More Ignorance in Arkansas

Opium Poppy

Willful ignorance is a pathetic condition I’ve written about before, but a new and unexpected manifestation came to my attention in the Saturday paper.[1] In an extended interview with the Arkansas Democrat-Gazette, Dr. J. Carlos Roman voiced his thoughts on the Arkansas Medical Marijuana Act and the various twists and turns on its way to becoming a functioning service to people in need. Among those thoughts was this stellar quote: “What are we going to do as a state and culture to make sure medical marijuana doesn’t become the next opioid crisis?”

Oh please, Scotty, beam me up now.

It’s possible Dr. Roman made this statement in an attempt to be politically correct, considering that he’s under fire for possible conflict of interest in his role as one of five members of the commission that oversees the licensing of Arkansas’ first growing and dispensing facilities. As such, he gave the highest score to the Natural State Medicinals Cultivation group. Entities that didn’t score so high were understandably miffed that Natural State was one of only five chosen for a license, considering that Dr. Roman’s friend Dr. Scott Schlesinger is one of the Natural State’s owners. Consequently, several of those potential licensees not chosen have sued for bias.

Roman argues that he didn’t expect or receive any quid pro quo for his ranking of Natural State. He also pointed out that he has worked for years in his role as a pain management physician to fight the opioid crisis. He says his reason for accepting the voluntary role on the licensing board was in part to “ensure that the medical marijuana industry gets off the ground responsibly.”

He goes on to admit that he was initially opposed to the amendment that voters passed in 2016 legalizing medical use, not because he was totally opposed to marijuana’s medical use but because of public “ignorance” and so-called false information about its medical potential touted by many supporters of the new law. He concedes a few benefits of natural marijuana might be in its use in appetite stimulation and anti-anxiety and admits he will “reluctantly” certify patients to receive ID cards required in the program.

He’s such a great guy, isn’t he? And now, through no fault of his own, he’s being villainized by permit applicants who didn’t score as high as the group co-owned by his friend.

Sometimes you have to appreciate karma. Because this scandal about his potential conflict of interest is exactly the kind of spotlight that’s needed for people like Dr. Roman.

Why? Because who should be more qualified or informed about medical research than a physician? Yet here we have a physician who specializes in pain management worrying that marijuana could become the next opioid crisis. Talk about willful ignorance.

Farmer slicing opium flower pod to harvest the resin. Condensed resin forms raw opium.

Any physician, especially a specialist in pain treatment, should be fully aware of the history and effects of opiates. The opium poppy has been used medically as far back as 4000 BCE. For that matter, so has marijuana. But opium has served a greater role in pain relief.

Not content with what nature had to offer in the opium plant, chemists in the 19th century began tinkering. The first result was morphine, introduced in 1827 by Merck. But after the Civil War with thousands of injured soldiers becoming addicted, Bayer Pharmaceuticals gallantly invented heroin which hit the marketplace in 1894 as a “safe” alternative. Less than twenty years later as the addictive potential of heroin became more widely known, German chemists synthesized oxycodone.

This new “safe” alternative medication spawned generations of synthesized opiate clones, each touted as safer than its precursor: Oxycontin, Percocet, Vicodin, Percodan, Tylox, and Demerol, to name a few. Now we have the latest spawn, Fentanyl, at fifty times the strength of heroin.

Now, in order to capitalize on marijuana’s therapeutic gifts, the chemists are busy again. Already pharmaceutical grade THC, one of many active ingredients in marijuana, has been synthesized for legal sale as Marinol. You see where this is headed. Soon, coming to a town near you, we’ll have a potentially lethal form of marijuana.

But not yet. What Dr. Roman should know and apparently doesn’t is that marijuana is very different from opiates is two important ways. It’s not addictive. Opiates are. And marijuana is non-toxic, meaning no matter how much you manage to ingest, it won’t kill you.

And therein lies the absurdity of his statement.

Not to single him out. I’d wager that most physicians in Arkansas and elsewhere have made zero effort to learn more about the chemical properties of cannabis.

…In a large-scale survey published in 1994 [by] epidemiologist James Anthony, then at the National Institute on Drug Abuse, and his colleagues asked more than 8,000 people between the ages of 15 and 64 about their use of marijuana and other drugs. The researchers found that of those who had tried marijuana at least once, about 9 percent eventually fit a diagnosis of cannabis dependence. The corresponding figure for alcohol was 15 percent; for cocaine, 17 percent; for heroin, 23 percent; and for nicotine, 32 percent. So although marijuana may be addictive for some, 91 percent of those who try it do not get hooked. Further, marijuana is less addictive than many other legal and illegal drugs.[2]

Please note that “dependence” and “addiction” are two very difference things, no matter how Anthony and others might interchange them.

Addiction is a primary, chronic, neurobiologic disease, with genetic, psychosocial, and environmental factors influencing its development and manifestations. It is characterized by behaviors that include one or more of the following: impaired control over drug use, compulsive use, continued use despite harm, and craving.[3]

Psychological dependence develops through consistent and frequent exposure to a stimulus. Behaviors which can produce observable psychological withdrawal symptoms include physical exercise, shopping, sex and self-stimulation using pornography, and eating food with high sugar or fat content, among others.[4]

Marijuana plant showing leaves, generally not containing much of the active ingredients, and flower buds, the primary medically-useful portion of the plant.

“Dependence” in itself is simply an adaptive state associated with a withdrawal syndrome upon cessation of repeated exposure to a stimulus such as the ‘high’ associated with marijuana. Some studies report that ending heavy marijuana use causes some users to experience wakefulness in subsequent nights and possibly headaches.

Compare that to opiate withdrawal. Within six to thirty hours of last use, symptoms include tearing up, muscle aches, agitation, trouble falling and staying asleep, excessive yawning, anxiety, nose running, sweats, racing heart, hypertension, and fever. Then within 72 hours, more severe symptoms ensue and last a week or more, in including nausea and vomiting, diarrhea, goosebumps, stomach cramps, depression, and intense drug cravings.

But more important than symptoms of withdrawal are the risks associated with use, most critical being the risk of overdose death. And this is where Dr. Norman’s ignorance takes center stage. People die from opiates at an increasing rate, about 181 people per day in 2017.

…Victims of a fatal [opiate] overdose usually die from respiratory depression—literally choking to death because they cannot get enough oxygen to feed the demands of the brain and other organ systems. This happens for several reasons… When the drug binds to the mu-opioid receptors it can have a sedating effect, which suppresses brain activity that controls breathing rate. It also hampers signals to the diaphragm, which otherwise moves to expand or contract the lungs. Opioids additionally depress the brain’s ability to monitor and respond to carbon dioxide when it builds up to dangerous levels in the blood.[5]

Compare that to the effects of marijuana.

Because cannabinoid receptors, unlike opioid receptors, are not located in the brainstem areas controlling respiration, lethal overdoses from Cannabis and cannabinoids do not occur.”[6]

Here’s a wake-up call to Dr. Roman and others in Arkansas playing this Mickey Mouse game over marijuana: in states where medical marijuana has been legalized, opiate-related deaths have decreased.

Over the past two decades, deaths from drug overdoses have become the leading cause of injury death in the United States. In 2011, 55% of drug overdose deaths were related to prescription medications; 75% of those deaths involved opiate painkillers. However, researchers found that opiate-related deaths decreased by approximately 33% in 13 states in the following six years after medical marijuana was legalized.

“The striking implication is that medical marijuana laws, when implemented, may represent a promising approach for stemming runaway rates of non-intentional opioid-analgesic-related deaths,” wrote opiate abuse researchers Dr. Mark S. Brown and Marie J. Hayes in a commentary published alongside the study.[7]

We are nearly two years from the day Arkansas voters approved a measure to provide medical marijuana to citizens of the state. With these lawsuits filed against the commission for potential conflict of interest, the date when persons in need might obtain legal weed moves even further from reach.

Dr. Roman’s apparent failure to educate himself is only the last of so many failures regarding public health and marijuana. Prohibition propaganda remains deeply entrenched in those who don’t bother to become informed. Legislative foot dragging has never been more egregious than in the months of throwing everything but the kitchen sink in front of the voters’ choice on this measure. The tragedy is that while all these men and women responsible for the public welfare fiddle with the law’s implementation, people are suffering needlessly. And dying.

~~~

[1] March 31, 2018 issue, page 1

[2] https://www.scientificamerican.com/article/the-truth-about-pot/

[3] https://www.naabt.org/faq_answers.cfm?ID=15

[4] https://en.wikipedia.org/wiki/Psychological_dependence

[5] https://www.scientificamerican.com/article/how-opioids-kill/ 

[6] See https://www.cancer.gov/about-cancer/treatment/cam/hp/cannabis-pdq#section/all; also https://www.leafscience.com/2017/10/17/overdose-marijuana/

[7] https://drugabuse.com/legalizing-marijuana-decreases-fatal-opiate-overdoses/

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Incessant Self-Righteous Ignorance

Thursday afternoon I got a phone call. I had forgotten it was the day before the anniversary of Roe v Wade, immersed as I was in my current writing project. Usually I hang up as soon as the pause-click-click tells me it’s a solicitor.

The woman said her name was Grace. This time I said “Hi, Grace.”

“How are you?”

“I’m fine, how are you?”

“I’m calling on behalf of the Right to Life. We need to stop the killing of unborn babies.”

“Oh,” I said, instantly furious. “Well, you can stop right there. I’m Pro-Choice.”

I hung up.

Then I spent the rest of the evening thinking of what I should have said.

  • Oh really, Grace? Are you referring to an embryo or a fetus? Do know what an embryo looks like or that 67% of abortions occur before eight weeks? So in this image of a human embryo, is this the chicken or egg phase? When you have eggs for breakfast, are you eating a chicken?
  • So are you in favor of government forcing women to have children? Is that part of your ‘smaller government’ plan? Smaller except the part where the Fetus Police want to control what’s going on INSIDE YOUR BODY?
  • Gee, Grace, how exactly would you suggest the government keep women from terminating unwanted pregnancies—should they require them to check in monthly for a pregnancy test? Then if they’re pregnant, the government can keep them in a Safe-For-The-Unborn-Baby Compound until the baby is born, thereby preventing any ‘home remedy’ abortions. Women wouldn’t be allowed to leave, so taking care of other children in the home or providing meals/laundry service for their husbands would have to stop, not to mention finishing school or keeping a job.
  • So you’re in favor of forcing women to produce children they don’t want? Tell me, Grace—do you think those women will be good mothers to those children? Did you know that 70% of abortions are performed on women making 200% or less than the federal poverty line of $11,670? Did you know that this same group of women, without health insurance, are far less likely to have access to birth control? Did you know that children from families with annual incomes below $15,000 were over 22 times more likely to experience maltreatment than children from families whose income exceeded $30,000? Did you know these children were almost 56 times more likely to be educationally neglected and over 22 times more likely to be seriously injured? Did you know that childhood poverty is closely related to the later incidence of crime? Think of prisons, Grace, more and more prisons built to hide away children forced on poor families by the lack of access to birth control.
  • So Grace, since I’ve got you on the phone, maybe you can explain to me how you plan to stop abortion. Ending unwanted pregnancies has been going on for thousands of years. Maybe you didn’t know that. Maybe you thought that it was only after the passage of Roe v Wade that women started having abortions. Maybe you didn’t know that throughout the ages, women have decided who will be born—not men, not governments, not churches. Women are the ones responsible for selecting future generations. I bet everyone alive today came from a woman sometime in the past who terminated other pregnancies. Even you, Grace, probably have a grandmother back in the mists of time who decided to limit the number of children so she could take proper care of the ones she already had.

I’ve got some abortion statistics for you, Grace, showing women’s reasons for obtaining an abortion.

    • 74% felt “having a baby would dramatically change my life” (which includes interrupting education, interfering with job and career, and/or concern over other children or dependents)
    • 73% felt they “can’t afford a baby now” (due to various reasons such as being unmarried, being a student, inability to afford childcare or basic needs of life, etc.)
    • 48% “don’t want to be a single mother or [were] having relationship problem[s]”
    • 38% “have completed [their] childbearing”
    • 32% were “not ready for a(nother) child”
    • 25% “don’t want people to know I had sex or got pregnant”
    • 22% “don’t feel mature enough to raise a(nother) child”
    • 14% felt their “husband or partner wants me to have an abortion”
    • 13% said there were “possible problems affecting the health of the fetus”
    • 12% said there were “physical problems with my health”
    • 6% felt their “parents want me to have an abortion”
    • 1% said they were “a victim of rape”
    • <0.5% “became pregnant as a result of incest”[1]

Shall we discuss some of this data? You’ll notice that almost all the reasons for abortion have to do with lack of birth control. What is your position regarding birth control? Do you agree that birth control and all related information regarding human reproduction should be taught by middle school level? Do you agree that birth control should be freely dispensed at middle school level to any student who requests it? How about churches dispensing free birth control so there aren’t so many precious Unborn Children being aborted?

Did you know that only 1.3% of pregnancies are aborted after 21 weeks and generally only for medical reasons?

≤6 wks 7 wks 8 wks 9 wks 10 wks 11 wks 12 wks 13 wks 14-15 wks 16-17 wks 18-20 wks ≥21 wks
37.2% 16.9% 12.8% 8.3% 5.5% 4.5% 3.5% 2.7% 3.3% 2.0% 1.9% 1.3%

Grace, did you know that President Obama’s Affordable Care Act mandated that all employers were required to provide 100% coverage for all birth control methods? The only exception came after religious groups refused to provide such coverage and took their argument to court where they won the right not to provide coverage.

Maybe you can explain that for me, Grace. If the horror is abortion, why is there such outrage about preventing unwanted pregnancies? Because that really doesn’t make sense.

I mean, yeah, I get it. I know the unspoken thought. People aren’t supposed to have sex unless they want a child because sex isn’t for enjoyment. Sex is a duty to produce another generation—period. Because the only reason we’re on earth is make more of us. So if you’re having sex for fun, to feel good, then you’re doing it wrong and God will smite you.

It’s true that in all this, it’s the woman who suffers. I’m guessing that has to do with eating a forbidden apple. That’s on Eve. So she’s the one who has to suffer, all part of God’s loving plan to make people do what He wants them to do, which is, evidently, to keep having babies.

By the way, Grace, I don’t know how old you are, but if you were around in 1987, that’s the year the world population reached five billion. Now picture where you were and what you were doing in 1987 and imagine twice as many people. Because that’s where we’ll be in another thirty years. Twice as many cars, twice as many houses or twice as many people living in one house, twice as many big cities. Twice as many people grabbing that last loaf of bread.

It’s true that much of that population growth won’t be in the U.S. or Europe. The growth will mostly occur in Africa, you know, that “shithole” place where people already born are starving and killing each other. And Asia, of course. Those are the places where humanitarian agencies bring in food and provide medical care, including birth control. So the moral stance of this ‘Christian’ administration is to cut off financial support for any humanitarian health care group that offers abortion counseling along with birth control. So if a woman wants to obtain birth control, she can’t get it because someone in that same facility is answering questions about or providing an abortion.

That’s so perfect. So genius. So in keeping with the goal of stopping abortion.

~~~

[1] Finer, Lawrence B. and Lori F. Frohwirth, Lindsay A. Dauphinee, Susheela Singh and Ann F. Moore. “Reasons U.S. Women Have Abortions: Quantitative and Qualitiative Perspectives.”Perspectives on Sexual and Reproductive Health, Guttmacher.org, September 2005.
White, Angela. “Cost of Giving Birth at the Hospital or at Home.” Blisstree.com, 21 September 2008.
“Why It Matters: Teen Pregnancy and Education.” The National Campaign to Prevent Teen Pregnancy, retrieved 19 May 2009.

 

A Presidential Stain

Just like in every other aspect of his privileged yet miserable life, Donald Trump can see only the surface. His “shithole” description of nations like Haiti or those in Africa is apt if you only see the poverty and political chaos. A thoughtful educated person would see beyond that surface to the culpability for all that of white Europeans.

African tribes lived fruitful happy lives in their native state, just as did the natives of the Americas. But their natural progress was interrupted by those from more developed cultures who took them as slaves and exploited the resources indigenous to their lands. Since emerging from the dark ages, European countries have sailed around the world trying to enforce their religious beliefs while at the same time seeking slaves and resources to enrich their nations.

That’s how Haiti became a predominantly black society. When Spanish explorers arrived in 1492, they found a widespread population of the Taino people, a Native American tribe. Disease and genocide pretty well eradicated the Taino by 1625 when Spain’s grip on the island loosened in the face of French, English, and Dutch incursions. France seized control of Haiti and by 1700, France had established plantations for tobacco and cotton and imported African slaves to work the fields. Within the next century, the agricultural focus turned to sugar cane.[1]

Intimidating slaves with unimaginable brutalities didn’t require many whites. Accounts of horrific tortures are preserved in Haitian histories. The island’s populations suffered not only the brutalities of enslavement but also the irregular devastation of earthquakes and tidal waves. The current status of Haiti resulted from the most recent earthquake eight years ago with “a death toll estimated by the Haitian government at over 300,000, and by non-Haitian sources from 50,000 to 220,000.” The quake destroyed the country’s capital city and in the intervening years, hundreds of thousands have died of starvation.

Clone this story of Haiti into a long list of other “shithole” countries referenced by our Moron-in-Chief, with a few tweaks and details thrown in. No one in Africa asked for Europeans to come into their midst to enslave their people and steal their natural resources. Just as Native American tribes had enjoyed a sustainable lifestyle in the lands now called the United States,  African tribes maintained long-held religious practices and lived in stable communities.

Facts about the exploitation of places now referred to as “Third World” are available to anyone with a modicum of curiosity and reason. In a world before Trump, knowledge of these facts by a person elected president would have been taken for granted. Such knowledge would inform attitudes as well as foreign policy, most especially our immigration policies as, allegedly, the most advanced nation on earth.

Slavery became common within much of Europe during the Dark Ages and it continued into the Middle Ages. The Dutch, French, Spanish, Portuguese, British, Arabs and a number of West African kingdoms played a prominent role in the Atlantic slave trade, especially after 1600. David P. Forsythe wrote: “The fact remained that at the beginning of the nineteenth century an estimated three-quarters of all people alive were trapped in bondage against their will either in some form of slavery or serfdom.”[2]

The conquest of African nations occurred for two reasons: Christian zealotry convinced of its supremacy and the acquisition of wealth. Christian and Muslim missionaries still plague Africa, preaching sin and redemption to people who originally possessed sophisticated spiritual beliefs that had served them well for millennia. Social disruption and war resulted—my religion is the true one and infidels must die. Much of the warfare in Africa today is based on conflicts between Christians, Muslims, and tribal traditions. This serves several objectives—it keeps the local people at a disadvantage so they’re more easily exploited and it sells weapons of war, fattening the wallets of First World industrialists.

As for the direct acquisition of wealth, in the ages before modern machinery, slaves were the machines who tilled, planted, cultivated, and harvested the crops. Crops for food, crops for textiles like cotton, and crops for rope and other industrial materials enriched farmers. More slaves equaled more money. If advancing social conscience hadn’t eliminated slavery, likely the advance of the machines would have accomplished much of the same thing. (Or, arguably, the elimination of slavery helped push the development of machines.)

But slaves weren’t the only wealth captured from these “shithole” countries and exploited by European conquerors.[3] “Africa has a large quantity of natural resources, including diamonds, salt, gold, iron, cobalt, uranium, copper, bauxite, silver, petroleum and cocoa beans, but also woods and tropical fruits.”[4] Once European nations discovered these resources, they couldn’t keep their hands off. Using primarily enslaved indigenous people to perform the labor in mining these resources, European nations built their wealth on the backs of African people and their native wealth.

This smash-and-grab mentality continues today. Much of the chaos of Central and South American countries is a result of American agricultural interests controlling the vast majority of suitable cropland. Here in these winter-free zones, crops can grow year round and keep the supermarket shelves full even in January. The story of American exploitation and criminal interference among our neighbors to the south portends a timebomb waiting to go off in our faces.

Under previous presidents and as the United States has tried to become more than an imperialist power in the world, programs to help improve conditions in “shithole” countries have been an important objective. Unlike our current president, previous holders of that formerly-prestigious office have supported programs to help improve conditions for native peoples. Education, health care, and social reforms have been part of an outreach that included a proportioned immigration quota.

The denigration of nations and even an entire continent by racist labeling shows nothing about those places or their people compared to what it shows about the person uttering the denigration. What Trump’s profanity reveals is a man totally bereft of curiosity, respect, and knowledge about the world around him, a man whose only goal in life is self-aggrandizement. That his petulant narrow vision should spread such shame over our entire nation is a horror that can end none too soon.

~~~

This post is dedicated to Martin Luther King, a man who rose to the pinnacle of human achievement, unlike the man current soiling the White House.

 

[1] https://en.wikipedia.org/wiki/History_of_Haiti

[2] https://en.wikipedia.org/wiki/History_of_slavery

[3] https://en.wikipedia.org/wiki/Exploitation_colonialism

[4] https://en.wikipedia.org/wiki/Natural_resources_of_Africa

The Health of Arkansas

Yesterday, Arkansas Governor Asa Hutchinson beamed as he announced a drop in the number of state residents receiving health insurance through Medicaid.

Today there are fewer Arkansans on Medicaid than when I took office in January 2015, while our state’s population continues to increase. In the last year alone, the rolls have decreased by 117,000 (10%). Because of the reduction in Medicaid enrollment, DHS is now projecting that it will spend roughly half a billion dollars LESS (taxpayer money) on Medicaid in SFY’19 than anticipated in the biennial budget.

Perhaps to some, this is great news. We’re saving money! Woopee! All those freeloaders out there sucking on the government teat are now out in the cold where they belong.

But wait. We’re talking about medical care here, people who are sick or disabled or otherwise unable to obtain health care because they can’t afford to buy insurance. By his own numbers, our governor just celebrated the fact that 117,000 people of Arkansas are no longer able to obtain health care.

Now maybe that’s not exactly true. Maybe some of those folks got well from cancer or liver failure or whatever caused them to qualify for Medicaid. Maybe some of them got great jobs and have insurance now through their employers. Maybe some of them became the sudden beneficiary of their Aunt Tilley’s fabulous estate. Or won the lottery.

Or maybe not.

The reduction might have something to do with the federal government’s deep cut in advertising about how to sign up for health care. Or the federal government’s reduction in the sign-up time period. Or the state’s questionable method of deciding who to remove from the program—the electronic data system currently in use automatically deletes anyone who doesn’t respond to a request for income information. As in, one lost piece of mail. One overlooked letter amid a pile of unpaid bills. One person’s inability to comprehend what is being asked of him as he undergoes chemotherapy.

Last year, the governor looked for all the ways he could reduce the amount of money Arkansas pays for health coverage. As reported in the Arkansas Times in the May 2, 2017, edition, the governor’s goal was to lower the income limits.

As part of the Affordable Care Act, Arkansas expanded Medicaid via a unique policy known as the private option, which uses Medicaid funds to purchase private health insurance plans for low-income Arkansans. The concept was later re-branded as “Arkansas Works” by the governor. The expansion covers adults who make less than 138 percent of the federal poverty level — that’s $16,400 for an individual or $33,600 for a family of four.

The governor’s proposed changes to eligibility remove anyone who makes more than the federal poverty line (that’s $11,880 for an individual or $24,300 for a family of four) from the Arkansas Works program. Only people who make less than the poverty line would qualify going forward. That includes not just the beneficiaries who are covered by private option plans but also those who were deemed medically frail under Arkansas Works (the 10 percent of beneficiaries with the greatest medical needs, who are currently routed to the traditional Medicaid program rather than private option plans).[1]

So just to be clear, any single person earning more than $990 per month or head of household with spouse and two children earning more than $506 per person would no longer qualify for government assistance in gaining health insurance. This hasn’t yet been implemented because the federal government has not yet responded to Gov. Hutchinson’s request for the change. But really, governor?

Even the 138% of poverty level leaves lots of people without access to care. In 2013, 21% of Arkansas adults went without health care because of the cost. Do bragging rights automatically come to Gov. Hutchinson because that number dropped to 15% by 2016? What is 15% anyway, besides a seemingly small number?

The state’s estimated population is 3,004,279. Take away 23.6% of that for people below 18 years of age (non-adults). That leaves 2,295,270 adults. Fifteen percent of that equals 344,290 adults in this state without health care. That’s a lot of friends and neighbors.

In a November 2017 report, the Arkansas Times explained another proposed part of Hutchinson’s Medicaid ‘reform.’

Those between the ages of 18-49 would be required to work 80 hours per month; if they were not working, they would have to participate in job training programs or certain approved volunteer activities. Beneficiaries must be in compliance for nine months out of the year or they would be removed from the program for the duration of the year. Beneficiaries 50 or older would not be subject to the work requirement; exemptions would be available for others who met certain criteria, such as caring for dependent children.[2]

Studies have examined the realities of financial need in the United States and have come up with a set of numbers that reveal just exactly how morally bankrupt is the governor’s reasoning (along with the increasingly evident moral bankruptcy of the entire Republican party).

For a family with two adults and two children, the average cost of living in the United States hovered around $65,000 per year in 2015. The figure excludes discretionary spending on nonessential goods and services, such as leisure, entertainment and luxury items.[3]

To be fair, another source gathering economic data specific to locations gives credit to a lower-than-average cost of living in Arkansas. For a family of four in Little Rock, the average monthly cost is $2876.46. For an individual not paying rent, the monthly cost is estimated at $819.24.[4] However, in the governor’s proposed lower income limit, in neither case is there any ‘leftover’ income adequate to buy health insurance. In case you didn’t notice, the estimated average cost of living for Little Rock is $400 MORE than the cutoff income level for those seeking Medicaid coverage under the governor’s preferred income guidelines.

It’s no secret that Arkansas is one of the unhealthiest states in the nation. We rank 48th. We have higher rates of diabetes, cardiovascular disease, cancer, and general poor health both physically and mentally. In particular, according to a January 1, 2018, report published in the Arkansas Democrat Gazette, from 2013 to 2016, “the percentage [of Arkansans] who reported that their mental health had not been good in 14 of the past 30 days rose from 14.7 to 16.4 [percent.]”

The report I’d like to hear from Gov. Hutchinson would show data about the number of marginally-employed people who have gained better-paying jobs. It would show how many of those suffering mental or physical illness have gained any improvement in their health. I’d like to hear that Arkansas is spending more, not less, on health care not only in direct services but in education—I’m talking about nutrition education, cooking lessons, and everything else humanly possible to teach people how to eat healthy—which, tragically, probably doesn’t include toaster pastries for breakfast.

I’d like to hear the governor talk about how vouchers and private schools won’t be allowed to siphon money away from public schools. I’d like to hear his analysis of how inadequate education leads to poor self-esteem and how a positive self-image is key to a person’s ability to pay attention to diet and exercise. I’d like to hear him talk about how a person who doesn’t feel good either mentally or physically is a prime candidate for substance abuse.

I’d like to hear the governor discuss the abysmal status of substance abuse treatment options in the state, a crushing health care issue that gets short shrift in public discussion. More on that in another blog.

The governor needs to say that fundamentals like good health and proper education make all the difference in how a person participates as a vital member of society or how he/she gains and maintains sufficient employment. He needs to say, again and again, that a person who is well, who has learned how to reason, and who recognizes the responsibility of self-care and citizenship is the kind of person we absolutely must gain a lot more of in this state.

At any cost.

~~~

[1] https://www.arktimes.com/ArkansasBlog/archives/2017/05/02/governors-proposed-cuts-to-medicaid-eligibility-will-increase-costs-for-working-poor-likely-to-increase-uninsured-rate

[2] https://www.arktimes.com/arkansas/state-still-awaiting-federal-approval-on-medicaid-expansion-changes/Content?oid=11322951

[3] Cost of Living https://www.investopedia.com/terms/c/cost-of-living.asp#ixzz53JNGsNLI

[4] https://www.numbeo.com/cost-of-living/in/Little-Rock

Oh, the Opioids!

It’s the season of giving, of looking back and looking forward as one year ends and another begins. What better time to consider a fresh outlook on drugs?

Here we are amid the Opioid Crisis, the latest in a long line of similarly heralded events sparking fear, outrage, and call for action. One hundred years ago, it was the Cocaine Crisis quickly followed by the Marijuana Crisis, then the Heroin Crisis. By the late 60s, it was LSD that elicited our fear and loathing.

Doomed to fail from the start, the so-called Drug War was about ‘just saying no’ alongside arming our friendly local cops with military weapons. What we’ve since discovered is that ‘saying no’ meant not talking about it, and that’s a direct route to where we are now. Even worse, we failed to recognize that a war on drugs was actually a war on Americans who use drugs. Now we have embattled inner cities rampant with gun violence and police who dress/act/think like commandos.

What we as a society desperately need to realize is that DRUGS ARE NOT THE PROBLEM. Substance abuse is a SYMPTOM of a much larger and more insidious problem. We’re self-medicating for existential despair.

Existential philosophy arose in the 1950s and early 60s as a way to discuss the unique condition of modern man. Due to mechanization and urban living, the ancient traditions that have helped us cope no longer apply. We are isolated from Nature and its rhythms and lessons that used to sustain us. We are isolated from the sorcery and magic we used to believe was God. We are isolated from our fellow man, often living alone or in nuclear family settings instead of tribal or extended family groups. And most difficult, we are isolated from ourselves, distracted from our thoughts and feelings by constant chatter and material diversions. This is, briefly, the four-fold alienation that describes modern existentialism.

Exacerbating the problem of our modern age are the failures of education, lack of job opportunities, lack of self-esteem, and poor health.

Public or private, schools are missing the target for many youngsters who desperately need logic and critical thinking. Trades we’ll always use, from plumbers to carpenters to seamstresses, are not taught nor are the fundamentals of operating a self-owned business.

Our culture fails to offer a buy-in for young people who need to know they matter. Public service options in avenues other than military are few and far between. Self-esteem has been relegated to displays of material wealth even when no such wealth exists. Debt to last a lifetime is the price we pay for these trappings of social status.

Even more critical is our declining health. Not only are fast food and prepared meals low in nutrition, they’re more expensive than basic foods prepared at home. We’re overeating and starving at the same time, piling on calories in sugar and fat while missing out on the micronutrients, vitamins, and proteins that lead to an uplifted mood and greater energy. No one is advertising chard sautéed with garlic.

Yet the greatest fraud about drugs is perpetuated by the very industries that bear the name of ‘drug manufacturer.’ Since the 1950s, the insidious promotion of drugs by companies like Pfizer, Eli Lilly, or Merck (to name a few) has increased proportionately to the nation’s substance abuse problem.

Slick advertising convinces consumers that with one magic pill, all of life’s ills will go away.

Television especially holds out the false promise. The suffering victim is cast in a muted gray-tone atmosphere while around them everyone else is blissful. With the magic pill, suddenly the victim joins the bliss, bathed in golden light. Meanwhile the precautions about negative effects from the medication are described in a hurried low monotone that fails utterly to overcome the visual imagery.

The message? Consume a drug and your life will be better.

It’s a message that’s not lost on the audience, young and old alike. Who doesn’t want to be part of that golden bliss? Who doesn’t want to live without pain, without worry? All you have to do is take a drug.

It’s exactly this message that has led to the current opioid crisis. It’s not that doctors are overprescribing, although some are. It’s not that manufacturers falsely claimed that OxyContin and its family of synthetic opioids are safe to use, although some undoubtedly did. It’s that all of it is part of a bigger scam wrought upon the American citizenry—that the inevitable aches and pains of life can be made painless.

When we read about the pioneers and ‘old timers,’ we’re aghast at what they endured. No indoor plumbing? No central heat? No food unless they grew it? We marvel at their toughness, their ingenuity.

Yet amid all the labor saving devices and easy consumer goods, we find ourselves without any test of our endurance or strength. We spend too much time in activities that show us nothing at the end of the day. How can we prove ourselves without any proof?

We’re looking for adventure and new horizons. Our natural tendencies as humans drive us toward activities that may result in trauma, pain, or even death. How do we turn back the very features of our make-up that have brought us out of the caves?

The hazard of certain drugs that lead to laws against them is the fear that persons under the influence will harm us. By escaping rationality through intoxication, people may unleash violent tendencies. No abused substance in history lives up to this threat more than alcohol, but our failed war on alcohol should have taught us important lessons about the harm such policies cause.

The need for a national conversation about drugs is long past due. All drugs. Pharmaceutical advertisements should be banned, particularly those requiring a prescription. After all, why are we encouraging people to decide what drugs they need instead of allowing doctors to do their job? Profits for pharmaceuticals should be heavily taxed despite the persistent whine that the money only funds research.

… evidence that Gilead itself uses its profits to “innovate” is thin at best. In 2016, the company reported profit of $13.5 billion. It spent $11 billion to repurchase its own shares, and about $2.5 billion on stock dividends.[1]

Drug manufacturing ranks among the most profitable industries in the world.

Until we set aside our conditioned response to the drug problem, we cannot solve this escalating crisis. We are throwing people away by failing to address fundamental issues that lead people to hide in a drugged haze. We are throwing them away a second time when we stigmatize their drug problem by involving them in the criminal justice system. Or when we force them into a drug court program with limited resources and over-dependence on 12-step programs and which fail to address underlying conditions such as inadequate nutrition.

Treatment programs generally fail in many ways partly because they are set up to create profit. Instead of looking to make money off of people suffering from addiction, we should be looking for ways to express our collection compassion and concern. We should make sure that intake is immediately available for any and all comers, that they’ll be offered a safe setting full of comfort and light, that individual counseling is the best money can buy. When we invest in our fellow man, it’s a win-win for everyone.

So I urge you to give it some thought and talk about this over the holidays as you meet with friends and family. Enjoy that glass of wine as you celebrate the season. Acknowledge the difference between use and abuse. Love your neighbor as yourself. Be part of the change we so desperately need.

~~~

[1] http://www.latimes.com/business/hiltzik/la-fi-hiltzik-gilead-profits-20171023-story.html

The Poverty of Conservatism

 

A continuing crisis plagues Arkansas. Like a snake eating its tail, poverty, addiction and mental illness, teen pregnancy, sexual violence against women, and low educational achievement perpetuate themselves as a result of entrenched conservative thinking. Costs for addressing these problems continue to skyrocket while the state’s earning power lingers near the bottom.

Where do we cut the snake?

Arkansas ranks 48th out of 50 states in terms of poverty. In 2015, 19.1% percent of the state’s households—one fifth—have incomes below the federal poverty line of $24,250 for a family of four.[1]  For 2016, the state’s population of 2,887,337 included 550,508 people living in poverty.[2]

In a direct correlation to the poverty rate, the state ranks 39 out of 50 states in how well students are educated.[3] The state slips further down the scale for persons 25 years of age when considering the following factors: Only 84.8% graduate high school. Only 21.1% obtain a bachelor’s degree, a ranking that puts Arkansas at 48th out of 50. And only 7.5% obtain graduate degrees, a rank of 49 out of 50.[4]

We hover near the bottom at 46 in terms of mental illness in a compilation of 15 factors including all ages, availability of treatment, and addiction rates.[5] Between 2010 and 2014, over one third of teens in need of mental health treatment did not receive it while over 53% of adults did not. Only 20% of Arkansas residents with drug dependence and 10% with alcohol dependence received treatment.[6]

The state consistently ranks in the top five for teen pregnancies with up to 80 births per 1000 occurring among teen girls ages 15 to 19. Of these, 60% are white, 27% are black, and 11% are Hispanic. Counties with the highest rates included Sevier, Nevada, Arkansas, St. Francis, Mississippi, Jackson, and Randolph.[7]

According to a 2014 report by the National Conference of State Legislatures:

Children born to teen parents are more likely to enter the child welfare or juvenile justice systems and to become teen parents themselves. Every year, thousands of young Arkansans enter one or both systems. Research shows that, nationwide, the children of teen mothers are twice as likely to be placed in foster care as their peers born to slightly older parents. Sons of teen mothers are 2.2 times more likely to be incarcerated than the sons of mothers aged 20 to 21.[8]

The crisis becomes most apparent in the number of Arkansas children in foster care. From March 2015 to March 2016, the total number of available and in-use beds in foster homes increased from 2,801 to 3,306, but the number of foster children also increased, from 4,178 to 4,791. A 2016 report states that substance abuse by caregivers accounts for over 50% of children in foster care.[9]

Despite such high rates of teen pregnancies, many Arkansas school districts do not provide any sex education. Many others offer abstinence-only education including a virginity pledge (14 districts[10]), a ridiculous non-starter since census records show that over 52% of Arkansas teens are sexually active. Only seven school districts provide comprehensive sex education addressing contraceptives, sexually transmitted infection, abortion, and sexual orientation.

The Centers for Disease Control report that 37.4% to 38.5% of women in Arkansas experience at least one event of sexual violence during their lifetimes. These experiences include rape, sexual coercion, and/or unwanted sexual contact.[11] Among sexually active teens, 18% of females report acts of violence (being hit, slammed into something, or injured with an object or weapon on purpose by someone they were dating) and 16% reported being raped.[12]

Are Arkansas citizens somehow genetically predisposed to suffer these conditions? Is it something in the water? Or might the answer be found in the conservative mindset of a majority of Arkansas citizens?

Arkansas ranks 5th in the number of churches per capita. Seventy percent of adults define themselves as ‘highly religious’ with 65% saying they pray daily and 77% saying they believe in God with absolute certainty.[13] The predominant religion practiced in Arkansas is Southern Baptist, a conservative Protestant sect which believes in a literal interpretation of the Bible.

Predictably, any push for sex education and contraceptives in public schools provokes conservative outrage. By religious thinking, unwanted pregnancies serve as punishment for illicit sex. The burden borne by women in unwanted pregnancy, childbirth, and childcare is God’s retaliation for the sins of Eve. As stated in Southern Baptist doctrine, “A wife is to submit herself graciously to the servant leadership of her husband.”[14] Prevention either through birth control or abortion upends the natural order of things as ordained by God.

The prevailing idea of conservative parents is that talking about sex and especially advocating for birth control of any kind creates a permissive attitude wherein teens are more likely to have sex. Data clearly dispute this belief. But the refusal to accept widely accepted evidence about the effectiveness of sex ed fits perfectly with the greater mindset of religious conservatives: willful ignorance about any and all information that doesn’t square with religious teachings.

Under the belief that addiction or non-marital sexual activity are moral failings, many efforts to address non-marital sex, sexual abuse or substance abuse rely on faith-based programs. Yet as noted by a counselor with twenty years in faith-based addiction treatment, “Often times, Christian programs view the secular approach to recovery as counterproductive to their message and will often discredit and even disregard medical or empirical based advice to addiction recovery.”[15]

While embracing some aspects of modern science and the advances of civilization such as automobiles, cell phones, DVRs, and medical progress, conservatives refuse to acknowledge other key findings of our times. Early religions strictly regulated a woman’s sexual activity out of concern for proving paternity and reducing conflict between competing males, among other things.  None of that matters today. Genetic testing quickly solves questions of paternity. But religion has become so institutionalized its practitioners can’t back up far enough to consider its origins or usefulness.

There’s a blind adherence to the tradition of making babies as the primary goal in life.

It doesn’t take a genius to figure out that teen pregnancy leads to lack of education which in turn leads to poor employment opportunities, or that a state with a high rate of poorly educated adults won’t attract many employers. It also doesn’t take a rocket scientist to understand that poorly educated people with poor job opportunities are more likely to turn to drugs or alcohol or suffer other forms of mental illness. Inadequate nutrition also plays a role, another cause and result of mental illness and poverty.

Further, an embattled position in poverty with subpar education leads people directly to unreasoned fear of Other—xenophobia and racism.

We have to start with the head of the snake. If we hold any hope of interrupting this vicious cycle, our state and national educational standards must require sex education. Such requirements must be imposed even in private, religious, and home school settings.

The requirements can’t stop there. All children must be required to learn the basics of science, history, political science, and other fields that serve as major elements in critical thinking about the modern world. While the state cannot dictate whether someone embraces any particular religion, we can dictate that our children are adequately prepared to make an informed choice about what to believe.

We cannot allow reactionary religious beliefs and tribalism to undo what civilization has achieved thus far.

The hue and cry against such reforms in education will be loud and long. State and federal legislators will be hard pressed to maintain a firm stance in the face of entrenched dogmatic beliefs. It will take true leaders to enact reforms in a time when leadership seems missing from public life. That means we must elect educated progressives who will carry the weight. The future of our nation depends on it.

~~~

 

[1] https://en.wikipedia.org/wiki/List_of_U.S._states_by_poverty_rate

[2] https://talkpoverty.org/state-year-report/arkansas-2016-report/

[3] https://www.usnews.com/news/best-states/rankings/education  The

[4] https://en.wikipedia.org/wiki/List_of_U.S._states_by_educational_attainment

[5] http://www.mentalhealthamerica.net/issues/ranking-states

[6] https://www.samhsa.gov/data/sites/default/files/2015_Arkansas_BHBarometer.pdf

[7] “Say no to sex, most state districts teach,” Ginny Monk. Arkansas Democrat Gazette. Sunday September 24, 2017. Page 1.

[8] http://www.ncsl.org/research/health/teen-pregnancy-in-arkansas.aspx

[9] “Children in foster care in Arkansas reaches all-tine high.” Brian Fanney. Arkansas Democrat-Gazette, August 22, 2016. Online access October 18, 2017

[10] “Say no to sex, most state districts teach”

[11] https://www.cdc.gov/violenceprevention/pdf/NISVS-StateReportBook.pdf

[12] https://www.hhs.gov/ash/oah/facts-and-stats/national-and-state-data-sheets/adolescent-reproductive-health/arkansas/index.html

[13] http://www.pewresearch.org/fact-tank/2016/02/29/how-religious-is-your-state/?state=arkansas

[14] http://www.sbc.net/aboutus/basicbeliefs.asp

[15] http://www.addictioncampuses.com/resources/addiction-campuses-blog/3-reasons-christian-rehabs-dont-work-according-to-a-pastor/

 

Conscious Evolution

Conscious evolution. We know enough. We know why. We know how.

Back when we wore skins and only knew our own tribe, we needed clues to identify the ‘Other.’ They would kill us, take our women and homes and food. We noted their skin color, how they dressed, what insignia they carried. We didn’t need to greet them or get to know them. We killed them before they had a chance to kill us.

Our fear and hatred of Other has followed us. It’s embedded in our DNA. Our survival depended on it.

Today, our survival no longer depends on fearing and hating Other. Now our survival depends on recognizing shared humanity. The majority of people understand this. But there’s that tiny minority, emboldened now by Trump, who just don’t get it.

We need to investigate what some white men fear that pushes them to march in the street with torches. Why they resort to violence. Why they feel oppressed.

They fear losing their concept of themselves as the best, most important, top-of-the-food chain guy. Their very identity is threatened.

Their fear derives from

  • Ignorance, a failure of our public schools in educating about history and anthropology. Supremacists assume that because whites have been predominant in the development of machines and other hallmarks of modern civilization, whites are therefore superior. This view fails to acknowledge the advanced machinery of ancient cultures like China, India, and the Middle East—non-white civilizations. This view also fails to reflect the harm machines have brought to all life forms on the planet—pollution, disease, and arguably a pace of living that destroy human peace and health.
  • Rapid change in requirements for earning a living. It’s no longer enough to hunt, fish, manage livestock, plow fields, and stack rock fences, occupations that served men well for thousands of years.
  • Loss of primacy in male-female relationships. That’s not to say alt-right men don’t seek out submissive women who will stroke their egos. Many do, and sadly there are plenty of women who accept, even enjoy, this kind of relationship. But in the workplace, on the streets, and elsewhere in our culture, women have gained a more equal position. They can vote, earn a living, and walk away from men who refuse to relinquish outdated ideas. They can abort rape impregnation, an age-old tool of male domination.
  • Loss of control over formerly subordinate groups. Such as slaves (African). Such as field workers (Hispanic). Such as ethnic groups (Jew). Now their kids go to school together. At least, until pressure from the alt-right succeeds in shifting sufficient tax dollars to private and ‘religious’ schools to allow low and middle income racists to send their kids to the same segregated right-wing private schools that the more affluent racists have been sending their kids to since integration.
  • Loss of power to control the terms by which our society operates. Through the courts, America’s promise of liberty and justice for all has gradually gained greater implementation. This has fueled the swelling alt-right push to place sympathetic right-wingers on the SCOTUS as well as lower courts across the country. They want courts that will give men the primacy they once enjoyed over women. They want courts to reinforce alt-right beliefs about marriage, sexuality, race, and all the other arenas where white male dominant beliefs have been challenged.
  • For many modern men, their ability to consider themselves men has been compromised by loss of sexual function or diminished genitalia as a result of exposure to toxic chemicals. This is only going to get worse as exposures increase. If such exposure doesn’t affect them personally, it may affect their sons. If they have any. Researchers confirm that sperm count continues to drop at a rapid pace. They also remark on the increase of boys born with compromised genitalia, now up to one in 350 male births. ‘Endocrine-disrupting chemicals are substances present in the environment that can interfere with normal hormonal balance and thus exert potentially adverse health effects on the human organism. Male reproductive system development and function may be susceptible to the effects of such environmental toxicants.’ Endocrine disruptors include multiple chemicals routinely appearing in pesticides, herbicides, plastics, and many other products as well as in chemicals that have now been outlawed such as PCBs, DDT, and atrazine, to name a few. Effects of exposure to these chemicals can carry through to subsequent generations.  (Also this article.)
  • Fear of Other derives from conscious and subconscious effects. A man may have a normal penis size and function fine sexually yet still feel insecure about his sexuality. He may experience urges that he can’t explain, which repulse him and defy his religious beliefs, such as same-sex attraction. In many cases, a man’s ability to feel secure in his sexuality depends on his ability to see himself in a dominant role both at home and in society. Yet many jobs require men to work under the supervision of a woman or a gay man or a racial or ethnic minority, all of which some men consider subordinates.
  • Desire for clear lines of authority. Hierarchy serves men well by defining exact ranks of dominance. Men can accept not being at the top of a hierarchy if at the same time they see that others rank below them. With hierarchy come prescribed methods of moving up through the ranks as well as methods for working within the system. Complaints flow up the chain of command. Men know who they’re working for and what to do if problems arise. In our modern world, traditional chains of command have been interrupted. Even in the military, men today may find themselves working alongside or even in lower rank than a woman or a transgender person. This flies in the face of many men’s instinctive expectation that those within the hierarchy are their peers, their own kind. Admiration and support for Trump derives in part from his authoritarian stance, his willingness to invoke violence, and other aspects of his personality which hearken back to old white hierarchical traditions. Hierarchy as a mind-set also dictates that people believe what their parents believed, and before that their grandparents.
  • Authority for racist views are encoded in the Old Testament, at least as alt-right adherents believe. “Genesis 9:18–29 has been popularly understood to mean that Ham was cursed, and this understanding has often been used to justify oppression of African people, the descendants of Ham. In this view Ham offended his father, Noah, and because of this his descendants are also cursed, and Ham is presented as the father of African people. The text does give the impression that Ham was cursed, but a more careful reading of the passage reveals that this is not so.” (quote source)

Efforts to stamp out alt-right beliefs only succeed in escalating the problem. We must re-think our approach to this threatening yet benighted portion of the population and consider them as injured children who must be nurtured through a re-training process. Many are under-employed, and must be taught how to perform jobs that fit into the modern workplace. Many are suffering severe emotional and psychological problems and need the best therapy our professionals can provide. Many also suffer illness including obesity, sexual dysfunction, and other medical conditions that impinge on their ability to feel whole. Many may suffer the effects of poor nutrition either from ignorance about proper diet or insufficient income.

For all these ills, men of the alt-right seek someone to blame other than the person they see in the mirror.

  • It can’t possibly be that they themselves have fallen into poor health through lack of exercise or poor nutrition. Rather, the reason they feel bad is that ‘commies’ and Jews have taken over their country.
  • It can’t possibly be that their workplace exposure to hazardous endocrine-disrupting chemicals has caused their impotence. Rather, it’s ball-busting women in general.
  • It can’t possibly be that their lack of curiosity or inability to learn has caused them to slip to the bottom in job skills or educational achievement. Rather, it’s the government sending their jobs overseas. It’s immigrants taking up jobs they might have had.

The alt-right is a manifestation of a pervasive illness affecting a certain portion of our population. They are the unevolved among us. We need to immediately start to design interventions that will effectively address their fears and failings. We need to tighten the standards of education to significantly limit homeschooling and improve curriculum for political science and history. We need to implement laws that punish those advocating violence against others and require attendance in appropriate therapy, job training, and/or health and nutrition treatment, just as in earlier years we have required certain groups to attend ‘sensitivity’ training.

These challenged humans suffer from delusions that they alone see the truth. Without an effective strategy to encourage their conscious evolution, there will be more blood in the streets.