The Star recently conducted an investigation into the usage of these pharmaceuticals in Ontario nursing homes. It discovered that in over 40 homes across Ontario, nearly half of the inhabitants are given these anti-psychotics. In about 300 homes, more than a third are on the pills. One home uses them on about 75 percent of patients.

The pills include olanzapine, quetiapine, and about 10 others, but none of them are approved by Health Canada for use on people suffering with dementia. Some of these medications even have a “black-box” warning on the label—the strongest possible warning on a pharmaceutical. Commonly the label cautions that patients with dementia have a 60 percent increased risk of death after using the drug.

Then why are nursing homes offering these drugs to its residents?

Olanzapine and quetiapine were approved in 2004 and 2005 by the U.S. Food and Drug Administration (FDA) for use on people with schizophrenia, bipolar disorder, and episodes of mania.

Yet, doctors continue to prescribe these drugs off-label, even though the government was warned about overuse of this anti-psychotics in 2007 by the auditor general. Yesterday, Ontario Health Minister Deb Matthews told the Star, “Let’s remember, it’s the doctors who prescribe these drugs, not the government.”

This sounds suspiciously like the blame game. Doris Grinspun would agree. She’s head of the registered nurses association and told the Star she is “quite frankly, outraged at anyone, let alone the minister, who tries to divert responsibility. It’s all of our responsibility.”

But it is a doctor’s choice to medicate a patient without fully divulging potential danger to relatives.

One family explained to the Star their aunt, lovingly known as Aunt Gerry, died four months after Wellesley St. nursing home used olanzapine to “quiet her down”. Her husband had no idea what the drug would do and would not have consented to it if he had.

This isn’t the first time Canada has been in trouble for its misuse of anti-psychotics. Prisons use these methods as well. A large amount of female inmates are given quetiapine to help them sleep. Last year, CBC and the Canadian Press discovered that about 400 of the 600 prisoners in five different correctional institutions are given “psychotropic medication—drugs that impact mood and behaviour,” the Star reported.

Quetiapine’s side effects include: diabetes, hyperglycemia, high fever, intestinal obstruction, and rigid muscles, to name a few.

Clearly, prescribing off-label is a common issue.

Matthews acknowledges it is a serious issue but did not explain any specific, rectifying action the government is suggesting doctors take. She did mention “doctors cannot prescribe this kind of medication without the consent of the individual or their substitute decision maker.” Which doesn’t say enough.

Grinspun has some suggestions of her own. She believes the province should increase staff numbers and provide in-depth training focused on those with dementia. Some homes mention trying to get their prescription rate down by learning to recognize triggers for agitation in seniors.

Dr. Andrea Moser told the Star good work has been done to limit the use of these drugs in nursing homes. “We’re making progress. We still have a long way to go.”

A long way sounds ominous. Especially for current patients like Aunt Gerry. The government and doctors owe these families better work to ensure a long way does not translate into a long time.

In Canada, there are nearly 40,000 medical marijuana patients; when the program was initiated in 2001, there were 100. Many patients grow their own marijuana, depending on their needs and ailment, such as multiple sclerosis, epilepsy, or chemo therapy. Most say they need the drug to function, and some require 40 grams or more a day to manage their condition. In such cases, patients would have to pay $200/day for the drug—a prohibitive cost, and one that is much higher than what it takes to grown the plant themselves.

The government contends the new change will help regulate medicinal marijuana, and protect patients from hazards such as fire, mould, and potential break-ins and burglary. It also claims the new law will also stop abuse of licences and black market trade.

Opponents to the law, however, say it really just makes it harder to get medicine patients desperately need.  John Conroy, a lawyer from Burnaby, B.C., has launched a constitutional challenge against the law. Conroy argues that the law would deny his clients’ reasonable access to medicine they desperately need. Not only will patients be unable to afford buying from state approved growers, he argues, certain strains of the plant that have been found effective for some conditions would no longer be available.

Conroy has asked for a temporary injunction to the law until the court makes a decision on his constitutional challenge. In the meantime, one couple is also suing the government for  $6.5 million, the amount they say they will be forced to pay for the medicine they could happily grow for a fraction of the price: $500. Many medicinal marijuana users are simply vowing to ignore the new law, and continue growing their own pot.

Let’s hope it is all one big, elaborate April Fool’s prank.

“Today’s data—from Canada’s 2010/11 Youth Smoking Survey (YSS)—shows that the tobacco industry’s flavoured products appeal to many more Ontario kids than we previously thought,” said Ontario Coalition Against Tobbaco’s Director Michael Perley on Monday. “The industry has avoided a 2009 ban on flavours in small filtered cigars by simply increasing the size of their products, which in turn has exempted them from the ban. There is only one way to deal with this industry’s efforts to seduce our kids with flavours: eliminate the latter outright.”

The tobacco industry circumventing regulations in order to sell greater amounts of their product to a naive consumer base? No. Not tobacco companies.  I won’t hear of this slanderous —

Oh right. Tobacco companies have been targeting youth forever. Even candy cigarettes have been regulated so that their branding cannot resemble real cigarette branding. You can’t get Popeye cigarettes anymore, you can only get “candy sticks”, without the red tip so as not to look like a lit cigarette. We’ve made it extremely difficult for tobacco companies to replenish their dying market base, but they’re still finding ways to circuitously target the cool kids.

The first cigarette I ever smoked was a Winston. It tasted like soot and had I been offered a watermelon flavoured cigarillo instead, I would have gladly accepted. So would any kid. It’s common sense that children will be more likely to try something that is more pleasingly flavoured. I’m not an anti-tobacco advocate by any means, but I do find the willingness of these companies to find new ways to entice youngsters troubling. I think the great Norm Macdonald sums it up well in this clip.

The push for a ban on these products seems like the only way to stop the relentless youth marketing strategies that tobacco companies employ. To me, it’s not that they do it—kids will always want to smoke, tobacco interests will always want kids to smoke— it’s the sneakiness of it that annoys me. Increasing the size of your cigarillos (Hey kids! Not only do our cool cigarette-cigar hybrids come in wacky flavours there’s more tobacco goodness in each puff!) to sidestep the Tobacco Act is not something lawmakers should let slide, just on principle if not because of the obvious health risks.

sweetclipart.com

Canada now has a working group dedicated to figuring out bee mortality. On July 9, environmental group Sierra Club Canada shared a press release announcing the group’s formation, which is made up of beekeepers, farmers, scientists and others in agri-business. The press release mentions the recent loss of 27 million bees near Elwood, Ont. In the release, Sierra Club Canada’s executive director John Bennett says, “This working group is the first real recognition of the impact of neonictinoid on bees,” referring to a pesticide still used in Canada, though banned by the European Union.

According to the Canadian Honey Council website, Canada’s bee population has dropped by 30 percent in the past year. Globally, bees are disappearing by the millions; detrimental news for our food supply—pollination is responsible for 70 percent of plants grown for produce—and agricultural business. A brochure from the council states, “In Canada it is estimated that the value of honeybees to agriculture is $1.3 billion.”

Both Ontario and New Brunswick have seen a decline in their bee populations, as have Alberta, Saskatchewan and Manitoba – the provinces responsible for 80 percent of the country’s honey production. Both honeybees and native bumblebee populations have been affected.

Hives have been found near void of working bees, leaving only the queen and immature bees. Though bees are social creatures that stay near their hives – the workers’ bodies are not found near the homes. Predators of abandoned hives, like hive beetles and wax moths, will not even enter the affected hives. This strange phenomenon has been dubbed Colony Collapse Disorder (CCD).

Since 2006, different theories have circulated regarding the cause of CCD. They range from viruses, such as the Israeli acute paralysis virus and the nosema virus, to cell phones and even Osama bin Laden (yup).

Now, neonictinoid pesticides are being looked at. Used for corn and soybeans, the pesticide was authorized for commercial use by Health Canada’s Pest Management Regulatory Agency in 2004. It replaced lindane, which was taken off the Canadian market after it harmed bees, birds, and other wildlife. Research published in the online journal Nature Communications says neonictinoid blocks a part of the bee brain, disabling them from linking floral scents to nectar. This research contributed to the EU ban, which upset neonictinoid companies Syngenta and Bayer. In a company statement, Syngenta disputed research findings: “The proposal is based on poor science and ignores a wealth of evidence from the field that these pesticides do not damage the health of bees.” Both companies warn the ban will cost billions of euros.

And now, we’ll get to see what Canada’s new working group determines in regards to this controversial pesticide.

Photo: http://tvnz.co.nz/world-news/new-female-sex-drive-drug-tested-5172215

It’s been 14 years since the erectile dysfunction pill Viagra hit the market, and it seems like women are finally close to getting one, too—in the form of a nose spray.

The product, called Tefina, is a testosterone gel that gets sprayed up the nose and absorbed within minutes, with effects that could be felt within hours. Aimed to combat Female Orgasmic Disorder (FOD), also known as anorgasmia, Tefina is “a bioadhesive ‘no touch’ intranasal low-dose gel formulation of testosterone.” From the company Trimel, the spray is designed for “use as required” treatment, and has virtually no androgen-related side effects like acne, hair growth, and voice deepening. It also is not expected to have risk of testosterone transfer from skin-to-skin.

The drug, which intends to increase orgasms for females, is being tested in Australia, the United States, and even Canada, where Health Canada recently approved the trials. Australian researchers are aiming for 240 pre-menopausal women, aged 18-49, to participate in this Phase II Ambulatory study. Canadian enrollment sites are expected to be up and running in the next 30 days, with actual product ingesting done at the patient’s home instead of in a hospital.

There seems to be a lot of heat surrounding the race to put a female equivalent of Viagra on the market, as is outlined in Liz Canner’s 2011 documentary Orgasm Inc. It’s not even just a question of what the most effective product will be, but also if it’s possible that a drug that can make women orgasm more often, and furthermore, if there’s even such a medical condition in the first place. As Jezebel reported, Orgasm Inc. asks whether Female Sexual Dysfunction (FSD) “will be an umbrella diagnosis for women who’ve never been stimulated properly, and questions the ethics of the companies who are more than willing to keep women in the dark about their own bodies in order cash in.” Still, Dr. Fiona Jane of Melbourne’s Monash University was quoted as saying that “female sexual dysfunction is a real thing” and thinks “up to 43 percent of women suffer from some form of sexual dysfunction.” According to a Trimel press release, FOD affects approximately one in five pre- and post-menopausal women worldwide.

This process has been a long and arduous one, and it still doesn’t have an end in sight. And, it still seems as if people are glossing over the larger issue here, which is weather or not there is even a disorder that can be dealt with in the first place. Are women really suffering from a dysfunction of some kind, or have they just not been pleasured in the appropriate way for their body (as a male friend of mine announced the other night, “Yo, all girls are different”)? Sexual pleasure is a complicated matter, and it’s not uncommon for women to have a harder time reaching climax in sex than men. The results from Tefina’s testing will be much anticipated, and probably, very interesting—regardless of which direction they sway. In the meantime, women will keep having sex, and hopefully, exploring the ways in which they can experience pleasure.

“Is a drug gonna help them?” asks Carol Queen, from the Good Vibrations Antique Vibrator Museum, in the Orgasm Inc. trailer. “Maybe if it has a map of the clitoris on the box.”

Canadian public health officials are taking a stance on marijuana use education, instead of advocating abstinence.

As we all know, marijuana is an illegal drug in Canada, a fact unlikely to change anytime soon. But this week, a team of public health experts seem to be facing reality.

Reality being, of course, that many people in Canada are recreational marijuana users. A Health Canada survey in 2010 showed that 10.7 percent of people over 15, and 25.1 percent of youth aged 15-24 had used cannabis in the past year.

Given these facts, a set of guidelines for marijuana use have been released, endorsed by the Canadian Public Health Association. Previously, the message to Canadians has been prohibition and abstinence. The new guidelines, according to the Toronto Star, address “prevention, education, and reducing risks among users.” The guidelines will be published in the Canadian Journal of Public Health.

Benedikt Fischer, co-author of the guildelines and chair in applied public health at Vancouver’s Simon Fraser University, told the Canadian Press that the “lower risk cannabis use guidelines” are modelled after the public health approach to alcohol consumption.

“We’re accepting the fact that this is a drug that’s out there, that people embrace, that people actually enjoy,” Fischer told the Canadian Press. “At the same time, absolutely it’s not a benign drug, it comes with a lot of acute and long-term problems that can be very hazardous and harmful to both individuals and society.”

Some of the risks higlighed in the guidelines, according to the Toronto Star‘s report, include:

“Age of use: The younger the user, the greater the risk, especially of mental illness or addiction. While most people don’t springboard to harder drugs, being young increases the odds of that happening. Researchers advise delaying use until at least (age 16) and preferably young adulthood.

Frequency of use: Daily or near daily use is linked to memory loss, cognitive problems, serious health issues and addiction, and should be avoided.

Driving: Anyone using marijuana should wait a minimum of three to four hours after consumption before driving. While public awareness around drinking and driving is huge, few people realize that marijuana impairs cognition and reflexes and acutely increases risks of car accidents.

High-risk groups: This includes pregnant women; older adults with hypertension and certain other health problems; and those with a history of psychotic symptoms themselves or in a family member.”

While these guidelines aim to bring more public awareness to marijuana use, there is some irony in this situation. Days before the release of these guidelines, the federal government introduced the Safe Streets and Communities Act ,which, among other things, has laid down stricter penalties for those convicted of growing marijuana, with jail time ranging from six months to a maximum of 14 years.

Like I said- it’s not looking like marijuana will be legal in Canada anytime soon. But if people are going to use marijuana regardless, then at least public health officials are finally recognizing the situation as it is.

Photo by Joanna Pecha

On March 18, 2000, Terence Young was at home catching up on the weekend paper when his 15-year-old daughter, Vanessa, came to ask his permission to go out with some friends that evening. Exhausted and not relishing the idea of another conversation about Vanessa’s curfew time, Young asked her to wait until after dinner. There was nothing remarkable about it.

But as Vanessa turned to leave, she suddenly went limp and collapsed, her head making a loud thump on the carpeted floor. Young ran to her, calling out to ask whether she was okay, thinking momentarily that it could be a joke, an overdramatic gesture by his teenage daughter. It wasn’t. As she lay motionless on the floor, Young frantically felt for a pulse, finding the spot on her neck where his first-aid training had taught him to press his fingers, but there was nothing. An ambulance rushed Vanessa to the hospital, and an exhausting, haunted night followed as the family kept vigil in intensive care. The next day, Vanessa Young died.

Her cause of death was later determined to be cardiac arrest, caused by the effects of Vanessa’s bulimia nervosa and possibly an undiagnosed underlying heart defect. But there was another factor: Vanessa had been prescribed a drug called Cisapride—better known by its trade name, Prepulsid—to assist her digestion and prevent vomiting. Terence Young was later to learn the drug had been linked to irregular heartbeats and other cardiac problems. In July 2000, Janssen-Pharmaceutica Inc., a subsidiary of drug giant Johnson & Johnson, voluntarily pulled Prepulsid from U.S. pharmacy shelves. In August 2000, Health Canada pulled it from the Canadian market. On April 24, 2001, a coroner’s jury concluded that Vanessa Young’s arrhythmia and cardiac arrest resulted “from the effects of bulimia nervosa in conjunction with Cisapride toxicity and possibly an unknown cofactor such as congenital cardiac defect.”

The potential danger of Prepulsid was known, but key information about the drug didn’t make it to the right people at the right time. Eventually the right decision was made—but it was too late for Vanessa Young.

Canada’s drug-approval process suffers some serious flaws. The proceedings lack transparency; scientific data often goes fully or partially unpublished; once on the market, approved drugs seldom receive long-term monitoring for adverse effects; compared to other countries, drug labelling is less rigorous; and the whole process is paid for, in large part, by the same companies it is supposed to be regulating.

To be fair, Health Canada, the ministry responsible for approving pharmaceuticals, is often in a difficult position: patients and doctors want effective treatments made available quickly, but the department’s job is to thoroughly test drugs for safety, which takes time. Speeding drugs to market and protecting public health are two mutually exclusive goals, afflicted at every stage by interests that are often financially, and sometimes emotionally, vested. And at every stage, the pharmaceutical companies themselves are there, embedded in the approval process.

The result is a system with conflicting loyalties, bizarre blind spots, and, sometimes, dangerous outcomes. Why is it that Canada lags so far behind in providing an open, accessible drug-approval process? I sought out some of Canada’s leading experts on health policy and drug safety to try and understand what in our drugapproval system is broken—and how we can fix it.

Part of the problem of understanding Canada’s drug-approval process is that so much of it takes place behind closed doors.

“The way that we deal with drug approvals is actually quite different than the U.S., in that theirs is a much more open process,” says Dr. Barbara Mintzes, assistant professor in the department of anesthesiology, pharmacology and therapeutics at the University of British Columbia. When the U.S. Food and Drug Administration, for instance, approves a drug for the market, the full review report is published online. Expert advisory committee meetings are open to anyone and transcripts are published on the FDA’s website. The public is invited to submit input, and scientific reviewers’ comments are also made public. Almost none of that happens in Canada.

Dr. Joel Lexchin, a professor at the School of Health Policy and Management at York University in Toronto, agrees that lack of transparency is a problem.

“The FDA demands that drug companies submit the raw, clinical data,” says Lexchin. “Then they will do their own reanalysis of the data to make sure that the way the companies analyzed it is appropriate.” Drug trials in the U.S. are also catalogued with redacted information in an online registry. “Not only do you know what trials were started but you’ll be able to see what the results of those trials are,” says Lexchin. “Health Canada doesn’t require the posting of trial results.” In contrast, the comments of Health Canada researchers reviewing drug company applications are never made public. In fact, the public may not even find out that a drug is under review.

“The drug-approval process in Canada is secret,” says Mintzes, “in that when a drug is being considered for approval, there’s no announcement to the public by Health Canada to say that’s happening. It’s up to the company whether or not they want to publish the clinical trials [they submit] and often they will decide to publish only a subset of their studies.”

Health Canada’s approval process, then, is a kind of black box: drugs go in one end, and some emerge at the other, but what exactly transpires inside to influence that decision is unclear. (Health Canada’s only response to interview requests for this story was to refer me to its website.)

Many critics say that money exerts too big an influence on approvals. The biggest culprit is user fees, in which pharmaceutical companies pay the government to fund the approval process. User fees were introduced in 1995, partly in response to federal budget cuts, based on the idea that, because they benefit from having their drugs for sale, drug companies should shoulder some of the cost of approving them.

“I think this is a mistake,” says Lexchin. By 1999, the Therapeutic Products Directorate, the Health Canada department responsible for assessing drugs’ safety and efficacy, got close to 70 percent of its budget from the companies it was supposed to be regulating. Today, Lexchin claims, it’s about a third, though recently proposed regulations from Health Canada aim to cover 50 percent of TPD’s budget with user fees. At that level, critics question who’s actually setting the agenda—the pharma companies or the public interest?

“User fees are totally inappropriate,” says Terence Young, Vanessa’s father, who is also a Conservative MP in Oakville, Ontario, and founder of the advocacy and research group Drug Safety Canada. “They create a situation where a drug reviewer feels that the company is like a client, that they should be working fast to get this drug approved because these companies are paying up to 50 percent of the cost of having drugs reviewed for approval. That is an inappropriate relationship.”

After the death of his daughter, Young became a fierce critic of the pharmaceutical industry and wrote about the civil and classaction lawsuits subsequent to Vanessa’s death in his book Death by Prescription. He echoes the sentiment—common enough to have become cliché—that drug companies have put profits above patients.

“Big Pharma’s profits are multiples, in most cases, of other industries,” says Young. “You cannot overstate their influence on modern medicine. We spend more money on pharmaceuticals, both prescription and non-prescription, than we do on doctors.”

In Canada, the effect of user fees is not just that it makes the drug companies clients of Health Canada, expecting value for money; the user-fee structure also influences approval deadlines. The 2004 User Fees Act gives Health Canada a set timeline to approve new drugs; if the agency misses its deadline, there are financial penalties: user fees for the following year are cut. “If you go, say, 20 percent over deadline, then next year the user fees are going to be cut by 20 percent,” says Lexchin.

That pressure to approve, says Young, inevitably influences the decisions of Health Canada reviewers. “Drug reviewers should not feel that their job depends on, in any way, approving a drug,” he says. “You approve a drug when you believe it’s effective and safe,” he says. “You don’t approve it by any given date. And if it’s doubtful, you don’t approve it.”

Lexchin and Young both argue for the elimination of user fees, to make the whole process publicly funded and cut down on industry influence. Young proposes a mandatory levy on pharmaceutical companies so they still fund the process, but without the strings attached.

Once a drug is on the market, additional problems crop up: follow-up research on drugs is relatively rare, and drug labelling is inconsistent.

With few exceptions, once a drug reaches the market and is being prescribed routinely by doctors, there is no system evaluating the long-term effects or adverse reactions for prescription drugs.

“Health Canada, at this point, doesn’t have the ability to require companies to undertake post-market trials; all they can do is ask companies to do it,” says Lexchin. He draws attention to a Health Canada policy called Notice of Compliance with Conditions that approves the drug but requires further testing. “They will approve it on the requirement that companies undertake additional trials to show that what looks promising actually is promising.”

But there’s no reporting on the progress of meeting those conditions. “You have drugs that were approved nine years ago under this policy that still haven’t met their conditions, and you can’t find out why because it’s considered confidential,” says Lexchin. “With the cancer drug Iressa, the trials showed it didn’t work, but Health Canada still left it on the market.”

Lexchin believes it’s probably still on the market because some cancer doctors think that, although it doesn’t work statistically, it might work on individuals. “We’re always dealing with statistics,” he says.

Monitoring of adverse drug reactions across the country is largely confidential. Young says it’s meaningless: “Health Canada never insists follow-up studies be done; they don’t even call the drug company back and say, ‘Did you do those studies?’ Because they get approval, and it’s open season.”

Pharmaceutical labels are notoriously difficult to read, and potential side effects or drug interactions get lost in a sea of technical and legal language. “They’ll say, ‘See look, here on page 19, right near the bottom it says you shouldn’t take it with grapefruit juice, so don’t say we didn’t warn you!’” says Young. “The labels are written by lawyers, for lawyers, to confuse. They should issue effective safety warnings in plain language so patients and doctors will know when a drug is safe.”

To try and reform some of the problems he and many doctors see with the Health Canada drug-approval regime, Young has tabled a private member’s motion to create an independent drug agency that focuses purely on safety. “If Air Canada had a crash of one of their planes, you wouldn’t ask Air Canada to investigate the crash. So when a drug company has a crash of its drug, like Prepulsid, why would we ask them to investigate their own crash?” he asks. “Prescription drugs used as prescribed in hospitals with no error are the fourth leading cause of death in our society. That’s why everybody has an interest in this.”

While the picture is troubling at the federal level, experts say provincial drug-review bodies do a better job of sorting pharmaceuticals by safety and efficacy. Because the provinces bear most of the cost of providing health care through provincial health plans, they have traditionally done a better job of prioritizing drugs that actually work well, since they don’t want to pay for ineffective treatments. Even so, the provincial bodies suffer some of the same problems of transparency and accountability.

Once Health Canada has approved a drug, the second level of screening is the Common Drug Review, a body funded jointly by the federal government and the provinces. There, a group of experts examines new drugs coming to the market. The provinces, though their processes vary, are responsible for deciding what drugs will go on pharmacy shelves, how much they will cost, and how to best use provincial dollars to pay for them.

“What they will do is look at that drug and compare it to other treatments in its class. They will determine whether the drug is costeffective to be used by the provinces,” says Alan Cassels, a drug policy researcher at the University of Victoria’s faculty of human and social development.

“Health Canada might review a dozen cancer drugs and say they’re all safe and efficacious. But that doesn’t help the provinces decide if they should fund it or not,” says Cassels. “And that’s really the information the provinces need in order to make decisions about whether they should be covered.”

“Health Canada’s standard of efficacy is so low that all you have to do, because of so-called commercial rights, is prove that your new drug works slightly better, even one percent better, than placebo and you can get it approved based on efficacy,” says Young. “The provinces, on the other hand, because they’re concerned with money and the cost of the drug, they actually demand a higher standard of efficacy than Health Canada.”

Two projects are trying to address some of these problems, to make at least part of Canada’s drug-approval process more transparent and open to the public.

Set to launch this spring, the pan-Canadian Oncology Drug Review, or PCODR, is a national review board specifically for cancer drugs. Funded by the provinces (except Quebec, which opted out) PCODR will make recommendations to the provinces on which cancer treatments would be most effective to fund. Notably, the PCODR review process will be much more open and transparent than the current structure.

“I’m very pleased that PCODR is going to include patient representatives,” says Dr. Chuck Blanke, head of medical oncology at the B.C. Cancer Agency and PCODR steering committee co-chair. “Everything is going to be as transparent as possible. Reviews will be posted on the website and there will be invited commentary from pharmaceutical companies, but also from patients and patient-advocacy groups.”

The Therapeutics Initiative is another example of an effort to pry open the approvals process. The initiative acts as an independent drug bulletin. Researchers look at the clinical trial evidence of safety and effectiveness of drugs after they’ve been approved for marketing, and the “independent” part is what’s key. “With independent drug bulletins, there’s a commitment not to have any financing or advertising from pharmaceutical manufacturers,” says Mintzes, who does research for the group.

Mintzes agrees that the provinces generally have a more transparent, better-informed drug-approval process. The Common Drug Review, she says, has improved the situation because provinces can share the cost of research, eliminating expensive duplication. “I think it’s been a big advance, and useful particularly for the smaller provinces, not having to review the same scientific data separately. Recommendations are posted on the Common Drug Review website, so it creates a situation of greater trust.”

Time constraints remain a problem, however. “Clinical reviewers are being asked to do a full systematic review within a short time frame of six weeks,” says Mintzes. “That’s a pretty short period of time for the depth of the report being expected. They get the same pressure from industry in terms of drug approval for marketing—pressure for the decisions to be made very quickly.”

And like at the federal level, technical details are still bound by confidentiality agreements. “Which is crazy,” says Mintzes, “if you think that this is evidence of potential for benefit or harm of a pill or medicine that a person is actually going to take. Those people, and the doctor who is recommending it, and the whole community, should have access to the full body of scientific evidence.”

Pharma companies generally come across as the villain in these stories, and for good reason: these are large, multinational corporations that reap huge profits exploiting government-aided monopolies on life-saving drugs. Stories abound of Big Pharma wining and dining doctors to cajole them into prescribing more. Of flying them to Caribbean resorts for what in the industry are called “continuing medical education” sessions, but which are actually just marketing junkets. Of drug-company sales representatives quietly persuading doctors to prescribe “off-label,” for conditions the drug wasn’t originally intended.

But experts say that what the pharma companies don’t do can be just as harmful to patients.

Fewer than 10 percent of new drugs are considered “breakthroughs” that substantially improve efficacy or attack a disease with a novel approach. The rest of the business consists of making slight tweaks to already-successful compounds. “It’s always these ‘me too’ drugs,” says Cassels. “You have a product, and if you modify a few molecules you can come up with your own version that’s almost the same but different enough so that you can get your own patent. ‘Me too’ drugs … are much less expensive to develop.”

“There are lots of diseases out there that we just don’t understand enough about,” says Lexchin, “and putting all your money into looking for drugs that are actually going to cure something—when you’re dealing with processes that are not well understood—is a big gamble that drug companies don’t want to take. So they’re going to go for, in general, the easy processes for new drugs, rather than looking for these real major breakthroughs.”

Frustratingly, there have been breakthroughs in Canada that, because they aren’t patented—and therefore are unlikely to be highly profitable—struggle to find funding even to finish clinical trials.

For example: dichloroacetate, or DCA, an inexpensive substance that has been used for decades to treat metabolic disorders. Researchers at the University of Alberta believe it could be used as an effective treatment for many forms of cancer, too. Research has shown that DCA can cause regression in several cancers, including lung, breast, and brain tumors. The next step is to run clinical trials on human cancer patients. But these trials may have to be funded by charities, universities and government. Drug companies aren’t interested, because without a patent, there’s little money to be made.

“Because drugs tend to be developed by for-profit companies, they’re only interested in products where they’ll have a monopoly for whatever the patent period turns out to be,” says Lexchin. “If they’re going to put all this money into it, then they’re going to want to be sure that nobody else can make that drug for whatever that patent period is. These things tend to be orphans.”

As Cassels confirms, “So much of what drives drug discovery is the ability to patent stuff. If they discovered that apple seeds cured cancer, no one would ever hear about it. Sad, but true.”

It doesn’t have to be this way. Despite the seemingly insurmountable obstacles facing those who would like to see a more open, transparent drug-approval process, the more engaged the public is through knowledge and dialogue, the better chance we have in creating a fully accountable process.

The experts concur that a more transparent, independent drug-approval process would raise Canada’s drug-approval system to levels already attained by many European countries and the U.S. One thing is for certain: an approvals process funded largely by the pharmaceutical industry itself is unacceptable and represents a threat to patient safety.

Prioritizing efficacy and thorough, truly independent safety testing will help create a situation of greater trust. Research focused on developing better drugs through patent reform is not an outlandish gamble, and should be recognized as inherent to the pharmaceutical business model and supported by government regulation. Safe, effective drugs are an integral part of our health-care system. But the current approval process is needlessly secretive, incomplete, and vulnerable to private interests. What’s at stake is not simply the public’s right to know, or wasted government spending, but the health and well-being of millions.

Yesterday Canadian economics blogger Mike Moffatt posted his thoughts about the costs of reducing the murder rate by 30 percent through water treatment. The post was based on a Big Think article that studied correlations between higher lithium amounts in public drinking water and drops in suicides and violent crime rates.

Lithium, a mood-booster, is used as psychotropic treatment against bipolar disorder. The theory, in a nutshell, is that giving the public a little bit of lithium makes us all a little more mentally stable.

The idea’s met some outcry. Aside from the ethical issues surrounding mental health, the Big Think author notes that lithium is known to be more powerful than fluoride, with greater chances of side effects.

But lithium isn’t the only substance that can be added to public drinking water. Thiamine has been proposed as a means of eradicating Wernicke-Korsakoff syndrome among alcoholics. And the use of fluoride has repeatedly caused a stir.

After six decades of fluoride use in public water supplies, there is still little scientific consensus on the issue.

The U.S. Centers for Disease Control and Prevention listed fluoridation of drinking water among 10 great public health achievements of the last century. At a a price near one dollar per citizen each year, the U.S. surgeon general has lauded fluoridation for its cost-effectiveness. More than 65 percent of the population uses fluoridated water.

But WHO data shows little-to-no difference in oral hygiene between countries who chose whether to fluoridate public water. WHO only advocates fluoridation for countries with poor health infrastructure, and removal of fluoride from water sources with too much of the substance.

Most European countries, western and eastern, started fluoridating until the ’70s and ’90s, respectively. Some countries now fluoridate salt or even milk instead, and toothpaste with fluoride has been prevalent since the 1970’s.

This month, the U.S. government proposed lowering the amount of fluoride added to public water for the first time in almost 50 years over increasing rates of fluorosis among children.

Fluoridation gained prevalence in the Western world in the 1950s, decades after researches studied a lower rate of cavities in areas where water sources are naturally rich in fluoride. Under the red threat, paranoid Americans rallied against fluoridation, calling it a communist plot to undermine public health and brainwash the population. Some today even argue that fluoridation violates Nuremberg laws forbidding human experimentation.

Fluoridation has often been controversial in Canada. Anti-fluoridation activists often point to research claiming a correlation with everything from lower IQ scores to diminishing thyroid hormone levels. Communities across Canada debate fluoridation every few years, a trend that’s existed since fluoridaiton began in Canada.

In recent years, research on humans and rats has proposed a link between fluoride and childhood osteosarcoma in boys, a rare bone cancer that killed Terry Fox and often leads to amputations. The Canadian Cancer Society notes that these claims are heavily contested and require further study. Conflicting research suggests long-time exposure to fluoride may not increase the risk of osteosarcoma. When fluoride is ingested, half the substance is absorbed by the bones and accumulates over time.

In a November referendum in Waterloo, Ontario, 50.3 percent voted against continuing fluoridation. Last week, the Calgary Herald published an editorial calling for an end to fluoridation. The city is considering doing away with its aging fluoridation equipment, which would cost $6 million to replace.

A 2009 Health Canada report found that 43 percent of Canadians use fluoridated tap water. Water quality falls under provincial jursidiction and fluoride usage in Canada varies by region, with Ontario clocking in at almost 76 percent fluoridation, a number that drops to 6.4 percent in Quebec and 3.7 for British Columbians.

Health Canada recommends 0.7 parts per million fluoride to water, the same level now being proposed in the U.S. Toronto’s fluoride level was reduced from 1.2 p.p.m. to 0.8 p.p.m. In 1999, then to 0.6 p.p.m. in 2005.

[Creative Commons Water photograph by Flickr user visualpanic]

Illustration by Dushan Milic

On a chilly afternoon in mid-June 2009, bush-pilot-turned-environmental-activist Joel Theriault is once again flying over the deforested landscape near his home. My passenger headset mutes the rush of air and deafening noise of the plane’s engine. Peering out of my side window, I can see the spider-veined pattern of rivers that flow through industrial-stamped forests, around checkerboard farmland, and regroup into lakes. As seen from the air, deforestation carves its brutal honesty into the land, vividly illustrating our self-destructive relationship with the forest. I recall Theriault’s earlier exasperation with the public’s ignorance of what happens to a forest that’s being logged: the tracts of cleared land are easy to see, but there is much more going on. The invisible threat is from the chemical herbicides that forestry companies spray—chemicals that seep unseen into nearby streams, marshes and lakes. “Where does the herbicide run-off go? We’re north of the Arctic watershed, so all our water goes up to the Arctic. But 40 miles south of us they’re doing the same thing and all of that water flows down into the Great Lakes and eventually makes its way into Toronto’s water supply. So, I think if people from Toronto recognize that they are being exposed to non-essential chemicals—which are being banned on their front lawns for health and environmental reasons—they’d be outraged.”

At one time, the name “Joel Theriault,” when spoken in the small northern Ontario town of Foleyet, could elicit threats of violence. For the past six years, Theriault has been involved in what Linda McCaffrey, director of EcoJustice Ottawa, characterizes as a “David and Goliath situation.” It’s resulted in childhood friends turning against him, a lawsuit from one of the world’s largest pulp and paper companies, Theriault’s struggles within a prominent environmental law organization, alienation from other activists, and stonewalling from a government agency. These are the result of Theriault’s mission to stop the use of herbicide spraying in northern Ontario forestry operations. “I’d better change it, or it’s going to drive me nuts,” he says.

Theriault’s battle affects 90 percent of Ontario’s land. Of the 58 million hectares of the province’s forests, 88 percent are owned and managed by the Ontario government (known as Crown forests) and occupy an area larger than many European countries. Although Crown forests are public, roughly a third (about 26 million hectares) are open to commercial logging, a $17-billion industry regulated by the Ontario Ministry of Natural Resources (MNR) that needs to be maintained. An essential part of this maintenance is the regeneration of clearcuts—allowing logged areas to grow back in a uniform fashion. For the last 20 years, that has meant the aerial spraying of herbicides to kill off competing vegetation so that the new trees will survive. Industry and government argue that it’s a cheaper, more efficient, and less hazardous way to maintain forests (since workers would otherwise be manually thinning vegetation or conducting controlled forest fires). Critics say that spraying chemicals on land used by local communities to hunt, fish, and camp is destructive and dangerous.

“It’s very challenging to grow conifers without herbicides,” says Susan Pickering, the former divisional forester for boreal Ontario employed by the multinational pulp and paper company, Tembec Enterprises, Inc. The industry’s herbicide of choice is glyphosate, which kills every unwanted plant, blade of grass and piece of vegetation it comes into contact with by destroying an essential protein-processing enzyme. Within six to eight months it chemically binds to the soil, making the ground safe for conifer seedlings to be planted (since the chemical is no longer available for uptake by their roots). The most widely used glyphosate-based herbicide in forestry is Monsanto Canada’s Vision, more commonly known by its agricultural brand name, Roundup. Ninety percent of the forestry market sprays glyphosate-based products, affecting approximately 70,000 hectares of Ontario’s forests annually. Theriault has seen what results from the aerial spraying of glyphosate over the forests near his home. “You can see it from the air, you can also see it from the ground. Everything’s dead except for the pine trees.”

Theriault rejects the notion he’s pitted himself against an immovable opponent. He can hold his own in a fight, although his adolescent appearance would suggest otherwise. He is 28 years old with delicate features and a smooth, rosy complexion—a striking contrast to his unkempt hair and patchy beard, which lends him a wild-wilderness-nut look. In his community, Theriault is well-known for his intensity and uncompromising commitment to his convictions. “He’s got more tenacity than I would have thought,” says his mother, Jeanne. “If he thinks it’s right and the best thing for the environment or the world or mankind, it’s above dispute.” Theriault is determined to win the war that has consumed much of his time, resources, and energy over the last six years. “I think you’ve got to pick an issue that bothers you that is attainable, that is manageable,” he says. To him, trying to transform the forest management practices of a couple of multi-billion dollar corporations in northern Ontario is “the most attainable of the issues out there.”

The forest was a constant feature in Theriault’s childhood. He was raised in an isolated outfitting lodge, the Ivanhoe River Inn. The lodge borders the northern Ontario forests a few minutes’ drive outside Foleyet, a town with a population of 216 in the district of Sudbury. The Ivanhoe River Inn is stationed on the edge of Ivanhoe Lake, a moderately sized body of water among a smattering of snake-like rivers that spread across northern Ontario. For over 10 years, Theriault has spent his summers working for his parents as a pilot at the lodge, flying supplies and clients to one of the family’s 31 isolated cabins on the lakes in northern Ontario. It was during this time that Theriault’s interest in herbicides began to deepen. As a pilot he began to notice changes in the landscape. Once-familiar swaths of greenery, shrubs and dense, dark forests took on a sickly yellowish-brown hue. From the air, vast clearcuts gave fallen trees the appearance of twigs strewn over patches of mud. Forests quickly became barren, marked by the occasional patchwork of brown brush. Theriault was horrified by the transformation and felt a personal responsibility to prevent its further destruction. “If you spend enough time somewhere—as it was for me—I kind of look at it and say, ‘Well, this is kind of a part of me.’ You start to claim some ownership over it,” he says.

In 2004, a hunting trip sparked Theriault’s interest to find out what exactly was being done to the forests around his home. Theriault was hunting in the Pineland forest, a mile away from cut blocks that housed signs stating that the area had undergone a recent herbicide spray. As he waded into a blueberry patch he discovered a black bear and quietly raised his rifle, shooting and killing the animal. Theriault used its meat in a stew for himself and his girlfriend at the time. When she suffered odd symptoms (dry itchy eyes, itchy throat, headache, nausea, heart pains) 20 minutes after the meal, Theriault saw it as nothing more than a bout of hypochondria. “We didn’t think anything of it,” he recalls. “I just thought, ‘Well, it’s not real, this is just something that’s in your mind.’” He admits his own throat felt strangely itchy after the meal, but ignored it. The next day, he cooked more of the bear meat—but this time telling his girlfriend it was deer, only to see her complain of the same reaction. Theriault’s curiosity was piqued. It just didn’t make any sense, he thought. He fed the same meat to some unsuspecting friends. “I had a couple of friends over, they’d eat the meat and I’d ask them, ‘How do you feel?’” It was tasty, but they experienced a dry, itchy sensation, they responded. To Theriault, it was more than coincidence. He knew that he’d been hunting near a former spray site. He had a hunch that what he’d been experiencing was a result of ingesting meat containing high concentrations of herbicides. But he couldn’t get a commercial or government lab to test the meat for herbicide contamination. While it’s true that some health effects associated with glyphosate-based herbicides include eye and skin irritation, headache, nausea, numbness, elevated blood pressure, and heart palpitations—Theriault had no way of linking the herbicide to his girlfriend’s symptoms.

Three years later, in 2007, Theriault experienced another bizarre incident that confirmed his earlier suspicions that herbicides were poisoning the wildlife near his home. He shot another black bear and when he field-dressed and quartered its carcass, he balked at the sight of its lungs. “Instead of nice healthy pink lungs, its lungs were totally bloodshot and full of blood lesions everywhere. They looked like red Jell-O.” White mossy spots covered the bear’s liver. Theriault says that the area that he was hunting in was a few miles from where herbicides had been sprayed.

Theriault’s experiences are not isolated. Similar reports of herbicide sprays killing rabbits and causing moose to develop cysts were noted in 1992. At that time, Ontario’s Environmental Assessment Board conducted one of the longest and most expensive hearings in Canadian history, in which Forests for Tomorrow (a coalition of environmental groups) challenged the forestry practices of the Ministry of Natural Resources and the industry—including the use of herbicides. During the four-and-a-half-year hearing, community members, aboriginal leaders, hunters, anglers and foresters all came forward to testify to the effects they thought Vision was having on the ecosystem. A particularly striking statement came from John Steinke, a guide who relayed what he witnessed while walking in a forest a week after it had been sprayed. “My dog couldn’t have survived if I didn’t carry it around,” he told the judiciary. “Most notable is the total lack of wildlife; there isn’t a bee, there isn’t a bird, there is nothing there.” The hearing ultimately decided that herbicide would continue to be used in forestry, as it was not threatening human health and was essential to the survival of the industry. Rick Lindgren, a lawyer with the Canadian Environmental Law Association and co-counsel representing Forests for Tomorrow recalls the hearing. “On some of the big ticket items like herbicide application and clearcut size we didn’t see much progress at all. In fact, all it really did was entrench the status quo.” Lindgren attributes the hearing’s results to the difficulty of altering long-established federally approved herbicide practices. “It was hard to say, ‘well, maybe you shouldn’t have registered these things for use, or the registration should be reconsidered in light of new or growing scientific evidence which suggests that there may be potential risks to applicators and the ecosystem,’” says Lindgren. The expert he’d arranged to testify on herbicide alternatives in forest regeneration practices was unable to attend at the last minute and the public testimony didn’t constitute hard evidence against the use of herbicides. “It’s one thing to say, ‘well they came in and sprayed and I saw this disappear, I no longer saw this species, I no longer saw that species.’ But try to prove cause and effect, that was difficult,” he says. Ironically, just as Ontario’s Environmental Assessment Board was rendering its decision to uphold the use of herbicides in the forestry industry, Quebec was moving towards enacting a provincial policy that would see all herbicides banned from use in public forests by 2001. But no precedent was set.

It’s difficult to win a battle that hinges on changing government regulations when the government itself resists. Brennain Lloyd, the project coordinator of the northern Ontario environmental group Northwatch, says that the Ontario government advocates for herbicide use in forestry: “The Ministry of Natural Resources’ mandate is to promote and support forest management, and what forest management requires in the present industrial worldview is the use of herbicides, so those things seem to be accepted as givens within the ministry.”

The MNR’s lack of presence on the ground during forestry operations is a result of the 1995 Ontario government reform agenda known as the “common sense revolution,” which slashed the budgets of ministries to reduce government spending and taxation, often through privatization. The MNR lost 50 percent of its forest management staff—including half of its field inspectors—and millions from its budget. In 1998, the MNR formally transferred Crown forest oversight to the forestry industry. “I had concerns that it was letting the fox look after the henhouse,” Lorraine Rekmans, the former executive director of the National Aboriginal Forestry Association, says of the shift in policy.

In fact, even though the MNR requires the forestry industry to adhere to certain standards in its application of herbicides, the industry is left to regulate itself, a policy known as the “forestry self-inspection system.” “The whole thing is constructed on a fundamental conflict of interest,” says Mark Winfield, a professor at York University who conducted a comprehensive review of the system. “Employees are effectively going to have to report non-compliance on the part of their employers,” he says. “That’s obviously problematic. Winfield’s research found that forestry inspections conducted by MNR employees uncovered violations at a much higher rate than those conducted by industry-employed inspectors. Michael Irvine, the MNR vegetation management specialist, acknowledges the criticism of the self-inspection system, but argues that forestry companies are subject to independent audits that examine the degree to which their ground operations comply with the province’s sustainable forest management regulations. But “the quality of the audit reports vary,” says Winfield. The process is poorly documented and varies from auditor to auditor.

Meanwhile, the chemical regulatory branch of Health Canada (the Pest Management Regulatory Agency) responsible for approving glyphosate-based herbicides has been widely criticized for its pro-industry bias. The federal Commissioner of the Environment and Sustainable Development has rebuked the PMRA for its slow and unresponsive regulatory approach and dependence on risk-assessment data from chemical companies that lack quality assurance and independent validation. The PMRA, along with the federal Minister of Health, have also been accused of ignoring scientific evidence of environmental and health risks when approving glyphosatebased products for use in Canada. As of September 25, 2009 a lawsuit has been launched (by a retired B.C. pediatrician, Josette Wier) against the federal Minister of Health on these grounds.

Theriault has tried to use government bureaucracy to his advantage in attempting to halt forestry operations. Over the course of six years he has filed several requests for individual environmental assessments that temporarily froze forestry operations near his home, sent foresters off the job, caused the industry to lose money, and inflamed tempers. “It’s amazing how one individual in Foleyet can shut down industry,” says Susan Pickering, who worked for Tembec when Theriault’s request for an environmental assessment (called an EA by insiders) froze the company’s operations in the spring of 2006.

Theriault recalls a time when his repeated requests for environmental assessments even caused his childhood friends who now work in the forestry industry to turn against him. “My fishing and hunting friends all of a sudden wanted to fight with me. Wanted to actually fist-fight me. They were so pissed because their bosses were telling them I was going to shut down the forestry in the whole province and they were all going to be out of jobs.” Although Theriault was never subject to physical violence, he was careful not to go to the local bar without friends, in case any confrontations arose. “I’d make sure I had backup there in case I had a group of belligerently drunk forestry guys who all wanted to fight me. Which was very well within the realm of possibility. What do you say to a drunken forestry guy who hates your guts because he thinks that you’re going to put him out of work?”

Theriault also noticed that with each environmental assessment request he made, the Ministry of Natural Resources became less receptive to his requests for information on forestry operations. “So I just stopped asking as myself,” he says. “It was unproductive for Joel Theriault to ask for information. It was more productive for aliases to ask for information. because then the guards were down.” In June 2009, foresters working for Tembec were sent off the job as a result of an assessment request filed by Theriault, which temporarily suspended the company’s logging operations. At the time, Tembec’s chief forester in Ontario, Alan Thorne, described the issue as “very sensitive,” explaining that “hundreds of thousands of dollars” could be lost. Of the EA requests filed by Theriault to date, none have resulted in a permanent halt to herbicide spraying.

Despite Theriault’s energy and obvious enthusiasm for his cause, his go-it-alone style has often backfired. Theriault attended law school—“I think that having a law degree is going to give me the tools to incite change that might not otherwise happen,” he says—but things haven’t exactly worked out as he planned. As a student of environmental law, Theriault focused on gathering evidence for his case against industry. To sharpen his arguments, he wrote papers on herbicides, discussed the issue with professors, attended and organized herbicide workshops, wrote petitions against the use of herbicides in forestry, went to forestry planning meetings, wrote letters to the editors of local and national newspapers on the subject of herbicides, and solicited help from other activists. He also started a website, Domtar.org, which he says was set up to showcase harmful practices and embarrass industry. The site, now relocated to Whitemoose.ca, contains aerial photos and videos of deforested land, numerous letters to the editor written by Theriault criticizing the industry’s use of herbicides, as well as his correspondence with scientists, academics, activists, and members of industry or government on the subject of herbicides.

Theriault’s aggressive critiques of the industry and government were often self-defeating, getting him kicked out of community forestry planning meetings and alienating him from other activists. “A lot of people who work in forestry, the pesticide industry or government really disdain me because of my activism,” says Theriault. Susan Pickering, who worked for Tembec until 2008 when she became the program manager for the forest research partnership at the Canadian Ecology Centre, adds, “I know that Joel has had court orders not allowing him to speak to the Ministry of Natural Resources because of his language.” Although the MNR denies filing a restraining order, Theriault says he’s been asked to leave meetings in which the Ministry officials were present.

Other activists have also steered clear of Theriault because of his reputation. Jennifer Simard, the executive director of the Mushkegowuk Environmental Research Centre, and an active member of the First Nations community in northern Ontario, has, like Theriault, witnessed the damaging effects of herbicides used in the forests near her home. Simard met Theriault at a 2006 symposium on forestry herbicides that she helped organize.

She describes Theriault as a “dedicated guy,” but his singleminded pursuit of a pesticide ban has also tended to alienate potential allies. “It’s too bad, and I think that he could be very helpful if he would just be more of a team player.” “Joel is a very intense individual, highly committed,” says Brad Morse, one of Theriault’s law professors. “But Joel has a bit of an aggressive streak. He’s not at all shy to challenge people. Joel doesn’t let anything stand in his way. I’ve suggested to him on some occasions to calm down a bit and to think more strategically.” Linda McCaffrey, Theriault’s former articling principal at EcoJustice in Ottawa, says he “has an unusual amount of confidence in himself and his priorities. I had been told by one of his professors that he was very talented and that he wasn’t easy to keep under control. And he’s not easy to keep under control, he’s absolutely his own person. He knows what he wants and he knows what he thinks.”

Theriault’s efforts culminated in the last year of his law degree when he directed a team of students to gather research for a petition submitted to the Canadian government in 2007. It was a request for an investigation of a violation of the Fisheries Act by Domtar and Tembec, claiming that Ontario lakes and rivers near their forestry operations were being contaminated with herbicides. It cited repeated incidents in which glyphosate contamination of drinking water occurred as a direct result of its use in forestry. In Denmark, glyphosate contamination in ground water resulted in the chemical being banned, and in 2006 glyphosate was detected in the well water of the northern Ontario town of Cochrane, although there was no proof linking the contamination to forestry activities in the area. The petition was ultimately rejected on the grounds that there wasn’t enough evidence to prove waterway contamination. Theriault was ultimately willing to do what the government wasn’t. His petition requested that specific lakes and rivers near forestry spray sites be tested for herbicide contamination, although Theriault was already on a mission to do this himself. After finishing law school, in his first week of articling in Toronto at environmental law advocates EcoJustice, Theriault told his bosses he wanted a week off. “I basically told my bosses in Toronto, ‘look, I want to go north to go water sampling. So we’ve got two options. Either you guys can send me up for a week and we’ll call it work, or if we can’t agree on that, then I’d like a week off. ‘ That’s how I said it.” Theriault acknowledges that his request was unusual, “Who takes a week off without being there for a week? Not many people. But I did.” His bosses granted him a week off to take water samples but Theriault was embarking on a task that would be a challenge for a multidisciplinary team of scientists to complete, let alone an individual. “He was highly committed, highly ambitious, courageous, very determined and not very experienced [in collecting water samples],” says EcoJustice director Linda McCaffrey, who worked with him in Ottawa. “After you’ve got all these samples you have to have them analyzed. And pesticide samples can be hellishly expensive to have analyzed. And you have to know who can analyze them. You can go to a commercial lab and, depending on the lab, they can give you an analysis result and it may not be meaningful at all.” Theriault admits his task was daunting, “It was a bastard trying to get water samples,” he says. For one, he had no idea where and when the spraying was happening. He asked MNR for that information, but the ministry told him it didn’t receive that information until long after spraying occurred, and that he’d have to ask the forestry companies directly (who, understandably, had no interest in sharing the information with him). So Theriault would fly around in his father’s seaplane, listen to his radio, and wait.

Theriault says he never would have known exactly when spraying took place if it wasn’t for the radio in his plane, which allowed him to intercept the communication of industry pilots who sprayed the herbicide. “I’d go up in the airplane and I’d hear: ‘Okay, Charlie Golf Lima X-ray Zulu. Two miles west of Five Mile Lake, aerial allocations ten’… I know exactly where you fuckers are. And that’s how I followed them.” But Theriault then had to spend time on the ground finding bodies of water near the spray sites. He spent hours driving remote rugged logging roads looking for signs announcing a recent spray. “In a week I probably put on 700 kilometers driving forester roads looking at signs,” Theriault says. “And the next part, after you know it’s been sprayed, is to be at the shoreline of the creek when the first rainfall hits.” So Theriault squatted at the shores of lakes, waiting for rain. “Just sitting there, just waiting and saying, ‘Fuck, I hope it rains soon, I’m ready to go home.’ And then trying to get those kind of water samples, which turned out to be just kind of impossible.”

Theriault gathered two water samples that he believed might have been exposed to Vision, but the commercial lab where he had them tested showed that any herbicide in the water was below MNR-regulated levels. Theriault was determined to keep trying, but his bosses at EcoJustice were not pleased. “After that it was like, ‘oh that was a big waste of time, a big disappointment.’ There was a lot of confidence lost after that,” Theriault says. “I think they kind of looked at it and they said, ‘Wow. Nice kind of vacation for you Joel. Now we’re going to do our work.” The crusade was temporarily suspended—but far from over.

A week after theriault’s sampling trip, and two weeks after his petition was filed with the federal government against Domtar and Tembec, Theriault was served with legal papers from Domtar. The company claimed that his website Domtar.org was libelous in its attempts to pose as the organization. Two weeks later, a lawyer from Domtar phoned Theriault’s boss at EcoJustice in Toronto. By Theriault’s account, “Domtar called and said, ‘Look this guy’s driving us nuts. We’re going to bring in legal action against him if you don’t stop him, and we’re going to bring legal actions against you guys personally.’ So that freaked out my bosses.”

He left the Toronto office in what everyone involved politely refers to as a mutually agreed-upon “leave of absence.” Several months later, Theriault moved to EcoJustice’s Ottawa office on the condition that he no longer advocate on the herbicide issue. McCaffrey, at EcoJustice in Ottawa, recalls the ordeal. “A Domtar lawyer phoned one of the lawyers in the Toronto office and accused Joel of unprofessional conduct,” she says. “I don’t know what the specific allegations were, but I guess they boiled down to a general allegation that his conduct was unprofessional in some way, but I don’t know what way that would have been. Anyway, the result was that Joel came to Ottawa to finish his articles. He agreed to give up his campaign and focus just on the work of this office.” (Domtar refused to comment on its interactions with EcoJustice or Theriault.)

In December 2007, Domtar took Theriault to court over his website domain name, resulting in Domtar.org being transferred to the corporation. Theriault was disappointed with his employer’s response to Domtar. “EcoJustice is this environmental activist group, you’d think that they’d see through the bullshit,” he says. Theriault was also discouraged because Domtar had effectively silenced him on the herbicide issue. “I couldn’t say anything about Domtar without fearing that I’d be laid off again and publicly humiliated and have my career destroyed.” Theriault was demoralized and exhausted. Domtar and Tembec continued to spray herbicides in the forests near his home, his petition had failed, and EcoJustice would only rehire him on the condition that he’d stop advocating for the issue that he cared about most.

In September 2008, Theriault finished his articling with EcoJustice in Ottawa, and continued to work with them until November 2009. He’s a certified lawyer, although he has yet to find a full-time job. He half-jokes that he’s temporarily retired, as he still spends summers working for his family’s business. But Theriault is far from giving up on the herbicide issue. In the evenings he can be found nursing a beer, composing editorials to his local newspaper on the subject. But his frustration is mounting; it’s become painfully clear that for years the only tangible progress he’s made is delaying forestry operations near his home and angering industry—and making enemies for himself. “Have I changed things so far? No I haven’t. No, I’m still plowing away at it. It’d be a different story if I was sitting here, complaining and griping about an issue and doing absolutely nothing,” he says, “which is where most of the world fits in.”

Theriault has recently filed a new environmental assessment request. Companies that spray pesticides around domesticated livestock grazing areas are required to abide by strict exposure limits; Theriault is asking that forestry companies be held to the same standard when spraying around animals that are hunted in the wild. He argues that hunters and local communities should be protected from pesticide-laced food just as surely as supermarket shoppers are. So far, the Ontario Ministry of the Environment has been receptive.

But while flying in his seaplane, I feel a blunt isolation from the devastation of the land, although its scars are clearly mapped out before me. I see Theriault reach his arm out of his tiny rain-stained window and snap pictures of the flattened landscape sliding below us. The crackle of my headset breaks the muffled silence as I hear Theriault’s voice. “I would rather just see this all burned and be able to re-grow from there than what’s being done.”

Dear Progressive Detective: I’ve heard of a new birth control pill, Seasonale, that reduces your period to four times a year instead of 12. I see the appeal, but messing with my cycle just seems like a bad idea. How safe are these kinds of contraceptives?

Extended-use hormonal contraceptives like Seasonale boost estrogen to levels that some experts link to increased risk of cancers, blood clots, and bone density loss. Yet published studies on such long-haul pills are generally not placebo-controlled, says Dr. Jerilynn C. Prior, professor of Endocrinology at the UBC Department of Medicine’s Centre for Menstrual Cycle and Ovulation Research. Prior argues such studies either use women on the standard pill as a control measure, or simply don’t bother with a control at all. Either way, those study results imply a woman on the standard pill is hormonally the same as an untreated woman—something Prior sees as grossly unscientific.

These studies have been published in respected medical journals, while concerns from experts such as Prior aren’t being taken seriously by reviewers, editors or governing bodies. “They scoffed at me when I suggested that placebo-controlled trials were necessary,” says Prior. “They got away with getting Seasonale accepted in Canada without doing placebo-controlled trials.”

What’s worse, Prior says many doctors and gynecologists rely on out-of-date trials. “The placebo-controlled trials of the birth control pill go back to when it was really a different drug. It had about five times higher estrogen doses,” she explains. “And the placebo-controlled trials were not done well by today’s standards.”

It’s not easy for the average citizen or researcher to look into the drug approval process, either. You’d have to submit an Access to Information Request form, which is limited and slow, says Anne Rochon Ford, coordinator of Women and Health Protection at York University. “We had an unbelievably long wait,” she says, “and when we did get it back it was significantly blacked out, like a prisoner’s letter.”

Ford adds post-marketing studies to monitor adverse side-effects for Seasonale aren’t being done effectively. “There’s a conflict of interest now because [Health Canada] requires pharmaceutical companies to pay for their evaluation,” says Prior. “It isn’t funded by parliament as much as it’s funded by the people it’s supposed to be regulating.” With such deeply vested interests— and such complex data—Progressive Detective asks for better research before opting for this kind of pill.