President Trump declared that opioids are now a “National Public Health Emergency.” At the same time he demonstrated his ignorance of important facts. That is likely the fault of Chris Christie’s chairmanship of the President’s Commission on Combating Drug Addiction and the Opioid Crisis. Only one of the Commission members, Dr. Bertha Madras, has any subject matter expertise. The other five are elected officials, all of whom have publicly demonstrated allegiance to the idea that the Drug War is the proper way to deal with an epidemic of overdoses.
To say that this is wrong-headed would be the observation of an astute student of the obvious. The War on Drugs was officially declared by Richard Nixon in 1971, but has been going on at least since the Harrison Narcotics Act of 1914. In a century we have experimented with banning one addictive drug, alcohol, only to discover that prohibition does not work. Yet politicians and their lapdogs in the press have slavishly insisted that if we do more of the same, we will eventually get a different result. Albert Einstein famously noted that this is one definition of insanity.
Widely distributing Narcan to drug addicts will probably save some lives when they overdose, but that’s like calling a wrecker to tow you to the tire store when one blows out after all four have been bald for a year. Sometimes you’ll get in safely, but other times you’ll end up injured or dead in an accident.
Dr. Madras is an expert in the cellular biology of addiction, but it is clear from her writings that she is most comfortable with remedies based in formulary controls, claims data surveillance, and education of physicians on reducing opioid risks. This top-down regulatory approach is shared by the congressman, state attorney general, and three governors who fill out the commission. In short, the Commission’s prescription was printed and signed before the Commission ever met. It completely ignores a century of experience in the field.
Opiates 101: A short course
In my 36 years in Anesthesiology, I became intimately familiar with the salient fact that all opiates are essentially the same drug. (See table) All work on the same receptor in the brain. All depress breathing so that in an overdose, the victim completely forgets to breathe until he is completely dead. All cause constipation, nausea, and vomiting. All change how one sees the world, and once your body is used to them, they all cause horrible withdrawal symptoms.
The only material differences between opiates lies in how quickly their effects start, how long they last, and how the drug is administered. In a sense, Remifentanyl is short acting Fentanyl, while Morphine, Heroin, and Dilaudid are delayed release Fentanyl. Oxycodone is essentially an oral form of Morphine. I could go on, but you get the point.
Knowing those facts made it easy for me to administer literally gallons of opiates safely. Had Heroin been legally available, it could have joined Fentanyl, Morphine, and Dilaudid as my front-line drugs for pain. After all, it has the same onset, duration, and side effects as Morphine and Dilaudid, with potency between them.
History 101: Why opium was banned
By now it should be painfully clear that there is no medical reason whatever for Heroin to be banned. It’s a good drug with definite medical utility. And Fentanyl has proven itself to be a very good drug since it was introduced into clinical medicine over fifty years ago. Yet suddenly there are wild cries to eliminate a “public health emergency” from a drug we’ve used safely for decades. Why should this be?
Opium has been used for both intoxicant and medical purposes for as long as we can trace history. It is an extract from a pretty flower that grows wild in many countries. It dulls pain by working more effectively at the endorphin receptor than endorphins, which your brain makes. As long as the strength of the drug is known, it is extremely safe. But do-gooders can’t leave well enough alone. Could it be they see some benefit for themselves?
Opium has been a cash crop for millennia, but by itself isn’t that highly profitable since harvesting and refining it is inexpensive. An addict can easily be supplied for a couple of dollars a day. A supplier needs a large market. Or he can have a smaller market at a higher price.
Our current obsession with the bad habits of others took full flower at the pen of William Randolph Hearst. During the building of the Trans-Continental Railroad, large numbers of Chinese laborers were imported. They took their one day a week off in the nearest shanty town where many smoked opium, got high, and slept it off. Hearst was a blatant racist with the largest megaphone in the country, the Hearst newspapers.
His hatred for the “coolie” sprang vividly from the headlines, cartoons, and editorials of his papers. Soon the “opium fiend” was a matter of public condemnation, even though the demon created in the printed word never existed, since opium does not lead to aggressive behavior. Shortly Congress passed the Chinese Exclusion Act of 1882, which prevented further Chinese immigration.
This did not end the frenzy. In 1914 Congress passed the Harrison Narcotics Act, again in the complete absence of evidence that individual consumption of narcotics caused harm to those not engaged in its use. Further, many, in the footsteps of the “coolies,” were able to use the intoxicating drug and continue to live a productive life.
When Harry Anslinger became the first Director of the Federal Bureau of Narcotics in 1930, the War on Drugs (by other names) became fully fledged. Never again would the wisdom of the effort to stamp out drug abuse be seriously questioned in the halls of power. Prohibition of one intoxicant, alcohol (1920-1933) was extended to other intoxicants, the opiates. Unlike alcohol which is consumed across wide socioeconomic classes and has been released from constitutional imprisonment, opiates remain the forbidden fruit.
The benefit of prohibition: Risk premium
While it is clear that, in the absence of proper medical indication, opiates are detrimental to well-being, addicts who are maintained on their meds are no threat to society. Many are able to function at a high level. So what benefit arises from prohibition? As James Carville famously said, “It’s the economy, stupid!”
When intoxicants are prohibited, a “risk premium” is created.
A risk premium is the return in excess of the risk-free rate of return an investment is expected to yield; an asset’s risk premium is a form of compensation for investors who tolerate the extra risk, compared to that of a risk-free asset, in a given investment.
When drugs are legal, there is no legal risk, and the cost to the consumer is the basic economic cost of the steps of production and distribution. As we noted earlier, this is less than the cost of your daily Starbucks latte’. It’s enough for a basic business but simply lacks the margin to support a criminal enterprise.
When drugs are illegal, a market still remains, since a significant portion of the population has wanted intoxicants throughout history. But now there is a notable risk to supplying the demand. So price increases to cover that risk. The curbside pharmacist has to get his supply somewhere. His supplier has the same problem, so the price goes up more. Now the customer has a problem.
If he’s going to empty his wallet to pay for all that risk, he wants a real bang for his buck. After all, he could end up in jail, too! This potency requirement raises the price on the other steps… again. It’s a vicious cycle. What started out as something cheap has become very expensive. And now there is profit for criminal enterprises.
Those enterprises will want to protect their turf from competition, and now we see violent crime start to appear around the drug trade. Customers who become addicted now have to find ways to support their habits, and various other crimes become common. Note that every level of crime was absent in the open trade for opioids. As soon as drugs became criminalized, bigtime crime moved in, because prohibition creates profits for them.
One more problem arises. How does a dealer keep his customers? He has to provide high quality product. This was demonstrated very well in the late 1960’s when Laotian General Ouana Rattikone marketed “999” heroin. It was a very consistent product so that a safe dose could easily be administered. When competitors made more highly refined heroin, he upped his game and produced “Double Uoglobe Brand” heroin. Reliable quality led to large sales.
Rattikone was in a protected area. Your distributor can’t do the same thing without attracting attention. But he can mix his product with other things. If he cuts it with inert materials, he can spread it further, but competitors will attack his poor quality. On the other hand, if he adds something a bit more potent, such as fentanyl, he will give the appearance of a better product.
Unfortunately, this competitive commercial response is now being seen in multiple markets with radically differing amounts of fentanyl. Now each addict is taking on a new risk every time he administers a dose. It may be worthless or it may completely stop his breathing until he is completely dead.
What if we legalized heroin?
Let’s review the chain of events. Prohibition introduces a risk premium, making crime pay. It also prevents the customer from knowing what dose he is getting. Many users will get overdoses, and many will die. Should we be surprised when that is today’s headline?
Suppose we legalized drugs? Apologists for prohibition claim we’ll see more addiction and more deaths. Instead “we need more detox and rehab programs.” Should we be surprised that this approach is promoted by people who profit from those programs?
Fortunately, we have laboratories that show what works. One of them is called Portugal. There, heroin was made legal in 2001. Sixteen years have shown that overdose deaths have almost vanished.
Addicts are maintained on steady doses of drugs they get for free from clinics. The total cost is less than that latte’ we mentioned earlier. And, curiously, addicts are slowly weaning themselves off of opioids in an average of ten years.
Imagine that! When they don’t have to resort to crime, addicts are able to maintain relatively normal lives and then act in their own self-interest. And no funds are diverted to unnecessary detox and rehab programs. And, by the way, no funds are spent on expensive drug interdiction efforts. No undercover cops infiltrate drug rings, because there aren’t any.
Suppose the United States was to do this? Our expensive rehab programs would go away, allowing money to be spent where it can actually do some good. But more important, the profit that fuels the Mexican drug cartels would dry up. We wouldn’t have Border Patrol agents running up against heavily armed drug gang members. There will be no need to prosecute the next El Chapo, because he won’t get rich enough to matter or to export his crime to the US.
What’s not to like?
In Lieu of what is Right – An Interview with Dr. Ken Wright
One of the most vapid and reliably anti-Constitutionalist members of Congress is known to anyone who takes to Twitter, Ted Lieu, of the California 33rd Congressional District, suddenly has a staunch conservative to square off against. I got to sit down for about an hour over the phone with Dr. Ken Wright, who was one of the most interesting interviews I’ve done this year (and after Erin Cruz, Austin Petersen, Shane Hazel, and Hunter Hill, that is saying something).
Dr. Wright is a renowned pediatric ophthalmologist who is invited to teach all over the world. For that reason (sorry doc) I thought he might have the demeanor of a college professor. Analytical without a lot of passion. I was right about the analytical part. I was dead wrong about the lack of passion. This is a man who in no way needs to run for Congress, but instead sees it as a public service that he is willing to take on to make the world better for his family and for all of ours as well. It’s probably worth noting that one of the most respected and freedom-oriented members of the Senate, Dr. Rand Paul, is also an ophthalmologist. I also have an acquaintance here in my home town who is a Constitutionalist and an ophthalmologist. There seems to be a pattern here.
I found Dr. Wright to be authentic, passionate about Constitutional freedoms, and a man who will not be bullied by anyone. He supports much of what President Trump is trying to do, however I have no trouble believing he would stand up to the President should he go off the rails. The people of the California 33rd would do well to put a man of such integrity into office, and with him get rid of one of the most staunchly anti-freedom members of the US House of Representatives, Ted Lieu.
BW: What specific experience and education make you feel makes you the most qualified to be a Congressman?
KW: With the present state of our representatives I think as long as you have a pulse you could do a better job. They’re bought. The special interest lobbyists are running the show. Any good, ethical citizen could do a better job and do what is right for the people.
**I needed to take a moment to stop laughing at this answer. It was funny because it’s true.**
I’m a pediatric ophthalmologist. I know people all over the world since I travel for teaching in my field. I was awarded a service medal from the President of Panama after Noriega was ousted due to the work I was doing there. I’m a doctor, and doctors use data and facts to make decisions. We don’t put a Band-Aid on an infection and expect it to go away. Dems in inner cities have made people dependent for more than 50 years with no way out and they end up in gangs or living on welfare. Let’s get factories into the inner-cities. Let’s get them jobs instead of food stamps and a few bucks. I want to actually solve problems instead of creating a never-ending cycle of dependency.
BW: What specific issues will be your main focus if elected?
KW: Immigration is a huge problem right now. President Trump gave Congress the job to put together a real plan for DACA and they’ve done nothing. We need a clear policy regarding immigration. To my mind we need to secure the border. Without that we have open borders. We need a wall for at least part of the southern border. It worked in Israel. Then you can think about what to do with 13 million illegals.
Whether they were invited by the government or not, many illegals came here because we wanted people to come here; we wanted them to do certain jobs like pick crops or be a housekeeper, and it would be wrong to send them all home after so many years. That said, criminals with so much as a DUI have to go. This is my problem with sanctuary cities; they allow criminal illegals to roam free and harm our citizens. This is not a Democrat or Republican problem, but rather an American problem.
The largely law abiding that we choose to let stay can get in line behind everyone else and perhaps pay some fines and do some service, but they shouldn’t be able to get to the head of the line like so many Democrats want, and they certainly shouldn’t be given blanket amnesty.
Healthcare is a big issue, mostly because the Democrats have made it that way with Obamacare. Despite what the Democrats say, there were never bodies lying in the street before Obamacare. No one is turned away from any emergency room. Everyone can get care. Not everyone needs health insurance. If you’re a 20 year old on your first job and in good health, perhaps you don’t need to spend money on health insurance, and it’s wrong for the government to force you to subsidize health insurance for others. We need to repeal McCarron-Ferguson Act which exempts insurance companies from most federal regulation including anti-trust laws. That would allow real free-market competition back.
BW: What failures do you feel have been made on the part of Ted Lieu?
**Note: I asked Dr. Wright to please try to keep this to a top 5 list… I know I could write an article just on this question**
KW: When the Syrian war was really going on he wanted to bring 200K refugees from Iraq and Syria and voted against the SAFE Act. That’s dangerous for America.
He doesn’t protect America first. He wants open borders. He’s for sanctuary cities. He votes against Kate’s Law every time it comes up. He has sponsored legislation for no-money bail, saying bail is unfair to the poor, yet judges can take that into consideration. He wants to take the discretion away from the judges.
He’s a hypocrite. On his web site the number one issue he talks about is climate change. And yet, when he was a state senator he accepted $13K from real estate developers who wanted to build a new stadium, and then he co-sponsors a bill to exempt the real estate developers from environmental regulations. He’s a career politician and has never had a real job in his life. I’ve had a real job. I’ve run a business and put people to work.
BW: What political challenges do you face and how do you plan to overcome them?
Well, District 33 is only 24% Republicans, which has discouraged the GOP and the GOP wasn’t even going to run someone in 2016. However, there’s almost 30% here with no party preference. I was able to take 37% in 2016 and I didn’t have a real organization. I have a whole organization this time and I think winning this district is doable.
BW: With the current debate over gun-control, what are your thoughts?
KW: Well this isn’t an easy issue. I think we all, or at least most, agree a civilian doesn’t need to own a surface-to-air missile. At the same time, the 2nd Amendment isn’t about hunting, it’s about being able to resist a tyrannical government. We need to find a balance. I think for certain weapons perhaps some form of mental evaluation might be in order. The problem is the Democrats always want to take it too far. Instead of making things simple and wanting to implement legislation that might actually save lives they are intent on disarming the population.
BW: There has been a lot of debate over President Trump’s tariffs. How do you feel about them.
KW: Great question. Would you agree that it is equally wrong for one to hire someone to commit murder as it is to commit murder yourself?
KW: Well by the same token, if it’s wrong for us to use slave labor to make our products, it’s equally wrong for us to allow China and other countries to use slave labor without any kind of penalty. The Chinese have a miles long factory where people were crammed into tiny rooms to live and work. It was so miserable that people were jumping to their deaths. Know what the Chinese government did? They put up nets outside the building so that people couldn’t even kill themselves to get away. It’s that miserable and yet we are profiting from it in the form of cheaper goods. You’ll notice that the President isn’t imposing these tariffs on Europe or Canada or other nations that play by the rule of civilized behavior.
BW: I’m personally very much against tariffs, but I have to admit that I never thought about it that way.
KW: Most people don’t.
BW: I ask this of all California candidates since your state pretty much has been the leader on this issue: What about legalization of Marijuana?
The half-life of marijuana is 3-4 days. If you smoke 2 or 3 times a week then the half life becomes about 2-3 weeks. Alcohol is metabolized much faster. I think it should be available but through a pharmacy, and not in smoking form. Physicians were encouraged to give more opioids for pain management and they found it to be profitable. This has led toward a lax attitude toward drugs. Marijuana should be available to those who need it, but we can’t be so careless with how it’s used.
BW: What do you want the people of the California 33rd to know about you?
KW: Both Republicans and Democrats need to realize that we are Americans first. Vote for someone who has the moral fiber to do what is right. Don’t vote for someone just because they might be at your end of the ideological spectrum.
You can learn more about Dr. Ken Wright by clicking here.
Kamala Harris: “Stop slaughtering babies! Abortions OK”
You may have missed it amid the wall-to-wall coverage of the Parkland shooting and the CNN Town Hall, but Senator Kamala Harris (D-CA) has become pro-life — she just hasn’t realized it yet.
Two days after the massacre, Senator Harris told MSNBC, “We cannot tolerate a society and live in a country with any level of pride when our babies are being slaughtered.” This just two weeks after she helped defeat a 20-week abortion ban in the Senate.
Apparently, Senator Harris, a staunch pro-abortion advocate and Planned Parenthood donation recipient, couldn’t hear the cognitive dissonance, referring to deceased teenagers as “babies,” while almost one million actual babies are literally being slaughtered every year.
According to the Guttmacher Institute, the United States saw 926,200 abortions in 2014, of which Planned Parenthood claims 323,999 — about one-third. In the same year, total gun homicides (including gang and drug related, all age groups, and the tiny fraction that is mass shootings) totalled only 11,000.
926,200 to 11,000 — even 323,999 to 11,000 — is not even a close contest. Babies are being slaughtered, Kamala, but not the ones you care about.
Harris’s appeals to deceased children contributed to increasing cries for a boycott of the NRA, but pro-lifers on Twitter such as Steven Crowder and Devin Sena were quick to point out the irony of supporting a murder mill that receives over $540 million in taxpayer funding while berating a much less influential group whose purpose lies in defending basic constitutional rights and has never killed a single human being.
But let’s take Senator Harris at her word; in the aforementioned interview, she insisted, “When you see the effect of this extreme violence on a human body, and especially the body of a child, maybe it will shock some people into understanding, this cannot be a political issue. We have to be practical.”
All right then, let’s look at what happens to a baby when it’s aborted.
Below there are diagrams of abortion procedures, but no actual photographs, as even I can hardly stomach looking at that horror or putting it on my website. Here’s one in an article on partial-birth abortions, and I’m sure you can find othersfairly easily if you really want to “shock some people into understanding.”
Let’s start with partial-birth abortions, also known as “dilation and extraction,” wherein the baby (read: living human child with its own DNA) is partially delivered through the birth canal until its head gets in the way, at which stage the abortionist stabs the baby through the back of the head, vacuums out the child’s brains, causes the skull to collapse, and removes the baby-shaped tumor, deeming the operation a success.
Next up is dilation and evacuation, a slight variant of the previous process, whereby the clump-of-cells-with-a-unique-heartbeat-and-pain-receptors is arbitrarily snipped to pieces by an abortionist with a toothy clamp and the leech’s body parts are ripped from the womb one at a time until he (or most likely “she” in many cultures) has fully exited the birth canal.
You may notice that I employed varying levels of sarcasm throughout that discussion, as this is and ought to be an intensely difficult topic to discuss. It’s disturbing, horrifying, and disheartening.
But Senator Harris is right, even if in the wrong way. We cannot just stand by as babies are being slaughtered, and if takes brutally direct language and agonizing photographs to “shock some people into understanding,” then so be it.
Almost one million babies are murdered in the United States every year. If that fact is less viscerally disgusting to me than seeing a picture of a premature child, then that’s a problem I need to work on.
The Guardian: Pro-lifers are “pro-death”
Today, on the 45th anniversary of Roe Vs. Wade, The Guardian published an article entitled, “Let’s call pro-lifers what they are: pro-death.”
The article states that the pro-life movement has, by adopting its very name, caused “the battle over reproductive rights” to take on “an apocalyptic tone.” This rhetoric, the article states, “turns every clash between the two sides [pro-life vs. pro-abortion] into a prelude to Armageddon, the final showdown between life and death, good and evil.”
It is only by using debunked and “mythological claim that abortion is a risk factor for breast cancer, lifelong depression and suicide,” the article claims, pro-lifers claim that they are protecting the lives of both the unborn and the mothers. The article does not acknowledge “academic studies dating back to the 1950s show that abortion increases the risk of breast cancer,” as were noted last year in the highly respected journal First Things, nor does the Guardian article acknowledge what psychologists have termed Post-Abortion Syndrome (PAS).
“We should take back the mantle of life.”
Using a 2015 article from NPR, the Guardian claims that “the US now bears the ghastly distinction of having the highest maternal mortality rate of all the world’s wealthy democracies.” The Guardian article maligns the maternal mortality rate in the United States, linking the mortality rate with laws imposing abortion restrictions.
Contrary to the article’s claim that maternal mortality rate is directly related to restrictions on abortions, however, the CIA World Factbook shows multiple countries which, having more restrictions on abortion than the US, have lower maternal mortality rates. These countries include Norway, Denmark, Poland, Sweden, Austria, and Germany, to name just a few.
The authors proceed to list various circumstances that may lead to the death of the mother. For example:
“Take the not-at-all-hypothetical case of a woman who wants an abortion because of a pre-existing health condition, like diabetes, that could lead to problems with pregnancy…”
The article concludes with the following exhortation.
“And surely the time has come to raise the charge that the “pro-life” movement is, in effect, pro-death.”
Ever since the anti-abortion movement claimed the “pro-life” label in the 1970s, the battle over reproductive rights has taken an apocalyptic tone. If the anti-abortion side is pro-life, then the other side – the millions of women who rally every January to keep abortion legal and safe – must be composed of the gaunt, gray-winged handmaidens of death.
This polarizing rhetoric turns every clash between the two sides into a prelude to Armageddon, the final showdown between life and death, good and evil. When charged with caring only for life in its fetal form, the anti-abortion side hoists its mythological claim that abortion is a risk factor for breast cancer, lifelong depression and suicide. Thus they can say that they do not only save fetal lives, but the lives of the women who carry these fetuses.
If I had to sum up a pro-lifer’s response to this article in one word, it would be celebration.
The pro-life movement is the only movement dominated, run, and lead by women; the only movement dedicated solely to saving lives and caring for women. The “pro-lifers” have earned their name with righteous labor and a glorious mission.
This is a battle “between life and death, good and evil.”
The fact the pro-abortion advocates are now attempting to re-frame “pro-lifers” as being “pro-death” shows the world precisely how effective the pro-life movement has been.
Make no mistake: this effort towards re-branding is nothing other than a sign of weakness.
This, I believe, is worth celebrating!
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