NFIA's Drug Abuse Update Online

Time to Write the New England Journal of Medicine

August 21, 2001 – Legalization proponents are orchestrating a campaign to flood the New England Journal of Medicine with letters protesting the journal's publication of a letter from doctors at Children's Hospital Boston who call attention to several (legalization) websites that give out inaccurate, sometimes dangerous, medical information about the drug Ecstasy. We passed along their alert to the editor of the journal and asked that it be forwarded to the authors. In order to counteract legalization proponents' effort, a concerted response from the prevention, treatment, and medical and scientific communities seems in order. We urge you to take the time to write a letter to the journal expressing your appreciation for highlighting this problem. It's easy to do via email. The address is letters@nejm.org

Following are background materials that give you the whole story:

1. An alert sent from Mark Greer, of Drug Sense, to legalization proponents. The alert contains the New England Journal of Medicine article.

2. A note NFIA sent to the editor of the journal.

3. The journal's reply.

4. The lead author's reply

1. DrugSense Alert asking legalization proponents to write protest letters to the journal:

Doctors Try To Legitimize Failing Drug Propaganda
-------
PLEASE COPY AND DISTRIBUTE
-------
DrugSense FOCUS Alert #217 Wednesday August 15, 2001

Drug policy reformers have been much more successful than prohibitionists at distributing accurate, persuasive information on the Internet. Some prohibitionists are rightly worried about this, but instead of trying to check their facts or attempting to determine what makes a web site appealing, they have simply resorted to attacking reform-oriented web site. The New England Journal of Medicine recently published a letter from some doctors who are concerned that "partisan" sites are more popular than the allegedly impartial sites sponsored by the federal government. This analysis completely ignores the ideological basis of most government sponsored anti-drug sites, which in turn unmasks the clear bias of the authors.

Please write a letter to the editor of the NEJM to let them know that far from having a monopoly on drug truth, federal web sites are just another tool in the endless propaganda campaign of the drug war.

**********************************************

PLEASE SEND US A COPY OF YOUR LETTER OR TELL US WHAT YOU DID (Letter, Phone, fax etc.)

Please post a copy your letter or report your action to the sent letter list (sentlte@mapinc.org) if you are subscribed, or by E-mailing a copy directly to MGreer@mapinc.org Your letter will then be forwarded to the list with so others can learn from your efforts and be motivated to follow suit.

This is VERY IMPORTANT as it is the only way we have of gauging our impact and effectiveness.

**********************************************

Contact Info:

Source: New England Journal of Medicine (MA)

Contact: letters@nejm.org

Extra Credit

Reuters reported on this letter, and the story was picked up by at least one newspaper - The Arizona Republic. The story started this way: "Internet surfers are far more likely to come upon Web sites with wrong and potentially dangerous information about illicit drug use than they are to find more reliable, informed sites, a new study shows." Please send a letter to the Republic to challenge this interpretation of the letter.

Title: US: Drug Web Sites Provide Harmful Information - Study
URL: http://www.mapinc.org/drugnews/v01/n1469/a01.html
Pubdate: Wed, 8 Aug 2001
Source: Arizona Republic (AZ)
Copyright: 2001 The Arizona Republic
Contact: opinions@arizonarepublic.com
Details: http://www.mapinc.org/media/24
Website: http://www.arizonarepublic.com/

**********************************************

ARTICLE

URL: http://www.mapinc.org/drugnews/v01/n1473/a08.html
Pubdate: Thu, 9 Aug 2001
Source: New England Journal of Medicine (MA)
Copyright: 2001 Massachusetts Medical Society
Contact: letters@nejm.org
Website: http://www.nejm.org/
Details: http://www.mapinc.org/media/290
Authors: Edward W. Boyer, Michael Shannon and Patricia L. Hibberd

WEB SITES WITH MISINFORMATION ABOUT ILLICIT DRUGS

To the Editor:

As part of our research on the relation between the Internet and substance abuse, we have identified several Web sites that promulgate information about illicit drugs. These "partisan" Web sites are easily identified by common search engines if one uses the names of illicit substances as search terms. With some pages viewed more than 160,000 times per day, partisan sites appear to be effective in reaching adolescents and young adults. In a recent study, 24 percent of college students used the Internet to obtain information on illicit substances, and 27 percent of Internet-using college students reported that Internet use increased the likelihood that they would use drugs.

The popularity of partisan Web sites may arise from their plausible descriptions of the preparation, dose, administration, and psychoactive effects of drugs (Table 1 ). Partisan sites also offer recommendations for management of the adverse effects of illicit drugs. As one partisan site says, "it is up to the drug user to stay out of [the physician's] hands."

To evaluate the quality of such information, we conducted a survey of seven partisan Web sites. With high interobserver reliability (kappa=0.81) between experts unaware of the source of the information, we found that every partisan site made potentially harmful recommendations for the management of the adverse effects of illicit drugs. Information from partisan sites has been linked to adverse outcomes: some partisan sites have described their own role in the deaths of drug users and some have been implicated in poisoning from 1,4-butanediol.

Table 1. Features of Partisan Web Sites as of May 24, 2001. See URL: http://www.mapinc.org/nejmtbl.htm

Unfortunately, Internet-based efforts to prevent drug use may not deflect visitors from partisan Web sites. We performed five separate searches using identical key words ( "GHB" [[]-hydroxybutyric acid], "ecstasy" [methylenedioxymethamphetamine or MDMA], and "psychedelic mushrooms" ) over a period of 10 months. Our first two searches listed 8 partisan and 2 federal antidrug Web sites in the top 10 results. The third search identified nine partisan sites and one federal site, whereas the final two searches identified eight partisan and no federal sites. In all searches, antidrug sites from the federal government failed to appear as often as the partisan sites, which dominate the search results. Moreover, sites of the Federal Website Initiative, part of a billion-dollar multimedia program for the prevention of drug abuse, did not appear in any of the search results.

These data suggest that the U.S. government, despite extensive and costly efforts, currently does not provide effective alternative sources of information about drugs on the Web, where partisan sites still get the attention of both search engines and users.

Edward W. Boyer, M.D., Ph.D. Michael Shannon, M.D., M.P.H. Patricia L. Hibberd, M.D., Ph.D.
Children's Hospital
Boston, MA 02115
(See http://www.mapinc.org/drugnews/v01/n1473/a08.html for references.)

**********************************************

SAMPLE LETTER

Dear Editor:

As the Executive Director of DrugSense and MAP, both very popular drug policy information web sites, I have seen tens of thousands of articles on drug policy issues. I would consider many either biased or inaccurate but, of all of them, possibly the most misleading and biased I have ever witnessed was the letter to the editor (disguised as a meaningful "study") in the latest issue of the New England Journal of Medicine. ("Web Sites with Misinformation about Illicit Drugs" by Boyer, E. W. and Hibberd, P. L. NEJM 8/9/01)

To refer to hundreds of valuable and informative web sites that urge sensible alternatives to our failed drug policy "partisan" while simultaneously insinuating that the web sites provided by the federal government are accurate and supposedly unbiased, is mind numbing in its incredibility. Such a view could only be reached by those who have either never made a serious study of such sites or who have a hidden agenda.

I defy any objective observer to analyze the content and accuracy of web sites such as Drug War Facts or The Media Awareness Project (MAP) and compare them for accuracy and content with the silliness at sites like the Partnership for a "Drug Free" America, which takes funding from the pharmaceutical (drug) industry. See: http://www.drugfreeamerica.org/

Look at the Office of National Drug Control Policy (ONDCP) or their "youth" site Freevibe there is simply no comparison between these weak and misleading sites as compared to the best of the drug policy reform information sites. The federal government sites are inaccurate and, all to often, appear to be intentionally so.

Instead of drawing this conclusion, the authors of the article sought out obscure quotes from sites such as http://www.erowid.org. While this site archives thousands of pages of valuable information, it demonstrates less than half the popularity of the MAP web site mentioned above for example. Any of these sites can be objectively evaluated and compared for relative popularity (which is a fairly reliable indicator of accuracy) by utilizing independent web site popularity evaluation sites such as http://www.marketleap.com/ Invariably the drug reform oriented sites out perform the government sites.

The MAP site above is the most popular drug policy information web site in the world. This can be verified by a truly unbiased and accurate study that DrugSense developed last March comparing relative popularity of web sites generally supporting existing policy compared to those suggesting sensible alternatives. It can be viewed at http://www.drugsense.org/webpop/

The "study" referred to got this point correct. Reform sites dominate the Internet. There is no contest. Why are these sites so popular even though they encourage an end to our insane and failed drug policy? It is really quite simple. They tell the TRUTH. The government, to put it as politely as possible, has been lying about drugs, drug policy, and the "effectiveness" of current policy for decades. The Internet has, at long last leveled the playing field so that the public can finally have access to some accurate information on the damage our existing drug policies have caused to our nation.

Finally the Drug Enforcement Administration (DEA) web site has numerous web pages similar to those disparaged in the table in this article as "partisan." The DEA even offers step by step directions for growing marijuana http://www.usdoj.gov/dea/pubs/intel/01001-intellbrief.pdf . This is precisely what the article accused the "partisan" web sites of doing.

If you hope to continue your long and prestigious reputation as a publication who strives towards objectivity and solid science, I hope and expect to see this letter published in your next issue.

Mark Greer
Executive Director
DrugSense (MAP Inc.)

contact info

*************************

IMPORTANT: Always include your address and telephone number Please note: If you choose to use this letter as a model please modify it at least somewhat so that the paper does not receive numerous copies of the same letter and so that the original author receives credit for his/her work.

**********************************************

ADDITIONAL INFO to help you in your letter writing efforts

3 Tips for Letter Writers

Letter Writers Style Guide

**********************************************

Mark Greer
Executive Director
DrugSense
MGreer@mapinc.org
http://www.drugsense.org/
http://www.mapinc.org/

Back

2. Note NFIA sent to the New England Journal of Medicine

Thursday, August 16, 2001 11:54 AM

Dear Sirs:

I thought you might be interested in a letter writing protest that drug legalization proponents are orchestrating against an article on scientifically inaccurate websites you published last week. We thank you for the article, and thank its authors for spotlighting in the medical community an issue we have been deeply concerned about for quite some time. Please forward the attached on to the authors, Edward W. Boyer, Michael Shannon, and Patricia L. Hibberd, who may find this of interest.

Thank you again.

Sue Rusche
Co-author
Executive Director
National Families in Action (NFIA)

Back

3. Reply from the New England Journal of Medicine

Dear Ms. Rusche,

Thank you for sending this information to us. We will share it with the authors of the letter we published.

Sincerely, Edward W. Campion, M.D.
Deputy Editor
EWC/ag

Back

4. Reply from the lead author

Thank you for the heads-up about the letter-writing campaign. If there is any countereffort, I would love to hear about that, too.

Ed Boyer

Back

Previous Updates

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Home 2001 Updates 2000-1999 Updates Back to NFIA Search NFIA	Current Update	Time to Write the New England Journal of Medicine August 21, 2001 – Legalization proponents are orchestrating a campaign to flood the New England Journal of Medicine with letters protesting the journal's publication of a letter from doctors at Children's Hospital Boston who call attention to several (legalization) websites that give out inaccurate, sometimes dangerous, medical information about the drug Ecstasy. We passed along their alert to the editor of the journal and asked that it be forwarded to the authors. In order to counteract legalization proponents' effort, a concerted response from the prevention, treatment, and medical and scientific communities seems in order. We urge you to take the time to write a letter to the journal expressing your appreciation for highlighting this problem. It's easy to do via email. The address is letters@nejm.org Following are background materials that give you the whole story: 1. An alert sent from Mark Greer, of Drug Sense, to legalization proponents. The alert contains the New England Journal of Medicine article. 2. A note NFIA sent to the editor of the journal. 3. The journal's reply. 4. The lead author's reply 1. DrugSense Alert asking legalization proponents to write protest letters to the journal: Doctors Try To Legitimize Failing Drug Propaganda ------- PLEASE COPY AND DISTRIBUTE ------- DrugSense FOCUS Alert #217 Wednesday August 15, 2001 Drug policy reformers have been much more successful than prohibitionists at distributing accurate, persuasive information on the Internet. Some prohibitionists are rightly worried about this, but instead of trying to check their facts or attempting to determine what makes a web site appealing, they have simply resorted to attacking reform-oriented web site. The New England Journal of Medicine recently published a letter from some doctors who are concerned that "partisan" sites are more popular than the allegedly impartial sites sponsored by the federal government. This analysis completely ignores the ideological basis of most government sponsored anti-drug sites, which in turn unmasks the clear bias of the authors. Please write a letter to the editor of the NEJM to let them know that far from having a monopoly on drug truth, federal web sites are just another tool in the endless propaganda campaign of the drug war. ******************************************** PLEASE SEND US A COPY OF YOUR LETTER OR TELL US WHAT YOU DID (Letter, Phone, fax etc.) Please post a copy your letter or report your action to the sent letter list (sentlte@mapinc.org) if you are subscribed, or by E-mailing a copy directly to MGreer@mapinc.org Your letter will then be forwarded to the list with so others can learn from your efforts and be motivated to follow suit. This is VERY IMPORTANT as it is the only way we have of gauging our impact and effectiveness. ******************************************** Contact Info: Source: New England Journal of Medicine (MA) Contact: letters@nejm.org Extra Credit Reuters reported on this letter, and the story was picked up by at least one newspaper - The Arizona Republic. The story started this way: "Internet surfers are far more likely to come upon Web sites with wrong and potentially dangerous information about illicit drug use than they are to find more reliable, informed sites, a new study shows." Please send a letter to the Republic to challenge this interpretation of the letter. Title: US: Drug Web Sites Provide Harmful Information - Study URL: http://www.mapinc.org/drugnews/v01/n1469/a01.html Pubdate: Wed, 8 Aug 2001 Source: Arizona Republic (AZ) Copyright: 2001 The Arizona Republic Contact: opinions@arizonarepublic.com Details: http://www.mapinc.org/media/24 Website: http://www.arizonarepublic.com/ ********************************************** ARTICLE URL: http://www.mapinc.org/drugnews/v01/n1473/a08.html Pubdate: Thu, 9 Aug 2001 Source: New England Journal of Medicine (MA) Copyright: 2001 Massachusetts Medical Society Contact: letters@nejm.org Website: http://www.nejm.org/ Details: http://www.mapinc.org/media/290 Authors: Edward W. Boyer, Michael Shannon and Patricia L. Hibberd WEB SITES WITH MISINFORMATION ABOUT ILLICIT DRUGS To the Editor: As part of our research on the relation between the Internet and substance abuse, we have identified several Web sites that promulgate information about illicit drugs. These "partisan" Web sites are easily identified by common search engines if one uses the names of illicit substances as search terms. With some pages viewed more than 160,000 times per day, partisan sites appear to be effective in reaching adolescents and young adults. In a recent study, 24 percent of college students used the Internet to obtain information on illicit substances, and 27 percent of Internet-using college students reported that Internet use increased the likelihood that they would use drugs. The popularity of partisan Web sites may arise from their plausible descriptions of the preparation, dose, administration, and psychoactive effects of drugs (Table 1 ). Partisan sites also offer recommendations for management of the adverse effects of illicit drugs. As one partisan site says, "it is up to the drug user to stay out of [the physician's] hands." To evaluate the quality of such information, we conducted a survey of seven partisan Web sites. With high interobserver reliability (kappa=0.81) between experts unaware of the source of the information, we found that every partisan site made potentially harmful recommendations for the management of the adverse effects of illicit drugs. Information from partisan sites has been linked to adverse outcomes: some partisan sites have described their own role in the deaths of drug users and some have been implicated in poisoning from 1,4-butanediol. Table 1. Features of Partisan Web Sites as of May 24, 2001. See URL: http://www.mapinc.org/nejmtbl.htm Unfortunately, Internet-based efforts to prevent drug use may not deflect visitors from partisan Web sites. We performed five separate searches using identical key words ( "GHB" [[]-hydroxybutyric acid], "ecstasy" [methylenedioxymethamphetamine or MDMA], and "psychedelic mushrooms" ) over a period of 10 months. Our first two searches listed 8 partisan and 2 federal antidrug Web sites in the top 10 results. The third search identified nine partisan sites and one federal site, whereas the final two searches identified eight partisan and no federal sites. In all searches, antidrug sites from the federal government failed to appear as often as the partisan sites, which dominate the search results. Moreover, sites of the Federal Website Initiative, part of a billion-dollar multimedia program for the prevention of drug abuse, did not appear in any of the search results. These data suggest that the U.S. government, despite extensive and costly efforts, currently does not provide effective alternative sources of information about drugs on the Web, where partisan sites still get the attention of both search engines and users. Edward W. Boyer, M.D., Ph.D. Michael Shannon, M.D., M.P.H. Patricia L. Hibberd, M.D., Ph.D. Children's Hospital Boston, MA 02115 (See http://www.mapinc.org/drugnews/v01/n1473/a08.html for references.) ******************************************** SAMPLE LETTER Dear Editor: As the Executive Director of DrugSense and MAP, both very popular drug policy information web sites, I have seen tens of thousands of articles on drug policy issues. I would consider many either biased or inaccurate but, of all of them, possibly the most misleading and biased I have ever witnessed was the letter to the editor (disguised as a meaningful "study") in the latest issue of the New England Journal of Medicine. ("Web Sites with Misinformation about Illicit Drugs" by Boyer, E. W. and Hibberd, P. L. NEJM 8/9/01) To refer to hundreds of valuable and informative web sites that urge sensible alternatives to our failed drug policy "partisan" while simultaneously insinuating that the web sites provided by the federal government are accurate and supposedly unbiased, is mind numbing in its incredibility. Such a view could only be reached by those who have either never made a serious study of such sites or who have a hidden agenda. I defy any objective observer to analyze the content and accuracy of web sites such as Drug War Facts or The Media Awareness Project (MAP) and compare them for accuracy and content with the silliness at sites like the Partnership for a "Drug Free" America, which takes funding from the pharmaceutical (drug) industry. See: http://www.drugfreeamerica.org/ Look at the Office of National Drug Control Policy (ONDCP) or their "youth" site Freevibe there is simply no comparison between these weak and misleading sites as compared to the best of the drug policy reform information sites. The federal government sites are inaccurate and, all to often, appear to be intentionally so. Instead of drawing this conclusion, the authors of the article sought out obscure quotes from sites such as http://www.erowid.org. While this site archives thousands of pages of valuable information, it demonstrates less than half the popularity of the MAP web site mentioned above for example. Any of these sites can be objectively evaluated and compared for relative popularity (which is a fairly reliable indicator of accuracy) by utilizing independent web site popularity evaluation sites such as http://www.marketleap.com/ Invariably the drug reform oriented sites out perform the government sites. The MAP site above is the most popular drug policy information web site in the world. This can be verified by a truly unbiased and accurate study that DrugSense developed last March comparing relative popularity of web sites generally supporting existing policy compared to those suggesting sensible alternatives. It can be viewed at http://www.drugsense.org/webpop/ The "study" referred to got this point correct. Reform sites dominate the Internet. There is no contest. Why are these sites so popular even though they encourage an end to our insane and failed drug policy? It is really quite simple. They tell the TRUTH. The government, to put it as politely as possible, has been lying about drugs, drug policy, and the "effectiveness" of current policy for decades. The Internet has, at long last leveled the playing field so that the public can finally have access to some accurate information on the damage our existing drug policies have caused to our nation. Finally the Drug Enforcement Administration (DEA) web site has numerous web pages similar to those disparaged in the table in this article as "partisan." The DEA even offers step by step directions for growing marijuana http://www.usdoj.gov/dea/pubs/intel/01001-intellbrief.pdf . This is precisely what the article accused the "partisan" web sites of doing. If you hope to continue your long and prestigious reputation as a publication who strives towards objectivity and solid science, I hope and expect to see this letter published in your next issue. Mark Greer Executive Director DrugSense (MAP Inc.) contact info ********************* IMPORTANT: Always include your address and telephone number Please note: If you choose to use this letter as a model please modify it at least somewhat so that the paper does not receive numerous copies of the same letter and so that the original author receives credit for his/her work. ****************************************** ADDITIONAL INFO to help you in your letter writing efforts 3 Tips for Letter Writers Letter Writers Style Guide ****************************************** Mark Greer Executive Director DrugSense MGreer@mapinc.org http://www.drugsense.org/ http://www.mapinc.org/ Back 2. Note NFIA sent to the New England Journal of Medicine Thursday, August 16, 2001 11:54 AM Dear Sirs: I thought you might be interested in a letter writing protest that drug legalization proponents are orchestrating against an article on scientifically inaccurate websites you published last week. We thank you for the article, and thank its authors for spotlighting in the medical community an issue we have been deeply concerned about for quite some time. Please forward the attached on to the authors, Edward W. Boyer, Michael Shannon, and Patricia L. Hibberd, who may find this of interest. Thank you again. Sue Rusche Co-author Executive Director National Families in Action (NFIA) Back 3. Reply from the New England Journal of Medicine Dear Ms. Rusche, Thank you for sending this information to us. We will share it with the authors of the letter we published. Sincerely, Edward W. Campion, M.D. Deputy Editor EWC/ag Back 4. Reply from the lead author** Thank you for the heads-up about the letter-writing campaign. If there is any countereffort, I would love to hear about that, too. Ed Boyer Back Previous Updates







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