrible I feel and how I wish I could take it out.

jordz

08/09/2009

i am 23 yro female and have a 6month implant it has changed my life so for all u people who speak but have not experienced the hell.. u do not understand its like winning the lottery for me.. i won me back i won my life back, my soul and my family!

affected mum

15/08/2009

unreal thoughts goin on out there people all for and against why dont you write on this forum when and if this affects you and your loved ones you would do anything to give these people a chance to regain their diginity but it seems you just want to get on the band wagon and knock anything that just may work if this affected you personally you lot that knock a good persons work would be the first to line up to get help no wonder jesus was crusified get real

W Farid

08/04/2009

To HealthyChristianRatepayer (08/04/2009),

I was somewhat bemused that instead of refuting the points I made with logical evidence-based discussion, you imply aspects of a position I didn't take (e.g. "but hey addicts are the lowest of the low who dont deserve a human rights charter,huh??") and make baseless comments of your own (e.g. implying that increased methamphetamine use relates to use of naltrexone implants [but nothing to do with the heroin drought]; naltrexone producing depression; polymer being dangerous).

Not once did I suggest that prescription heroin outcomes were inferior to outcomes from getting tough with the law and other pharmacotherapies. The comparison I made was with the outcomes of abstinence (the ultimate objective of naltrexone-pharmacotherapy).

I'm not interested in entering into juvenile and baseless name-calling (e.g. "hypocrite") - the stance I adopted was to refute fallicious claims by yourself and others.

Healthy Christian Ratepayer

08/04/2009

We dont send smokers to jail for being addicted to nicotine , nor do we send alcoholics to jail for being alcoholics... so why is there a "abstinence or jail" mentality/morality here in WA???..Seems addicts are co-erced
into "treatments" experimented on pigs ( Naltraxone) or Methadone ( a Nazi favourite)
The bottom line is after 50 million dollars wasted trying to create a "drug -free WA"( sure, for those who have support networks and a far away family beach house, Naltraxone may be useful) fresh start cannot change view now ( from unrealistic abstinence only to heroin assisted practical living / social reintegration)..even if the evidence is documented and piling up in favour of diamorphine (scandal free heroin) ( Swiss,Dutch ,Germans,Danish and English, Canadian medical pros seem to think prescription heroin is the least damaging treatment for both the addict and the community and most effective in crime/disease control
Time to wake up and stop being hyp

Healthy Christian Ratepayer

08/04/2009

RE W Farid

06/04/2009 (quote)"I think it is fair to presume that health and social outcomes from abstinent patients would be superior to outcomes from patients receiving prescription heroin."( And unless they stop sinning and comply to our "abstinent ways" they can rot in jail ???)
Actually according to the swiss model addicts receiving prescription heroin abstain from polyuse/reduce consumption of cocaine and other substances , whereas WA addicts receiving the "Naltraxone miracle snake oil" seem to switch to methamphetamine ( which as a result switches crimes against property /burglary or petty theft to psychosis induced violent crimes against people).I think its "fair to assume" the community would much rather deal with a properly medicated placid heroin addict than a rampaging ,out of control meth user ( which strangely has increased proportionally since Oneill has been peddling his anti-heroin goods

Healthy Christian Ratepayer

08/04/2009

Naltraxone implanted patients risk feeling mutilated..moere depressed than when on heroin ( but hey addicts are the lowest of the low who dont deserve a human rights charter,huh??)
Why the opposition to prescription heroin when the evidence is overwhelmingly positive from the Euro countries that tend to not mix church and state???
If a 30 yo addict lives to 60yo and addiction is a lifelong battle and needs re-implanting 2 implants every six months..for a total of 60 implants to combat addiction, that sounds very dangerous to say the least apart from the logistics of finding room in the abdomen considering it takes 3 yrs for the plastic to liquify into the bloodstream

If clean regulated prescription heroin was available to addicts for whom nothing else works... religious idealogues/ err tax free charities ( afterlife subsciption) would no longer need to "prey/pray in the gutter"
to be continued

W Farid

06/04/2009

HealthyChristianRatePayer (11/03/2009) - PART 3

Your assertions regarding Dr O'Neil and his attitudes towards science are misplaced. If you want to see the evidence-based science on this particular implant with regards to its safety and efficacy there are a number of peer-reviewed publications available, and the independent research is on-going.

Regarding the polymer encasing the drug, it degrades in accordance with the 'reaction/diffusion phenomenon'. Basically, it absorbs water from surrounding tissue and undergoes a reaction into a permeable (dissoved) form whereby it can be excreted. Moreover, the polymer (poly,DL-lactide) is the same one used in other medical devices, such as stitches which dissolve. Accordingly, I think your concerns regarding its carcinogenicity are misplaced.

Finally, I agree with your philosophy that control and regulation is a desirable outcome - regaining control of their lives is exactly what this treatment strategy is intended for.

W Farid

06/04/2009

HealthyChristianRatePayer (11/03/2009)
strangely cut off too - PART 2

Implementing mandatory counselling for patients receiving naltrexone implants would be considered by most health professionals as a responsible course of action.

Naltrexone is an opioid receptor antagonist, so it will block the effects of opioids (e.g. morphine) and reduce cravings for other pleasurable substances (e.g. alcohol). What naltrexone can ensure is that patients are abstinent from opioids for an extended period of time so that they can imperative psychosocial strategies can be implemented successfully to maximise the chances of long-term abstinence. There is nothing "hocus-pocus" about cognitive behavavioural therapy and the establishment of support networks. Some patients benefit from a utilising religion as a means of behavioural control. Some patients are not religious and elect NOT to engage in discussions of spirituality/God.

W Farid

06/04/2009

kerryn (19/01/2009)

There is evidence-based clinical research. If you work in the drug and alcohol sector, then you should already be aware of these.

The answer to your final question on why substitute with another drug, is simple - because it isn't a substitution per se - in other words, they are not substituting one opioid for another. Because naltrexone is an opioid antagonist (blocker), the patients will not become addicted to it. It is for the purpose of protecting them against relapse and overdose, while they sort themselves out (e.g. attend counselling, renew relationships, get a job, etc).

When the time comes where they have overcome their cravings and have a renewed outlook on life, they can stop using the naltrexone without experiencing the withdrawal that comes with heroin, methadone and buprenorphine.

W Farid

06/04/2009

To Damon Brogan (19/01/2009)

There is much independent, peer-reviewed evidence on the safety and efficacy of this specific preparation (refer to articles by G Hulse).

For your information, the implant is approved by the TGA in accordance with the 'Special Access Scheme' (SAS) under 'Compassionate Guidelines' for use in opioid-dependent people. As previously stated, it is continuously being evaluated fully so that it may receive full TGA approval. In the meantime, the product is constantly being scruitinised by the TGA, particularly in relation to safety. If deemed unworthy/unsafe at any stage, the TGA would not hesitate in revoking the SAS authority to use it.

W Farid

06/04/2009

Bec (13/01/2009),

You are very much mistaken when you say that people don't feel heroin's high when using naltreone but can overdose from a small amount of heroin is used. Naltrexone while in the system at sufficient levels (above 2 ng/ml) will protect the person from overdose if they attempt to use heroin. Accordingly, the sustained-release preparations are a promising alternative for opioid-dependent patients seeking to become opiate-free.

Please ensure you get your facts right before expressing them on an open forum such as this.

W Farid

06/04/2009

To HealthyChristianRatepayer (11/03/2009),
Firstly, I think you should recognise that your proposed objective "to keep people in treatment" is clearly different to that of Dr O'Neil, which is to remove the need for future treatment is markedly different. Notwithstanding the benefits from the Swiss/Dutch prescription heroin model, I would presume this is in comparison to a lack of treatment or other treatment programs. In addition, I am not aware of any comparative studies between heroin prescription and sustained-release naltrexone. Regardless, I think it is fair to presume that health and social outcomes from abstinent patients would be superior to outcomes from patients receiving prescription heroin.

Your comments regarding counselling demonstrate that you have a limited understanding of the issues surrounding addiction. Implementing mandatory counselling for patients receiving naltrexone implants would be considered by most health professionals as a responsible course

W Farid

04/04/2009

Carol (12/03/2009) failed to mention that her son died in the U.S.A. while undergoing treatment with a new experimental naltrexone implant which according to her involved poor/no post-implant monitoring by the doctors involved. This, to me, translates as poor clinical practise by the doctor(s) involved and resulted from the used of an understudied preparation which did not provide sufficient prophylaxis.

Carol is not referring to the implant used by Dr O'Neil which has been studied extensively in preclinical and clinical trials, with, to my knowledge, research for safety and efficacy still being undertaken to this day.

My continued condolences for your loss Carol.

Carol

18/03/2009


Oxycontin deaths, methadone deaths, heroin deaths, cocaine, fentanyl etc, are many times Naltrexone treated patients.

Naltrexone does have potential for abuse, in street use, prisons , and private practice or funded programs.

Naltrexone is an old drug, it came to market as nothing more then a "theory" as was reported by the NIDA and also the dangers of implants.

Naltrexone was tested against 25 mg. IV HEROIN in trials and did not complete trials due to "poor patient compliance".

Naltrexone was approved by the FDA AS SAFE FOR ALCHOHOL ABUSE, NOT drug abuse.
Naltrexone deaths never receive Media attention, but the bogus ' cure'
did.

Early studies were said to be for ' Selected , Highly motivated PATIENTS' with Very Close Supervision by doctors who treat these patients , NOT THE GENERAL PUBLIC FOR TREATMENT OF DRUG ADDICTION.

The Implants have been proven harmful and deadly in trials.
You do not have to over ride the Naltrexone to be dead .

carol

12/03/2009

My son had a Naltrexone Implant 10 yrs ago when we did not know it was experimental.
He was dead within 2 months.
His autopsy read accidental overdose with no report of the Implant or levels of Naltrexone in his system as they report any other treament or drug found at autopsy.

Healthy Christian Ratepayer

11/03/2009

Part 2 ( strangely got cut off )
The most effective way to keep people in treatment is the Swiss /Dutch prescription heroin program...
This may be a lil hard for those who believe its their duty to inflict heaven
on us all, to wrap their brains around..
But what else can you possibly have to say about a treatment that
cuts disease by 50% ,allows addicts to be functional and working ( many report feeling ill from the toxicity of methadone)pay their taxes, contribute to society ,eliminate drug dealing ( no market, no supply )
..I dont know in which evangelical utopia these people would have us live??? Ban McDonalds coz its making our kids fat/diabetic?,Ban Parachuting in case chute doesnt open?Ban milking the cow in case we get trampled to death?Ban fishing in case you hook your eye out?
The "war on drugs" is killing/hurting more ppl and society more than drugs themselves...Control and Regulation will always succeed better than prohibition and punishment..

Healthy Christian Ratepayer

11/03/2009

The problem with Naltraxone and Dr Oneill is ,he says it (the implant) works in conjunction with counselling (quote)" no choice counselling" (meaning coerced into treatment).Many addicts are polyusers and so many opiate addicts switch to meth/amphetamines (a much worse drug on health and society)after being "treated" ,or are switching to injecting prescription drugs
Either the drug "works" or it doesnt...saying it works in combo with prayer and other hocus pocus is about as close to evidence based science he seems to want to get...
I want to know, what happens to the plastic when it dissolves into the bloodstream...will it prove carcinogenic?
Also i believe the housing is just a pool of recyclable statistics /guinea pigs on demand..a bunch of desperate "losers" who ought to shut up n be grateful for being cut open and given as many human rights as afforded to a lab rat.The most effective way to keep people in treatment is the Swiss /Dutch prescr

Joanie Sanderson

24/02/2009

I am a Counsellor working with families who suffer with addictions, watching the dispair of clients trying to come of drugs and get their lives together is hard. we have such a big problem in this country and Dr George O Neil is trying to address this great need with his Naltrexone implant I have read up on it and really believe not only that he should receive funding this is going to save millons of dollar in the long run because if we can help the addicts we can help a whole family who will also suffer the effects of stress and sickness due to the addicts problem... Dr O'Neil is an awesome man and I commend him and his family and staff on the wonderful work they are doing.

Nola

05/02/2009

This wonderful man is basing his claims on hundreds of changed lives and the tears of joy from mothers everywhere

chandra

02/02/2009

Let's hope the Premier can see the sense in funding this worthwhile and life saving program. I agree that the drug needs to be registered with the TGA and hopefully this will eventually happen when the poor doctor has sufficient time, funds and staff to enable this. In the meantime he is facing an uphill battle and there is a very real chance that people will die if they cannot receive the help they need. Come on everybody, naltrexone DOES work - read the research on oral naltrexone for a start, ask the addicts lining up at the clinic why they come back for successive implants - because it WORKS. Sometimes the temptation to use between implants in the beginning is overwhelming but this is not failure, this is human nature, wanting to have the best of both worlds. As people adjust to a new way of life and see the benefits of remaining opiate free they eventually stop returning to the clinic and this a win/win situation for all concerned - the patient, the clinic and the community.

anonymous

21/01/2009

One group of people who will be upset if Naltrexone implants are stopped are the drug mules who get implants to protect them against overdose if one of the condoms full of heroin bursts in their stomach.

anarchar

20/01/2009

As far as I know these implants have not been given TGA approval for use in humans (I think they have been designed for animals). If this is the case I suggest that the good Doctor backs up his claims with some evidence based, peer reviewed research and gets TGA approval for use in humans.

kerryn

19/01/2009

Mixed feelings! Yes but no! Funding should be based on evidence based clinical research, tried, tested and evaluated. I work in the D&A Sector and have heard mixed comments from clients- some it works others it doesn't. i do however believe a shift away from methadone and Subutex/ Suboxone substitution, would be beneficial to clients wanting to cease their drug use. Methadone unfortunately becomes addictive. My thoughts on Naltraxone are mixed. Because yes it stops cravings, but to be prescribed clients need to be detoxed from Opiates. if a client has acheived detox and withdrawal. Why substitute with another drug??? Maintenance programs already exist.

Damon Brogan

19/01/2009

Naltrexone has TGA approval for treating alcohol dependence, not opioid dependence, and I am not aware that the implant delivery technology has been approved for either. Were there hard scientific evidence to support the continued use of this technology for the treatment of opioid dependence, perhaps it could be welcomed as an addition to available treatment options. But all these years and no independent, peer-reviewed evidence? Bin it.

st.eve

19/01/2009

Naltrexone has shown itself to be a failure in treating people with an addiction to opiates. Naltrexone stops most, but not all, opiates from having an effect on the user -but does nothing to help the user deal with their cravings. It is this craving for drugs that needs to be managed if someone is to cease their drug use - the 2 other pharmacotherapy options for opiate addicts Methadone and Buprenorphine have shown themselves to be better than Naltrexone in reducing the craving for opiates.

It should also be borne in mind that Naltrexone dramatically reduces tolerance to opiates - as soon as the implant becomes inactive (and there is no way of predicting precisely when this will be) the user is at an extremely high risk of fatal overdose should they return to using opiates.

All in all - Naltrexone has shown itself to be a costly and ineffective way of treating opiate addiction. The government should not be expected to subsidise such ineffective and potentially fatal treatments.

Peter O'Loughlin

18/01/2009

Prior to expending more taxpayers money on yet another 'silver bullet' treatment, one should consider the objective and independent views of the authorative Cochrane report into naltrexone, (NXT) which concluded that the studies supporting it did not provide an objective evaluation of NXT treatment.

Nor should we overlook the findings from Australia which reported that research on NXT implants there had not followed the usual scientific processes.

Shirley Cook

14/01/2009

Surely anyone can see that it is better for the government to help fund this than to have to keep paying out for the crimes and prison sentences of addicts? These are people who want to be off their drugs. There are many people who have benefitted greatly from this treatment, and the government is saying they want to get tough and do something about the drug problem. Here we have a man who has been trying to help these people and paying for it from his own pocket. These people do not have the money to pay for their treatment. Their families either can't or won't pay. So the O'Neill family suffers to try and help these people. For all those who knock this program and are against it's funding, think what you would like if you or one of your family were affected by addiction. It can happen to anyone, anywhere, of any background. George O'Neill is not anti anyone, he is a man who loves all and is just trying to help those unfortunate enough to have addictions. Lobby the government for help

Katie

13/01/2009

Dr O’Neil and the Naltexone implant have helped hundreds of heroin addicts kick their addictions Naltrexone is NOT an experimental drug….Oral Naltrexone has been around for years and IS approved by the Therapeutic goods administration. The trouble with the oral tablet is the patients forget to take it. The implant provides a slow release of the Naltrexone and will keep the patient covered for 6 months by BLOCKING the brains receptors to heroin. So basically the patient will no longer crave the drug. Dr O’Neill and his Fresh Start Recovery Programme then help the patient turn their life around by helping them into houses and employment.
This treatment is life saving and a breakthrough…..and I have never understood why the government will not fund something that is clearly working. 3 million is nothing compared to the cost of drug fuelled violence and crime.
I hope Mr Barnett sees sense and allocates funding to the clinic.

Owen

13/01/2009

Naltrexone is an opioid receptor antagonist used primarily in the management of alcohol dependence and opioid dependence.
Its use in alcohol (ethanol) dependence has been studied and has been shown to be effective[2]. Its mechanism of action in this indication is not fully understood, but as an opioid-receptor antagonist it's likely to be due to the modulation of the dopaminergic mesolimbic pathway which ethanol is believed to activate.
There are a number of practitioners who will use a naltrexone implant placed in the lower abdomen, and more rarely, in the posterior to replace the oral naltrexone. This implant procedure has not been shown scientifically to be successful in "curing" the subject of their addiction, though it does provide a better solution than oral naltrexone for medication compliance reasons. Naltrexone implants are made by at least three companies, though none are FDA approved.
(Wikipedia)

Bec

13/01/2009

Naltrexone is a highly experimental drug that removes a bodies ability to process heroin. The person with the implant feels no 'high' if they consume heroin, but they can overdose off an extremely small dose (usually much less than the patient is used to taking). This treatment is useless and dangerous without dedication from the patient to actually stop - therefore making it pointless. A single Doctors egomania is no reason for funding to be given.

Mike

13/01/2009

The funding has been rejected due to lack of evidence, do a clinical study and he'll get his funding. The Government has already given out significant funding to this guy, now repay the Government and provide some hard evidence.

crystal

13/01/2009

This man isperforming a service that is undoubtably valuable to all of the community, and yet again our blinkered decision makers take the populist and easy way out and put a stop to it.

The amount of damage caused to people and property by alcohol use and abuse far outweighs the cost of a program like this...its time we take a harm minimisation plan to all drugs.

jier

13/01/2009

What is 'Nalfrexone'. Not one reference to what it is or what it is supposed to do!!!!

Hampe

13/01/2009

Is this treatment experimental?

Jan Damave

13/01/2009

This great man deserves all the help from the government he can get. He is saving lives and are not all lives equal?

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