June 23, 2004

Northwoods to 9/11

Was 9/11 the resurfacing of Operation Northwoods?

The following appeared in an abridged form as the introduction to Ambushed by Toby Rogers.

Operation Northwoods
Operation Northwoods was an early '60s plan by the Joint Chiefs of Staff to create a pretext for an invasion of Cuba by carrying out terror attacks against Americans in US cities.

The plans are described in Body of Secrets (Doubleday), by investigative reporter James Bamford (see "U.S. Military Wanted to Provoke War With Cuba" at ABC News.) According to the ABC report, "The plans reportedly included the possible assassination of Cuban ÈmigrÈs, sinking boats of Cuban refugees on the high seas, hijacking planes, blowing up a U.S. ship, and even orchestrating violent terrorism in U.S. cities. The plans were developed as ways to trick the American public and the international community into supporting a war to oust Cuba's then new leader, communist Fidel Castro."

The plan laid out a design for attacks on Americans by the US government. "The desired resultant from the execution of this plan would be to place the United States in the apparent position of suffering defensible grievances from a rash and irresponsible government . . . and to develop an image of a threat to peace in the Western Hemisphere," the document said matter-of-factly. "We could develop a Cuban terror campaign . . . in Washington . . . Hijacking attempts against civil air and surface craft should appear to continue . . . It is possible to create an incident which will demonstrate that a Cuban aircraft has shot down a chartered civil airliner en route from the US to Jamaica, Guatemala, Panama or Venezuela . . . It is possible to create an incident which will make it appear that Communist Cuban MIGs have destroyed a USAF aircraft over international waters in an unprovoked attack."

According to ABC, "The plans had the written approval of all of the Joint Chiefs of Staff and were presented to President Kennedy's defense secretary, Robert McNamara, in March 1962. But they apparently were rejected by the civilian leadership and have gone undisclosed for nearly 40 years."

Three days after the presentation of the plan to McNamara, Kennedy personally told the Chairman of the Joint Chiefs of Staff Gen. Lyman L. Lemnitzer that "there was virtually no possibility of ever using overt force to take Cuba."

And there it lay.

JFK rejected Northwoods. After being tricked by the CIA into the Bay of Pigs invasion/catastrophe, he vowed to tear the CIA apart and scatter it to the winds. He also ordered withdrawal of American troops from Vietnam. Soon after that Kennedy was assassinated. Within a week of his death his order to withdraw from Vietnam was rescinded and replaced with orders to build up troops in Vietnam. The next year a phony incident in the Gulf of Tonkin was used as a pretext to escalate the Vietnam War. But nothing as outrageous as Operation Northwoods was attempted at that time.

The Bay of Pigs
There is evidence that George Bush's involvement with the CIA dates back at least as far back as the 1961 Bay of Pigs invasion of Cuba, which was given the CIA code name Operation Zapata. The names of the ships used for the invasion were Houston, Zapata and Barbara. Bush's oil company at the time was Zapata Oil, based in Houston. Bush had named his plane in World War II "Barbara."

On November 29, 1963, a week after the assassination of JFK, a memo was issued by J. Edgar Hoover saying "Mr. George Bush of the CIA had been briefed on November 23rd, 1963 about the reaction of anti-Castro Cuban exiles in Miami to the assassination of President Kennedy." (Originally published in The Nation, 8/1/88. See Paul Kangas in The Realist: )

October Surprise
Bush claims not to have been a member of the CIA until he became director under the previous unelected president, Gerald Ford. Bush maintained his contacts in secret meetings with the agency during the Carter years, and Bush and William Casey were central figures in the shadowy negotiations that came to be known as "The October Surprise." The Reagan-Bush campaign secretly negotiated with the Iranians who were holding the U.S. hostages. The apparent result of the negotiations was that the hostages were not released before the 1980 election, which would have greatly boosted Carter's chances of re-election. (See Gary Sick's October Surprise for the whole story.)

The incident had a precedent in 1968 when presidential candidate Richard Nixon secretly communicated with the regime of South Vietnam urging its President Thieu to hold off on making the peace settlement President Johnson was desperately trying to pressure him into before the 1968 election.

Nixon used his contacts from his term as Eisenhower's vice president to contact South Vietnam's president Thieu. The message was simple: Hold out. You'll get a better deal under a Nixon presidency. And Thieu did, but American soldiers dying in Vietnam as the war dragged on for four more years didn't. (See The Arrogance of Power by Anthony Summers)

Bush Under Reagan
In the early days of Reagan's presidency, Bush established himself as a powerful operator behind the scenes, arguably more powerful than Reagan himself. From the moment of the shooting of Ronald Reagan in March 1981 -- only two months after Reagan's inauguration -- George Bush took advantage of the power vacuum created by Reagan's removal to put structures of power in place that he would use during the rest of Reagan's term to run various covert operations. During the first critical months of the new administration, when its foundations were being built, Bush essentially took power.

While Reagan convalesced from the shooting, Bush took a command position over new offices created by the new administration with names like the Special Situation Group, the Crisis Management Center, the Terrorist Incident Working Group, the Task Force on Combating Terrorism and the Operations Sub Group. When Reagan returned from his convalescence, he took on the formal appearance of the presidency, but he was largely disengaged. In a very real sense, the first Bush presidency was a 12-year term.

Iran Contra
The criminal adventures of the Bush syndicate continued in the '80s with the funding of a death squad terrorist militia to overthrow the democratically elected government of Nicaragua through terrorizing and slaughtering the population. When Congress explicitly outlawed the use of U.S. tax money to arm and sustain the Contras, as the death squads were called (or "Freedom Fighters" as Ronald Reagan called them), the Reagan-Bush administration kept the money flowing to the Contras from sales of weapons to Iran. While they continued the scam, they pretended in public that "we will never negotiate with terrorists." "Terrorists" at that time, after the Iranians had "brought the American giant to its knees" by taking of hostages, meant Iran.

The secret arms-for-hostages deals with the Iranians (the Iran Contra affair), were a logical extension of the kinds of negotiations that were undertaken by Bush and Casey with Iranian officials in the October Surprise when Carter was president.

According to retired Navy Lt. Cmdr. Al Martin, a former officer in the Office of Naval Intelligence, a plan was hatched in the 1980s by the Reagan-Bush administration to provoke a limited nuclear war with the Soviet Union to cover up Iran-Contra crimes and install a military dictatorship in the U.S. Under the scenario, George Bush Sr. would have been president of the military government. Also involved in the alleged scheme were Iran-Contra criminal Oliver North and CIA Director William Casey.

Bush On Top
The kinds of wars perpetrated under Reagan, including the invasion of Grenada and the covert war against Nicaragua and countless covert operations, continued under Bush Senior, who invaded Panama, aided in the overthrow of Haiti's president Aristide and attacked Iraq. But Bush did not handle the public role of president as well as Reagan. The more people got to know him, the more they smelled something fishy. When he was defeated by Clinton in '92, he only received 37% of the votes cast, which are typically only about half the number of eligible voters.

Bush, like his mentor Nixon, was frustrated by the people, who distrusted both of them instinctively. Both shared a hunger for war that was constantly stifled by popular resistance. The population had to be frightened to get them to back a war, to give up their lives for the cause. It's traditional for rulers to create pretexts for war.

Less than two years before the election of 1992, Bush was riding on approval ratings in the 80s as a result of the staging of the Gulf War, and he looked untouchable. He seemed so formidable at the time that few credible opposition candidates even bothered to put themselves through the humiliation of getting trounced by him.

The Accidental President
By a quirk of history, one unlikely young governor from Arkansas did put his hat in the ring. The public's enthusiasm for Bush's war, which had artificially boosted his ratings, quickly dissipated, and as the economy continued to deteriorate, the population soured on him and Clinton beat him.

Clinton broke the momentum of the 12-year Bush reign, and the far right detested him for it. He managed to take a couple of steps to stop the hemorrhaging of money under Reagan and Bush that had created by far the largest deficit in history, and which was dragging down economic activity. Then he turned to his next big project, which was to be his legacy: the creation of a national health care system that would administer affordable health coverage for all Americans.

Clinton's plan was simple: cut the insurance companies - and their huge profits -- from the system, and use the money saved to operate the system. Under the plan healthcare would be administered by a civil organization that was created to provide healthcare, not to maximize profit. Instead of making some shareholders rich, it would provide healthcare for the population, the way it is done in most other modern countries.

But the major corporations that own the insurance companies could never allow Clinton to take away the easy money they made off insurance, so they used their enormous financial clout to mount an all-out campaign to destroy him by any means necessary. With the takeover of Congress by the Republican party, and the takeover of both parties by big money, the corporate fascist faction had the powers of government at its disposal for its partisan agenda.

The right wing never accepted Clinton as a legitimate president, and fought him every step of the way, using any force it had at its command. A campaign was launched to smear him, and bring him down with some kind of scandal (as well documented in The Hunting of the President by Joe Conason, now made into a film). The Paula Jones lawsuit was financed privately by the Clinton hunters. The nearly endless and fruitless Whitewater Investigation cost well over $70 million of taxpayers hard-earned money to investigate and re-investigate every aspect of Clinton's life, and especially every detail of his affair with Monica Lewinsky, for whom the Republican hound dogs in the House Judiciary Committee seemed swelteringly hot. Other than the illicit sex act, the investigation turned up nothing that could be used against Clinton.

Clinton, for all his faults, was brilliant in eluding the hounds, but his effectiveness as president became a non-issue. It took a nearly a superman just to hold onto his office while under an endless onslaught. He would never ever again attempt anything so disobedient to the corporate powers-that-be as trying to provide the American people a functioning healthcare system. Instead he will be remembered for his success in passing the kinds of bills George Bush himself would have passed if he'd had a Republican legislature, such as the gutting of the welfare system and the establishment of the misnamed North American Free Trade Agreement, which is for all practical purposes a constitution for a global corporate dictatorship.

The Coup of 2000
Although Clinton's presidency was an interruption of the right wing agenda, the attacks of the right, culminating in Clinton's impeachment, crippled his agenda and made sure he didn't follow any of his poor-boy impulses to serve the people rather than the corporate masters. Then came the son of Bush to put the right wing agenda back on track.

The Bush presidency was established through the coup of Dec. 12, 2000, in which thousands of voters in Florida were prevented from voting, and when it looked like Bush was going to lose anyway, his daddy's friends on the Supreme Court stopped the vote counting and declared Bush the winner arbitrarily, based on a rapidly plummeting 525-vote lead.

Like any of the incidents in this brief outline, volumes could be written on the ways the Bush machine corrupted the democratic process in the election of 2000, and this broad survey is not the place to go into detail. (For a more comprehensive report, see The Best Election Money Can Buy by Greg Palast, a good description of the massive program of voter fraud that was carried out by the Bush machine under Jeb Bush in Florida.)

The Project for a New American Century
That brings us to the Project for a New American Century (PNAC), the neo-conservative Washington-based organization funded by three foundations closely tied to Persian Gulf oil, weapons and defense industries, whose plan "Rebuilding America's Defenses: Strategies, Forces and Resources for a New Century," was completed in Septemer 2000. It outlined a plan for world military domination, which we now see beginning to play out. The plan called for an attack on Iraq, whether or not Saddam Hussein was in power, in order to solidify a power base in the Middle East.

The plan was drawn up for Dick Cheney, Donald Rumsfeld, Paul Wolfowitz (Rumsfeld's deputy), George W's younger brother Jeb and Lewis "Scooter" Libby (Cheney's chief of staff).

"Rebuilding America's Defenses" said that the desired military build-up needed an attack on America to kick it off. "The process of transformation," the plan said almost wistfully, "is likely to be a long one, absent some catastrophic and catalyzing event-like a new Pearl Harbor."

The American Free Press asked Christopher Maletz, assistant director of the PNAC about what they meant by the need for "a new Pearl Harbor."

Maletz answered, "They needed more money to up the defense budget for raises, new arms, and future capabilities. Without some disaster or catastrophic event" neither the politicians nor the military would have gone along.

As George W. Bush's former Secretary of the Treasury Paul O'Neill recently revealed in The Price of Loyalty by Ron Suskind, attacking Iraq was the administration's raison d'etre "from Day One." The PNAC document makes it clear that the real meaning of Iraq to the elites of the PNAC was to use it as a base for its planned domination of the Middle East and its oil.

"Rebuilding America's Defenses" makes it clear: "The United States has for decades sought to play a more permanent role in Gulf regional security. While the unresolved conflict with Iraq provides the immediate justification, the need for a substantial American force presence in the Gulf transcends the issue of the regime of Saddam Hussein."

The National Security Strategy
In September 2002, the plan of the Project for a New American Century became the official policy of the United States when the Bush administration presented its paper "The National Security Strategy of the United States of America" to Congress. The presentation of an annual statement of foreign strategy is mandated by a law passed in 1986.

The plan stated that the U.S. will not allow any other country to build up a military capability that could threaten U.S. superiority. It proclaimed that the U.S. has the right to strike pre-emptively at any country it deems a threat. (See the Washington Post. See also "Exposing the PNAC")

9/11
Finally we come to 9/11, a catastrophe in which literally hundreds of normal security procedures had to fail in order for it to happen. There was a period of 35 minutes between the second attack on the World Trade Center -- when it was clear to millions of people around the world that the U.S. was under attack -- and the attack on the Pentagon. And not only was the commander in chief sitting doing nothing in a 6th grade classroom after hearing of the two attacks in New York, the U.S. defense establishment was nowhere in sight, as if the $400 billion-a-year behemoth did not exist.

George W. Bush himself -- no matter which of the several conflicting stories he tells about his own behavior that day -- failed utterly to defend the country or to respond to the crisis when it was ongoing. Somehow his behavior was spun into that of a hero by the mythmaking machinery of the corporate media.

The Bush administration has aggressively exploited 9/11 from the moment it took place to further its agenda and the plan laid out in the papers of the Project for a New American Century: to dominate the world militarily and squelch civil liberties domestically.

The administration's vigorous attempts to block any investigation of the attacks of 9/11 make it hard to know to what degree the Bush regime is responsible, to what degree it was a lapse, and to what degree was it intentional. But the inescapable bottom line is, Bush was presiding over the country, was commander in chief of the armed forces and was responsible for the country's defense.

There is a massive body of evidence that indicates that the official story of 9/11 is not true, and that something else was going on besides a handful of Saudi Arabians with box cutters. A number of websites catalog the discrepancies well, including Fromthewilderness.com, makethemaccountable.com, and Unansweredquestions.org.

The possibility that the president of the United States would either allow an attack on Americans to further a political agenda is so horrifying that many reject the possibility out of hand. David Corn of The Nation stated a common reaction when he said "the notion that the U.S. government either detected the attacks but allowed them to occur, or, worse, conspired to kill thousands of Americans to launch a war-for-oil in Afghanistan is absurd."

Corn writes that "to execute the simultaneous destruction of the two towers, a piece of the Pentagon, and four airplanes and make it appear as if it all was done by another party -- is far beyond the skill level of U.S. intelligence." Beyond the capability of the military-intelligence establishment with hundreds of billions of dollars to spend every year, but the operation was not, according to the official story, beyond the powers of a Muslim extremist operating in a cave in Afghanistan.

Obviously someone did it and it was a very impressive operation. We are told it was Osama bin Laden, and perhaps it was. Corn, like most Americans, is more comfortable believing his government would never be capable of failing to act to protect its own people. History clearly shows otherwise.

What fact eliminates the possibility that the 911 attack was a version of Operation Northwoods that was not rejected? The horror that the possibility evokes causes many to reject the possibility out of hand. But setting that reluctance aside and looking at the evidence coldly, the evidence seems to lead us directly to the possibility that this administration dusted off the old Northwoods and put it into action.

Technology for the remote control piloting of aircraft has existed since the 1940s, and is installed in many passenger aircraft like the ones used on 9/11. The CIA uses drone planes to carry out assassinations, (see "Drones of Death" in the Guardian at The Guardian), yet Condoleezza Rice and Dick Cheney's claimed that "no one" ever thought of using planes as weapons before.

Elaborate measures were taken to protect Bush from attack by hijacked planes that it was feared might be used as weapons in the summer of '01 at the G8 economic summit in Genoa.

Why did the administration go through such acrobatics to pretend no one in the defense establishment had ever thought of using hijacked planes as weapons, when it is so obviously untrue? Why does the administration struggle so hard to keep investigations into 9/11 from proceeding? And why do Americans not see a great crime in the coverup itself, even if the administration committed no crime related to 9/11?

All of these outrages stare us in the face - so close we can't see them. We can't focus. They maintain a moving target. They keep so much stuff flying around no one can keep up with them. But focus for a minute on any one aspect of it - how can they get away with suppressing an investigation into 9/11? - how could they get away with stopping an election and delivering a bogus, illogical ruling just to get a political ally into power? - how can they pass a budget that doesn't stand up to basic arithmetic? - and the magnitude of the outrage becomes clear.

In Ambushed Toby Rogers presents the underside of the Bush administration, the side that is too scary to look at by establishment media. He provides us with a compelling view of the sleuth working on the crime of the millennium. It is a mystery worth solving.

One of Rogers' most intriguing discoveries was a piece of news reported on the morning of September 11 by CBS correspondent John Slattery. Slattery reported that he had encountered someone at Ground Zero who identified himself as a member of the White House Advance Office. The man claimed he had informatioin that a third plane was on its way. It is striking that that was the same piece of erroneous information the U.S. military was telling the Port Authority at the time.

Perhaps the most fascinating thing about the Slattery story was the reaction of the White House to anyone who asked about it. For some reason, any questions to the White House press office about 9/11 throw the place into a panic. The staff are rendered dysfunctional. They can't answer. They can't say they can't answer. They just put it off, push it away. It's an agency in denial.

Obviously the administration has a big problem with 9/11. It has spun it into a great triumph of leadership for George W. Bush, but there is little to support it. Bush took a month-long vacation the month before the attack. Warnings during that summer were numerous, and in many cases quite specific. Bush did nothing at all. Ashcroft stopped flying commercial aircraft, but no official warning was given to the people, or even to the relevant agencies that may have prevented the attacks.

Somehow all of Rogers' delving into the seamy side of American politics has not made him cynical. Go figure. He hangs onto an old-fashioned faith: that the truth will out. I hope he is right.

More on Ambushed:
Democrats.com
Forbes Book Club
Amazon.com

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The Department of Defense is training all of its personnel in its current Antiterrorism and Force Protection Annual Refresher Training Course that political protest is "low-level terrorism." 

The Training introduction reads as follows:

"Anti-terrorism (AT) and Force Protection (FP) are two facets of the Department of Defense (DoD) Mission Assurance Program. It is DoD policy, as found in DoDI 2000.16, that the DoD Components and the DoD elements and personnel shall be protected from terrorist acts through a high pirority, comprehensive, AT program. The DoD's AT program shall be all encompassing using an integrated systems approach."

The first question of the Terrorism Threat Factors, "Knowledge Check 1" section reads as follows:

Which of the following is an example of low-level terrorism activity?

Select the correct answer and then click Check Your Answer. 

O   Attacking the Pentagon

O   IEDs

O   Hate crimes against racial groups

O   Protests

*** 

The "correct" answer is Protests.

A copy of this can be found on the last two pages of this pdf.  

The ACLU learned of this training and on June 10, 2009 sent a letter to the Gail McGinn, Acting Under-Secretary of Defense for Personnel and Readiness, objecting to their training all DoD personnel that the exercise of First Amendment rights constitutes "low-level terrorism."  

For those who have worried about a trend - evident, for example, in the USA PATRIOT Act, the universal and ongoing government surveillance of all of Americans' electronic communications that began in February of 2001 (seven months before 9/11), the global war on a tactic (terrorism), therefore making this war unending, the unprecedented pre-emptive arrests of protestors at the 2008 Republican National Convention with those protesters being charged as "domestic terrorists," the justifications for torture, pre-emptive wars of aggression, ongoing occupations, American gulags such as Bagram, suspension of habeas corpus, and "prolonged detention" for acts someone might commit, not what they have done, FBI et al infiltration of protest groups and the government's acknowledged use of undercover agents (agents provocateurs) in said infiltration, thus giving the government under the rubric of fighting domestic terrorism unrestrained and unsupervisable power to suppress legitimate political activities, the unleashing and justifications for Christian fascists to murder those they do not like (such as the assassination of Dr. George Tiller and the killing at the Holocaust Museum a few days ago) - this news adds further fuel to the fire. 

These are not items from some famously vilified, non-US dictatorial regime. These are items from the good ole USA, land of the free and home of the brave.

Just how brave are we now? How free are we still? Are we brave enough to be "winter soldiers" and stand up against these fascist moves? Or will we go down in history in infamy, the way the "Good Germans" of the 1930s and 1940s did?  

Lilly Sold Drug for Dementia Knowing It Didn’t Help....

By Margaret Cronin Fisk, Elizabeth Lopatto and Jef Feeley



June 12 (Bloomberg) -- Eli Lilly & Co. urged doctors to prescribe Zyprexa for elderly patients with dementia, an unapproved use for the antipsychotic, even though the drugmaker had evidence the medicine didn’t work for such patients, according to unsealed internal company documents.

In 1999, four years after Lilly sent study results to the U.S. Food and Drug Administration showing Zyprexa didn’t alleviate dementia symptoms in older patients, it began marketing the drug to those very people, according to documents unsealed in insurer suits against the company for overpayment.

Regulators required Lilly and other antipsychotic drug- makers in April 2005 to warn that the products posed an increased risk to elderly patients with dementia. The documents show the health dangers in marketing a drug for an unapproved use, called off-label promotion, said Sidney Wolfe, head of the health research group at Public Citizen in Washington.

“By definition, off-label means there is no clear evidence that the benefits of a drug outweigh the risks,” Wolfe said. “The reason why off-label promotion is illegal is that you can greatly magnify the number of people who will be harmed.”

In 1999, when Lilly began its marketing push, Zyprexa’s only approved use was for patients suffering from schizophrenia, according to the FDA. In 2008, Zyprexa was Lilly’s best-selling drug, with $4.7 billion in sales, while antipsychotics as a group topped U.S. drug sales last year, with $14.6 billion.

Seven Studies

In a request for a December 2003 meeting over a proposed label change, Lilly told the FDA that data from seven studies showed Zyprexa didn’t alleviate symptoms of Alzheimer’s or other dementia.

The studies found death rates among older dementia patients taking Zyprexa were “significantly greater” than those who didn’t get the medicine, the company said, according to the unsealed documents.

“Plaintiffs are releasing one-sided, cherry-picked documents obtained in discovery to selected news media in an effort to try their cases in the media,” said Lilly spokeswoman Marni Lemons, who added that the company will fight the lawsuit. She declined to answer specific questions about the studies.

Lilly pleaded guilty in January to a federal misdemeanor charge of illegally marketing Zyprexa for off-label uses to elderly consumers. The company admitted illegal promotions from September 1999 through March 2001, while denying such practices beyond that date.

Medical Journals

The documents also revealed Lilly officials wrote medical journal studies about Zyprexa and then asked doctors to put their names on the articles, a practice called “ghostwriting.”

Lilly employees compiled a guide to hiring scientists to write favorable articles, complained to journal editors when publication was delayed and submitted rejected articles to other outlets, according to the documents.

Lilly’s internal documents, which number about 10,000 pages, were unsealed as part of suits against the drugmaker by health insurers and pension plans seeking to recoup monies spent on Zyprexa. The insurance plans contend the papers indicate that Lilly promoted the antipsychotic to doctors treating elderly patients even after March 2001.

The plaintiffs cite documents including a 2002 business plan calling for expanding prescriptions in off-label use. They also point to notes from Lilly sales representatives through 2003 recording efforts to press doctors to prescribe elderly patients Zyprexa for mood symptoms, irritability and insomnia.

$6.8 Billion in Damages

Insurers and other so-called third-party payers contend Lilly should pay as much as $6.8 billion in damages for downplaying Zyprexa’s health risks, including excessive weight gain and the risk of contracting diabetes, and marketing the drug for unapproved uses to pump up profits.

Bloomberg News obtained copies of the documents after U.S. District Judge Jack Weinstein in Brooklyn, New York, ordered their release on May 1. In September, Weinstein allowed insurers and other payers to sue Lilly as a group after finding “sufficient evidence of fraud” to let the case go to trial. Lilly appealed that ruling.

The Indianapolis-based drugmaker agreed in January to pay $1.42 billion to the U.S. government and more than 30 states to settle off-label marketing allegations over Zyprexa. The agreement included a $615 million penalty for the federal criminal charge.

Lilly has paid $1.2 billion so far to settle more than 32,000 individual claims by patients, the company said in an April 30 securities filing. About 140 claims remain, Lilly reported.

12 States

The company also faces suits from 12 states over its Zyprexa marketing practices. Cases brought by South Carolina and Connecticut officials are set for trial later this year.

The unsealed documents support the claims of the insurers suing Lilly, said lawyer Thomas Sobol, of Seattle-based Hagens Berman Sobol Shapiro LLP. His firm represents the plaintiffs suing the drugmaker for overcharging on Zyprexa and provided Bloomberg News with copies of the documents.

Bloomberg News filed a letter brief asking the court to unseal the documents.

Zyprexa was initially approved in 1996 for use with schizophrenia sufferers. In 2000, Lilly received the FDA’s approval to sell it to those dealing with the mania stage of bipolar disorder.

The drug has never been approved for use with dementia patients, according to the FDA’s Web site.

Even before the drug was on the market, Lilly researchers were eyeing whether elderly dementia patients could benefit from taking the antipsychotic, according to the unsealed documents.

Company Study

A 1995 company study of users taking between 1 to 8 milligrams of Zyprexa “did not show efficacy in alleviating the psychotic symptoms and behavioral disturbances in elderly” patients suffering from “primary degenerative dementia of the Alzheimer’s type,” according to a study summary that was unsealed.

The company also noted that three patients taking Zyprexa died during a study or within 30 days of its completion, while only one control-group patient expired, according to the unsealed documents.

J. Alan Webber, a Lilly executive, acknowledged in a Feb. 16, 1995, note that FDA official Paul Leber wasn’t impressed with study results in connection with Zyprexa’s effectiveness in treating older dementia patients.

“Dr. Leber was not enthusiastic about study HGAO (psychotic demented elderly) with respect to the indication for use, and extensive discussion did not resolve the disagreement,” Webber said, according to the documents.

Back to the FDA

In 1998, Lilly went back to the FDA seeking approval to market Zyprexa to those battling Alzheimer’s, the most common form of dementia, the company said in its 2003 request for a meeting on a proposed label change. Lilly withdrew its bid to promote Zyprexa for Alzheimer’s cases in 1999, according to the document·

In a November 2000 memo to Lilly salespeople, company executives said the dementia marketing initiative was abandoned because the FDA questioned Zyprexa’s effectiveness in treating the ailment.

“It was withdrawn due to vagueness on the FDA’s part regarding a definition of efficacy,” Lilly officials said in the document·

In a 2003 memo to FDA regulators citing the clinical studies, Lilly researchers acknowledged the death rates among older dementia patients on Zyprexa in the reviews were two times higher than their counterparts taking placebos.

Patient Deaths

Deaths among the patients taking Zyprexa in the studies were “significantly greater than placebo-treated patients (3.5 percent v. 1.5 percent, respectively),” Lilly officials said, according to the unsealed documents.

The studies didn’t find Zyprexa was effective in treating dementia, the company acknowledged in this document·

Lilly recognized this earlier, according to a 2002 document entitled “Zyprexa in serious mental illness (65 plus years) -- A Strategy Review.”

“The treatment of serious mental illness for people over the age of 65 has been identified as a growing opportunity for Zyprexa,” the authors wrote. “Unfortunately, attempts to gain the data to support an application for an indication in the treatment of dementia have to date been unsuccessful.”

Lilly, which first marketed Zyprexa to psychiatrists, sought to expand its customer base in 1999 by focusing on long term-care facilities, particularly nursing homes, according to the unsealed documents.

Primary Care Physicians

It later began targeting primary care physicians, known as PCPs, as another potentially lucrative Zyprexa market. Such physicians frequently deal with dementia patients, according to the unsealed files.

Another benefit to the strategy was that many of those practitioners were “unaware of Zyprexa weight gain issue,” according to a December 1999 Lilly sales memo, referring to one of the drug’s possible side-effects.

Lilly viewed dementia as the “key” to the elderly and PCP markets, according to an undated document, “Elderly - PCP Sales Aid.” In that paper, executives urged salespeople to “utilize dementia and symptoms as entry.”

Lilly marketing executives envisioned expanding “Zyprexa’s market by redefining how primary care physicians treat mood, thought and behavioral disturbances,” according to the December 1999 memo. The strategy included: “Focus message patients; symptoms and behaviors (rather than diagnoses),” according to the unsealed internal company documents.

Zyprexa Sales

Lilly officials in 2002 reported Zyprexa sales grew due to “an expanding prescriber base in primary care, off-label use including PTSD and sleep,” according to a document called “Zyprexa Business Summary,” referring to post-traumatic stress disorder. The company’s goal was to reach $6 billion in sales by 2006, according to a July 2002 Zyprexa marketing plan.

Lilly’s long-term care unit also saw Zyprexa sales rise 2.9 percent in the second quarter of 2002 as sales of Risperdal, Johnson & Johnson’s rival antipsychotic, fell, according to the 2002 marketing plan.

At that time, long-term care sales made up about 20 percent of Zyprexa prescriptions, according to the summary. Of that number, 65 percent were written for nursing-home patients.

Overall, prescriptions for older patients were the “2nd biggest money-producing segment” for Zyprexa in the U.S., according to a Feb. 15, 2002, e-mail from Lilly researcher Peter Feldman to Denice Torres, the company’s global marketing director.

Internal Memos

In that e-mail, Feldman said company officials were saying in internal memos that they were going to stop studying Zyprexa’s potential health benefits for elderly consumers.

That would risk “killing the goose that lays the golden eggs to save on poultry feed costs,” Feldman said in the unsealed messages.

Torres assured him older consumers would continue to be a prime target for Zyprexa sales, according to the e-mail.

“Elderly remains an important aspect of target PT and affiliate focus,” she said in the message.

Increased Zyprexa sales to elderly patients also won Lilly’s long-term care unit praise in a 2003 newsletter unsealed as part of the documents.

“For two consecutive years, you have been on top and have turned in above-plan performance,” Grady Grant, Lilly’s national sales director, wrote in the newsletter. “I look forward to working with you as we set our sights on overtaking Risperdal as the number one antipsychotic in the marketplace!”

‘Driving Force’

“Once again you have all shown that LTC is a driving force for Zyprexa in the US affiliate in 2002,” Mike Murray, another Lilly executive, wrote in the newsletter. “We must continue to accelerate the growth of Zyprexa.”

Unsealed documents also showed Lilly salespeople prodded doctors to prescribe the drug for off-label uses, according to “call notes” Lilly turned over in lawsuits against the drugmaker. Portions of some call notes, which record sales visits to doctors, are cited in a recently unsealed June 15, 2007, filing by the insurance plans.

One sales representative wrote in a March 7, 2003, note she’d persuaded a doctor to write Zyprexa prescriptions for use in “elderly pts, help sleep and irritability.” Another asked a doctor to try Zyprexa “in elderly who are not thinking clearly and are suspicious and hostile,” according to an Aug. 31, 2001, note.

Common Adverse Effects

In June 2004, Paula Rochon, a senior scientist at the Institute for Clinical Evaluative Sciences in Toronto, published a literature review in the British Medical Journal showing there were only five trials available analyzing antipsychotics’ effect on the elderly, and that in those trials, adverse effects were common.

In May 2008, Rochon found that atypical antipsychotics triple the risk of a patient’s death or hospitalization within a month of starting therapy, according to research published in the Archives of Internal Medicine. About 17 percent of nursing home patients suffering from dementia are prescribed an antipsychotic within 100 days of their admission, according to her study.

The insurance plans, states and former Zyprexa patients suing Lilly also claim company officials hid the drug’s health risks and failed to properly warn patients they could develop diabetes by taking the medicine. Former users contend the drug leads to increased weight gain, which can spark the disease.

In 2001, marketing executives advised salespeople not to duck questions about whether Zyprexa caused some users to gain weight, according to an internal memo.

“Acknowledge weight gain but present it as a manageable side effect,” Lilly advised its sales force, according to the documents. “With most customers, we will continue to address the diabetes concern only when it arises,” the December 2001 document said. “Get back to selling!”

The case is UFCW Local 1776 and Participating Employers Health and Welfare Fund v. Eli Lilly and Co., No. 05-CV-04115, U.S. District Court, Eastern District of New York (Brooklyn).

To contact the reporters on this story: Margaret Cronin Fisk in Detroit at mcfisk@bloomberg.net; Elizabeth Lopatto in New York at elopatto@bloomberg.net; Jef Feeley in Wilmington, Delaware at jfeeley@bloomberg.net.
Last Updated: June 12, 2009 00:01 EDT

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Stillness Speaks
by Eckhart Tolle
eckharttolle. com
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Stillness is your essential nature. What is stillness? The inner space or awareness in which the words on this page are being perceived and become thoughts. Without that awareness, there would be no perception, no thoughts, no world.

You are that awareness, disguised as a person. When you lose touch with inner stillness, you lose touch with yourself. When you lose touch with yourself, you lose yourself in the world. Your innermost sense of self, of who you are, is inseparable from stillness. This is the I Am that is deeper than name and form.

The equivalent of external noise is the inner noise of thinking. The equivalent of external silence is inner stillness. Whenever there is some silence around you — listen to it. That means just notice it. Pay attention to it. Listening to silence awakens the dimension of stillness within yourself, because it is only through stillness that you can be aware of silence.

See that in the moment of noticing the silence around you, you are not thinking. You are aware, but not thinking. When you become aware of silence, immediately there is that state of inner still alertness. You are present. You have stepped out of thousands of years of collective human conditioning.

Look at a tree, a flower, a plant. Let your awareness rest upon it. How still they are, how deeply rooted in Being. Allow nature to teach you stillness. When you look at a tree and perceive its stillness, you become still yourself. You connect with it at a very deep level. You feel a oneness with whatever you perceive in and through stillness. Feeling the oneness of yourself with all things is true love.

Silence is helpful, but you don’t need it in order to find stillness. Even when there is noise, you can be aware of the stillness underneath the noise, of the space in which the noise arises. That is the inner space of pure awareness, consciousness itself.

Become Aware of Awareness

You can become aware of awareness as the background to all your sense perceptions, all your thinking. Becoming aware of awareness is the arising of inner stillness. Any disturbing noise can be as helpful as silence. How? By dropping your inner resistance to the noise, by allowing it to be as it is, this acceptance also takes you into that realm of inner peace that is stillness.

Whenever you deeply accept this moment as it is — no matter what form it takes — you are still, you are at peace. Pay attention to the gap — the gap between two thoughts, the brief, silent space between words in a conversation, between the notes of a piano or flute, or the gap between the in-breath and out-breath.

When you pay attention to those gaps, awareness of "something" becomes — just awareness. The formless dimension of pure consciousness arises from within you and replaces identification with form.

True intelligence operates silently. Stillness is where creativity and solutions to problems are found. Is stillness just the absence of noise and content? No, it is intelligence itself — the underlying consciousness out of which every form is born. And how could that be separate from who you are? The form that you think you are came out of that and is being sustained by it.

It is the essence of all galaxies and blades of grass; of all flowers, trees, birds and all other forms. Stillness is the only thing in this world that has no form. But then, it is not really a thing, and it is not of this world.

When you look at a tree or a human being in stillness, who is looking? Something deeper than the person. Consciousness is looking at its creation. In the Bible, it says that God created the world and saw that it was good. That is what you see when you look from stillness without thought.

Do you need more knowledge? Is more information going to save the world, or faster computers, more scientific or intellectual analysis? Is it not wisdom that humanity needs most at this time? But what is wisdom and where is it to be found? Wisdom comes with the ability to be still. Just look and just listen. No more is needed. Being still, looking, and listening activates the non-conceptual intelligence within you. Let stillness direct your words and actions.