What causes drug abuse and how to stop it?

http://chasingthescream.com/
http://www.scientificamerican.com/article/portugal-drug-decriminalization/

I saw this guy (J Hari) on Maher last night and was pretty impressed with his reporting on the Western approach to the drug war, and how we totally botched it. It's pretty well-established that the US method of heavy-handedly attacking the supply and harshly punishing the consumers is an utter, expensive failure. We need to address demand, but what is the right approach - education, medical treatment, intervention?

Hari is saying that those responses could help, but they don't get at the root cause. Drug abuse is mostly driven by psychological distress due to environmental-social factors. Racism, violence, lack of economic opportunity, low self-esteem, alienation, and other negative influences lead an individual to turn to drugs for escapism, pleasure, release, etc. If a person has a comfortable home, decent job, loving family and community, and safe/positive surroundings, there is a very low chance that they will abuse drugs (unless they happen to be the minority of us who truly have an addictive biology, but then they would likely become addicted to something legal like booze or shopping).

Why is it that US drug abuse is highest in lower-income, at-risk communities and the youth? I think Rx drug abuse (which is a much bigger problem than illegal drug abuse) could be a different story, because that might be driven by over-prescription of those drugs by our health system. And since they're synthetic compounds, it's possible that the drug companies have engineered them to be very potent (and potentially addictive). But I'm not sure. Heroin is unanimously seen as the most addictive illegal drug, yet people get it legally all the time in the form of medical morphine. Anyone who has had an operation doesn't become a heroin addict, so the drug itself is not inherently the problem.

Portugal used to be the European nation with the worst drug problem (an estimated 1% of the adult pop. using). It is also a fairly poor and underdeveloped nation by EU standards. They tried the "US way" for fighting drugs, and it failed of course. So in 2001 they decided to scrap it - decriminalize ALL drugs and use the law enf. money on rehab and social development instead. Of course the conservatives predicted that all hell would break loose. But a decade later, needle drug use was down 50%, and so were OD deaths and drug-related HIV infections. Abusers were given medical rehab, but also given access to jobs, education, housing, etc. The former abusers were treated like humans and given a life, not like American convicts who are labeled as junkies and thrown in with the murderers and rapists. The Portuguese who employed and housed addicts were compensated by the gov't. It can work. A lot of the previous detractors came around and admitted that they were dead wrong.

Look at the countries with the worst substance abuse problems:

• Iran (heroin) - crippling sanctions and a repressive, fundamentalist gov't
• Russia (booze) - huge wealth inequality, corruption, and poor life prospects for many (interestingly the UK is also a big booze abuser)
• Latin America (meth) - huge wealth inequality and gang-police violence
• Afghanistan (heroin) - war, poverty, corruption, and fundamentalism
• US (mixed) - fairly large wealth inequality, some communities with racism/violence

So maybe the solution for winning the war on drugs has nothing to do with drugs. Just fix society to be more just, inclusive, safe, and prosperous - even for the most lowly among us. Actually I think a lot of ills could be indirectly fixed with that approach.

Injustice even at the roof of the world

http://m.newyorker.com/online/blogs/newsdesk/2014/04/everest-sherpas-death-and-anger.html?utm_source=tny&utm_campaign=generalsocial&utm_medium=facebook&mbid=social_facebook

http://www.npr.org/2014/04/18/304574129/disaster-on-everest-marks-deadliest-day-in-mountains-history

Maybe you heard about the deadliest day in Everest history. Most people understand that climbing is very risky no matter what, but a recent trend has been shifting the danger from the high-paying Western customers ($50-90K per person) to the staff of sherpas that climbing org's employ to "set the table" for the customers. These sherpas (lowercase "s" for the profession, uppercase "S" for the ethnic group that represent the vast majority of sherpas) are paid $2-8K per expedition, with a death insurance of $10.5K to their families. So you can see where the majority of the profits go.

It's not just financials, but the climbing experience too. Sherpas have to traverse the more hazardous portions of Everest dozens of times (maybe even 30) for every one pass from a paying customer. They haul gear back and forth, set up acclimation camps, and lay down ropes and ladders. The most dangerous stuff that is usually core to climbing. Now the paying customers just pack water and a camera, literally. Not surprisingly, western death rates on the mountain have plummeted in the last 20 years, but guess who is picking up the slack? Some of this is due to better use of canned oxygen and dexamethasone (a drug that makes edema less likely). But O2 is heavy - guess who hauls the cans up and down for the customers? And most sherpas do not have modern medical care, so they don't get dex in their villages and their employers don't seem to want to buy it for them.

Understandably, the sherpas have threatened to strike unless climbing org's and the Nepalese gov't give them better safety protection and family benefits. This is coming from a traditionally stoic people. It would be like if the Hulk tells Capt. America that he is worried about the next mission - you better freaking pay attention.

The "outsourcing" of risk and concentration of profits stink of the negative side of globalization. Of course the top climbing org's are exclusively foreign-owned. Yes the sherpas are paid better than their next best available employment alternative, but it is not worth a job that is many times more dangerous than being a soldier in Iraq, statistically. And remember, Blackwater contractors got six-fig salaries and hazard bonuses at the expense of the US taxpayer, just to cook or drive a truck.

I thought the whole point of climbing a mountain was to prove your mettle? It is you and the rock, not you + an army of support staff because you can afford it. Of course for such a challenge as Everest, it is a team effort, but this is not right IMO. Is this just another way for big shot 1%ers to have a story to tell and show how badass they are? But in reality, they are only doing about 1% of the work needed to climb and survive Everest - at the expense of many local deaths. Hey, no one wants to die - I get that. But then don't climb freaking Everest; play a round at Pebble. They want their cake and eat it too, like most everything else in their amazing lives. And it doesn't matter about the consequences to others. They get what they want because they earned it and deserve it, just like Romney said.

I hope the sherpa strike works out, and they get at least 75% of the available profits from expeditions. Because they are the key resource (like the student athletes vs. the NCAA). Any schmuck can manage the front desk, assuming zero risk. And maybe the sherpas will let Joe Wall St. haul his own damn tent and tanks next time, if he is such a Master of the Universe.

I hope Pope Francis delivers more hope and change than Obama

Not sure if you've been following some of the recent comments from Pope Francis, but he is definitely a better "Maverick" than McCain and Palin. I know there are many different levels of belief on this email list (each no better than the rest), so I don't mean to get too deep in the religion weeds here. But as a lifelong confused/jaded Catholic, I mostly just want to comment on the new pope's effectiveness vis-a-vis the core beliefs of the church, and what his org needs to do to be more successful in the 21st Century.

http://news.yahoo.com/pope-says-church-cannot-obsessed-gays-contraception-abortion-163220900.html

Yes, Christianity has to be about more than quasi-arbitrary rules... all the things we are not supposed to do (and imposing that on others who are doing no harm). That is Taliban style. Faith isn't about prohibition and guilt - it's about being happy and doing good. And what is the point to fight for the welfare of unborn fetuses when you will turn your back on them after they are born into bad circumstances? Many Christians do act like Christ, but many more are astoundingly silent or complicit regarding greed (Francis spoke out), violence, and basically any other bigotry and injustice that doesn't directly affect them. But that is the strange marriage of Christianity and western free market & social conservatism - for them to pretend to be compatible, something's gotta give (and it's usually an abdication of core Christian values).

Francis is like the polar opposite of Benedict (the least inspiration pope since the Nazi appeasers IMO), and is more in tune with reality and modernity (and Jesus' teachings). I think some hardliners are seriously going to plot to kill him (it has likely happened before). Francis is saying/doing all the right things considering the constraints of his office, except really coming clean and contrite about the sex abuse scandals and the inferior role of women in the church. Maybe he's working up to that. But so far he has chosen to live like a common man (as opposed to Benedict's Prada slippers), literally washed the feet of his flock, and held a peace vigil and fasting for the people of Syria.

Other Christian denominations are leaps and bounds ahead of the Vatican on gender and sexuality tolerance, but on the record Francis said that he is not opposed to gay priests, and has no right to judge anyone who practices goodwill and searches for the Lord. Let's see if he actually implements this in the church. This contrasts Benedict's statement in 2005 that gays would not be welcomed in the priesthood (but bishops who cover up sex abuse are fine?), and that homosexuality is an evil disorder. Supposedly God loves all his children, so why would he create and curse some to lead "evil" lives just so self-righteous bigots can denounce them to feel better about themselves? Well, why would God curse innocent children to be born into starvation, war zones, and AIDS (and bless others with safety, riches, and opportunity)... but I guess we'll never have an answer for that.

He's also said that atheists can go to heaven just like believers. Doing good is the criterion, not some ceremonial label. Clearly stuff like this has ruffled some feathers among the stuffy establishment types. But the College of Cardinals picked this man to lead (and came to their decision rather quickly compared to Benedict). It's not like Francis was always a rebel, or he would have never risen in the church's ranks. As recently as 2010 Francis spoke out against gay adoption in his native Argentina, but apparently he has changed his views for the greater needs of the office (some might think divine inspiration, or just sensible rebranding?). Maybe the Cardinals realized that the church has pretty much been failing in every way, especially with the young, vulnerable, and poor of the world (the most blessed people according to Jesus). So a big change was needed, like Obama-sized change. I just hope at the end of his papacy, we have more to show for it than a health care policy mess and drone strikes.

So far Francis has been mostly talk, though that's kind of his job. He isn't the head of a state (well, not a very big one), so he can't really change our lives as much as civic leaders. He does have a lot of financial and human resources at his disposal that he could deploy. But in general he is there to inspire. And it seems he is doing a good job of that, especially in the "growth markets" that the church will depend on in the future. He's the first non-European born pope in centuries (though he is ethnically Italian), and he is a huge hit among the young of the developing world. During the Brazil protests, he mingled with the crowds and spoke about inequality (Brazil is the largest Catholic country in the world and also has one of the biggest wealth gaps). While the silver-haired septuagenarians in the west are the church's core following (and cash cow), everyone knows that their time is short (and their kids and grandkids are not going to church anymore). Maybe the pope's message doesn't resonate with them, and he may make them uncomfortable (not necessarily a bad thing for a leader to do at times). But where are they going to go... join the LDS? :) Maybe Francis could get some of them to rethink their antiquated and frankly un-Christian beliefs. Ironically or maybe not, most of this email has nothing to do with religion. It's about getting people to consider the benefits of not being intolerant, selfish pricks. If Francis can move the needle a bit there, then he should be canonized.  

Like the GOP, there is a struggle for the soul and future of the church. The hateful, egocentric, self-serving, and power-hungry factions of both the GOP and the Catholic Church may hold disproportionate sway now, but it can't last or their future is doomed. Just get back to basics: why does the church exist? Not to look after itself, conceal crimes/corruption, and act superior judging others. It should help people through education and compassion. I think Francis realizes that the bigger the leader, the more of a servant he or she must be. A servant, not a king. Any leader could benefit from that lesson, from POTUS to parent.