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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Smoking

I kind of quit smoking when I was 33 after having incessant heart palpitations. I think the actual trigger had been the exhaust we breathed stuck in traffic the night before after watching fireworks at the mall. Plus I’d had a lot of dental work done which involved repeated doses of ephedrine. Whatever. The doc looked at my EKG and said I had to quit smoking. And drinking caffeine.

I loved smoking. Maybe I imprinted on my father’s lifelong relationship with Winstons. Maybe I was just a natural addict. Maybe the boost I got from nicotine helped me jumpstart the confidence I so badly needed.

Pretty much within the first several weeks of college, I bought Winstons and started smoking. I learned how to French inhale. I learned how to flip ashes and thump butts out of car windows. After a year or so, I gave it up temporarily because my soon-to-be husband didn’t like me to smoke and I wanted him more than I wanted cigarettes.

For a while.

I could write an entire story about my life with cigarettes, about the on again, off again drama while married to him. About the shift to Kools after I met a particular man who was my lover for three months. One spring night as a thunderstorm raged outside, I ran out of Winstons. He offered me a Kool and that was that.

Smoking felt even more exhilarating with Kools, the intense menthol burn on the inhale, the slightly sweet smoky exhale. I loved each new pack in its clean white and green colors, the ceremony of tapping the pack, of pulling the little cellophane thread that opened the top, the careful tearing off one side of the foil interior wrap and the skilled thump on the side of my finger to knock the first lovely white cylinder loose. These were gifts, objects of beauty. That first puff felt wonderful, but it was the second hit that filled my lungs and my body with the full tobacco experience.

If anyone ever wanted a hit of my cigarette, they did not get the second hit.

Cigarettes were my best friend. They were there for me when the rest of my world dissolved into runny shit. In lonely moments, in anger, in grief, I turned to my faithful companion. In the dark of night, I relied on the warm cheery glow of a cigarette’s lit end. In hunger, in drunkenness, in the hours of tripping my brains out, the cigarette was there, centering me, reminding me of myself. Being the lighthouse in the storm.

With my first pregnancy at age twenty-seven, I bravely stopped smoking. Time slowed to a crawl. I so wanted to do right by the future child growing inside me. Then one night my husband and I had a vicious fight. I leapt into the old Ford 150 and drove to the nearest gas station where I purchased a pack of Kools. Then I drove to a vacant parking lot and lit that old friend and sat there crying and smoking. I subsequently smoked through all three of my pregnancies.

I required a cigarette when on the telephone. Otherwise I might leap out of my skin in annoyance with yet another incessant nonsensical blathering about whatever, or another tale of romantic angst, or whatever the fuck it was someone else had to tell me and I thought I had to listen as the minutes of wasted life ticked by. Without cigarettes, I finally learned to just draw my line in the sand and make whatever excuse was necessary to end the call.

After the doc said I had to quit and pointed out that I risked having some other woman mother my young children because I could fucking die, I stumbled out of the building into the glare of July sunlight and sat in my blazing hot car with the windows down while I smoked my last cigarette. I cried. Deep body shaking sobs. Then I drove up North Street, finished the last drag on that luscious Kool then tossed the rest of the pack out the window. Yes, I looked back. The little green and white pack lay forlorn on the pavement.

That wasn’t the end of my smoking. I went through a period where I’d meet a friend for a beer and she smoked my brand and I’d luxuriate in the pleasure of ‘just one.’ Only I never could smoke just one. ‘Just one’ after weeks or even days of abstinence resulted in dizziness and nausea. I had to smoke more often if I wanted to tolerate the effects. And I did smoke more. I stopped and started smoking so many times I lost count. The craving would get so bad, I’d buy a pack, smoke one then throw the pack away. Then I’d buy a pack, smoke one, and keep the pack in my glove box until the next insurmountable craving forced my hand.

It took nearly ten years before I really quit. I’d have dreams of smoking, feel the pleasure of smoke curling over my tongue, drawing deep into my lungs, brushing past my lips as I exhaled. In the dream, I’d panic that I’d started smoking again, that I’d never be free of it, that I’d always be tortured by an addiction I couldn’t beat. Even now, nearly thirty years later, I sometimes have that dream. In recent years when the dream occurs, I know in my dream that it’s a dream. For years, though, I’d wake up not sure if I had started again.

Side note: Maybe I have this dream often. I don’t know because I mostly can’t remember my dreams anymore. Why is that? My life is crumbling away before my very eyes.

I understood my thing with cigarettes was a real addiction. To me, addiction is the ability of a chemical to make a place for itself in the recesses of a human brain and take up residence there. A more refined understanding is that it isn’t the chemical itself that takes up residence, but the effect that chemical has inside the body. The whole endorphin receptor thing. The euphoria that results from those effects will live forever inside me, always ready for that moment when I might finally lay down my guard and say ‘why not?’ and bring flame to the tip and inhale.

Knowing that, I sometimes lament my father’s last request for me to bring him a cigarette. Or, more accurately, I lament my response.

We all knew he was dying. Eighty-five years of life and Winstons finally came to collect its debt in atrophied heart muscle and congested lungs. He spent his days and nights those last weeks in a hospital bed in the family room, unable to walk and perhaps in pain. But he never said he hurt. He didn’t complain.

On one of my last visits before he died, he held my hand and asked if I’d get ‘the old man’ a cigarette. I said no, you know you can’t smoke, you’re on oxygen. But later I thought, what the hell was I thinking? I could have turned off the oxygen. I could have bought a pack and wheeled him to the porch and watched him enjoy the hell out of that damn thing.

It would have been the rational, kind thing for me to do. He hadn’t smoked in nearly a year at that point, so I’m not sure how dizzy it would have made him. Maybe it wouldn’t have been the joyous sensation he expected. Maybe he would have coughed or choked. But he was dying anyway.

I should have done it.

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/

 

On Legalizing Drugs

“Americans must confront the reality that we are the market,” Secretary of State Rex Tillerson said this past Thursday. “We Americans must own this problem.”[1]

Meeting with his Mexican counterpart, Tillerson acknowledged the role of American drug consumption in the proliferation of violent Mexican drug cartels. Citing the enormous demand for heroin, cocaine, and marijuana by Americans eager to get high, he argued that “drug trafficking had to be addressed as a ‘business model,” attacking cash flow, gun procurement, production and distribution.’”

Oh, please. You’d think that an administration that promised new approaches would make some tiny effort to think outside the prohibition box. But never once in Tillerson’s comments or those of his colleague Homeland Security Secretary John Kelly did a new idea appear. Never once did they hint at any effort to consider the success of other nations where various types of legalization and regulation have greatly reduced drug problems.

Take, for example, the success of states like Colorado now in its fifth year of marijuana legalization. Sales of the legal herb generated tax revenues exceeding $150 million between January and October 2016, $50 million of which the state is using to pump up its school systems.[2] Significant shares of this revenue stream will support improved drug treatment, drug education programs, and various projects targeting at-risk populations.[3] All these expenditures help increase education, job skills, and opportunity for persons who might otherwise fall victim to substance abuse.

Yes, Americans are the market. But instead of devoting resources to learning more about why Americans are uniquely prone to drug use and abuse, outdated policies continue to treat Americans as children to be scolded and punished. This attitude helps foster voters’ disgust with government.

Punishment has become increasingly more severe as subsequent generations of policymakers have embraced the government-as-nanny model. Any incremental step away from prohibition has come wrapped in controversy, implemented only in states where the voice of reason has a chance to be heard. Now with the Trump Administration and its appointment of Jeff Sessions as head of the Justice Department, we face the prospect of a full-bore return to the good old failed policies of the past.

Why is there no discussion of legalization and regulation? A modest approach might be similar to that of Portugal, who years ago legalized all drugs. “Weed, cocaine, heroin, you name it – Portugal decided to treat possession and use of small quantities of these drugs as a public health issue, not a criminal one.”[4]

While our nation’s drug warriors lament that such an approach would lead to higher use rates among the young and greater ease of availability would increase use rates, the fact in Portugal is that youth aren’t using more, adults are using slightly less, the rates of HIV and Hep C infection are down, and – hear this – hardly anyone dies of overdose.

Compare that to the alarming rise in U. S. deaths from opiates which more than tripled between 2010 and 2015.

Drug overdose is the leading cause of accidental death in the US, with 52,404 lethal drug overdoses in 2015. Opioid addiction is driving this epidemic, with 20,101 overdose deaths related to prescription pain relievers, and 12,990 overdose deaths related to heroin.[5]

It’s way past time to face reality: people are going to use drugs. As far back as we can peer into human history, people have consumed everything from beer to cannabis to opium to hallucinogens. These practices are part of who we are, part of our religions, part of our ability to think outside or within ourselves.

Legitimate questions await answers about why various types of drug use throughout the millennia have transformed into today’s raging torrent of human suffering, but we’re not devoting any resources to answer those questions. Have the pressures of our fast-paced modern age forced us to seek refuge in intoxication? Is our multicultural society at fault in erasing old customs and rites of passage that could help us confront our existential crisis? Have the conveniences of our technological age created too much leisure time? What is the impact of a pharmaceutical industry’s marketing campaign flooding us with ads suggesting that the solution to every human ill is a drug?

We simply don’t know.

We should have learned a hundred years ago that criminalizing a popular intoxicant only creates bigger problems. Those who championed alcohol prohibition wanted to stamp out drunkenness. The blissful concept assumed that if alcohol were made illegal and its producers and users criminalized, everyone would simply stop drinking.

New York City Deputy Police Commissioner John A. Leach (right) watching agents pour liquor into the … New York World-Telegram and the Sun Newspaper Photograph Collection/Library of Congress, Washington, D.C. (neg. no. LC-USZ62-123257)

Far from it. For their trouble in passing the Eighteenth Amendment, the “dry” crusaders found their cities overrun by heavily armed criminals fighting over territory. People flaunted the law, patronizing highly popular speakeasies where drinking served as joyous rebellion against overweening authority.[6] No matter how many barrels of liquor were spilled into public gutters, ever more enterprising moonshiners set up shop in hidden hollows.

It took just over fourteen years for prohibition fervor to sour. Amendment Twenty reversed it in 1933.

As Lincoln famously said in 1840:

“Prohibition… goes beyond the bounds of reason in that it attempts to control a man’s appetite by legislation and makes a crime out of things that are not crimes… A prohibition law strikes a blow at the very principles upon which our government was founded.”[8]

Sadly, it seems little of this lesson actually sank in. Prohibition policies continue to frame our national approach to substance use and abuse, siphoning money into hit squads of heavily armed urban police and burgeoning prisons instead of desperately needed research and treatment of addiction.

Reality is that prohibition does nothing to reduce the market for drugs, but it does create a thriving underworld where dealers make huge profits. Stamp out every drug producer/dealer in the nation and tomorrow another crop will rise to the surface. Among the poor, especially those in marginal economies of Mexico and other Latin American countries, the potential benefits far outweigh the risks. Our inner city youth’s only hope of achieving the American dream seems to lie in the profitable drug trade. It’s about supply and demand.

The economics of prohibition can’t be overstated. Trade in illegal drugs generates so much profit that gangs can afford all the expensive weapons they might ever want. The spiraling up of urban warfare now involves military gear and tactics among the police and armor-piercing bullets in automatic weapons carried by adolescent criminals. The payoff comes in fancy cars, jewelry, and a lifestyle not achievable by legal means. Tax free.

A war on drugs is, after all, a war on our people, with rising collateral damage to our cities, institutions, and most of all, innocent bystanders.

Ironically, prohibition policies fail utterly to accomplish the goal of eradicating drug use/abuse. A smattering of evidence from states with legalized marijuana shows that teen use has dropped, suggesting that by removing the ‘forbidden fruit’ aspect of the drug, rebellions teens may lose interest. Meanwhile on the black market, no ID is required for purchase, and studies have found that teenagers can obtain marijuana more easily than beer. [9]

We the people have to decide what we’re going to do about this, because our so-called ‘leaders’ won’t make the first move. We have to decide and then make our voices heard. Compare:

  • a militarized police force versus friendly neighborhood police to protect and serve.
  • urban warfare versus reclaimed neighborhoods and inner cities
  • illegal search and seizure and loss of property even you’re not convicted of a crime versus government butting out of private lives
  • an overwhelmed judicial system versus our Constitutionally-guaranteed due process
  • half of federal prisoners in jail for drugs and the fact that drug offenses comprise the most serious offense for 16% of state prisoners versus an enormous reduction of prison population
  • our ever-growing investment in prisons versus a renewed investment in schools, mental health care, and state-of-the-art addiction treatment centers.
  • taxpayers struggling under drug war costs versus a regulated, taxed drug industry ensuring purity, restricting sales to adults only, and producing substantial new revenue streams
  • American citizens treated as children by government deciding what they can do in their personal lives versus each person responsible for his/her welfare. Want to be homeless, die in a ditch? Go ahead. Ask for help, we’ll be there for you.
  • overdose of drugs like heroin often resulting from zero information about purity or strength versus a regulated market that includes labeling for purity and precautions about use.

There are no upsides to the drug war. By any tally, this approach has been an enormous policy fiasco partly responsible for the decline of inner cities and disrespect for government in general. Government has never bothered to assess the effectiveness of its policies. No one can cite data showing that getting tough on drug traders and users has reduced supply or demand.

Indeed, judging by the rhetoric of our newest batch of politicos and the news flowing to our ears and eyes on a daily basis, we can say with certainty that drug prohibition continues to be an abysmal failure.

~~~

[1] http://www.latimes.com/politics/washington/la-na-essential-washington-updates-tillerson-puts-onus-of-drug-trafficking-1495131274-htmlstory.html

[2] http://fortune.com/2016/12/13/colorado-billion-legal-marijuana-sales/

[3] https://leg.colorado.gov/sites/default/files/15-10_distribution_of_marijuana_tax_revenue_issue_brief_1.pdf

[4] https://www.washingtonpost.com/news/wonk/wp/2015/06/05/why-hardly-anyone-dies-from-a-drug-overdose-in-portugal/

[5] http://www.asam.org/docs/default-source/advocacy/opioid-addiction-disease-facts-figures.pdf

[6] https://en.wikipedia.org/wiki/Prohibition_in_the_United_States

[7] http://www.autofoundry.com/293/the-best-moonshine-cars-of-all-time/

[8] http://www.americanantiquarian.org/proceedings/44807229.pdf

[9] http://www.cbsnews.com/news/teens-pot-easier-to-buy-than-beer/

Frankenpot

frankenpot-scientist-final

Last night PBS NewsHour featured a story about the new cannabis derivatives. Mostly it focused on 99% pure THC and how dangerous it is. How it can be addictive. How it can be abused.

This is what we do, we humans. We take something that’s pretty much perfect the way Nature makes it then we fuck it up. Gild the lily.

I predicted this, actually. Not that I’m taking in satisfaction in seeing my prediction come true.

The push behind 99% pure THC isn’t from pot heads. It’s from pharmaceutical companies. It’s from doctors who want to prescribe an exact dose of some chemical that they think will provide x-result. It’s from legislators whose balls shrink when facing a question of whether to legalize cannabis for people to use as they see fit—because the culture war is still going on.

You know, that war where the bulk of an entire generation smoked weed and saw truth no one wanted them to see. That truth about how America talks out of both sides of its mouth—oh, we’re a Christian nation. Oh, let’s go to war. Let’s segregate blacks. Let’s be complete and utter jackasses to anyone not exactly like us.

Weed opened a generation’s eyes to chemicals poisoning our food, air, and water, to the worship of wealth, to our rights to our bodies and our lives, our innate morality. In the epiphany of getting high with friends, we saw love was the answer. Peace was the answer.

We said fuck off to the corporations and war machine and went back to the land.

They didn’t take it lying down. They waded into our pot parties with batons, guns, and arrest warrants. Some of us stuck it out. We grew weed in ditches and creek banks. They came with their helicopters and tracking dogs. We grew weed in spare bedrooms and closets. They came with their infrared cameras.

Then we started the real work—political work, outing ourselves as advocates for cannabis. The result is currently 26 states with laws allowing medical use and a growing tide of states allowing recreational use.

In response, the Establishment has said, oh, grow your own? Smoking weed? That can’t possibly be allowed. It’s not real medicine. Real medicine comes in pills and needles that doctors can prescribe in exact dosage because, as we all know, people don’t know shit about what they need. They can’t tell if one puff is enough. Or three.

This is how it works. You take a perfect God-given plant and make it dangerous. This arrogant strategy has worked with just about every magical plant our ancestors relied on. Only with our clever modern techniques of science, we have made them deadly. Opium – a natural anesthetic used as far back as history takes us. Useful, relatively safe. But let’s improve that, because doctors, science, politicians. Let’s make morphine.

Decades pass. Oh, wait, morphine is addictive. Let’s fix that—let’s make heroin.

Decades pass. Oh wait, heroin is addictive even worse than morphine. Let’s make opiate clones, you know, OxyContin and Oxycodone and all that.

Uh-huh. How’s that working out?

It happened to coca leaf. A simple leaf. Stuff a few in between your back teeth and your cheek and let it work while you hike up the Andes and hoe your potato crop. Then the geniuses got ahold of it. Cocaine! Wonderful—let’s put it in snake-oil tonics and feel-good drinks so we can make money.

Then, no, wait, people get hooked on this feel good stuff. Let’s make it more scientific. Voila! We have amphetamine, methamphetamine, and Adderall we hand out to our kids like candy. Gee, anyone have any idea how we got so many people addicted to meth?

Now we’re on the same road with cannabis. Not enough to take what we’ve been given. No, we’ve got to meddle, ‘improve,’ synthesize and concentrate. Satisfy the corporate agenda to create something they can profit from. Take away a person’s right to grow his own poppy, his own cannabis alongside the tomatoes and peppers. Separate him from his instincts toward health and well-being and put him in the hands of doctors and pills.

It’s always about the money.

And about taking personal responsibility away from individuals.

The cycle of harmful effects from this new Frankenpot is just beginning.  But the harmful effect of this mindset should be familiar by now. It screams to us from our militarized police forces and our overcrowded prisons, from the violent underworld spawned by prohibition, from the desperate alleyways where homeless addicts hide.

What happens when you gild a lily?

To gild refined gold, to paint the lily, to throw a perfume on the violet, to smooth the ice, or add another hue unto the rainbow, or with taper-light to seek the beauteous eye of heaven to garnish, is wasteful and ridiculous excess.” William Shakespeare‘s 1595 play King John, iv.2

The lily dies.

Straining on a Gnat

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In light of a recent update to federal regulation of commercial chemicals, pointed questions arise about laws governing controlled substances. Consider last week’s announcement of funding for a study of synthetic pot. The press release from the University of Arkansas for Medical Sciences emphasized the importance of knowing ‘what is safe.’ A federal grant of $2.7 million will fund research into K2 and Spice, a study to be led by Paul Prather, professor of pharmacology and toxicology.

“People who smoke K2 and Spice are basically playing Russian roulette,” Prather warned. “You’re injecting this compound that has literally never been tested.”

I had to laugh out loud. What are K2 and Spice compared to the 84,000 commercially used chemicals that have never been tested? What logic lies behind aggressive policing of intoxicants that a limited percentage of the population might voluntarily use periodically and the simultaneous abject failure to test chemicals that the entire population unwittingly touches, ingests, and inhales on a daily basis? Everything from dryer sheets to shampoo to spray sanitizers is loaded with mystery chemicals.

This lunacy fits perfectly with the hit-or-miss tradition of government policies rife with misinformation, driven by profiteering, and shrouded in hysteria and secret agendas instead of rational analysis of fact.

People who use K2 and Spice seek a legal alternative to marijuana.  Unlike these modern synthetics, however, marijuana has been in use as a medicine and intoxicant since pre-history. Archaeological evidence points to cannabis use in ancient China, ancient India, ancient Egypt, and by the Scythians contemporary to ancient Greece. If the criteria is ‘what is safe,’ then marijuana has long since exceeded the requirement.

If public policy were based on thoughtful analysis, marijuana would be legally sold like alcohol and this $2.7 million appropriated to study K2 would be spent on examination of why the U. S. has a higher rate of drug use and abuse than any other nation on earth (which goes hand in hand with our skyrocketing prison population).[1] The proportion of people in the United States who have used cocaine at some time during their lives is higher—by a factor of four—than in 16 other nations surveyed by the World Health Organization (WHO). The United States also leads in lifetime use of cannabis and tobacco.[2]

There’s a common misconception that drug laws are based on comprehensive scientific conclusions about the dangers of those drugs. Government funding to study drugs props up the fiction that our laws are based on ‘what is safe.’ This fantasy has been promoted by those with vested interests or a social agenda in mind. Drug laws have turned our local police departments into militaristic hit squads. Prisons are a growth industry. Selective enforcement of drug laws against immigrants, racial groups, the counter culture, and inner city poor places these potentially troublesome groups under government control.

Drug laws do nothing to stop addiction.

Consider the cautionary tale now unfolding about OxyContin. Blessed with extensive clinical testing and FDA approval, Oxy has been the darling of pain relief since the 1990s. Similarly, a century earlier Bayer Pharmaceutical introduced a new wonder drug named heroin.[3] “The sales pitch that created an instant market to American doctors and their morphine addicted patients was that heroin was a ‘safe, non-addictive’ substitute for morphine.”[4]

Now that OxyContin addiction rates have soared, a predictable crackdown has restricted supply. The result is a shift from oxy to black market heroin and rising overdose rates.

Drug warriors and doctors alike seem to be asking the wrong questions.

The more obvious right question: Why does the U.S. lead the world in substance abuse?

The less obvious: What role does our daily cocktail of manmade chemicals play in our mental and physical health, including addiction?

If the health and welfare of our citizenry were the force guiding federal and state policy, then why has it taken until June of this year for the federal government to authorize new provisions in the nation’s Toxic Substances Control Act? Originally passed in 1976, the TSCA allowed all 62,000 chemicals that were in commerce before that year to stay on the market unless the Environmental Protection Agency later found that they posed an “unreasonable risk.”

Now over 84,000 untested chemicals are in commercial use. In the intervening forty years, the EPA has required testing of only 250 chemicals and banned only nine, among them dioxin and hexavalent chromium. The new rules impose a mandatory requirement for the EPA to evaluate tens of thousands of in-use chemicals and establish risk-based safety standards along with requiring public transparency for chemical information. [5]

A day late and a dollar short. For decades, activists have pushed for laws more like those in Europe where substances generally can’t go to market unless manufacturers can provide data showing they’re safe.[6] Clearly we’ve got this backwards.

Before you start feeling reassured by this recent change in the U.S. regulation of chemicals, please note that

“The new law requires EPA to test tens of thousands of unregulated chemicals currently on the market, and the roughly 2,000 new chemicals introduced each year, but quite slowly. The EPA will review a minimum of 20 chemicals at a time, and each has a seven-year deadline. Industry may then have five years to comply after a new rule is made. At that pace it could take centuries for the agency to finish its review.”[7]

One gaping hole in our official ‘what is safe’ question is whether any of these chemicals might increase the risk of addiction. For example, the chemical Bisphenol A (BPA) is found in many products, including canned foods, plastics, and dental sealants, and is similar in structure to the hormone estrogen. Ask any woman whether hormones affect mood and attitude. Or any man, for that matter. Studies have linked BPA exposure with many health problems including obesity, early puberty, and miscarriage. Whether levels of BPA in the environment are harmful to people is still being studied.

Other chemical pollutants may affect mood, impair reproduction, and trigger cancer and other disease. Consider just one particular chemical, tributyltin, which is used as a wood preservative and glass coating among other things. In animal studies, it was found that exposure to tributyltin increased the number of fat cells, thus possibly setting into motion a genetic propensity at birth for obesity.  Some chemicals have been found to cause male frogs to become female.  It’s a long and terrifying list.

84,000.

Admittedly other factors in American life influence the rates of intoxicant abuse. As a multi-cultural society, we have few ties that bind. What are our rituals that serve as guideposts, rites of passage that help define a young person’s purpose or meaning? What shortcomings in Western medicine lead us to treat an ailment’s symptoms rather than dig out the cause? What ignorance and greed allows drug companies to saturate our media with ads that condition us to seek a pill for every ill?

Simultaneously, chemicals have become the modern savior for everything from bad odors to agriculture. We are routinely exposed to a smorgasbord of substances which may trigger our need for drugs or at least compromise us in myriad ways we hardly understand. While government awards contracts to study K2 which last year caused fifteen people to lose their lives, cause of death data from 2013 finds 29,000 deaths from alcohol, 18,893 deaths from prescription drugs, and 17,000 from all illegal drugs combined.

We can rest assured K2 will be proven harmful. Then what? Build more prisons?

Even those numbers pale in comparison to data from 2006 showing workers in chemical industries suffer more than 190,000 illnesses and 50,000 deaths annually related to chemical exposures. Workplace chemical exposures have been linked to cancers and other lung, kidney, skin, heart, stomach, brain, nerve, and reproductive diseases.

Consider the following abstract for a 2008 study by the National Institutes of Health:

“While proper brain function requires the complex interaction of chemicals perpetually occupied in purposeful biochemistry, it is well established that certain toxic substances have the potential to disrupt normal brain physiology and to impair neurological homeostasis. As well as headache, cognitive dysfunction, memory disturbance, and other neurological signs and symptoms, disruption of brain function may also manifest as subtle or overt alteration in thoughts, moods, or behaviors. Over the last four decades, there has been the unprecedented development and release of a swelling repertoire of potentially toxic chemicals which have the capability to inflict brain compromise.

“Although the ability of xenobiotics to induce clinical illness is well established, the expanding public health problem of widespread toxicant exposure in the general population is a relatively new phenomenon that has spawned escalating concern. The emerging area of clinical care involving the assessment and management of accrued toxic substances such as heavy metals, pesticides, plasticizers and other endocrine disrupting or neurotoxic compounds has not been fully appreciated by the medical community and has yet to be incorporated into the clinical practice of many consultants or primary care practitioners.”[8]

That pretty well says it all.

~~~ 

[1] http://www.cbsnews.com/news/us-leads-the-world-in-illegal-drug-use/

[2] https://www.drugabuse.gov/news-events/nida-notes/2009/11/united-states-ranks-first-in-lifetime-use-three-drugs

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

[4] http://www.narconon.org/drug-information/heroin-history.html

[5] https://www.epa.gov/assessing-and-managing-chemicals-under-tsca/frank-r-lautenberg-chemical-safety-21st-century-act

[6] https://www.washingtonpost.com/news/energy-environment/wp/2015/03/19/our-broken-congresss-latest-effort-to-fix-our-broken-toxic-chemicals-law/

[7] http://www.pbs.org/newshour/updates/it-could-take-centuries-for-epa-to-test-all-the-unregulated-chemicals-under-a-new-landmark-bill/

[8] http://www.ncbi.nlm.nih.gov/pubmed/18621076

 

Photo credit: https://www.flickr.com/photos/jurvetson/131023758/