Paying More for Drugs at TrumpRx

 

TrumpRx: Where to Pay a Lot for Drugs

A recent announcement by the Trump administration promotes a new government website, TrumpRx.gov as a means to lower prescription drug costs for consumers.

As presented in the link, the TrumpRx site lists 43 drugs and details savings. (All 43 drugs are listed at the end of this post). The site connects consumers to where the drugs can be purchased in their brand name form directly from the big pharm companies using coupons and by paying cash out of pocket.

The site is a sham. It will regularly have the consumer paying more for the drugs than when purchased elsewhere, often a lot more.

Along with providing examples of the additional costs for many of the drugs at TrumpRx, I will provide advice on getting lower cost drugs. The CBS article that I referenced above does not provide a critical analysis of the increased costs of using the Trump website.

What Determines How Much You Will Pay for Drugs

I have taught medical students about drug prices for over twenty years.

First, a bit of orientation to the subject. The major determinants of how much you are going to pay for a given drug are: 

1. where you live or where you are making the purchase.
2. whether you have insurance, private or government, and whether the drug is partially or fully covered by that insurance.
3. whether the drug is available in a generic form.
4. whether you have coupons or qualify for discounts from the drug manufacturer.
5. whether you can take advantage of such cost-saving strategies as pill-splitting.

I will address each of these.

  1) The TrumpRx website assumes you live in and are purchasing drugs in the United States. Fine, if that is your case. This post is directed to you and your circumstances. 

  2) If you have insurance and the drugs are covered fully or partially by insurance (including Medicare and Medicaid) then the numbers cited as savings by TrumpRx aren't related to your situation. 

  3) The TrumpRx site only directs the consumer to purchase drugs that are brand name and directly from companies that make a big, sometimes huge, mark-up. I will give examples of those mark-ups below. Generic drugs save a lot. 

So are generic drugs equivalent to the brand name drugs? Drugs are three things: they are chemical entities, they are amounts (such as 50 mg), and they are formulations (pill, extended release pill, capsule, injection, etc.). A generic drug that is the same chemical entity, amount, and formulation is equivalent to the brand name. And it is a LOT cheaper.

  4) Drug companies often put out coupons or else have special programs for those who can't pay the full retail price. This is the only savings matter addressed on TrumpRx. TrumpRx links to the big drug manufacturers where individuals can get a direct discount by paying out of pocket.

  5) Finally, there are additional cost-saving measures such as pill-splitting that, if the current administration encouraged, could save the consumer a lot. Rather than go into this matter in detail, I'll present the rationale and how-tos in this link. 

The Non-Savings of TrumpRx

When I went to the site to scan the claimed savings, a number of drugs jumped off the page. 

Let's start with pantoprazole (brand name, Protonix). Pantoprazole is a powerful suppressor of stomach acid production. It belongs to a class called proton pump inhibitors or ppI. It is likely that a patient prescribed this could also be prescribed another ppI, a cheaper drug in this class, or even a drug in a related class that has the same effects. But, for the sake of argument, let's say you need to buy pantoprazole, the only ppI on TrumpRx. If you go through TrumpRx, you will buy it from Wyeth Pharmaceuticals, a subsidiary of Pfizer, and you will be buying the brand name, Protonix. 

This is the information given at the TrumpRx website. 

Protonix: Original price: $457.28. TrumpRx price $200.10. Savings $247.18. These costs are for 30 pills (once a day) and 20 mg.

The TrumpRx site also gives the same prices for 30 pills and 40 mg, and a slightly different price for packet versus delayed release. 

So, let's say you buy Protonix in its generic formula, pantoprazole. I'm going to choose Walmart prices for comparison, not because they are the absolute cheapest, but because they are representative of providers with lower-end costs, and because Walmart stores are ubiquitous. Other stores may save you more with coupons.

According to GoodRx.com, Walmart charges $14.94 for 30 pantoprazole pills at 20 mg. 

For 30 pills of 40 mg, the price is $15.66. With pill-splitting, this works out to $7.83 for a 30-day supply. 

So, let's compare. 20 mg pantoprazole, 30 days.

Manufacturer's original price (from TrumpRx page): $457.28

TrumpRx price: $200.10

Walmart plus pill-splitting: $7.83. 

TrumpRx represents a 2556% markup.

A typical TrumpRx coupon.

I was thinking of doing this for a bunch of the drugs on the list, but I think that would be beating a dead horse. Instead, I'll do one more. 

When I first looked at the list of drugs, being in alphabetical order, the first ones that jumped out at me were Azulfidine in two formulations. I recognized it as being available generically and it seemed cheating that Trump Rx was claiming the same drug twice just based on whether or not you wanted extended release tablets. 

Azulfidine (brand name) is sulfasalazine (generic name). Sulfasalazine is used for rheumatoid arthritis, Crohn's disease, and ulcerative colitis. Typical dose is 500 mg, 3 to 4 times per day.

TrumpRx says: Original price: $199.20. TrumpRx price $99.60. Savings $99.60. This is for 120 pills (three or four times a day, approximately a one-month supply) and 500 mg.

According to GoodRx.com, Walmart charges $31.94 for 120 pills at 500 mg. 

So, let's compare. 500 mg sulfasalazine, 120.

Manufacturer's original price (as referenced in TrumpRx): $199.20

TrumpRx price: $99.60

Walmart: $31.94.

TrumpRx represents a 212% markup. 

And When it's Brand Name Only, the Savings are also a Lie

For some drugs you have no choice but to go with the brand name and pay the manufacturer prices. Let's look at Wegovy (brand name), an antidiabetic and weight loss drug, for example. With brand name only drugs, the savings can be real. Or not. Manufacturers regularly present discounts all on their own and the numbers presented on TrumpRx are lies. 

This news story is dated 11/17/2025.

"The Danish drugmaker is lowering the price of the drugs for existing cash-paying patients to $349 per month from $499 per month. . . . Also on Monday, Novo Nordisk launched a temporary introductory offer, which will allow new cash-paying patients to access the two lowest doses of Wegovy and Ozempic for $199 per month for the first two months of treatment." 

This is echoed at the TrumpRx website: 

Wegovy, Original Price: $1349.02. (exactly $1000 more than what was mentioned in the November article) TrumpRx Price: $199.00. You have to read the note below to get the actual price. "New patients pay $199 for the first two monthly fills of Wegovy® (semaglutide) injection 0.25mg and 0.5mg, then $349/month." 

The $349 price is described in the above news article as something negotiated by Trump back in November. However, if you use the previous price, $499, you have a savings of 30%. The $1349.02 original price is a lie.

Tallying Them Up

So, how many of the drugs on the TrumpRx website are available as generic? This requires judgment calls. For example, Airsupra (brand name) is a combination of two generic drugs. It is only available as a combination in brand name and for a lot more money than taking the two generics individually.

With that in mind, this is my tally from their list, 1 drug was discontinued in 2023, 3 are listed twice in different formulations (so, in actuality, there are 40 different drugs), 12 are not generic in any formulation, 3 more are not generic in the particular presented formulation, 1 is a judgment call to call generic (recombinant FSH), 3 are combinations of 2 generically-available drugs, and 25 are available as generic in the given formulation.

The Drugs.

Abrilada pen. Available generic, but not as a pen administration device.

Airsupra. A combination of two drugs, albuterol and budesonide, both available as generic (and cheap).  

Azulfidine Tabs and Azulfidine En Tabs. Available generic, sulfasalazine. 

Bevespi is not generic.

Cetrotide available as a generic, cetrorelix acetate.

Chantix available as a generic, verinocline.

Cleocin available as a generic, clindamycin.

Colestid available as a generic, colestipol.

Cortef available as a generic, hydrocortisone. (FDA approved in 1952)

Cytomel available as a generic, liothyronine. (we teach this drug as not recommended)

Diflucan available as a generic, fluconazole. 

Duavee is not generic.

Estring. Available as a generic, but not in its "ring" device.

Eucrisa is not generic.

Farxiga available as a generic, dapagliflozin. 

Genotropin. A complex matter, but simplest to say not generic.

Gonal F. A complex matter. It is a recombinant FSH. Other forms of FSH are generic.

Insulin Lispro is actually the generic form!

Levoxyl is available as a generic, levothyroxine.

Lopid is available as a generic, gemfibrozil.

Medrol is available as a generic, medroxyprogesterone.

Ngenla is not generic.

Nicotrol. A discontinued drug (2023). Still, TrumpRx gives a price of $271.16.

Ovidrel is not generic.

Ozempic Pen is not generic.

Premarin is available as generic, conjugated estrogens.

Premarin Vaginal Cream form is not generic.

Prempro is a combination of two generic drugs, conjugated estrogens and medoxyprogesterone, both listed above. There is not a generic form that includes both together.

Pristiq is available as a generic, desvenlafaxine.  

Protonix is available as a generic, pantoprazole. 

Tikosyn is available as a generic, dofetilide.

Toviaz is available as a generic, fesoterodine fumarate.

Vfend is available as a generic, voriconazole.

Viracept is not generic. (surprising. It could be generic.)

Wegovy is not generic.

Wegovy Pill is not generic.

Xeljanz is available as a generic, tolfacitinib. 

Xigduo Xr is available as a generic, a combination of dapagliflozin and metformin.

Zarontin is available as a generic, ethosuximide.

Zavzpret is not generic.

Zepbound is not generic. 

Zyvox is available as a generic, linezolid.

Martin Hill Ortiz is a professor of pharmacology and author of several novels. 

My new novel, In the Shadow of the Tower, the third in the series, The Skyline Murder Mysteries, is now available for pre-order on Kindle. It will be available as a paperback. 

A nation on edge. A city crawling with gangsters. A plot that could change history forever.

Miami, 1933. The nation is in the grip of the Great Depression, and former New York World reporter Alan Priest is struggling to survive as a freelance journalist. His wife, Lorraine, once a sought-after magazine model, is watching her own career fade with the times. Together, they are drawn into a dangerous investigation that reaches far beyond headlines and photographs.

When Alan and Lorraine uncover a mob conspiracy to assassinate President-elect Franklin D. Roosevelt, they find themselves racing against time—and against forces far more powerful than they imagined. To stop the plot, the intrepid pair must navigate a maze of corruption, betrayal, and shifting loyalties, battling ruthless gangsters and questioning even those who claim to be allies.

The first two in the series, Floor 24 and The Missing Floor, are available in multiple formats, including as audiobooks. The audiobook of Floor 24 has quite a complimentary review here.

Available for preorder

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The Death of Marilyn Monroe: Pharmacological and Medical Notes

I've taken a hiatus from my posts regarding Robert F. Kennedy, Jr. and his attacks on Dr. Anthony Fauci and science in general to evaluate some other conspiracy theories.

The Death of Marilyn Monroe.

In this post, I apply my experience in pharmacology to the death of Marilyn Monroe, another person whose official determination of death by suicide has been challenged, and whose actual means of death has been claimed to be part of a conspiracy.

Spoiler alert: I cannot say definitively that Marilyn Monroe was not murdered. I can comment on whether the pharmacological evidence is consistent with a self-administered and suicidal drug overdose. 

The Case

The undisputed facts. Alright, some conspiracy theorists out there dispute everything, and to be fair, some "undisputed" facts turn out to be incorrect. Some diversions from the presented times are apparent in different primary sources. Nevertheless, I have to proceed from some platform, and for the purposes of my analyses, there is little difference.

Marilyn Monroe's lifeless body was discovered at approximately 3:05 a.m. on August 5, 1962. She was pronounced dead at 3:35 a.m. From advanced rigor mortis, she was determined to have been dead for several hours, sometime during the evening of August 4. She weighed 53 kg (117 lbs.) at time of death. 

Medical Examiner's Death Report, Thomas Noguchi

According to the Los Angeles Police Department Death Report. "A bottle marked 1½ grains Nembutal [pentobarbital], prescription #20853 and prescribed by Dr. Engelberg, and referring to this particular bottle, Dr. Engelberg made the statement that he prescribed a refill for this about two days ago and he further stated there probably should have been about 50 capsules at the time this was refilled by the pharmacist." One and one-half grains equals 100 mg pills. Another source says the bottle contained 25 100 mg pills.

The following values of drugs were found, postmortem. 

Plasma levels of pentobarbital (Nembutal): 45 ug/mL. Hepatic tissue levels of pentobarbital: 130 ug/mL suggesting an accumulation over time. (Note: plasma levels, rather than blood levels, are what are commonly reported. For the purposes of any analysis relevant to this case, plasma levels equal blood levels.)

Plasma levels of chloral hydrate: 80 ug/mL. (Note: this probably referred to trichloroethanol. Chloral hydrate has a half-life of approximately 5 minutes and then becomes its active form, trichloroethanol.)  

Pertinent to the absorption of the drugs, the gastrointestinal tract, the stomach, small intestine, and colon were examined and described in the autopsy. 

"The stomach is almost completely empty. The contents is brownish mucoid fluid. The volume is estimated to be no more than 20 cc. No residue of the pills is noted. A smear made from the gastric contents and examined under the polarized microscope shows no refractile crystals. The mucosa shows marked congestion and submucosal petechial hemorrhage diffusely. The duodenum shows no ulcer. The contents of the duodenum is also examined under polarized microscope and shows no refractile crystals. The remainder of the small intestine shows no gross abnormality. The appendix is absent. The colon shows marked congestion and purplish discoloration. The fecal content is light brown and formed." Source.

The Drugs

Pentobarbital is a barbiturate, popular in the 1960s as a sleep and anti-anxiety medicine. It is highly addictive and easy-to-overdose. These pills had the nickname "yellowjackets" due to the yellow coloring of some of their doses (although the 50 mg capsule was orange). They were available as 30, 50, and 100 mg capsules. 

Pentobarbital was recommended for no more than short term use as a sleep aid: beyond addiction, the patient becomes tolerant to its effects, requiring more to obtain the same effect. Although 100 mg was commonly given as a sleep aid, up to 500 mg per use could be prescribed. 

The fact that it was commonly prescribed at the time was poor medicine on the doctors' part. A special drug-dependence committee set up by President Kennedy in 1962, concluded that there may have been as many as 250,000 Americans addicted to barbiturates.

Pentobarbital has largely been replaced by the safer (but far from perfect) benzodiazepines.

To determine the significance of plasma levels of drugs in the blood, several properties of the drugs are required. These are the volume of distribution, the bioavailability, the half-life, and the toxic and lethal levels. These can be obtained from the literature. For pentobarbital, the volume of distribution is 0.6 L/kg, or, for Ms. Monroe at time of death, 31.8 liters. The bioavailability (percent absorbed) is 95%, close to the entire dose. The half-life is 5.1 days. The toxic and lethal levels will be discussed in the next section. Oral or rectal pentobarbital takes approximately 20 to 60 minutes to induce sleep. 

Chloral hydrate has been around since the 19th century when it was a common addiction among those using it as a sleep aid. It is notorious for being a "black-out" drug, a "Mickey Finn" slipped into drinks to kidnap and sequester sailors, into victims' drinks as an early sort of "Ruffie," and it made a great additive to a drink in action stories when the bad guy wanted to knock out the detective. 

The volume of distribution of chloral hydrate is similar to that of pentobarbital, 0.6 L/kg. The half-life of its active form is approximately 9 to 10 hours. Its bioavailability is nearly 100%. Source. An oral dose takes approximately 30 to 60 minutes to induce sleep. 

Analyses

Question #1. Approximately how much of a dose of pentobarbital had to be absorbed into Ms. Monroe's blood to achieve her plasma level of 45 ug/mL? 

First of all, it cannot be said from the available evidence when she took her dose. Could she have had a lingering value of pentobarbital in her blood from a previous dose which was supplemented by a fatal dose? Possibly. 

However, the total dose she took, as seen in her plasma concentration, can be calculated: concentration x volume of distribution/bioavailability. (31.8 liters x 45 ug/mL (or 45 mg/L) / 0.95) This would work out to approximately 1500 mg. (1.5 grams or fifteen of her pills) (Note: people are variable and literature figures do not necessarily match an individual.) 

Question #2. Was that dose lethal? 

This is a more complicated case than that of Kurt Cobain. Monroe took two drugs, two CNS depressants, and the combination of drugs is possibly what caused her death. When determining lethal doses, few, if any, studies look at multiple drugs taken at the same time (much less a specific pair of drugs), so studies that examine single entities and their lethal dose values are only suggestive.

What do studies say about the lethal dose of pentobarbital? Ms. Monroe had 45 ug/mL of pentobarbital. Pentobarbital can put a person into a deep coma with cardiovascular compromise at 30 ug/mL although one case study found a patient surviving a dose of 116 ug/mL (ibid). Conclusion: by itself, it could have caused death.

Question #3. How much chloral hydrate did Ms. Monroe likely take? 

Figuring in her weight and the trichloroethanol concentration, I estimate she took 2500 mg (2.5 grams) of chloral hydrate, between four to six times the recommended dose. One thing to note here is the term "average." After dosing, people do not necessarily have the average concentration. What can be said is that Ms. Monroe did not have an absurdly high number and could have well have taken chloral hydrate at her usual dose for sleep, rather than trying to kill herself through the dosage. From the rate at which she used chloral hydrate from her prescription, it appears not unusual for her to take ten at a time. Unlike the figure given for pentobarbital which has a relatively long half-life, her dose of chloral hydrate was probably taken recently and does not reflect an accumulation from previous days.

This article states that 4 grams of chloral hydrate is typically toxic to an adult and 10 grams typically fatal. However, as the article points out, people vary with some surviving up to 28 grams. 

The chloral hydrate by itself was not likely fatal.

 

Question #4. What is the significance of the empty stomach and the lack of discoloration of the feces? 

As mentioned above, the stomach is a way station. Any ingested pills would have to be dumped into the small intestine before being absorbed. 

The medical examiner Thomas Noguchi (still alive at 98) addressed the lack of pills or pill residue in her stomach in an interview. 

Noguchi: The autopsy found a large amount of Nembutal and chloral hydrate [in her blood and liver], but the case wasn't typical because the stomach was empty. I did not see any residue, although the stomach and gastric lining were much reddened. But this is standard for barbiturate abuse. And this was not the first time we'd seen an empty stomach. Like the liver, it gets used to handling the drug and passes it quickly into the small intestine. 

Marilyn Monroe biographer Donald Spoto, argued it was significant that the stomach did not show any pill residue, suggesting that the drugs were delivered by enema. No drug residue was described in the colon and the feces were firm and of normal color.

My Best Estimate of What Happened.

Marilyn first took her primary sleeping agent: chloral hydrate. She took several times the regular dose so that she would not wake up from any effects from the drug with which she intended to end her life: pentobarbital. 

When a lethal dose of drugs are taken orally, the effects are not immediate. In this case, even the sedation would have taken a half-an-hour. 

There are many studies that look at the transition of drugs in overdose from the stomach to the intestines. This is an important field of research. If the drugs are still in the stomach, a stomach pump will still be helpful and so would induced vomiting. Once the drugs transit to the intestines, these interventions are marginally helpful.

This study of stomach contents after the ingestion of an overdose shows that the emptying time of the stomach is highly variable. Even within an hour after ingestion, sometimes you'll find the remnants of pills, sometimes you won't. 

After the pills reached her small intestine, they would have been absorbed until the point of death, when blood circulation, and therefore absorption, would stop.

The amount of pentobarbital in her blood was sufficient to kill her on its own, although death would not have been certain. The chloral hydrate added to its efficiency.

One surprise that came to me while performing this analysis is that Ms. Monroe's plasma levels of pentobarbital were equivalent to having taken 15 pills. Enough to kill her, but where were the rest? It is possible they were dissolved in the intestines, unabsorbed because absorption stopped the moment she had a lethal dose of the drug in her blood. With the prescription being two days old, it is possible she ingested some the previous evening. Finally, the 15 pills is not written in stone: such drug parameters as half-life and volume of distribution vary between people.

A final note. Pentobarbital has very different properties from the similarly named phenobarbital. I have seen the two confused in non-scientific commentaries.

Martin Hill Ortiz is a professor of pharmacology and author of several novels. 

My new novel, The Missing Floor, is now available from Oliver-Heber books. The first in the series, Floor 24, is newly available in audio book format. The audiobook has quite a complimentary review here.

The Missing Floor

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Some Notes on Conspiracies: Kurt Cobain and Marilyn Monroe's Deaths.

 

General Notes on Conspiracies and Notes on the Deaths of Kurt Cobain and Marilyn Monroe.

I've written 20 posts and over 35,000 words now on Robert F. Kennedy, Jr.'s book on Anthony Fauci. I'm halfway through the book and frankly I've skipped over a lot, in part because Kennedy repeats himself. What quickly became clear to me is that RFK Jr. is a conspiracy theorist, and a low-grade one at that. He consistently makes hyperbolic and tortured arguments that don't stand up to the slightest degree of scrutiny and which are often contradicted by the sources he cites. When the sources do agree, they are often books from other conspiracy theorists, YouTube videos, and websites. On one occasion I found him citing a neo-Nazi site.

I've begun reading Voodoo Histories by David Aaronovitch. I publicized it in my previous post. It has some good points but as I've continued on, I find it dissatisfying. 

After discussing conspiracy theories in general, he sets about tackling famous conspiracies, one after another. I feel as though by surveying so many, he fails to provide the depth that is needed to address any one of them.

My first disagreement came when he mentioned the case of Julius and Ethel Rosenberg in passing, saying they are both guilty. My understanding is that the general historical belief is that Julius was caught dead to rights, while Ethel was charged to make him confess. If his point was that there really is enough evidence to point to the guilt of both, he should have presented it. 

In one extended chapter he goes over JFK's assassination, and Marilyn Monroe and Princess Diana's deaths. In doing so, some of his dismissals of conspiratorial evidence comes across as glib.

Not that I blame him. The reason for such glib dismissals is built into conspiracy theories: they are near infinite in their scenarios and quite often those promoting the theories just make up crap. Trying to disprove infinite crap is problematic.

Let's look briefly at JFK's Assassination.

First of all, let me say that I am agnostic on whether JFK's murder was a conspiracy. I think there are aspects that point to a conspiracy and things that do not. I am not often humble, but I will say that I, pretending to know for certain what happened in JFK's assassination would be claiming insights beyond my sphere of knowledge.

Nevertheless, several things strike me. First of all, there are a thousand completely (or at least mostly) contradictory theories as to what happened. This means that 999 of these are wrong. If it was not the mob, then all those overheard mob confessions were boasts (lies) or inventions. If it was the mob, then those CIA second gunmen stories were false. I realize this is being simplistic. Some theories have the CIA by way of the mob. But there are also theories about pro-Castro, anti-Castro, Soviet Union, Illuminati, right wing, left wing parties, Lyndon Johnson, Richard Nixon (who was in town that day), George Bush, Woody Harrelson's and Ted Cruz's fathers, among many others. I read a book about an accidental round being shot by a member of the Secret Service entourage: a theory that negates all the others.

Which gets to the main problem: how to debunk the 999 false theories. It can't be done. Believing in Oswald as the lone gunman does have the advantage that it is a singular theory. 

Which gets down to this. Even if there is a true conspiracy theory, nine-hundred-and-ninety-nine other conspiracy theorists are selling you snake oil. 

I do not have expertise regarding rifles, the possibility of the trajectory of the "Magic Bullet," how the CIA or a dozen other organizations handle secret plotting. Using a common sense approach, Occam's Razor, etc., only gets me so far. 

This works both ways. I don't give credence to either those who debunk the Magic Bullet or to those who claim what happened by way of the bullet's trajectory was ordinary. I'm not saying who is right or wrong. I'm just saying I can't tell. Life is like that. All of us live in a limited bubble of knowledge. I have to accept that and yet I'm not ready to totally devote myself to some conspiracy guru and glom on to conspiracy theories just because I don't know.

Ultimately, I tend to fall back on a couple of maxims. I don't believe a conspiracy theory just because some expert has claimed it so, and I tend to believe incompetence explains more world events that supercompetent conspirators. I think it is useful for maintaining mental health to believe in the fewest conspiracies possible. 

Which also gets to the fact that I do have an area of expertise, much of which I have used in my critique of RFK, Jr.'s book. I am an expert in pharmacology, AIDS, and in a general sense, health sciences. I can sniff out phony statements in these fields. RFK's claims regarding hydroxychloroquine, AZT, ivermectin, his advocacy of injecting ozone, etc.: I can make definitive statements about these. 

I decided to direct my expertise to what can be said and what can and can't be said in regards to the pharmacology in two famous cases, both of which fit into conspiracy theories and books: the deaths of Kurt Cobain and Marilyn Monroe. Kurt Cobain is the simpler one, and I'll start there.

The Death of Kurt Cobain: Smells Like Bad Journalism.

When I teach my students the concept of the fatal dosing of drugs, I discuss the Kurt Cobain case. 

LD 50, lethal dose 50, is the dose of a drug that will cause death in 50% of individuals. It is measured either as dose administered, or as how much drug is found in the plasma. This latter number, given by concentration, is determined by post-mortem assay (if the subject died) or else the concentration that appears in the blood of high-dose survivors.

From a slide I present in class:

The author of "Who Killed Kurt Cobain?" said Cobain's death could only be murder. Cobain's blood contained 1.52 ug/mL heroin/morphine. (Heroin spontaneously breaks down into morphine by the time it is measured.)

The LD50 of morphine is 0.5 ug/mL.

The author states "This level [Cobain's 1.52 ug/mL] is widely known to represent three times the lethal dose of heroin. . ." and "a blood morphine level of 0.5 ug/mL is . . . the established maximum lethal dose, even for severe addicts." The author argues that the high dose of heroin would have been nearly instantly fatal or incapacitating and would not have permitted Cobain time to employ a shotgun to kill himself. 

I ask my students: What’s wrong with this argument?

There is a whole lot wrong with the author's brief statements. 

1. There is no such thing as a "maximum lethal dose." If you double that "maximum," it is still lethal. This book invented this nonsense term.
2. LD50 is the dose that kills 50% of individuals, not all of them.
3. Three times the LD50 has nothing to do with three times the lethal dose for any individual.
4. LD50 is not adjusted for "even in severe addicts."
5. LD50 does not address what is "nearly instantly fatal or incapacitating." Heroin kills by respiratory arrest. Not breathing does not cause instant death. He would have plenty of time to employ a shotgun, especially if it was already loaded and prepared.
6. The cited figure of 0.5 ug/mL is the LD50 determined in rats. Lethal dose studies do not generally take place in humans. The number determined in rats does not directly correspond to humans: it is an extrapolation.

Conclusion: the toxic values of heroin/morphine did not in any way prevent Cobain from committing suicide. I've not read the rest of the conspiracy book on Kurt Cobain's death. I do have a prejudice against his work due to the arguments in the field in which I am an expert, pharmacology.

Kurt Cobain's Suicide Note

Next Up: Marilyn Monroe.

Martin Hill Ortiz is a professor of pharmacology and author of several novels. 

My new novel, The Missing Floor, is now available from Oliver-Heber books. The first in the series, Floor 24, is newly available in audio book format. The audiobook has quite a complimentary review here.

The Missing Floor

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Kennedy's Citations

 

Kennedy's Citations

 I began my critique of Robert F. Kennedy, Jr.'s book on Dr. Fauci with an entry titled "Big Conspiracy." There are those who will wrap their arms over your shoulder and pretend to be your friend, all the while pointing to someone else, saying that "they are the real enemy." As you walk along, they will be robbing you. Usually they will point to an enemy that does have real faults. In Kennedy's case, he targets, at times, Big Pharm. 

These people scratch the itch of paranoia, blur the lines of reality, and make money from selling you their books and making speaking engagements. Sometimes they believe what they sell or at least convince themselves of their con. Robert Preston, as Professor Harold Hill (no relation), said, of believing his phony scheme, "There's always a band."

I cannot count Kennedy among the true believers. His arguments are so dishonest, so insincere and calculating, that I believe he must know he is lying. He will take a reference and claim it says the opposite that it does. He cloaks himself in famous names and quotes marginal sources as authorities.

This is clear in the citations that Kennedy has at the end of chapters. For a book purported to be about science, relatively few citations are from scientific studies. Instead, he quotes conspiracy books and conspiracy news articles. He cites YouTube videos that sell conspiracies. I'm surprised he doesn't cite his own book on Fauci as a source. (He does cite his website as a source of his information.)

For Chapter Six of his book, I decided to tally his citations, 180 in total. 

For his most common source, he cites anti-HIV books 39 times. These books have accusational titles and lengthy subtitles such as Peter Duesberg and the Duesbergians: How a Brave and Brilliant Group of Scientists Challenged the AIDS Establishment and Inadvertently Exposed the Chronic Fatigue Syndrome Epidemic. The book, Virus Mania: How the Medical Industry Continually Invents Epidemics Making Billions at our Expense had 24 citations by itself.

The full list of books cited is at the bottom of this page. 

He cites newspaper articles 36 times. This includes 25 of what I would term mainstream media, and others that are niche publications. On top of this, he cites pop magazines, such as Spin, 6 times, and a mainstream magazine, once. One pair of newspaper articles by Elinor Burkitt is cited 18 times.

Actual articles in scientific journals are cited 29 times, or 16.1% of the time. 

YouTube videos are cited 24 times. Blogs are cited 12 times.

The remaining groups of citations are less than five times each (drug insert, website, etc.)

This is not how a reasoned argument is bolstered. This is a person citing books every bit as incompetent as his own as proof of what he is saying. Kennedy never tries to present the other side of the argument, that HIV does cause AIDS, or look at its possible merits. He never cites a book that says such, or a newspaper article. He does cite Duesberg often, in support of Duesberg.

Full List of Books Cited in Chapter Six:

Peter Duesberg and the Duesbergians: How a Brave and Brilliant Group of Scientists Challenged the AIDS Establishment and Inadvertently Exposed the Chronic Fatigue Syndrome Epidemic

Virus Mania: How the Medical Industry Continually Invents Epidemics Making Billions at our Expense

Impure Science: AIDS, Activism, and the Politics of Knowledge, Rethinking AIDS: the Tragic Cost of Premature Consensus, Inventing the AIDS Virus

The AIDS War: Propaganda, Profiteering, and the Genocide from the Medical-Industrial Complex

Death Rush: Poppers and AIDS

AIDS: The Burden of History

The Chronic Fatigue Syndrome Epidemic Cover-Up: How a Little Newspaper Solved the Scientific and Political Mystery of Our Time

Dancing Naked in the Mind Field (no subtitle!)

Science Sold Out: Does HIV Really Cause AIDS?

A book on conspiracy theories and the damage they cause:

Conspiracies do exist. Probably at a rate of one per thousand conspiracy theories.

Martin Hill Ortiz is a professor of pharmacology and author of several novels. 

My new novel, The Missing Floor, is now available from Oliver-Heber books. The first in the series, Floor 24, is newly available in audio book format. The audiobook has quite a complimentary review here.

The Missing Floor

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RFK, Jr. and HIV, Part Three: Kaposi's Sarcoma and AZT

I am continuing my series reviewing Robert F. Kennedy, Jr.'s book on Anthony Fauci. In the last two entries (1, 2), I have been critiquing his many pages dealing with his many arguments that HIV is not the cause of AIDS. I continue this here. 

AIDS and Kaposi's sarcoma

On page 224, Kennedy begins a subchapter entitled Kaposi's Sarcoma with the statement, "In 1990, four leading scientists at the CDC suggested in the Lancet that Kaposi's sarcoma was common in young gay men who indisputably did not have HIV." (emphasis mine, the reason why, below) 

As is typical, Kennedy can't get anything right. He seems to be referring to this article which was published in the Lancet in 1990, Kaposi's sarcoma in HIV-negative homosexual men.  It had six authors but only one member of the CDC.

They did not find the phenomenon "common." The paper says that in 349 male homosexual or bisexual patients in a dermatology practice who had Kaposi's sarcoma, 6 had no signs of HIV infection. The "young" gay men averaged 45 years old. 

Kennedy goes on to say several times that Kaposi's sarcoma (KS) is the defining disease of AIDS. Pages 224 and 225: "KS—the disease most central to the definition of AIDS," ". . . KS was the initial and defining symptom of AIDS," "The very existence of AIDS was inextricably linked to KS," and "Kaposi's sarcoma was the AIDS-defining illness. 'In the beginning,' says Farber, 'AIDS was Kaposi's sarcoma.'" Kennedy does tend to repeat his points, add nausea. [sic]

Although I will allow that Kaposi's sarcoma's presence was found early on, it wasn't present in the initial report. It certainly wasn't the defining disease of AIDS as pointed out in an actual study by four members of the CDC published in Lancet in 1990. They came to the conclusion that "Among persons with the acquired immunodeficiency syndrome (AIDS) reported to Centers for Disease Control by March 31, 1989, 15% (13,616) had Kaposi's sarcoma."

Since one of the authors, Thomas Peterman of the CDC, was in on both studies, I assume that Kennedy confused the two papers, and somehow came to conclusions neither paper said.

Kennedy quotes Gallo in saying, "HIV . . . might only be a catalytic factor in Kaposi's: there must be something else." As I mentioned in a previous post, Gallo went down a rabbit hole looking at the protein "tat" as a cofactor in Kaposi's. 

The cause of Kaposi's sarcoma is now well-understood and involves the virus HHV-8 which becomes active in immunocompromised patients, much the way that HIV-caused immunodeficiency causes complications by cytomegalovirus.

AZT as Culprit

On page 225, RFK, Jr. begins a subchapter titled "AZT as Culprit" with "After 1987, Dr. Duesberg and his followers argue, the vast majority of 'AIDS deaths' were actually caused by AZT—Dr. Fauci's 'antiretroviral' chemotherapy purposefully concocted to kill human cells." The phrase "purposefully concocted to kill human cells" means tested as an antitumor agent (and not even in humans).

He goes on to say, "The FDA, after all, had deemed AZT too toxic to use for even short-term cancer therapy." (Page 226) This is a complete lie. Prior to being tested as an antiviral, AZT had been tested only in mice as an anti-leukemic. The FDA does not make such pronouncements of toxicity on human cancer therapy based on animal trials. Furthermore, as the original reports show, AZT did not fail due to toxicity, it failed due to not having sufficient toxicity against tumor cells. 

Jerome Horwitz was the main researcher who synthesized and tested AZT in the 1960s. To quote the account as presented in the Los Angeles Times, "When Horwitz tested AZT, or azidothymidine, on leukemic mice, nothing happened. He admitted defeat and didn’t think about it again until the mid-1980s, when scientists were randomly testing drugs in a frantic search for one that would combat AIDS."

To quote Horwitz directly in the journal article he wrote about it, "None of the synthetic analogues [including AZT] manifested significant activity when screened against L1210 leukemia in BDF mice," and there was "low cytoxic [sic, correctly cytotoxic] activity observed with these agents as anti-leukemia drugs." Low cytotoxic activity says that they were not toxic to cells.

Like many compounds that fail at one use, AZT became a repurposed drug. Before the outbreak of HIV, AZT was tested as antiviral back in the 1970s against a different virus and failed. 

Kennedy goes on to say, "Cancer patients typically take chemo agents for only two weeks. Thanks to Tony Fauci's Fischl study, doctors were now prescribing AZT for life!" (page 226)

Cancer patients will certainly be surprised to learn that they only take chemotherapy for two weeks. That statement is a slap in the face of chemotherapy patients who are enduring therapy for many months. 

AZT belongs to a class of chemical called nucleoside analogs. These drugs are commonly used for viral illnesses. There are 27 different approved nucleoside analogs and they are used for HIV, hepatitis B, hepatitis C, COVID-19, cytomegalovirus, herpes simplex virus, and varicella-zoster virus infections. These are not weird, highly toxic chemicals although, as with any drug, their toxicities should be kept in mind. 

AZT is not "highly carcinogenic." It is rated 2B in terms of carcinogenicity, "those that have been classified as possibly carcinogenic to humans."

With this as background, AZT has several significant toxicities. It can not only inhibit HIV viral replication but mitochondrial function. Among its chief potential toxicities are lactic acid build-up, fatigue, liver toxicity, and anemia. 

On page 228, in a subchapter titled "Is AZT Mass Murder?", Kennedy says, "The [AIDS] death rate climbed precipitously after the commercial introduction of AZT. In 1987, "AIDS deaths rose by 46 percent." He goes on to provide the numbers of deaths by year: 16,469 dying in 1987, 21,176 in 1988, 31,694 in 1990, and 37,040 in 1991." 

Lets look at the growth in the number of HIV infections. 

The estimated number of those 13 and older infected with HIV in the United States by year infected.
From: Bosh, et al, 2021

The numbers presented in the above graph are only estimates which is why the numbers are rounded off and repeated. (Before 1984, for example, there was no HIV test. Even after 1984, it was not universally applied and estimates have to be made of the number of those untested but positive.) Putting the above graph's figures into table format:

New HIV cases, US, by year.

1981 20,000

1982 60,000

1983 60,000

1984 130,000

1985 130,000

1986-1990 85,000 each year.

The ability to determine whether people were HIV positive and the ability to determine the safety of the blood supply began in the mid-80s and this event curtailed the increase in cases per year. Let's compare the two sets of data. Since HIV takes years to cause AIDS, the HIV line in the graph below represents HIV infection year plus six. The graph is mine.

Orange dots represent new HIV cases (plus six years) and blue dots represent AIDS deaths (Kennedy's figures). HIV cases increased at a much greater rate than death due to AIDS. AZT is certainly not the only reason why the AIDS death rates declined in comparison to the infection numbers. Care for AIDS patients improved over time, among many examples, prophylaxis for PCP pneumonia. Care could start sooner due to the knowledge of patients being HIV positive. It is likely that the early AIDS cases were rapid progressors with a more virulent virus: that is why they were found to have AIDS ahead of others. 

Another major reason for a continuing increase in number of AIDS deaths is due to the fact that AZT, when used a single agent, is a weak drug. 

AZT was never great. From March 1987 to October 1991, it was the only antiretroviral therapy approved in the United States. To address the main problem regarding AZT, I refer to another class of anti-HIV drugs, the NNRTIs. When the NNRTIs were discovered, they were immediately noted as being powerful anti-HIV drugs and relatively safe. However, the virus quickly gained drug resistance being fully resistant in a matter of weeks. On their own, they proved nearly useless. AZT is similar, however, its usefulness, on its own, lasted months, not weeks. 

AZT is still used as are the NNRTIs. In combination, resistant mutations of the virus have a much reduced chance of escape. Multi-drug therapy for HIV allows a patient to live nearly a full life equal to those who are HIV negative.  

Continued in Kennedy's Citations. 

Martin Hill Ortiz is a professor of pharmacology and author of several novels. 

My new novel, The Missing Floor, is now available from Oliver-Heber books. The first in the series, Floor 24, is newly available in audio book format. The audiobook has quite a complimentary review here.

The Missing Floor

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RFK and HIV, Part Two

I am continuing to look at the RFK, Jr.'s presentation about "the doubts that exist" as to whether HIV causes AIDS. In the previous entry, I looked at a number of miscellaneous topics in Chapter Five and focused heavily on RFK's arguments about Koch's postulates from 1890. 

Going through Kennedy's arguments is a frustrating task. He commits a sin that is commonly referred to as a Gish gallop. This is a means of arguing by throwing a hundred things out regardless of quality and expect the debater to waste time disputing minutiae. If the debater doesn't do this, he claims victory by saying that there was so much the debater did not address. 

As I've documented time and again, Kennedy often presents bat-shit crazy or wholly contrived arguments. I have undertaken many hours dissecting Kennedy's lies. There are many more I neglect. This should not be my life's work. He should be responsible for his own honesty. In a just world, he would correct himself. 

As noted in my last entry, Kennedy claims to be agnostic as to whether HIV causes AIDS. He does however, spend 65 pages presenting arguments that it doesn't, and dedicates no space to the arguments that it does. This is typical of his fake evenhandedness. 

In this section I'm going to go briefly over Kennedy's criticism of tests to determine whether someone has an HIV infection and then dive into Duesberg's alternative view of what causes AIDS.

On page 190, Kennedy says, "The most significant diagnostic tools doctors use to determine if someone is infected with HIV, and therefore, whether they have AIDS are:

1. HIV antibody test.

2. PCR viral load tests.

3. Helper cell counts. (CD4 cells)"

This is poorly worded. Infected with HIV does not mean the patient has AIDS as I discussed in the previous post. CD4 counts do not diagnose whether someone has HIV. They correspond to immunological status. And his list doesn't include tools that researchers use such as p24 antigen, culturing, full virus sequencing, or in some instances, electron microscopy. 

General Comment on Diagnostic Tests

First, let's consider a general matter about tests. No test is perfect. The television show "House," devoted whole episodes to trying to diagnose through testing and exam. There are four possible outcomes to any disease test. First is a true positive. That means the test shows someone has the disease and, indeed, that person does have the disease. Then there is the true negative. That means the test shows someone does not have the disease, and, indeed, that person does not. Then there are the unwanted outcomes. False positive. In this case the test shows someone does have the disease when that person doesn't. Finally, there is false negative. In this case, the test says the person does not have they disease when they actually do. 

The obvious idea behind a test is to have the true positives and true negatives vastly predominate. For a specific test for tuberculosis, false positives can range from 1-2% to higher, depending on the patient's circumstance and the study. This doesn't mean that Mycobacterium tuberculosis doesn't cause tuberculosis or that the test is useless. With science, uncertainty in any given approach goes with the territory. That's why the lawyers add provisos with the tests: this is not a definitive diagnosis. They don't want the test manufacturers to get sued.

There have been lawsuits from people falsely diagnosed as having HIV. To avoid these, the diagnostic exam companies add a disclaimer. This disclaimer results in something good (we do have tests) and something bad (the companies have less incentive to better their tests). As I said, no test is perfect.

Kennedy cites such lawyerly provisos to dismiss HIV tests as being useless and meaningless. Page 192, "Do not use this kit as the sole basis for detecting HIV infection." 

HIV Antibody Tests

Kennedy's first complaint is about the HIV antibody test. He throws out head-scratching arguments. "HIV antibody tests were not actually designed to specially to detect HIV." (page 191) Of course not. They detect antibodies. I have already commented on Kennedy's bizarro comment "High antibody level indicated that a person had already successfully battled against infection and was now protected from the disease." Such an argument says that every battle against diseases is successful. 

Kennedy includes this statement on how antibody tests are made which should make researchers laugh. (Page 190) ". . . the inventor must isolate the target virus and expose it to human cells in a petri dish, which then generate the specific antibodies responsive to that virus."

Kennedy says that "Gallo's antibody test also reacts to people with fever, pregnant women, and people who have overcome a tuberculosis infection." (page 190) Why Kennedy is still talking about Gallo's 1980s antibody test is one problem, but the notion of what percent of tests have false reactions is dealt with pretty well in this explanatory article. It depends on how prevalent the true local infection in HIV is. If you almost never have a true HIV infection locally, then many positive reactions are likely to be false. If it is common, then the likelihood of a false positive is diminished. That's the nature of disease testing. The source gives a 94.5% true positive rating for men who have sex with men in the United Kingdom. 

My ongoing frustration with Kennedy is that a mature and interesting discussion of these matters is both possible and informative.

PCR Testing 

On page 185, Kennedy starts a rant on PCR, a general method used to detect all sorts of illnesses and causative agents. He continues this in several spots, including page 190 and 191, with a subchapter titled "PCR Testing Deficiencies." His mind does jump around. 

So, what does PCR do? Every organism has genetic material that is specific to its species. In straightforward PCR (and there are many variants), you use a pair of segments of DNA (called primers) to amplify copies of a region of the genetic material of a specific organism. That genetic region represents a "DNA fingerprint" of the organism. PCR is also used in forensics to provide a sequence of genetic information that is unique to a particular human and which is considered definitive in criminal cases.

On page 191, Kennedy says, "The Polymerase Chain Reaction (sic) PCR technique does not measure the actual, live virus in the body . . ."  No, PCR doesn't measures "live" viruses. No one says viruses are "alive" by the standard definition of life, anyway. Perhaps he means to say "viable virus," or "infectious virus," but I shouldn't have to write his book for him.

Done right, PCR proves the presence of a specific organism's genetic material. 

As I said, PCR can be thought of as genetic fingerprinting much in the same way the genetic fingerprint of a criminal can prove the source of biological material. Blood on a glove. Semen in a rape kit. In the case of HIV, it is the genetic signature of the virus. Can something go wrong? I know of a case where the police mislabeled the blood samples and arrested a man because his voluntary DNA sample matched another tube of blood with his voluntary DNA sample. PCR can't overcome that. Contamination in the lab can screw up results. Otherwise, done right, PCR tests are a standard means for identifying the presence of a wide variety of infectious organisms, and can be used to detect mutations that exist in genetic diseases. PCR is one of the great inventions of the last half-century.

On pages 190-1, Kennedy cites Kary Mullis, the inventor of PCR to say, "Quantitative PCR is an oxymoron. PCR is intended to identify substances qualitatively, but by its very nature is unsuited for estimating numbers." Sorry, Dr. Mullis, yes (duh) PCR can be quantitative. There is an entire field called real-time PCR. It can be used for many diseases and is a standard means of measuring gene expression. Searching the Library of Medicine online, the phrase "real-time PCR" brings in over 100,000 papers. ("Quantitative PCR" as a search term brings in 48,000 results, although many of those are bound to overlap with the previous search.) Quantitative PCR has a very straightforward means of testing amounts in comparison to standardized controls of known quantities. 

There are different varieties of PCR which cover many different diseases including those that quantify gene products, disease organisms, and HIV.

Kennedy repeatedly says that PCR can only amplify viral fragments. While this is usually all that is necessary, this is a review of papers that look at full genome length amplification. 

CD4 Tests

Kennedy devotes only one short paragraph to discussing CD4 tests (page 192). He argues that CD4 counts are merely a surrogate marker and "The problem is the use of a surrogate endpoint, which is notoriously im- precise (sic)." I mostly agree. Surrogates are imprecise. That doesn't make them useless. My own experience with those with very low CD4 counts from patients is that they were at the end stage disease process. This was before 1995 and the arrival of powerful HIV therapy. Much fewer HIV patients have collapsed immune systems these days. 

Duesberg's Theory About What Causes AIDS and Kennedy's Homophobia.

On page 181, Kennedy writes: "In July 1981, CDC reported a unique outbreak of immune deficiency-related health problems in a group of highly promiscuous gay men in Los Angeles, New York, and San Francisco."

The above is an example of RFK, Jr.'s book includes a number of anti-gay snide remarks. Homosexuals are highly promiscuous! As he says, cited further below, they are all drug users. 

The July 3, 1981 MMWR publication (actually the second report of the phenomenon which would become known as AIDS) nowhere describes the cohort as "highly promiscuous." They are referred to as homosexual and the degree of their sexual behavior is not mentioned. The actual July 1981 report. 

On page 222, RFK gets around to commenting on the actual first report of what came to be known as AIDS from June of 1981. Kennedy states "The first AIDS cases were five gay men—all unknown to one another—diagnosed with a rare (PCP) pneumonia and Kaposi's sarcoma, a form of cancer that previously only afflicted elderly men." The actual June 1981 report. 

I clench my teeth here. Why can't Kennedy get anything right? None of the first five cases had Kaposi's sarcoma. 

Further down the paragraph on page 222, he references Dr. Michael Gottlieb (co-author of the first report, and, in part, a discoverer of AIDS) and goes on to say, "The men were all promiscuous party enthusiasts in the "fast lane" gay lifestyle" and "They daily had multiple anonymous sexual partners—upward of a thousand per year—and contracted most of the sexually transmitted diseases like syphilis, gonorrhea, and hepatitis B." 

What does the Gottlieb's MMWR paper say? "The five did not have comparable histories of sexually transmitted diseases" and "Two of the five reported having frequent homosexual contacts with various partners."

While Gottlieb did not say what Kennedy claimed, he did, however, in an interview, trash Duesberg and spoke of his own early work on AZT. (Warning: the link has auto-starting videos of the interview, so you might want to mute your computer if you merely want to read.)

GOTTLIEB: Disinformation and a false narrative did not originate recently. Peter Duesberg and his colleagues were ahead of the time in disseminating misinformation and a false narrative, for unclear motives. Duesburg and the AIDS deniers did a huge amount of damage and undoubtedly cost peoples' lives. [snip] Peter Duesberg is flat wrong. One has only to look at the success of ART in changing HIV from a death sentence to a manageable condition with projected longevity for young people that approximates what their lifespan would have been without HIV. The only thing different is the fact that they are treated with medication that addresses HIV specifically and not any other virus or factor in their lives. [emphasis mine]

GOTTLIEB: My message to them is to stop it.

The full paragraph and context of Kennedy's statement about Gottlieb and the promiscuous gays reads (Page 222). I include a commentary below this.

The first AIDS cases were five gay men--all unknown to one another--diagnosed with a rare (PCP) pneumonia and Kaposi's sarcoma, a form of cancer that had previously afflicted only elderly men. Dr. Michael Gottlieb, a researcher searching California hospitals for new diseases with unusual symptomology, is credited with the initial discovery and its epidemiological context. (the following sentence, with its repeat portion, is presented as it is in the book.) in  Los Angeles in 1981 by Dr. Michael Gottlieb, a researcher searching California hospitals for new diseases with unusual symptomology. The men were all promiscuous party enthusiasts in the "fast lane" gay lifestyle. They were taking many different recreational drugs simultaneously and combining drugs in excess of patterns among straight drug users. They frequented bars, clubs, and bathhouses. They had multiple daily anonymous sexual partners--upward of a thousand per year--and contracted most of the common sexually transmitted diseases like syphilis, gonorrhea, and hepatitis B. They were, therefore functionally addicted to a pharmacopoeia of antibiotic prescription medications; "all of that created a situation where a handful of gay men," say Mark Gabrish Conlan "were burning the candle at both ends and putting a blowtorch to the middle. It's no wonder that after a while, their immune systems started to collapse and they started getting sick in these unusual ways that previously only been seen in older people whose immune systems had deteriorated with age." 

There is a lot to unpack there. Old people do not get immunodeficiency diseases in any way similar to those with AIDS. Kaposi's sarcoma was not just known in "elderly men." Outside of AIDS, it has a very specific genetic and regional occurrence. Dr. Gottlieb was not "searching California hospitals for new diseases." You would think from the above paragraph that Gottlieb, a respected AIDS researcher, was the one claiming these men were "in the fast lane." The transition to Conlan's words are not clear. Conlan is a journalist. Where Conlan's quote came from is unclear, it is not among Kennedy's citations. 

Why does this matter? Kennedy puts forward the crackpot theory that it was through wild drug use that gay people destroyed their immune systems thus causing AIDS. This drug use was specifically tied to "poppers," which typically refers to amyl nitrite.

Kennedy (page 223) says that poppers "are very powerful oxidizing agents." They are moderately powerful oxidizing agents. They are used clinically for angina. He goes on to say they are "powerfully mutagenic and carcinogenic." They are not. And, "poppers are radically immunosuppressant in rodents." A study in humans show limited effects, reversible within a week. 

If poppers cause AIDS, I wonder what the act of telling whoppers causes? Kennedy offers this one. Page 223, "Prior to 1987, every AIDS patient acknowledged heavy consumption of poppers." 

Through 1987 there were 50,280 US cases of AIDS. That is remarkable that they all confessed to heavy consumption of poppers. Did they interview 5,000? Doubtful. And 100% confessed to using poppers? Including those who got AIDS from transfusions? Hemophiliacs? (My first work studied AIDS in children.) Of course, Kennedy's statement is completely made up. 

AIDS is not a gay disease. In the year 2000, for the US, 41% of those living with AIDS were infected by male-to-male transmission. This number is slightly exaggerated. Bisexual men with AIDS are often pigeonholed as to getting HIV through gay contact. 

More recently, among those newly diagnosed with HIV (2022), 67% were male homosexual or bisexual, 22% were heterosexual, and 7% were IV drug users. That is for the US and AIDS is a worldwide phenomenon. 

Refusal to Debate.

On page 218, Kennedy begins a subchapter on the refusal to debate HIV deniers and Duesberg called Refusal to Debate. I personally have been attacked as someone who has promoted the deaths of hundreds of thousands because of my views which align with those of Fauci. Kennedy himself presents subchapters titled AZT As Culprit and Is AZT Mass Murder? I personally believe that when Duesberg influenced South Africa to deny HIV treatment due to personally pressing his case that HIV does not cause AIDS, he helped cause hundreds of thousands of deaths, a figure presented in this article in the Journal of Acquired Immunodeficiency Syndrome. I cannot debate such a person. I have no respect for the things that come out of his mouth.

I go on to look at Kennedy's sections on Kaposi's sarcoma and AZT in my next installment. 

Martin Hill Ortiz is a professor of pharmacology and author of several novels. 

My new novel, The Missing Floor, is now available from Oliver-Heber books. The first in the series, Floor 24, is newly available in audio book format. The audiobook has quite a complimentary review here.

The Missing Floor

Continue reading →