Claire Murray (14 March 1985 – 1 April 2010) – A casualty of Perth’s Generation deX.
April 1 2011 is the first anniversary of the death of Claire Murray, a casualty of Perth’s Generation deX. In 1998 her parents, Mick and Val Murray, took Claire aged twelve to a paediatrician. She was diagnosed with ADHD and put on 40 milligrams of dexamphetamine a day. Tragically, although hardly surprisingly, Claire went on to develop an addiction to amphetamines. She then moved onto heroin, and caught hepatitis B through needle sharing. Her liver failed and she received a transplant in 2009.
Within months of receiving the transplant Claire returned to abusing heroin and her donated liver failed. In March 2010 Claire’s aunt Caroline courageously volunteered a partial liver donation for transplant and Claire and her aunt were operated on in Singapore. Sadly, Claire’s second transplant failed due to complications, and she died aged twenty-five in Singapore on 1 April 2010, surrounded by Mick, Val and other family members, but away from her daughter Chloe (4) and son Taj (2).
Mick and Val Murray attributed Claire’s addiction to her introduction to dexamphetamine. A letter written by Mick and read out in the Western Australian Parliament six weeks before Claire’s death stated — ‘My daughter, Claire Rita Murray … is a heroin addict with three to six months to live. Claire was an A grade student at Ursula Frayne Catholic College until she was twelve years of age. At this time Claire was diagnosed with ADHD and introduced to her first drug dexamphetamine. Claire was prescribed 10mg of this drug four times a day for a period of eighteen months; and from that day on my daughter Claire and her family’s problems began.’
Val and Mick have told me Claire’s paediatrician never informed them of the potential side effects and addictive properties of dexamphetamine. They found out the hard way when Claire had headed down the pathway of drug abuse. They told me they did not realise that the ‘medication’ Claire was taking was in fact amphetamines. They acknowledged the name ‘dexamphetamine’ would imply that, but they said Claire’s paediatrician advised them that it was safe and effective.
It was not until February 2010 when I gave Val and Mick a copy of GlaxoSmithKline’s prescribing information that they ever saw any warning like the following warning for dexamphetamine….
AMPHETAMINES HAVE A HIGH POTENTIAL FOR ABUSE. ADMINISTRATION OF AMPHETAMINES FOR PROLONGED PERIODS OF TIME MAY LEAD TO DRUG DEPENDENCE AND MUST BE AVOIDED. PARTICULAR ATTENTION SHOULD BE PAID TO THE POSSIBILITY OF SUBJECTS OBTAINING AMPHETAMINES FOR NON-THERAPEUTIC USE OR DISTRIBUTION TO OTHERS, AND THE DRUGS SHOULD BE PRESCRIBED OR DISPENSED SPARINGLY. MISUSE OF AMPHETAMINES MAY CAUSE SUDDEN DEATH AND SERIOUS CARDIOVASCULAR ADVERSE EVENTS.[i]
Dexamphetamine like all ADHD stimulants and other drugs with a high potential for addiction and abuse is a schedule 8 drug (the equivalent of a schedule II drug in the US). The prescription and dispensing of schedule 8 drugs are supposed to be tightly controlled by government health authorities so as to limit the potential for abuse and protect vulnerable consumers from reckless prescribers.
In 1998 the mechanism that was supposed to safeguard Claire and other children from reckless prescribers was the (WA Health Department) Stimulants Committee. The Stimulants Committee was charged with oversighting the responsible prescription of dexamphetamine and Ritalin. However, the Stimulants Committee frequently granted ‘block authorisation’ to very frequent prescribers who were considered to be familiar with the manufacturers prescribing guidelines. Heavy prescribers should have been the most accountable but because of ‘block authorisation’ were the least accountable.
Claire’s paediatrician had bloc authorisation. In fact Claire’s paediatrician was on the Stimulants Committee and was therefore charged with making sure that responsible prescribing occurred.
Bloc authorisation was granted for prescribing within guidelines dosages. GlaxoSmithKline the manufacturer of Dexidrine recommends that ‘In pediatric patients 6 years of age and older, start with 5 mg once or twice daily; daily dosage may be raised in increments of 5 mg at weekly intervals until optimal response is obtained. Only in rare cases will it be necessary to exceed a total of 40 mg per day.’[ii] Claire’s paediatrician’s decision to prescribe 40 milligrams a day was against the manufacturer’s advice but just within the range that did not require him to apply for individual ‘off label’ authorisation. Obviously starting Claire, a tiny 12 year old, on such a high dose increased the risk of her becoming addicted.
When he was a member of the Stimulants Committee Claire’s paediatrician sought to further weaken the already flimsy protection offered by the committee by arguing that ‘block authorisation’ should be extended to enable unrestricted ‘off label’ prescribing (outside manufacturers guidelines). Fortunately he was unsuccessful and after WA prescribing controls were significantly tightened in 2003 retired from ‘treating ADHD’ which had previously constituted much of his practice. These reforms came too late for Claire and others in Perth’s Generation deX, however mercifully far fewer (but still too many) WA children are now prescribed ADHD amphetamines. (refer Rise and Fall of Child ADHD in Western Australia )
In March 2010 Claire’s situation became highly publicised when the Western Australian government provided a $240,000 interest-free loan to her family so that she could undergo a live liver transplant in Singapore. Despite the fact that it was only a loan and the live donor was Claire’s Aunty there were many ignorant and ugly comments expressing the view that Claire as a drug abuser was responsible for her fate and did not deserve a second chance.
In state parliament I argued that Claire ‘did not go out and abuse recreational drugs, as many of us did through choice when we got a bit bored on a Saturday night at 18, 19 or 20 years of age… She did not make that choice; that choice was made for her when she was 12 years of age. That is why Claire deserves a first chance.’
Tragically whilst the operation initially appeared to have been successful complications resulted in Claire passing away on 1 April 2010. Val and Mick have lost a daughter and Chloe (now 5) and Taj (3) have lost their mother. As well as dealing with the grief and helping raise Chloe and Taj, the Murray family is tens of thousands of dollars out of pocket and saddled with an unpaid $240,000 debt to the WA State Government.
In the meantime the ADHD industry continues to profit by promoting the drugging with amphetamines of inattentive and/or impulsive but perfectly healthy children.
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