Stratfor has an excellent piece on the production of methamphetamine in Mexico and Central America, production techniques and precursor chemicals.
Based on evidence obtained from raided laboratories in the United States and Mexico, it appears there are two primary methods of methamphetamine production in those countries: the phenyl-2-propanone (P2P) method and the reduction method.
Sometimes referred to as “building up,” P2P is considered the more difficult of the two methods. It requires more chemicals and materials and more sophisticated chemistry. In fact, the chemical process is so technical and complex that it requires several days to complete, necessitating a skillset akin to that of licit chemists. It also entails a purification step that increases the potency of the final product. While P2P produces a more potent final product, the method is subject to the competence of the manufacturers and the quality of the chemicals being used. P2P is the method most employed by Mexican criminal organizations because its two primary requisite precursor chemicals, methylamine and phenyl acetic acid, are loosely regulated in Mexico.
Reduction is the manufacturing method primarily used in Asia and the United States. This method involves mixing ephedrine or pseudoephedrine with a few easily attainable precursor chemicals. With reduction, a manufacturer can cook a small volume of meth (a few ounces) in as few as eight hours. Indeed, the key difference between the manufacturing methods is that reduction requires less time and less sophistication than P2P, and ultimately it produces an inferior product.
It should be noted that the manufacturing method has nothing to do with production scale. Either method can be used to cook large or small quantities of the drug. It can be manufactured in a hotel, apartment, home, car trunk or backpack. However, to produce meth on an industrial scale, a manufacturer would need more space. Past seizures have taken place in large warehouses (around 1,600 square meters, or 17,000 square feet), small ranches (6-40 hectares, or 15-100 acres) or even mid-sized homes.
Cost of production also differentiates the two methods. While meth is more cheaply rendered by reduction, both methods are extremely cost effective. Depending on the price of chemicals used — determined by the quantity of chemicals purchased and the legitimacy of the supplier — the cost of manufacturing 1 kilogram (2.2 pounds) of meth comes to anywhere between $150 and $4,000. The use of methylamine, which is highly regulated, expensive and, as stated, only used in the P2P method, is the key factor in this price range; substituting methylamine with a mixture of methanol and anhydrous ammonia drastically reduces the cost. According to the U.S. Department of Justice’s National Illicit Drug Prices Mid-Year 2009 report, the wholesale market price for meth is $19,720 per kilogram while its street value is $87,717 per kilogram. Needless to say, this is a huge markup.
But it is not necessarily the overall cost that determines the production method of Mexican criminal organizations, or any meth manufacturer. Rather, it is the availability of precursor chemicals that matters. Mexican manufacturers could save vast sums of money by exclusively using the cheaper reduction method. But the Mexican government’s strict regulation of ephedrine and pseudoephedrine compels criminal organizations to use other methods, such as P2P, that require less-regulated precursor chemicals.
Read all of the report and then you can watch this video on the effects of methamphetamine on the mouth. The American Dental Association authored the video.
Methamphetamine abuse and oral health: A pilot study of “meth mouth”
Michele C. Ravenel, DMD/Carlos F. Salinas, DDS/Nicole M. Marlow, MS/Elizabeth H. Slate, PhD/Zachary P. Evans, PhD/Peter M. Miller, PhD
Abuse of methamphetamine (meth), a potent central nervous system stimulant, has been associated with significant dental disease. Current descriptions of “meth mouth” are limited in their scope and fail to illuminate the potential pathogenic mechanisms of meth for oral disease. The purpose of this pilot study was to characterize the oral health of subjects with a history of meth abuse as compared to nonabusing control subjects. A total of 28 meth abusers and 16 control subjects were enrolled. Interviews and surveys regarding meth abuse, dental history, oral hygiene, and diet were collected. A comprehensive oral cavity examination including salivary characterization was completed. We observed significantly higher rates of decayed surfaces, missing teeth, tooth wear, plaque, and calculus among meth abusers. No significant difference in salivary flow rates were noted, yet results showed significant trends for lower pH and decreased buffering capacity. These findings suggest that salivary quality may play a more important role in meth mouth than previously considered. Salivary analysis may be useful when managing a dental patient with history of methamphetamine abuse. (Quintessence Int 2012;43:229–237)
The ADA lists the suspected causes as dry mouth, poor oral hygiene, frequent consumption of sugary and carbonated drinks, tooth grinding and clenching, and possibly the acidic nature of MA itself.
In a study in ISRN Dentistry (June 26, 2011), street samples of MA had pH levels from 3.02 to 7.03, with 72% of samples below the critical pH point of 5.6, i.e. able to cause significant damage to tooth enamel if abused by a route that brings MA into contact with the oral cavity.
Although this would seem to indicate that injecting MA rather than smoking or snorting it may lead to less enamel damage, this hasn’t been borne out by the research. Researchers at the University of California, Los Angeles (UCLA) reported in the Journal of the American Dental Association that, among abusers of MA, IV users actually had a higher prevalence of oral disease and missing teeth than those who smoked MA, probably due to more advanced addiction and greater self-neglect.
“Those who use MA may make the transition from noninjecting drug use to injecting drug use, as their dependence on MA becomes more severe,” Vivek Shetty, DDS, DMD, professor of oral and maxillofacial surgery at the UCLA School of Dentistry and lead author on the JADA study (March 2010, Vol. 141:3, pp. 307-318), told DrBicuspid.com.
“The injected substance has almost 100% bioavailability, and the onset of the drug high is fairly rapid, generally 15 to 30 seconds.”
It is interesting that IV Meth users have more dental disease than those that smoke the drug. One would think that the constant heat and dehydration of the oral tissues would contribute to more dental destruction. But, perhaps, the more intense rush from IV drug use leads to more self-neglect.
In any case, salivary analysis of patients may give dentists a better idea of the mechanism of addiction and how to combat it at an early stage.
Watch below an embedded video below from a dentist colleague, Dr. Mitchell A. Goodis, DDS in Northern California and his interview of the many methamphetamine user patients, whom he has treated.
Thousands of kids get free dental care under Medicaid in Texas. Texas taxpayers foot the bill, including putting crowns on the teeth of toddlers who don’t yet have their permanent teeth.
A News 8 investigation finds that some dentists want that Medicaid business so badly, they hire recruiters to bring in patients.
At a Texas Health and Human Services Office on Masters Road near Dallas, a man quietly stands in the parking lot, waiting for mothers who’ve just received food stamps to emerge from the waiting room.
He is a recruiter. He’s handing out cards for Happy Teeth Dental, just two doors down in the same complex.
At another HHS office across town, two women also wait for new food stamp recipients. They’re handing out cards for Lancaster Dental a few miles away.
And at another HHS office just up the road, Bear Creek Family Dentistry has a small kiosk set up to recruit new patients.
Medicaid parents are regularly solicited by dentists offering free stuff — such as iPods, zoo tickets, and electric toothbrushes — if they take their kids to certain dentists.
It is a little-seen side of Medicaid dentistry, a $1.5 billion business in Texas, where, statistics show, welfare and unregulated free enterprise come together like nowhere else in the United States.
Watch the video expose which is embedded below:
All I can say is wow!
There needs to be some action on the part of the Texas Dental Board to enforce the anti-solicitation law and from the Feds to cut off the spigot of taxpayer money flowing to these dentists.
I know the United States Senate is investigating dentistry medicaid across the country. But, the abuses are rampant and this is before new federal funds will be doled out under ObamaCare’s Affordable Care Act.
An Irvington dentist who was disciplined by the state after a 6-year-old girl died during a routine procedure eight years ago is again under investigation following the death of a second child in his care last week.
Patrick Bamgboye, 64, was still on probation for the earlier incident when 3-year-old Juan Quiej and his mother arrived at Dental Health Associates last Wednesday.
Juan, who was there to have cavities fixed, was restrained in a cocoon-like papoose to limit his movement and administered a local anesthetic, his mother said.
Shortly afterward, the boy went limp, his lips turning blue. He had stopped breathing. He was later pronounced dead at a local hospital.
The death has sparked an investigation by the state Division of Consumer Affairs, the agency that oversees the Board of Dentistry, officials confirmed Tuesday.
“We need to know what happened and why,” said Thomas Calcagni, the division’s director.
In addition, Acting Essex County Prosecutor Carolyn Murray said in a statement her office was working with the Attorney General’s Office to determine if a criminal probe should be launched.
We want to share with you the tragic news of the death of a three-year-old boy in New Jersey. New Jersey officials are investigating dentist and AAPD & ADA member, Dr. Patrick Bamgboye, after the child died in his care while restrained and under local anesthetic for a routine cavity-filling procedure. Dr. Bamgboye was still on probation following a suspension by the Board of Dentistry for the death of a six-year-old girl in 2004.
Similar to the three-year old boy, the six-year old girl had been placed in a papoose and given a local anesthetic, and stopped breathing during the procedure. But a medical examiner determined that she had died of natural causes because she suffered from several serious medical conditions, including cerebral palsy. The Board of Dentistry investigated her death and filed a complaint against Bamgboye in 2008. An administrative law judge in 2010 found no gross negligence, but the board suspended Bamgboye for three months in January last year and placed him on probation for an additional 21 months. The Division of Consumer Affairs, which oversees the Board of Dentistry, is investigating. The Essex County prosecutor’s office is reviewing the case with the attorney general’s office to determine whether a criminal investigation is warranted.
These are my links for February 13th through February 14th:
“Dogs Against Romney”? Democrats Say Unleash the Hound! – Tomorrow outside the Westminster dog show at Madison Square Garden at noon the group “Dogs Against Romney” will protest “to ensure pet lovers are aware that Mitt Romney is mean to dogs,” according to the group’s press release.
While it may seem silly to some, Democrats are have every intention of making sure – if Romney wins the GOP nomination – that every voting American knows about the story of Romney putting his family dog Seamus in a kennel on top of his roof and driving from Boston to Canada, with said canine Seamus making his displeasure known in a rather scatological way. “I have a yellow Lab named Winston,” Fox News’ Chris Wallace said to Romney. “I would no sooner put him in a kennel on the roof of my car than I would one of my children. Question: What were you thinking?” “This is a completely airtight kennel, mounted on the roof of our car,” Romney replied. “He climbed up there regularly, enjoyed himself. He was in a kennel at home a great deal of the time as well. We loved the dog. It was where he was comfortable.” “When Seamus crapped all over the car I’m fairly certain he wasn’t expressing pleasure,” one top Democrat told ABC News.
“Simply put,” Frisch wrote, “the progressive movement is in need of an enemy. George W. Bush is gone. We really don’t have John McCain to kick around any more. Filling the lack of leadership on the right, Fox News has emerged as the central enemy and antagonist of the Obama administration, our Congressional majorities and the progressive movement as a whole.”
“We must take Fox News head-on in a well funded, presidential-style campaign to discredit and embarrass the network, making it illegitimate in the eyes of news consumers.”
What Frisch proceeded to suggest, however, went well beyond what legitimate presidential campaigns attempt. “We should hire private investigators to look into the personal lives of Fox News anchors, hosts, reporters, prominent contributors, senior network and corporate staff,” he wrote.
After that, Frisch argued, should come the legal assault: “We should look into contracting with a major law firm to study any available legal actions that can be taken against Fox News, from a class action law suit to defamation claims for those wronged by the network. I imagine this would be difficult but the right law firm is bound to find some legal ground for us to take action against the network.”
Laura Richardson’s ethics woes mount – Democratic Rep. Laura Richardson instructed taxpayer-funded House aides to work on political redistricting last year, sources familiar with the situation told POLITICO.
Such activities could amount to a violation of prohibitions against lawmakers pressuring aides to do political work, as well as rules against using official resources, including staff, for campaign purposes.
The redistricting work, which has not previously been disclosed, allegedly occurred after it became clear Richardson was under investigation over another set of allegations that she forced House aides to perform political and personal tasks in violation of House rules. Richardson did not respond to repeated requests for comment.
Sources told POLITICO that Richardson’s congressional aides collected information about communities outside her district, organized a workshop to train constituents in advance of a public meeting of California’s independent redistricting commission, and wrote talking points for those constituents to deliver during the public-comments portion of the meeting at Long Beach City Hall in April 2011.
The redistricting work was done at Richardson’s direction — rather than on a voluntary basis — these sources said.
A spokesman for the Ethics Committee declined to comment on the Richardson case, but several sources indicated that investigators have expanded the probe and are now looking into the redistricting angle.
Iranians’ Internet access blocked temporarily: experts – Most computer users in Iran were blocked from accessing email, social networking and other services in recent days, U.S.-based Internet experts said on Monday, raising fears the government is extending the reach of its surveillance on ordinary citizens.
Internet service providers presumed to be acting at the Iranian government’s behest began blocking the most common form of secure connections on Friday, according to the outside experts and Iranian bloggers. Traffic rebounded to normal levels on Monday.
The cutoff apparently affected all encrypted international websites outside of Iran that depend on the Secure Sockets Layer protocol, which display addresses beginning with https, according to Earl Zmijewski of Renesys, a U.S. company that tracks Internet traffic worldwide.
California lawmaker writes ‘Public Employees Bill of Rights’ – Assemblyman Roger Dickinson, D-Sacramento,(right) has introduced legislation that would give unionized state workers more workplace discipline protections and first dibs on state government work.
SEIU Local 1000 and the Union of American Physicians and Dentists support AB 1655, the “Public Employees Bill of Rights Act.” Here’s what it would do:
• Gives unionized state employees priority over outside contractors and excluded state workers to fill permanent, overtime and on-call positions.
• Sets a one-year statute of limitations for employers to take an adverse action against a state employee. (The current law allows disciplinary actions up to three years after the discovery of fraud, embezzlement or records falsification.)
• Establishes a peer review committee to provide workplace operations input.
• Guarantees that the state won’t impose “unreasonable quotas” on employees.
• Bans extra work created by vacancies, furloughs of layoffs without “fair compensation.”
• Gives priority to workplace safety and health grievances.
• Explicitly bans workplace discrimination.
• Strengthens whistleblower protections.
• Requires employers exercise “preventive and corrective” actions before administering harsher employee discipline.
• Settles grievances in favor of the employee if the employer misses contractual deadlines for response.
• Defines protections and performance and merit evaluation processes for professionally licensed employees.
• Guarantees independent legal representation for professionally licensed workers named as codefendants in litigation against their employers.
A Center for Health Reporting article published in The Bee over the weekend detailed the shortcomings of the managed care program, including long wait times and comparatively low rates of dental care among the more than 110,000 Sacramento County children covered by the program.
In a letter to California Department of Health Care Services Director Toby Douglas, Steinberg called for immediate action to address what he called a “crisis in prevention and treatment services.”
“Despite that state funding, disturbing specific patient cases as well as the department’s own data cited in the article make it abundantly clear that prevention and treatment services are woefully inadequate for those children most in need,” the Sacramento Democrat wrote in the letter.
In addition to the investigation, Steinberg asked the administration to step up its monitoring of dental plans under contract with the program and withhold payments or cancel contracts with plans that fail to provide proper access to care or meet other performance standards.
A new Pew Research Center poll found Santorum and Romney neck-and-neck, with Santorum winning 30 percent of the support among Republican registered voters to Romney’s 28 percent — a difference that falls well within the poll’s five percentage point margin of error. Separately, Gallup’s latest tracking survey of the Republican race found Romney with 32 percent support and Santorum right on his heels with 30 percent.
Of concern for Romney, the Pew poll shows him struggling among the conservative groups that make up the Republican base. Among self-identified conservatives, Santorum leads Romney by an 11 percent margin, 36 percent to 25 percent. Among Tea Party supporters, Santorum leads 42 percent to 23 percent.
Romney’s support among Tea Party supporters is essentially unchanged from last month, when he received 26 percent support from Tea Party supporters to 24 percent each for Santorum and Newt Gingrich. But Santorum’s lead among the group may be a sign that they have begun to see him as the alternative to Romney.
The American Spectator : Can Mitt Close the Deal? – Cold, bleak February has turned into a happy time for us. It’s given us a short break from the constant barrage of debates, speeches and “crucial” primaries in the Republican presidential nomination contest. February has given us, and the candidates, a bit of time to think. Let’s make the most of it.
The nomination is still up for grabs. Mitt Romney has the clearest path to it but Newt Gingrich, Rick Santorum, and Ron Paul are all promising to take it all the way to the convention. To those who natter about how cool a “brokered” convention would be, I say don’t wish for something because you might get it. (Among other frightful questions, who can be the brokers? It’ll be a food fight that benefits only the media.) The Republican Party is too weak and fractured to come out of such an event united and strong enough to win in November.
So let’s assume that Romney is the nominee. The arithmetic is pretty simple. Mitt Romney plus an energized Republican base can beat Obama in November. Romney without an energized base will lose. But the Republican base is conservative, and Romney hasn’t closed the deal with conservatives. Can he?
Let’s face it: Romney isn’t one of us. At CPAC last Friday he said he governed Massachusetts as a “severely conservative” Republican in the tone of voice my late maternal grandmother used to say she was severely constipated. We know his record as state candidate and governor, and national candidate since 2007. We need not rehearse it here. Suffice it to say that it defines him as a transactional conservative. He will apply conservative principles as a business owner might apply production scenarios and estimated profit margins to negotiating a deal. They aren’t part of his core, but will be useful tools for him in campaigning and, if he wins, governing.
National Review calls on Gingrich to bow out of presidential race – The National Review is calling on Newt Gingrich to drop out of the Republican presidential race, arguing the former House Speaker should clear the way for Rick Santorum to seize the mantle as the Anti-Romney choice for conservatives.
“It is not clear whether Gingrich remains in the race because he still believes he could become president next year or because he wants to avenge his wounded pride: an ambiguity that suggests the problem with him as a leader. When he led Santorum in the polls, he urged the Pennsylvanian to leave the race. On his own arguments the proper course for him now is to endorse Santorum and exit,” the editors of the influential conservative online magazine wrote in an op-ed posted Monday.
Santorum moves ahead in Michigan – Rick Santorum’s taken a large lead in Michigan’s upcoming Republican primary. He’s at 39% to 24% for Mitt Romney, 12% for Ron Paul, and 11% for Newt Gingrich.
Santorum’s rise is attributable to two major factors: his own personal popularity (a stellar 67/23 favorability) and GOP voters increasingly souring on Gingrich. Santorum’s becoming something closer and closer to a consensus conservative candidate as Gingrich bleeds support.
Santorum’s winning an outright majority of the Tea Party vote with 53% to 22% for Romney and 10% for Gingrich. He comes close to one with Evangelicals as well at 48% to 20% for Romney and 12% for Gingrich. And he cracks the 50% line with voters identifying as ‘very conservative’ at 51% to 20% for Romney and 10% for Gingrich.
Maj. Courtney Schapira poses with, from left, dental technician Nasir, dental clinic chief Dost Muhammad and dentist Janat at Forward Operating Base Lightning. Schapira is currently on a six-month deployment in Afghanistan as the Chief Dental Advisor at Paktia Regional Military Hospital in Gardez and is from the 628th Medical Group at Joint Base Charleston, S.C (Photo by Staff Sgt. Sarah Martinez)
In a remote valley of war torn Afghanistan, a Joint Base Charleston Airman is playing a vital role enhancing the country’s practice of dentistry.
Major Courtney Schapira, from the 628th Medical Group at JB Charleston – Air Base, is currently assigned to the Medical Embedded Training Team at Forward Operating Base Lightning as the Chief Dental Advisor at Paktia Regional Military Hospital in Gardez, Afghanistan.
“Our team is made up of 21 medical advisers from different NATO countries,” said Schapira. “We each have our own areas of expertise such as internal medicine, nursing, pharmacy, etc.”
Schapira deployed in November 2011 and is the first and only dental adviser assigned there.
“The Afghan dentists that I work with are excited to have a U.S. dental advisor and are eager to learn from me,” said Schapira. “They are asking questions and taking the initiative to do things on their own.”
Paktia Regional Military is an Afghan National Army hospital that only treats ANA, Afghan police and civilians with combat-related injuries.
The standard of dental care in Afghanistan is much different than in the United States. The clinic is not current with modern preventive dentistry.
According to Schapira, the dentists are very skilled and adequate at their profession, however, their techniques, materials and thought processes behind their treatments are out-dated.
“The dentists here used to rarely make patients numb prior to treatment,” said Schapira. “This is both painful for the patients and can turn what may be a single appointment in the U.S. into two or three appointments here, simply because the patients can only tolerate so much pain. Since my arrival, they now numb patients prior to any surgical procedure.”
During her first few weeks in Afghanistan, Schapira felt overwhelmed by the challenges facing her. Her efforts were divided in multiple directions. Supplies, non-working equipment, outdated techniques, infection control and patient administration all needed her attention.
“I realized I couldn’t improve everything at once,” said Schapira. “So, I set goals for myself and for the clinic. After most of the equipment was modernized, so I turned my focus to the supply inventory.”
These are my links for February 7th through February 8th:
Santorum revives campaign with wins in Colorado, Missouri and Minnesota – Rick Santorum had a breakthrough night Tuesday, winning GOP presidential contests in Missouri, Minnesota and Colorado, all of which is expected to breathe life into his struggling campaign and slow Mitt Romney’s march to the Republican presidential nomination.The Santorum triumphs promise to, at least temporarily, alter the face of the campaign going into the crucial “Super Tuesday” contests, as the caustic tone of the primaries is expected to continue and intensify. Romney and his allies have signaled that they will use their financial advantage to launch stepped-up attacks on Santorum and on former House speaker Newt Gingrich, the other main challenger.
Three-state sweep revives Santorum’s White House hopes – Former U.S. senator Rick Santorum rejuvenated his presidential hopes on Tuesday with a shocking sweep of the three nominating contests in Colorado, Minnesota and Missouri, dealing a blow to wounded front-runner Mitt Romney.Even though Romney still holds strong advantages in financing and organization, his campaign will now have to refocus to fight back the challenge from the surging conservative Santorum.
Backed by a wealthy “Super PAC” that pays for attack ads against rivals, Romney had excelled in major contests thus far in the race. After big wins in Nevada and Florida in the previous week, he did little campaigning in Minnesota and Missouri and had been expected to win easily in Colorado.
WR man charged with practicing dentistry without a license – A dentist who surrendered his license in 1993 was indicted Tuesday on allegations he practiced dentistry without a license in 2011.
Chester Kyle Little, 58, of Warner Robins, is accused of performing dentistry from June 30, 2011, to Aug. 25, 2011, at an office located at 2533 Hillcrest Ave. in Macon, according to an indictment filed Tuesday in Bibb County Superior Court.
Little’s license initially was issued in 1977, according to licensing records held by the Georgia Secretary of State.
He surrendered the license following allegations he “knowingly made misleading, deceptive, untrue or fraudulent representations” in connection with claims submitted to the Georgia Department of Medical Assistance in 1986 and 1987, and allegations that he possessed cocaine with the intent to distribute, according to the records.
Ninth Circuit to 7 Million California Voters: You Are Irrational Bigots – In a breathtaking exercise in ill-natured illogic, a divided Ninth Circuit ruled 2–1 that because Prop 8 does not take away civil-union benefits for same-sex couples, it’s an unconstitutional exercise in irrational animus towards gay people.Dishonestly, the court claimed it did not require any heightened scrutiny to reach this result.
The very timid dissent (“please don’t go after me!”) points out that Baker v. Nelson is ruling precedent and that the differences between same-sex and opposite sex couples in terms of the state’s interest in responsible procreation could be rationally related to a legitimate state interest.
Back in 2004, when we fought about a Federal Marriage Amendment, gay rights advocates said we were alarmists for claiming that they would go to federal court seeking a right to impose gay marriage on all 50 states.
That was so last decade.
Ban on gay marriage struck down (FINAL UPDATE) : SCOTUSblog – In dissent, Judge Smith argued that the Supreme Court’s Romer decision did not control the outcome in this case. He went on to conclude that California had sufficient interests to justify the enactment of the same-sex marriage ban: steering childbearing into the realm of marriage among couples biologically capable of having a child together, and promoting strong parenting by providing for children to be born into the more stable relationship of such marriages. He credited the arguments of the backers of Proposition 8 that their measure would further those interests sufficiently to justify its enactment.The Smith dissent thus provides a basis for more conservative judges on higher courts to decide differently than the panel majority did.
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