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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Frankenpot

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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.

Smoke This!

Marijuana medical choice dilemma health care concept as a person standing in front of two paths with one offering traditional medicine and the other option with cannabis.

When considering the pros and cons of medical cannabis, voters benefit from knowing as many facts as possible. Most people are not aware that the human body manufactures chemicals identical to those found in the cannabis plant. This stunning nugget of information was discovered as recently as 1990.

Wikipedia: “The endocannabinoid system (ECS) is a group of endogenous cannabinoid receptors located in the mammalian brain and throughout the central and peripheral nervous systems, consisting of neuromodulatory lipids and their receptors. Known as ‘the body’s own cannabinoid system,’ the ECS is involved in a variety of physiological processes including…regulation of appetite, immune system functions and pain management…and are found in the brain and nervous system, as well as in peripheral organs and tissues.”[1]

Native to central Asian and the Indian subcontinent, the cannabis plant found in ancient literature and prehistoric burials served as medicine for seizures, pain, and other human ailments. Over time, three differing species have developed–sativaindica, and ruderalis— with the more psychoactive and medically useful plants diverging from a type containing less psychoactive agents—hemp–used for rope and textiles and farmed extensively through World War II.

At least 113 active cannabinoids have been identified in the plant, one of which—tetrahydrocannabinol (THC)—is the chemical cloned for medical use as the legal pharmaceutical drug Marinol. Many patients report better results from natural cannabis than with Marinol, perhaps due to the balancing effects of the plant’s other ingredients.

Another element of natural cannabis, cannabidiol (CBD), is highly effective in treating seizures and muscle spasms.[2] Families with children suffering seizures are pulling up stakes to move to states where their ailing child can access legal CBD oil. In natural proportions, all 113 active elements in cannabis balance each other in important ways that no synthetic isolated elements like Marinol could ever do.

Those advocating for more research and FDA approval before allowing medical use fail to acknowledge the fact that cannabis has been in the human pharmacopoeia for at least 5000 years. Compared to that, FDA approval means nothing. But aside from that, the fact is that drug companies are not going to invest the millions of dollars required to gain FDA approval of natural cannabis. They’d never recoup their investment on a plant that people can grow in their back yards. And they’ve started to understand that medical cannabis outshines many of their most profitable drugs both in effectiveness and in the absence of dangerous side effects. Drug companies are above all else profit-driven corporations.

It’s a little known fact that before the government will allow legal access to cannabis plant material for medical research, the researcher’s goal must be to find the harms that could be caused by the plant. If a researcher wants federal approval to research the potential medical benefits of natural cannabis, the request will be denied. These conditions are written into federal law.

Those in Arkansas voicing opposition to medical cannabis haven’t researched the issue with an open mind. They react based on old prejudices and discredited propaganda. There’s still the culture war specter haunting cannabis, that stinky weed that hippies used as part of their rebellion from the Establishment. It’s still a point of contention between parents and their teens in the ongoing generational battle over control.

Yet studies in states with legal medical cannabis have found reduced use of illegal drugs by teens and reduced rates of crime.  A multi-year study published by the journal Lancet Psychiatry found: “…When researchers looked at marijuana use over time in the 21 states where medical marijuana was legal by 2014, they found no change in marijuana use after a medical marijuana law was passed, compared with before. About 16 percent of teens said they had used marijuana in the past month before a law was passed, compared with 15 percent who said the same after a law was passed.”[3]

The fact is, the long anticipated ‘end of civilization as we know it if marijuana is legalized’ has simply failed to materialize.

A 2014 Texas study states: “Results did not indicate a crime exacerbating effect of MML on any of the Part I offenses. Alternatively, state MML may be correlated with a reduction in homicide and assault rates, net of other covariates. These findings run counter to arguments suggesting the legalization of marijuana for medical purposes poses a danger to public health in terms of exposure to violent crime and property crimes.”[4]

Researchers at the Norwegian School of Economics used FBI statistics “to investigate the effect of the legalization on two types of crime: theft and violence. In the study, they looked at the 18 states that had introduced such laws before 2012…The researchers found a clear decline in both theft and violent crime in the states that legalized marijuana and share a border with Mexico.”[5]

Arkansas’ governor and others who voice alarm about opioid addiction should think again about their opposition to medical cannabis. One notable result of medical cannabis laws is the reduction of prescription drug use. “Fewer people are using opioids in states that have legalized medical marijuana, according to a study published September 15 in the American Journal of Public Health that bolsters advocates’ claims that marijuana can substitute for more deadly drugs.”[6]

An extensive study by the RAND Corporation (2015) concluded that legal medical cannabis reduces opioid use: “The fact that opioid harms decline in response to medical marijuana dispensaries raises some interesting questions as to whether marijuana liberalization may be beneficial for public health. Marijuana is a far less addictive substance than opioids and the potential for overdosing is nearly zero.”[7]

On November 8, citizens of Arkansas have an opportunity to cast a vote for compassion and common sense in the Natural State by bringing back the right to use this natural medicine. In the process, they also have the opportunity to nudge this state a baby step closer to the vision and advantages enjoyed by citizens in 25 other states of this nation.

 

 

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

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

[3] Quoted from http://www.ctvnews.ca/ctv-news-channel/medical-marijuana-laws-don-t-lead-to-increased-use-by-teens-large-u-s-study-1.2424012 ; Lancet study is at http://www.thelancet.com/pdfs/journals/lanpsy/PIIS2215-0366(15)00217-5.pdf

[4] http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0092816

[5] http://sciencenordic.com/legalization-medical-marijuana-reduces-crime

[6] http://www.usnews.com/news/articles/2016-09-15/study-opioid-use-decreases-in-states-that-legalize-medical-marijuana

[7] https://www.rand.org/content/dam/rand/pubs/working_papers/WR1100/WR1130/RAND_WR1130.pdf

 

Newborn Abuse — the latest atrocity in our war on drugs

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Another story of government overreach.

In 2003, the federal government began requiring states to develop strategies to deal with drug-dependent newborns. This came in response to an increasing number of babies born with opioid dependence. The government’s concern directly reflects the rise in opioid addiction nationwide.

“The number of prescriptions for opioids (hydrocodone and oxycodone products) have escalated from around 76 million in 1991 to nearly 207 million in 2013, with the United States their biggest consumer globally, accounting for almost 100 percent of the world total for hydrocodone (e.g., Vicodin) and 81 percent for oxycodone (e.g., Percocet).”[1] Most recently, tightening availability of prescription opioids has shifted abusers to heroin, an early pharmaceutical derived from the opium poppy and grandfather of the modern ‘codone’ products. Heroin is cheaper and in most cases more available than the pharmaceuticals.

No matter what form, opioids pose a real threat of addiction for many users. According to Wikipedia, “opioid addiction and opioid dependence, sometimes classified together as an opioid use disorder, are medical conditions characterized by the compulsive use of opioids (e.g., morphineheroincodeine, oxycodonehydrocodone, etc.) in spite of consequences of continued use and the withdrawal syndrome that occurs when opioid use stops … The opioid dependence-withdrawal syndrome involves both psychological dependence and marked physical dependence upon opioid compounds. Opioid use disorders resulted in 51,000 deaths in 2013 up from 18,000 deaths in 1990.”[2]

It’s not like opioid-dependent pregnant women don’t know they’re sharing their addiction with their fetus. But like all addicts, these women are severely challenged in overcoming their need for the drug not only because of the nature of the drug but also because whatever led them to abuse drugs in the first place has not been addressed. After all, not everyone legitimately prescribed opiate drugs becomes an addict.

Within one to three days after birth, infants born addicted to opioids suffer neonatal abstinence syndrome (NAS). This withdrawal experience may require doctors to administer slowly decreasing doses of morphine or methadone to ease the process. Providing medical protocols to deal with this condition was the intent of the federal law.

Despite this initial specific focus on opioid withdrawal among newborns, states have begun implementing laws that target mothers who test positive for any illegal drug use. The National Institutes of Health agree that “Alcohol and other drugs used during pregnancy can also cause problems in the baby. Babies of mothers who use other addictive drugs (nicotine, amphetamines, barbiturates, cocaine, marijuana) may have long-term problems. However, there is no clear evidence of a neonatal abstinence syndrome for these drugs.”[3]

Notably, millions of American women have used and continue to use alcohol, marijuana, nicotine, and/or prescription drugs during pregnancy with no known ill effect to their offspring. Yet in many states, zealous, usually conservative lawmakers have seized on the situation as yet another way to attack illegal drug use. Newborns and mothers are profiled and drug tested without consent. Infants are separated from their mothers. Mothers are sent to jail.

The State of Arkansas is one of eighteen states which requires health care professionals to profile mothers and newborns to determine who should be drug tested. In 2014, Tennessee became the first state in the nation to pass a law allowing women to be charged with a crime if their babies are born with symptoms of drug withdrawal. Other states, such as Alabama and South Carolina, use interpretations of existing laws to prosecute pregnant women who use drugs.[4]

The potential penalties under Alabama law are especially stiff: one to 10 years in prison if a baby is exposed but suffers no ill effects; 10 to 20 years if a baby shows signs of exposure or harm; and 10 to 99 years if a baby dies.[5]

There is no known law which requires prosecution of fathers for their use of any substance which might have contributed to a newborn’s impairment.

The American College of Obstetricians and Gynecologists guidelines recommend that in cases where substance abuse is suspected, doctors use a separate form to seek consent for drug testing; women can opt out simply by not signing. These guidelines are widely ignored. In Arkansas, for example, if a health care provider or allied professional such as a social worker believe an infant might have been exposed to illegal substances in utero, a claim of probable cause meets the criteria of child abuse and federal laws protecting privacy don’t apply. Mothers are tested without consent and the case is turned over to authorities.

Such professionals employ a widely varying and undocumented set of criteria to identify newborns and mothers to be tested. Conspicuous symptoms such as premature delivery, low birth weight, seizures, fever, hyperactive reflexes, or rapid breathing are among the more obvious reasons to test the newborn. Yet hospitals also single out mothers who obtained little or no prenatal care even though this unfairly targets the poor or those who live far from medical facilities.

Persons who fit certain cultural stereotypes may also be at risk of greater scrutiny: compare the likelihood for suspicion of drug use in a young woman with dreadlocks and reeking of patchouli compared to that of a well-to-do woman with no counterculture identifiers. Racial profiling is also widespread in these cases as is suspicion of women who have engaged a midwife.

Aside from all the outrages involved in these policies, the fact is that they close the barn door after the horses are out. Once the child is born, whatever fetal harm might have occurred is already done. The rational approach would recognize that a few newborns may need intervention treatment and their mothers need access to counseling. End of story.

Instead, state lawmakers take whatever injury might have occurred to a fetus and explode that into the worst case scenario for the newborn infant by separating it from the mother—no cuddling at the breast for milk (one of NIH’s recommended treatments of NAS is breastfeeding), no mother’s heartbeat, no familiar voices. If we wanted to ensure that an already-challenged newborn suffer the greatest possible harm, we can rest assured that arrest of the mother fits the bill.

[I concede that in a very few cases, the mother’s behavior is so out of control that the infant is better off not in her custody. Very few.]

Legislators eager to punish mothers ignore the fact that the damage is already done. They justify punitive action in the belief that punishment serves as a deterrent. But—point of fact—if threat of punishment served as a deterrent, no one would use illegal drugs.

Marijuana use is not known to result in birth defects or NAS. One study even shows benefits to infants born to marijuana-using mothers.[6], [7] But according to a 12/18/15 report in the Arkansas Democrat-Gazette, of the 970 new Arkansas mothers referred to social services in 2014, 65% were for marijuana use.

Lawmakers also skim past the obvious hypocrisy in screening mothers only for illegal drugs when fetal alcohol syndrome has long been identified as a common cause of birth defects. Many of the distress symptoms in newborns can also result from the mother’s use of tobacco.

If punishment for theorized harm to the child is the state’s objective, then why aren’t alcohol and tobacco included in the screening? Why aren’t those mothers arrested and separated from the child?

I’ll tell you why. Because a driving purpose behind such laws is to punish mothers for illegal drug use.

If the real goal is to reduce the number of impaired newborns, a bureaucracy will need to be established which monitors all women of childbearing age with monthly testing for evidence of pregnancy. Once pregnant, women would be placed on 24-hour watch to ensure proper nutrition and adequate exercise. Prospective parents will undergo genetic testing  and embryos will be screened for congenital defects and aborted when appropriate. Controlled environments for gestating women will need to eliminate potential stressors such as spousal abuse and financial troubles. Any possibly harmful substances such as alcohol, tobacco, or illegal drugs would not be allowed.

Ah, brave new world with our Alphas and Epsilons.[8]

There’s nothing wrong with states supporting protocols by which medical professionals can more adequately address NAS in compromised newborns. But compromised newborns should not be used to indict the mothers for real or imagined crimes. There’s no proof that illegal substance abuse alone is the cause of a particular newborn’s problems. A majority of distressed and/or premature newborns come from poor mothers and/or mother who use alcohol and nicotine and/or mothers who don’t exercise or eat properly.

Keep in mind there’s no scientific evidence that an addicted newborn suffers subsequent permanent damage.[9], [10]

The rush to prosecute illegal substance-using mothers of newborns does not assure that their future pregnancies will produce perfect children. Nor, in most cases, does it provide any benefit to the child.

Are women now fetus delivery systems answerable to the state?

Proactive encouragement toward good health and responsible behavior is as far as a free society can go to ensure the best possible outcome in any life pursuit of its citizenry, including parenthood. This approach involves all those abhorrent liberal ideas like sex education in the public schools and easy access to birth control. Access to abortion. Clean air and water. Greater public understanding of proper nutrition. Excellent education. Good job training and job opportunities. Community clinics with affordable, high quality mental and physical health care.

If we want to decrease the American trend toward ever greater substance abuse, we need to take immediate steps to stop commercial advertising of prescription drugs. There is not and never will be a magic pill for most of life’s troubles even if these ads insinuate otherwise.

We need to reorient our medical community toward prevention instead of pharmaceuticals.

We need to devote more resources toward understanding the factors that contribute to substance abuse and addiction and address these problems at their roots: disenfranchisement, poverty, lack of opportunity, low self-worth, racism, mental illness.

Have we done this before rushing to prosecute mothers?

No.

 

Learn more and offer your help at http://www.advocatesforpregnantwomen.org/ 

[1] http://www.drugabuse.gov/about-nida/legislative-activities/testimony-to-congress/2015/americas-addiction-to-opioids-heroin-prescription-drug-abuse

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

[3] https://www.nlm.nih.gov/medlineplus/ency/article/007313.htm

[4] http://www.huffingtonpost.com/entry/pregnant-drugs-crime_5692ea9ee4b0cad15e653dd0?section=politics

[5] http://www.al.com/news/index.ssf/2015/09/covert_drug_tests_child_abuse.html

[6] http://www.ncbi.nlm.nih.gov/pubmed/1957518

[7] http://www.druglibrary.org/schaffer/hemp/medical/can-babies.htm

[8] https://en.wikipedia.org/wiki/Brave_New_World

[9] http://healthland.time.com/2012/05/01/number-of-babies-born-suffering-drug-withdrawal-triples/

[10] http://www.adoptivefamiliescircle.com/groups/topic/Baby_born_opiate_addicted….terrified/

Best Burger Ever

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Brenda’s Bigger Burger circa 2012. The metal railing was added when a street widening took half the parking lot. Photo from an article by Dustin Bartholomew, November 8, 2012, in the Fayetteville Flyer, Fayetteville, Arkansas

Today was one of those days when I came face to face with the passage of time. In traffic at a stoplight, I studied my surroundings and realized that Brenda’s Bigger Burger property sat vacant with a big ‘SOLD’ sign on the parking lot. A pang of nostalgia twisted in my chest. I knew it had closed. I just hadn’t thought about what it meant.

Through no fault of its own, the place always marked a pivotal moment in my life.

I never knew Brenda’s Bigger Burger existed until December 1970. Never mind that it stood on the corner of 6th and South Hill, an intersection I had passed countless times growing up. Several blocks further down South Hill nestled the modest little white building where my parents dragged us kids to church every time the doors opened.

On this particular weekend, my church-going days had long since passed. Finally. Now at the end of my first semester back at university after nearly three years living in California, I sat in the front passenger seat of Sam Holloway’s white Ford Galaxie waiting impatiently for our food. I was starving.

In retrospect, I realize that my ravenous appetite had not just a little to do with my first marijuana ‘high’ the previous night.

Momentous enough in its own right, my initiation into the drug culture hardly topped the chart of radical changes that occurred that night. Even more staggering was the fact that I had unexpectedly become unfaithful to my husband.

I could lay all this at the feet of Sam Holloway, a friend of an old friend whom I’d encountered on campus just a few days earlier. Old Friend and I were both married, him in grad school and me finishing my bachelors. We agreed to get together sometime.

‘Sometime’ turned out to be one evening a few days later when he called and wanted to stop by with a friend. They brought a six-pack. I was on my second glass of Chablis.

When Old Friend and Holloway arrived stamping snow off their shoes at my carport door, I was baking banana nut bread to send to my husband. He was stationed at Clark Air Base in the Philippines earning a captain’s hazardous duty pay as a courier flying in and out of Southeast Asia with top secret missives. Our separation had begun in late September, an eighteen-months’ tour for him before he could get out of the military and enough time for me to finish my degree.

I’d been lonely. I’d fretted over whether to dally, an inclination I’d fought even while still in California. We’d been together five years, married for nearly three. We’d discussed new ideas like open marriage but hadn’t made any moves.

That doesn’t excuse what I did. In an open marriage, there would have been an agreement. This was more delicious and awful than that, unplanned, unexpected, and entirely outrageous.

Old Friend passed out on his fourth beer and snored at the end of the couch. Having no other furniture, I sat in the middle of the couch and Holloway leaned back on the other end, his hand-tooled alligator cowboy boots crossed at the ankle. Twirling one end of his elaborate mustache, he pulled a skinny yellow cigarette out of his jacket pocket and flicked his Zippo. Sweet smelling smoke spiraled from the tip.

Several minutes later, the ‘high’ hit me with a warm caress on the back of my neck. My forehead floated upward. Lights dazzled. Colors like the black and white plaid sofa and the big red and yellow candlesticks I’d made out of flower pots began to pulse. Even more intriguing were Holloway’s green eyes.

Incredible as we found it, we’d been born on the same day in the same town. His mother and my father both taught school at Rogers before we moved away. My father was remembered there, Holloway said.

It was the Chablis. It was the weed. It was the strange coincidence of our connections and the scintillating repartee that flew back and forth between us. It was a slice of time cut from both our regular lives and set aside for this experience.

The next morning every icy surface including the streets glistened in bright sunshine. The ground had been white with snow for two days. Just driving across town to Brenda’s had been an slippery adventure. He insisted on Brenda’s, so that’s where he took me.

The food came out steaming hot, a sizzling beef patty on a big round bun. My teeth sank into the burger and saliva instantly flooded my mouth. Yellow mustard! Fresh sliced onion! Dills lovingly arranged so that each bite included just enough pickle. Tomato when real tomatoes were all you could get.

The burger and fries came wrapped in thin tissue paper, enough layers that when Holloway spread out the fries on the seat between us, the fat didn’t seep through to the upholstery. Heaped in long limp strands, the fries were salty golden treasure.

My hands trembled as I ate. I savored my Dr. Pepper down to the last crunchy nugget of ice. For the third time in less than 24 hours, I died and went to heaven.

I broke two more promises before it all ended. One I broke immediately, my promise never to smoke cigarettes again. After we’d crumpled the mustard-stained tissue papers, Holloway pulled out his pack of Winstons. My brand.

The other, the promise to myself that I’d never do that again? I lasted ten days. The affair lasted a scant two months before we both moved on. The marriage lasted another three years.

When the day arrives that Brenda’s building falls before the bulldozer blade, I can tell you right now—I will shed tears. Not only for Holloway or what we had. Not only for the marriage or the man I never quite stopped loving.

My tears will also fall for the fact that there’ll never be a better burger than the one I ate that day.

[From an untitled work in progress which may or may not see print in my lifetime…]