Flashback – Responsibility and Excuses

[How things have changed from when I originally titled this “Evidence Abounds” back in 2011. These days news is dominated by coronavirus and politics (or the mixture). What hasn’t changed is the tendency to use excuses in place of responsibility and the media’s willingness to encourage this behavior. First see the flashback comments.]

How hard is it to find evidence of problematic behavior in one or more of the five dimensions or of institutionalized support for these habits? – Surprisingly easy.  There are days when I have to pick and choose among available topics.

Today I have an Associated Press article left over from 3 weeks ago presenting research that tells how hormones make it more difficult to keep weight off after dieting.  The headline begins, “Not your fault!”  This is right out of the poor discipline/poor responsibility playbook.  It gives people the excuse that they can’t stick to their diet because of their hormones.  Ironically the header above the article features six advertising links, five of which are for weight-loss products, programs or surgery – the easy answers that everyone looks for when faced with the hard work of getting back to and staying at the right weight.  This is practically the definition of discipline and responsibility failures that bubble up into many other societal issues and crises (budgeting, smoking, and alcohol abuse, to name a few).

How, in the first place, can any reputable scientist say that hormones are the problem?  Didn’t humans have the same hormones many years ago when the number of overweight Americans was less than half of what it is today?  It just doesn’t add up.

Second, how can the parent of a teenager use hormones as an excuse for regaining weight and not let that teenager use hormones as an excuse for any of their own destructive decisions?  This sounds like a can of worms ready to be opened.

I have sometimes jokingly said that if I ever got arrested for anything, I’d just tell the police that what I was doing was performance art and protected under the First Amendment.  Now, I guess, if that doesn’t fly, I have the excuse of hormones to fall back on.  

[Well, that was then, but in 2020, a NOVA episode was dedicated to blaming obesity mostly on genes using examples of rare cases. It's a little hard to believe that our genes are so much different from Americans living in the 1950s and 60s. Does evolution work that fast, or is it just another handy excuse?]

Some Odd Thoughts for the New Year

1.  The opioid epidemic rages.  “More than 63,600 people died from drug overdoses in 2016” with 66% of those deaths coming from opioid abuse.  The most publicized initiatives are:  increasing availability of naloxone (narcan) to revive people who have overdosed; and needle exchange programs to reduce the risk factors for AIDS and hepatitis.

This New York Times article explains the first.  “Every day across the country, hundreds, if not thousands, of people who overdose on opioids are being revived with naloxone. Hailed as a miracle drug by many, it carries no health risk; it cannot be abused and, if given mistakenly to someone who has not overdosed on opioids, does no harm. More likely, it saves a life.”

Perhaps an important question to ask is whether these programs are doing anything to change behavior.  One FDA study from a few years back, when the problem wasn’t as widespread, estimates that almost one in five patients are receiving naloxone not for the first time.  This was based on EMT data.  With it now available to many private citizens, spouses and roommates, such incidents could be higher.  Some people are so seriously addicted that a brush with death is insufficient disincentive, while some taxpayers are asking how many second chances should be allowed.

Needle exchanges are likewise controversial.  Some programs recommend a one-for-one swap, but don’t enforce it.  Others receive objections from neighbors about an increase in discarded needles on the street.

But this from the LA Times almost 4 years ago:  “Alcohol is responsible for about 88,000 deaths in the U.S. each year, according to a new government report on the toll of excessive drinking.”  That’s 88,000 compared to 63,600. 

What's the deal?  Why is only one considered a crisis?  Is it because alcohol is legal?  Is it because we have been fighting (and losing) the war on drugs since 1970 but quit fighting a war on alcohol in 1933?  Is it because an overdose death is immediate but an alcohol-related death is often gradual?  Or is it just another instance of "shark attacks" where what makes the best headlines gets attention?

2.  Back in November I wrote that when looking for reasons to be offended, some people aren’t satisfied citing ordinary matters.  They will dig deep and use plenty of imagination to uncover the most obscure examples.  In mid-December we learned of a Boston University professor “who has researched the origins of the popular Christmas carol ‘Jingle Bells’ [and] says she has found proof that the seemingly-innocent song is steeped in racism.”  Why not add White Christmas to the list, pretending it doesn’t snow around Boston?  Forget white; a quick search of the Internet reveals that using the C-word to describe the holiday is not politically correct and may be offensive.

3.  A few weeks ago the New York Times reported that the pentagon spent $22 million on the Advanced Aerospace Threat Identification Program to investigate UFO sighting.  A pet project of former Senate Majority Leader Harry Reid, the funds were hidden in the budget.  Coincidentally, most of the money went to an aerospace research company run by one of his personal friends.  Shouldn’t revelations of such waste and abuse of power be as disturbing as a senator mock-fondling an actress?  Yet it goes in and out of the news cycle with almost no comment except for a few lame UFO jokes.

 A couple of other comments on the UFO investigations:  one on cost, the other on value.  First, I heard in one report that the program was discontinued in 2012, but the government employee running it resigned only this year - good work if you can get it.  Second, with cell phone cameras everywhere and the tendency to take pictures of and post every unusual (or ordinary) event, what is the likelihood of having aliens in our midst without evidence being spread all over social media?

4.  Wildfires in California have burned about 300,000 acres of mostly trees and brush.  The Governor conceded that this kind of devastation will become a new normal due to changing weather patterns.  How would the situation improve if the State and the people who so loved trees allowed logging companies to harvest a reasonable number to build new houses instead of leaving them all in place to help spread the fires and to act as fuel, destroying occupied houses?  The Governor’s real message is that they are consciously choosing to continue yesterday's policies, knowing they will get the same result.  Critical thinking, anyone?

Behavioral Aspects of the War on Drugs

The War on Drugs has been going on for 50 years with little to show for it except on-going criminal/gang activity, the highest prison population in the world and the occasional headline story of a “drug-lord” or “kingpin” captured or convicted – cheered by the police and press as a great victory, and cheered by the next in line in the drug cartel as a long-awaited promotion.  But are we making any progress?

Based on a survey of 67,800 one source found:  “In 2013, an estimated 24.6 million Americans aged 12 or older – 9.4 percent of the population – had used an illicit drug in the past month. This number is up from 8.3 percent in 2002.”  No progress there.  And the CDC puts this number at 10.1% in 2015.  Up again.  US News piles on with a report of a “heroin epidemic” showing a 15-year increase.  So the main purpose has been thwarted, and we get the bonus of unintended consequences.

One major failing is how drug prohibition keeps organized crime in business and funds terrorist activities – Afghanistan being the world’s number one producer of heroin.  The dynamic of illegal activities and violence in America is eerily similar to that of alcohol prohibition in the last century although drug-war proponents refuse to admit it.  Today the government has, in effect, handed control of a multi-billion dollar market to violent criminal networks and gangs overseas, in Mexico and in the streets of our major cities.  With all the money involved the incentive is far too great to persuade them to give up even when faced with threats of arrest or being murdered by rival operators.

A second failure comes with the increased danger of the products.  Drugs are dangerous themselves, but the danger escalates when illegal, often backroom operations are involved in production and distribution.  Buyers can’t be sure of what they are getting, purity or dosage.  The danger is many times greater than unintentional overdoses of prescription drugs with that info available right on the label.

Another danger comes to law-abiding citizens indirectly from higher exposure to the criminal element on city streets and from muggings and property crimes to support the habit (with fewer resources freed up to investigate those other crimes).  Those already addicted who want help have less chance of getting it, afraid of reporting their problem.  And what about kids asleep in the bedroom while their parents cook up meth in the kitchen?

Just as legalizing alcohol did not lead to a spike in drinking, there is no reason to believe that legalizing drugs would lead to a sharp increase in drug use.  Colorado and a few other states have become laboratories to test the validity of this assumption while enjoying added benefits.  Yesterday Fox Business reported that Colorado “made an extra $200 million in tax revenue last year from legalized marijuana sales” and New Jersey expects to raise $300 million a year.  Revenue from marijuana sales no longer goes to street gangs, Mexican smugglers or other shady characters.

Legalizing drugs is not an endorsement of drug abuse any more than legal liquor is an endorsement of alcoholism.  The idea would be to control quality and regulate supply.  No one wants to see fellow citizens struggle with drug addiction; but the current situation is unacceptable, and doing the same thing, or doing the same thing with increased intensity, will not change the outcomes. 

It makes sense to take the same approach to the illicit drug abuse problem as we are taking to the more recent prescription abuse problem.  It should not be treated as a legal problem but a public health and education problem.  On balance, the failed war on drugs has been much more deadly and destructive than the drugs themselves, solely because the drugs are illegal, leading to deadly violence between warring factions, battles between the police and suppliers and harm to innocent bystanders from shootouts, chases and explosions.

But recreational drug use is immoral!  So are gambling and drinking, some say, and smoking and dancing and rock and roll!  Where do you draw the line?

Grandma Fell Off the Wagon

The news was coming from all major sources earlier this week.  The incidence of drinking among Americans over 60, especially among women, is rising.  A story from the CNN wire cites a recently published study of analysis of “over 145,000 responses to the National Health Interview Survey from 1997 to 2014. They observed a steady increase in the number of older adults who consumed alcohol. Men reported higher numbers of regular and binge-drinking tendencies than women, but the largest percentage increases were seen in the female population.”

In light of my entry one week ago about the need for careful definitions and last time about studies that give us very little new information, this was worth looking into.  Experts believe this trend will increase the need for more “public health programming,” whatever that is.

They clearly define current drinkers as those who consumed “12 or more drinks in any one year in their lifetime and one or more drinks in the past year.”  That is a very broad range, but here is the concern.  “In the US 20 years ago, 54% of men 60 and older were reported to be ‘current drinkers,’ and 37.8% of women fit the same description.” By 2014, both groups had seen increases:  Men rose to 59.9% and women to 47.5%.  The difference decreased from 16.2 to 12.4 percentage points.  Actually, based on the definition, those numbers are lower than I expected.

The other increase comes in binge drinking: “consuming five or more drinks in a single day in the past year.”  For men the increase was from 19.9% to 22.5%, and it was from 4.9% to 7.5% for women.  These are people over 60 whose bodies are less able to adapt to large alcohol consumption.  They are also more likely to be on medications that may interact poorly with alcohol – hence the concern.

A couple of questions come to mind.  First they base their numbers on self-reporting, which is typically less reliable; but with such a large sample this is less of a concern.  Second, they are not talking about a stable population.  Those who are 60 today were 40 twenty years ago and likely carried their drinking habits forward over those years.  Many of those over 60 twenty years ago may not be around to answer the latest survey.

In summary the article recommends doctors have a talk with older patients.  My doctor has a talk with me about alcohol.  He asks how much, and I say (honestly) rarely more than one drink a week.  And he is OK with that because according to the Mayo Clinic: “Moderate alcohol consumption may provide some health benefits,” with emphasis on the may.  And they define moderate for healthy adults as “one drink a day for women of all ages and men older than age 65.”  (That's a lot more than the 12 drinks per year cited above.)

Another question is whether this is really news.  An analysis published last December found pretty much the same trends, but looked at people over 50 who answered a different survey.  This one didn’t clearly define binge drinking.  (Perhaps they used the different definition from the NIH of 4 drinks or just let the survey respondents decide for themselves.)  Also, the Huffington Post featured information from yet another survey about two years ago telling how the increase in binge drinking for women of all ages was greater than that of men.

Although men may have a greater drinking problem, some outlets seem more distressed at the prospect of women catching up.  The headlines on at least two sites, CBS and newsmax, about that most recent study read:  “More older women are drinking hard,” downplaying the same trend among men.

In any case, just wait a month or two and there will be more headlines and more shocking stories.  This may be an important issue to the subscribers to the journal Alcoholism: Clinical and Experimental Research, but to the media it is just a periodic opportunity to try to incite a little panic in the general public – until the next crisis or shocking research finding comes along.

Are You Afraid of Yourself?

Some pieces of information have come together recently to lead me to the conclusion that people are more and more becoming afraid of spending time with their own thoughts.  They seem to dread facing what’s in their heads.

The first sign was a message on a neighborhood e-mail group when construction workers broke ground for a new branch library.  One neighbor complained that it would increase traffic and possibly draw an undesirable element to this part of the city.  Besides, she said that she had no use for a library and found reading boring.  (I guess the Internet to her is just one long series of cute puppies and kittens.)

That was a little hard to believe, but not too unusual.  Next the post office delivered a card from my cable company telling me in large red letters to AVOID BOREDOM, by signing up to take my entertainment with me everywhere.  Now I like entertainment, but everywhere?  Don’t I want to have a little quiet time to think?

Apparently I am a minority for considering that based on the number of people I see in public who can’t put their phones down, much less turn them off.  This phenomenon is most visible among teenagers, which is why I was very surprised to hear on a television health segment that 60% of high schoolers reported binge drinking.

That was shocking, but also wrong.  Actually, the CDC reported last year that although alcohol is “the most commonly used and abused drug among youth,” and that “people aged 12 to 20 years drink 11% of all alcohol consumed in the United States,” a reputable survey showed that 35% of these youth reported drinking some amount of alcohol in the last 30 days and 21% binge drank – binge drinking being defined as men consuming five or more drinks and women drinking four or more drinks in 2 hours.  “Around 90% of alcohol consumed among under-21s is in the form of binge drinking.”

Well, 21% is better than 60%, but the National Institute of Health (NIH) published a study (done on rats - no teenagers were intoxicated) with findings showing a strong link between binge drinking during adolescence and impaired cognitive functions later in life including effects on learning, memory, impulse control and making decisions.  With more than 1 in 5 teens setting themselves up for long-term cognitive problems, what that means to our future healthcare needs, not to mention our nation’s future in general, I’ll leave for you to think about.

All that reminded me of an NBC story from a number of months ago about accidental deaths.  The number of overdose deaths “have doubled in the past 14 years and now more people die from accidental overdoses than in road accidents in most U.S. states.”  Overall, more people die accidentally from drugs than from car accidents and more than half of those deaths are related to prescription drugs.

When I lump these seemingly unrelated events together I begin to wonder if Americans are afraid of being alone with their thoughts.  Reading is not as enticing as zoning out in front of the TV.  It takes more concentration and effort.  That can seem boring.  If I am encouraged to take my entertainment with me, the advertisers must assume that I am incapable (or afraid) of amusing myself for even short periods of time.  Their assumption is borne out by the millions of teens who, even with easy access to this 24/7/everywhere music, movies and other entertainment, feel the need to drink themselves into oblivion.  And much of the rest of the population finds solace in prescription pills.  Are these all attempts to numb ourselves against the terrible prospect of some unexpected thought popping up?

It seems like what is called for is a little discipline, choosing to occasionally deny the instant gratification, and perspective, appreciating what we have and rediscovering all the wonderful things about our lives.  This self-induced isolation, drawing away from the outside world without seeming to acknowledge the inner world, is a scary symptom.

Shortest Month of the Year

In honor of the shortest month, here are a few short examples in the key behavioral dimensions.

(Critical Thinking)  A yogurt container reads "From cows not treated with rBST."  Below is added “No significant difference has been shown between milk derived from rBST treated cows and non-rBST treated cows.”  The only reason to make the first statement would be to satisfy people who incorrectly believe that there is a difference.  Would a farmer intentionally put water into his tractor’s fuel tank or something harmful into his cows?

(Perspective)  Last year at this time, you couldn’t turn on the radio or TV without hearing about Jeremy Lin, a basketball player from China playing for the Knicks.  He was “Lincredible,” sparking “Linsanity” at Madison Square Garden.  This year it took two searches to find recent news about him.  When I did, it was asking “What does Jeremy Lin need to do to turn his season around?”  A better question would be:  Why do we allow ourselves to be so easily caught up in the hype?

(More Perspective)  Does anyone know what suffering means anymore?  A radio ad asked me if I was suffering from hair loss.  Well, I have a lot less hair than I used to, but I’m certainly not suffering!  Another asked if I was suffering from hypertension.  I thought it was called the silent killer because it shows no physical symptoms until it’s too late.  Again, I hear of couples suffering from infertility.  The inability to have children could be a huge disappointment to some, but is it suffering?

(Discipline)  “Binge drinking continues to be a worrisome, under-recognized health problem among women and girls, according to a new CDC report. Nearly 14 million women binge drink about three times a month, and consume an average of six drinks per binge…” Social pressure and other factors may contribute, but no one is holding a gun to your head forcing you to drink to excess.  It's just a poor choice.  (The same goes for men.)

(Responsibility)  Whatever happened to:  “Ask not what your country can do for you…”?

(Critical Thinking)  Another reason to exercise caution with dietary supplements is that in response to FDA warnings, at least one company just changed the name on the bottle and kept selling it. 

(Even More Perspective)  How can the number one news story on January 15, 2013, according to all the major media outlets, be that Lance Armstrong admits using drugs?  All he did was ride a bicycle.  Sure, he was the best in the world, but really, how important do we make riding a bicycle?   During the same week another story considered important enough to make national headlines told of a Notre Dame football player’s non-existent girlfriend.  While we are stressing over these issues, people are dying in Syria and rioting in Egypt.

(Economic Understanding)  If the government couldn't borrow money and couldn't spend more than they had unless they sent everyone a letter saying, “This is what we are doing and your share is $X; please send a check,” would that change their behavior?

(More Critical Thinking)  How can every car insurance company save me money over every other car insurance company?  All their ads say so.

(Final Critical Thinking)  In another example of substituting derogatory nicknames for scientific discussion, as happened last year with "pink slime," the critics of a genetically engineered salmon have dubbed it "frankenfish."  The company spent 17 years doing research and winding through the approval processes of the FDA and other government agencies.  The salmon are shown to be environmentally safe and safe to eat, but opponents hope to build a grassroots protest by attaching a scary name.