from the world's big
We could cut the opioid death rate by 50% – but we’re not
As more and more people die, drug companies keep reaping in a massive profit.
Maia Szalavitz is widely viewed as one of the premier American journalists covering addiction and drugs. A neuroscience writer for TIME.com and a former cocaine and heroin addict, she understands the science and its personal dimensions in a way that few others can. is the first book-length exposé of the "tough love" business that dominates addiction treatment. Her newest book is Unbroken Brain: A Revolutionary New Way of Understanding Addiction.
Maia Szalavitz: Well, I think like in terms of—seeing famous people that we love die from drugs should make us question why we so stigmatize and attack people with addictions. I mean some of our most beloved artists, musicians, writers have been addicted. I mean I find it kind of interesting that we don't see addiction as a "white problem" when you have like William Burroughs and Lou Reed and Kurt Cobain—and I could list 20 other heroin addicted rock stars. So, this is a condition that can affect not just anybody, but people who are in some sort of emotional pain. Addiction kicks people who are already down. And it doesn't look like celebrities should be that kind of person. But I think that a lot of the drive and the grit and the, you know, what you need in order to achieve great success is also a risk for addiction. Because in order to be a successful rock star you have to process despite rejection a lot and you need to be able to just keep going and keep going. And if that kind of drive and passion gets focused on a drug it is particularly destructive.
So, I think in order to help deal with opioid addiction, for one we need to have naloxone in every first aid kit. There is absolutely no reason why people who are surrounded by other people should ever die of an overdose. If you are injecting and other people are there—which is the case 50 to 60 percent of the time—naloxone should be there. And this is not going to encourage more drug use, because it's an awful experience to get awakened with naloxone, but it will save lives. And so that's one way we can turn the tide on this. The other way that I think we can turn the tide on opioid addiction is we really need to provide greater access to drugs like methadone and Suboxone, which is also called buprenorphine.
Those two drugs taken indefinitely, i.e. potentially for life, are the only thing that cut the death rate by 50 percent. And if we really want to solve this problem we could get rid of half of it if we could enroll many more people in these maintenance programs. Now there's a lot of the barriers to that. One is that we only allow doctors prescribing buprenorphine to see a hundred patients—now they just raised it to 200—this is ridiculous. They can prescribe opioids for pain to 10,000 patients but you can only prescribe for addiction to a hundred patients? This is really silly. We also have this idea that you can't provide these medications without also providing counseling. And we don't to do that for any other medical service. We don't say, "You can only get your insulin if you do X counseling on diet," or whatever. We realize that people need the tools to stay alive regardless of if they are improving as quickly as we would like them to do. And forced counseling doesn't actually help anyway. So what we should do is we should have different thresholds for treatment. So with buprenorphine some people may just want to show up and get a dose, and that's it. And that will work as sheer harm reduction. That should be available in emergency rooms.
You need to register people so that you don't end up with people getting multiple doses, and you need to be a little more careful with methadone than with buprenorphine because there is a big overdose risk for patients who are naïve to methadone, and it's a difficult drug to prescribe. So that needs to be a little more controlled, but we have it way too controlled and isolate it from the rest of medicine in a way that we don't do with any other drug. So, we have the tools to dramatically reduce the death toll for celebrities and for everybody else—we're just not using them.
- Drug companies make huge profits by flooding the market with overly powerful — and highly addictive — drugs.
- Some high profile deaths over the last several years have brought this problem to the headlines. It's everyone, not just middle America, who is getting hooked.
- Why do we let Big Pharma rule over? Journalist and author Maia Szalavitz investigates.
Unbroken Brain: A Revolutionary New Way of Understanding AddictionList Price: $18.00New From: $10.81 in StockUsed From: $10.94 in Stock
- Opioids: Things your doctor should tell you before prescribing ›
- Child deaths from opioids rising, says Yale study ›
Join multiple Tony and Emmy Award-winning actress Judith Light live on Big Think at 2 pm ET on Monday.
Frequent shopping for single items adds to our carbon footprint.
- A new study shows e-commerce sites like Amazon leave larger greenhouse gas footprints than retail stores.
- Ordering online from retail stores has an even smaller footprint than going to the store yourself.
- Greening efforts by major e-commerce sites won't curb wasteful consumer habits. Consolidating online orders can make a difference.
A pile of recycled cardboard sits on the ground at Recology's Recycle Central on January 4, 2018 in San Francisco, California.
Photo by Justin Sullivan/Getty Images<p>A large part of the reason is speed. In a competitive market, pure players use the equation, <em>speed + convenience</em>, to drive adoption. This is especially relevant to the "last mile" GHG footprint: the distance between the distribution center and the consumer.</p><p>Interestingly, the smallest GHG footprint occurs when you order directly from a physical store—even smaller than going there yourself. Pure players, such as Amazon, are the greatest offenders. Variables like geographic location matter; the team looked at shopping in the UK, the US, China, and the Netherlands. </p><p>Sadegh Shahmohammadi, a PhD student at the Netherlands' Radboud University and corresponding author of the paper, <a href="https://www.cnn.com/2020/02/26/tech/greenhouse-gas-emissions-retail/index.html" target="_blank">says</a> the above "pattern holds true in countries where people mostly drive. It really depends on the country and consumer behavior there."</p><p>The researchers write that this year-and-a-half long study pushes back on previous research that claims online shopping to be better in terms of GHG footprints.</p><p style="margin-left: 20px;">"They have, however, compared the GHG emissions per shopping event and did not consider the link between the retail channels and the basket size, which leads to a different conclusion than that of the current study."</p><p>Online retail is where convenience trumps environment: people tend to order one item at a time when shopping on pure player sites, whereas they stock up on multiple items when visiting a store. Consumers will sometimes order a number of separate items over the course of a week rather than making one trip to purchase everything they need. </p><p>While greening efforts by online retailers are important, until a shift in consumer attitude changes, the current carbon footprint will be a hard obstacle to overcome. Amazon is trying to have it both ways—carbon-free and convenience addicted—and the math isn't adding up. If you need to order things, do it online, but try to consolidate your purchases as much as possible.</p><p>--</p><p><em>Stay in touch with Derek on <a href="http://www.twitter.com/derekberes" target="_blank">Twitter</a>, <a href="https://www.facebook.com/DerekBeresdotcom" target="_blank">Facebook</a> and <a href="https://derekberes.substack.com/" target="_blank">Substack</a>. His next book is</em> "<em>Hero's Dose: The Case For Psychedelics in Ritual and Therapy."</em></p>
Chronic irregular sleep in children was associated with psychotic experiences in adolescence, according to a recent study out of the University of Birmingham's School of Psychology.
A time for sleep<div class="rm-shortcode" data-media_id="Mt29uUqI" data-player_id="FvQKszTI" data-rm-shortcode-id="931343dee3c02121445e51e94ba22446"> <div id="botr_Mt29uUqI_FvQKszTI_div" class="jwplayer-media" data-jwplayer-video-src="https://content.jwplatform.com/players/Mt29uUqI-FvQKszTI.js"> <img src="https://cdn.jwplayer.com/thumbs/Mt29uUqI-1920.jpg" class="jwplayer-media-preview" /> </div> <script src="https://content.jwplatform.com/players/Mt29uUqI-FvQKszTI.js"></script> </div> <p>Previous studies had already suggested a link between persistent nightmares in childhood and psychosis and borderline personality disorder (BPD) by adolescence, but researchers at the University of Birmingham's School of Psychology wanted to see if a similar connection existed between these mental disorders and other childhood behavioral sleep problems.</p><p>To do this, they scoured data from the Avon Longitudinal Study of Parents and Children, a longitudinal cohort study that followed approximately 14,000 children born in Avon, England, in the early 1990s. The study followed the children for more than 13 years. During that time, mothers filled out questionnaires asking about the children's lives. Factors looked at included housing, parenting, nutrition, physical health, mental wellbeing, environmental exposures, and so on. </p><p>The cohort study inquired about sleep routines, sleep duration, and awakening frequency when the children were 6, 18, and 30 months old, and then again at 3.5, 4.8, and 5.8 years. It also assessed mental health in adolescence using semi-structured interviews, such as the Psychosis-Like Symptom Interview.</p><p>"We know that adolescence is a key developmental period to study the onset of many mental disorders, including psychosis or BPD. This is because of particular brain and hormonal changes which occur at this stage," <a href="https://www.birmingham.ac.uk/staff/profiles/psychology/marwaha-steven.aspx" target="_blank">Steven Marwaha</a>, professor of psychiatry at Birmingham and senior author on the study, <a href="https://www.sciencedaily.com/releases/2020/07/200701125431.htm" target="_blank">said in a release</a>. "Sleep may be one of the most important underlying factors—and it's one that we can influence with effective, early interventions, so it's important that we understand these links."</p><p>After compiling the data, the researchers discovered an association between children with irregular sleeping patterns and teenagers with <a href="https://www.mind.org.uk/information-support/types-of-mental-health-problems/psychosis/about-psychosis/" target="_blank">psychotic experiences</a>—that is, episodes when the person perceives reality differently than those around them. Even when depression at 10 years old was considered as a mediating factor, their findings still suggested "a specific pathway between these childhood sleep problems and adolescent psychotic experiences." </p><p>Toddlers with shorter nighttime sleep duration and late bedtimes were likewise associated with a <a href="https://www.nimh.nih.gov/health/topics/borderline-personality-disorder/index.shtml" target="_blank">borderline personality disorder</a>—a disorder marked by a pattern of varying moods, self-images, and behaviors—in their teenage years. Depression at age 10 did not mediate this particular association, suggesting a separate and more specific pathway. </p>
A more restful tomorrow<p>While the sample size was large and mental health was assessed with a validated interview, there nevertheless remain limitations to this data. For starters, sleep habits were based on mothers' reports. Because they came from memory, versus a more direct observation method such as actigraphy, these data may be prone to imperfect recollection and reporting error. There are also many confounders that could be secretly nudging the results, such as family conditions, prenatal medicines, and a host of environmental factors. Finally, <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6024884/#:~:text=Sleep%20difficulties%20in%20youth%20with,fear%20of%20dark%20%5B13%5D." target="_blank">the relationship between sleep problems and mental disorders</a> is both complex and two-way.</p><p>As such, the study shows an association between poor childhood sleep later mental disorders but does not prove a causal link. Parents need not worry that a string of nightmares or the eternal struggle settle into bed will be the first ingredients in a witches' brew of debilitating mental disorders. The goal of the study, the researchers point out, is not to create undue worry but improve our ability to recognize the signs of at-risk children and deliver necessary interventions earlier.</p><p>"The results of this study could have important implications for helping practitioners identify children who might be at higher risk for psychotic experiences or BPD symptoms in adolescence, and potentially lead to the design of more effectively targeted sleep or psychological interventions to prevent the onset or attenuate these mental disorders," Isabel Morales-Muñoz, the study's lead researcher, <a href="https://www.healio.com/news/psychiatry/20200702/childhood-sleep-problems-linked-to-adolescent-psychosis-borderline-personality-disorder#:~:text=Sleep%20problems%20during%20early%20childhood,study%20published%20in%20JAMA%20Psychiatry." target="_blank">told Healio Psychiatry</a><u>.</u></p><p>If a parent reading this is worried that their child's sleep patterns are deleterious, the take away should not be despair over an unyielding fate. It should be to seek professional help as soon as possible to begin improving sleep duration and quality. Even if you aren't worried, it's worth remembering that childhood experiences lay the foundation for a lifetime of salubrious sleeping habits. It's so much more than beauty rest.</p>
Construction of the $500 billion dollar tech city-state of the future is moving ahead.
- The futuristic megacity Neom is being built in Saudi Arabia.
- The city will be fully automated, leading in health, education and quality of life.
- It will feature an artificial moon, cloud seeding, robotic gladiators and flying taxis.
The Red Sea area where Neom will be built:
Saudi Arabia Plans Futuristic City, "Neom" (Full Promotional Video)<span style="display:block;position:relative;padding-top:56.25%;" class="rm-shortcode" data-rm-shortcode-id="c646d528d230c1bf66c75422bc4ccf6f"><iframe type="lazy-iframe" data-runner-src="https://www.youtube.com/embed/N53DzL3_BHA?rel=0" width="100%" height="auto" frameborder="0" scrolling="no" style="position:absolute;top:0;left:0;width:100%;height:100%;"></iframe></span>
Are we genetically inclined for superstition or just fearful of the truth?
- From secret societies to faked moon landings, one thing that humanity seems to have an endless supply of is conspiracy theories. In this compilation, physicist Michio Kaku, science communicator Bill Nye, psychologist Sarah Rose Cavanagh, skeptic Michael Shermer, and actor and playwright John Cameron Mitchell consider the nature of truth and why some groups believe the things they do.
- "I think there's a gene for superstition, a gene for hearsay, a gene for magic, a gene for magical thinking," argues Kaku. The theoretical physicist says that science goes against "natural thinking," and that the superstition gene persists because, one out of ten times, it actually worked and saved us.
- Other theories shared include the idea of cognitive dissonance, the dangerous power of fear to inhibit critical thinking, and Hollywood's romanticization of conspiracies. Because conspiracy theories are so diverse and multifaceted, combating them has not been an easy task for science.