Tag: Drugs

An Epidemic of Disconnection

An Epidemic of Disconnection

Posted on by jabittan
Over the last few years I have become increasingly aware of the importance of developing real senses of community and connection between everyone in our societies. Johann Hari’s book Chasing the Scream was one of the books that kickstarted these ideas in my mind. We are social creatures, and we create the worlds we live in together, through shared efforts and visions. As we have lost our shared visions and isolated our efforts, our communities have suffered, and people have responded with drugs, addiction, and further isolation. We have created an epidemic of disconnection, and we have been facing the consequences for the last several years.

 

In his book, Hari writes, “The places with the biggest opioid crises are also the places with the highest suicide rates and the highest antidepressant prescriptions—which help us to see that what is really going on is an epidemic of deep disconnection.”

 

Drug abuse, addiction, and overdose are common across the country, but are not evenly distributed. There are parts of our country where deaths of despair are a major concern and are so prevalent that among some demographics overall life expectancy is decreasing. People are facing incredible challenges, and don’t have the support systems and communities that they need to help them through their challenges. Drugs are a way to blunt the pain, to numb the constant worry, and to try turn off the part of the mind that only sees life as downward spiral. The epidemic of disconnection that we see in our country is self-reinforcing and threatens lives and communities.

 

We need to find more ways for people to belong, for people to matter, and for people to be engaged in creative endeavors in their community. Isolating ourselves with Netflix, gating off our communities, and building walls between ourselves, our property and the outside world of trouble will only exacerbate the epidemic of disconnection and further the inequalities which lead to our societal problems. We have to find more ways to invest in our communities, to do things together (even in a pandemic), and help encourage people to be responsible to each other and society. We cannot only be responsible to our own homes, families, and bank accounts. In order to combat the opioid crisis, we have to reconnect with people who feel disconnected and isolated, and help fill their lives in ways that opioids never will.
Police and Violence

The Connection Between Police and Violence

Posted on by jabittan
A few weeks back the United States saw huge protests against police violence and use of force by law enforcement officers. That violence and use of force falls disproportionately on minority populations who have been evicted and incarcerated at rates beyond what one would expect given the demographic breakdown of the United States population. Amidst protests of police brutality, in several dramatic and high profile instances, what the United States saw was extreme police aggression toward protesters, bystanders, and media reporters that seemed to confirm the idea that police use of force was out of control and in need of reform.

 

Following the protests, there were questions about whether police presence at protests actually incited more violence than it prevented. People asked if police needed to show up in riot gear at Black Lives Matter protests, and what would happen to the police and during protests if police forces had not shown up with riot gear.  Many argued that the police themselves sparked the violence that they responded to with force – in effect, the argument suggests that police showing up prepared for violence furthered the violence.

 

The idea that police enforcement lead to an increase in violence is one that I came across about a year ago while reading Johann Hari’s book Chasing the Scream. In the book, Hari argues that greater drug enforcement and more police action against drug users and dealers leads to more crime, not less. He writes, “Professor John Miron of Harvard University has studied the murder statistics and found that statistical analysis shows consistently that higher [police] enforcement [against drug dealers] is associated with higher homicide, even controlling for other factors. This effect is confirmed in many other studies.”

 

Arresting drug dealers and gang members doesn’t reduce the demand for drugs in a given region. Arresting low level drug dealers and gangsters doesn’t lead to much other than an arrest record for the individual, making it hard for them to find legitimate work, leaving drug dealing as one of the few lucrative opportunities available. Arresting a high level drug dealer or gangster creates instability. If you remove a leader in the drug trade, then a power vacuum exists. Competing gang members will vie for the top spot, and might also have to face off against rival gangs to defend their turf. Arrests and enforcement end up creating instability and more violence than they solve. This is part of why homicides increase after a gang member is arrested.

 

Similar to police forces that respond to protests with riot gear, and contribute to the likelihood of people actually rioting, police who arrest gang members and drug dealers actually create more violence and murder, not less. At a time when we are questioning the role and effectiveness of our police services, we should think about whether their actions achieve their intended goals, or whether their actions create a cycle that leads to more police enforcement. If responding in force creates situations for violence violence, then our police should not respond forcefully before it is necessary. If enforcing drug laws creates more violence, then we should ask whether we should be doing something else with our law enforcement.

 

Our police can be what we need them to be and what we ask them to be. The last few decades, what we have asked them to be is a quasi-militant force. The focus was not saving all lives, but on showing force and dominance. It is fair to ask if this is the goal we really want for the police, or if we want them to actually contribute to more safety and less violence for all lives in our communities.
pharmaceutical advertisements

Thoughts on Pharmaceutical Advertisements

Posted on by jabittan
“The reality is that most people hear more from pharmaceutical companies (16 to 18 hours of pharma ads per year) than from their doctor (typically under 2 hours per year).” writes Dave Chase in his book The Opioid Crisis Wake-Up Call. Chase is critical of American’s looking for a quick fix and expecting a pill to solve their problems. He says that short doctors appointments and a bombardment of pharmaceutical advertisements on TV contribute to the mindset that any disorder or illness can be fixed in a matter of minutes with a quick pill. With how much we hear from drug companies, and how little time we spend with someone who is trying to work with us in depth to correct behaviors, change our thoughts, improve muscle imbalances, or make adjustments to help us live a more healthy lifestyle, it isn’t hard to understand why most people think of medical care in the form of a pill.

 

I am wary of pharmaceutical advertisements. I don’t really understand if I am the target audience or if medical professionals are the target audience. I’m not sure if the goal is to just normalize taking pills, or if the goal is to educate patients about a potential solution for a potential problem. I’m not sure if the idea is to get people away from taking generic medication in favor of brand name drugs, or if it is to get people to try a medication and see if it helps them.

 

However, I also remember seeing a study which suggested that drug advertisements did help improve people’s health literacy, and did lead to patients being more likely to ask about medications which would help them, without finding an increase in patients asking about medications that wouldn’t be helpful for them. `When primary care providers are stressed, have limited time with patients, and are likely to miss important details, having patients with goals and specific questions about beneficial medication is important for overall health gains and an improved doctor-patient relationship. Additionally, advertisements approved by the FDA and at least somewhat regulated are better places for people to gain medical information about a drug than a Reddit or Facebook post from a random person.

 

Ultimately, I think I fall on the side of banning direct pharmaceutical advertisements. I find they are overly broad, dangerously support the idea that all one needs is a pill to solve all health problems, and ultimately are more about pharmaceutical companies than about improving health in general. I’m not 100% sure this is the best course, but I’d put my confidence around 75% sure this is the best path to pursue. I don’t think it would hurt America to be a little less focused on pills as cures rather than focused on lifestyle changes, especially if we start to favor policy changes that would support more healthy lives.