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The scientific reality regarding drug use and addiction

lurgee says...

I remember many moons ago while installing change kiosks for Chase Bank. We would install them 5 hours before they opened. I'll never forget seeing a group of zombies lining up at the door of this unlit building while we were setting up the kiosk. There must have been at least 30 of them when I last looked. I thought it was a methadone clinic. Nope, just overpriced java.

Payback said:

So, cocaine isn't all that addictive




... but what about Venti Mocha Double Shot Frappacinos? My life becomes a Hell-hole of depravity and suffering when I skip a morning...

ChaosEngine (Member Profile)

newtboy says...

It's another shame that his "evidence" is also complete supposition that a stay in a rehab (for illicit drug use) months earlier somehow equates to inappropriate hard core anti depressant usage without supervision.
I'll just hope for random patients sake that's not his own experience as a 'clinical psychologist' that he's speaking from. (Oh, my wife, an ex-pharmacist, just clued me into the fact that psychologists can't prescribe medicines, is it therefore likely his apparent anti-anti-depressant position is just an extension of jealousy of those who can?)
(Somehow I feel he doesn't tell his patients about Videosift, I think he might lose some if they read his posts and put 2 and 2 together).

ChaosEngine said:

Shame your "evidence" comes from a website that is a front for a law firm to sue pharmaceutical companies.

The reality is that the link between antidepressants and suicide is complex and not fully understood yet. For a start, antidepressants (by their very nature) are prescribed to people who have an increased risk, thus skewing the results. While there may be a link, there's also a serious issue of people who go off their meds having an increased risk.

So it's certainly not as black and white as you paint it.

liberty and virtue and the freedom to choose

ChaosEngine says...

There are plenty of times when I've had both the means and motivation to kill someone. What stopped me? Yeah, I didn't want to go to jail, but primarily I stopped myself because I know that killing someone is wrong and that cutting me off in traffic is not a morally justifiable reason for murder.

As for your marriage, that's a perfect example of how your argument falls apart. Are you telling me that there would be no repercussions on your life if you got caught cheating on your wife? Because unless your wife would just roll her eyes and go "oh asexymind, you and your crazy extramarital affairs", you are being coerced and therefore your decision to not sleep with all the women lining up outside your door is not virtuous.

Just because there are negative consequences to an action, doesn't mean that not performing that action isn't the virtuous path.

But bloody hell, do we need those negative consequences! You only have to look at the finance industry to see how people behave when there are no repercussions.

We don't live in an abstract philosophical conundrum where people will be moral "if we just give them the chance!!!"

We live in a world that has been ceaselessly fucked over by the powerful. Where the poor get exploited and the environment gets destroyed because the majority of those in power (and I don't mean politicians, I mean the people with power) are complete psychopaths, in the clinical sense of the word. If we didn't have government rules, you'd still be working on the weekend and your kids would be working with you.

asexymind said:

ChaosE - This may be a matter of semantics and definitions. Depending on how you define the terms, I agree with your point.

And, in moral philosophy, if it is not your _choice_, it is not an ethical choice. Sorry if this is philosophical bullshit, but think about it: your "not killing someone" because you don't have the motivation or means is not a virtuous choice, it is simply not NOT an unethical one. It is the lack of a negative, not the presence of a positive. Virtue is about our choices, not our defaults.

I am married and monogamy is part of my commitment. If no other woman would deign to sleep with me, my not sleeping with them is no indication of my virtue. It is only in the face of propositions to which I say "no" that I am exercising the virtue of fidelity.

Last Week Tonight with John Oliver: Dr. Oz

draak13 says...

So, this is a major misconception by the public about where the money actually goes when drugs are developed. Read the link you have there, but with a more realistic eye about where the money is going. Drugs are SUPER expensive, but only because they're super expensive to discover. 'Drug discovery' is a tremendously difficult thing, to the point where it is the wetdream of a professional drug discoverer in the pharma world to discover 1 drug in their 30+ year career. During that time, the team of pharma researchers all have to be paid for their PhD level of expertise, and the human cost in developed countries is quite expensive! If there are 1000 people in one pharma company, and each person makes ~70+ thousand, and benefits cost another 100+ thousand per person each year, then the human cost alone in that rough exercise accounts for 170 million yearly for just 1000 people, and can touch the billion dollar figure per year for very large companies. That is where the money is going in that 1.3 billion dollar figure.

The major problem lies in developing a substance that actually does something, and you know exactly what that something is, including all side effects. To get a statistically valid clinical trial is actually a rather hard thing to do; a poorly designed clinical trial can prove whatever you want it to. Considering your St. John's wort example, the most costly 'drug discovery' component is already finished, it would just need to go through clinical trials as a drug for antidepression. The body of evidence in place may already serve for early phase clinical trials, and it may just need to go through a couple of more trials to prove its efficacy (and determine side effects). It would cost some money, but it would NOT be so prohibitively expensive as starting from complete scratch.

Considering this, the idea that it's 'unfair' to make the supplements world actually prove their product does what it is promised to do (or at the very least, not be harmful) is a bit odd. Quackery is illegal for moral reasons, and hard to argue that what the supplements world is doing is not quackery; particularly with the Dr. Oz zeal, false promises are being sold millions of bottles at a time. It is in the public's interest to get this stuff tested and approved!

ShakaUVM said:

Here's the thing though - if the FDA regulates supplements in the same way they do drugs, the price of supplements would go through the roof. It costs 1.3 BILLION DOLLARS to get a new drug approved by the FDA. (http://www.forbes.com/sites/theapothecary/2014/01/24/shocking-secrets-of-fda-clinical-trials-revealed/)

Last Week Tonight with John Oliver: Dr. Oz

ShakaUVM says...

John Oliver is wrong.

Yes, some supplements (say, the milk thistle found in Rockstar Energy Drink) are just snake oil. But other supplements have clinical effects, such as St. John's Wort (http://www.webmd.com/depression/guide/st-johns-wort) for minor depression and, arguably, glucosamine and chondroitin (http://en.wikipedia.org/wiki/Clinical_trials_on_glucosamine_and_chondroitin)

Here's the thing though - if the FDA regulates supplements in the same way they do drugs, the price of supplements would go through the roof. It costs 1.3 BILLION DOLLARS to get a new drug approved by the FDA. (http://www.forbes.com/sites/theapothecary/2014/01/24/shocking-secrets-of-fda-clinical-trials-revealed/)

So the supplements market provides a very useful alternative, something that John Oliver simply doesn't understand. You can either pay ten bucks for a 300 pack of St. John's Wort, or you can pay ten times that amount for the FDA approved antidepressant, Zoloft.

The sad truth is that the FDA really does overregulate the drug market, which is one of the major reasons health care is so fucking expensive in this country. John Oliver lives in magical fairly land where regulating supplements would come with no cost, but in reality regulating it would just close down the only inexpensive drug system we have in the world.

Scientific studies do exist for supplements (I read through the studies while my wife was at UCSF Pharmacy School taking their mandatory alt med class), and if you do your research, you can distinguish the snake oil from the supplements that have real effects.

Muslims Interrogate Comedian

newtboy says...

No, they aren't the best argument, but were one someone else brought up as outliers in Christianity, which they are not, they are simply vocal about their beliefs in inappropriate places and times...their beliefs are (in large part, but with exceptions) mainstream.
I think fewer 'Christians' are accepting those with a 'gay lifestyle' than you believe, they are simply realizing that publicly spouting their hate speech doesn't get them far anymore. They still believe we're all going to hell for not believing as they do...or that we're all demons trying to trick them into hell.
Granted anti abortionists are a better example, and are still main stream Christians. Militant 'born agains' (usually the bombers at the abortion clinic) are a better example, as they're a violent sect of Christianity that paints the whole religion with their zealous insanity....and one that has tried time and time again to make their ridiculous beliefs into law for all.

My_design said:

I don't think they are your best argument. Westboro's popularity stems from their rally's at the funerals of military veterans. Something a majority of Christians have an issue with. As far as their anti-gay sentiment goes, many Christian sects are revising their views on the gay lifestyle, although it is causing some serious rifts.
Now if you were to exchange Westboro for Radical Anti-Abortionists that bomb abortion facilities and kill doctors...well then you have a pretty strong argument!

Her Neighbor got a New Car - It Blows Flames.

Chairman_woo says...

No denying it's a damm fine engine of basically equal performance (give or take by year). I just feel that in comparison it's a little more clinical and lacks quite the same character as the Rolls Royce (not that it lacks character!). For me it's not quite as elegant looking either (Let's face it the Daimler is a bit of a black block).

Then again I guess I'm a little biased by nationality (not a fan of nationalism at all but little things like this can still get under ones skin).

radx said:

I'm rather fond of the DB 605 myself.

Emily's Abortion Video

enoch says...

i am personally pro-life.

that being said,i do not feel i have the right to judge another for decisions they make in regards to their own body.

i have personally escorted four women to have this procedure done and though i may have disagreed with their choices,i did,however,understand them.

their decisions weighed heavily on them.they struggled with the morality and consequences and ultimately the inevitable shame/guilt/regret.

i offered to escort these women not as a way to approve of their decision but rather to protect them from the usual throngs of judgmental,rabid fundamentalist christians that congregated at the few clinics that performed this procedure.

they behaved like anything BUT christians and the shame they attempted to project on my escortee (is that even a word?) should have been directed at themselves.

the long term effects of this choice leaves deep and long lasting scars and i have never met a woman who chose this procedure lightly.

let he who is without sin cast the first stone.
judge not lest ye be judged.

who are we to judge anothers path?
by what right do we reserve such moral authority?

The REAL Reason You're Circumcised

SDGundamX says...

Whether he had one or not is irrelevant. The studies that were done on those who actually did have them later in life showed that it usually had either no effect on sex or actually improved it unless complications developed from the procedure (see the American Academy of Pediatrics 2012 Technical Report on Circumcision).

The benefits of newborn circumcisions are well-documented at this point (see for example the Mayo clinic's most recent report on the topic.) We know it also can reduce the risk of HIV infection in at risk populations.

Basically, if it does no harm and can actually have benefits, it's a valid medical procedure regardless of whether parents are choosing to do it for religious reasons or not.

Of course, should future research actually prove the risks outweigh the benefits then it should be stopped. We need to base these decisions on the medical evidence and not on our cultural prejudices.

xxovercastxx said:

Were you circumcised later in life so you are able to compare sex before and after? If not, then no, you can't say that.

THIS SITE IS A JOKE (Comedy Talk Post)

chingalera says...

You would'nt know a clinical diagnosis chicco, if it were up a familiar ass next to your recent comments littering your own profile-Check the manual then please, check the bullshit-The needle on the gauge is constantly in the red.

Just as your assessment is full of shit regarding myself, so is your recent spamdity self-excursion into your own psyche...Retention my ass, the problems' in a mirror.

chicchorea said:

self referential proof again...MPD

THIS SITE IS A JOKE (Comedy Talk Post)

chingalera says...

Disorder?? Go check this user's profile for a more clinical example of his particular disorder..

chicchorea said:

...if it wasn't for the "lazy blind,...eye," as chingalera so choggielike calls it, he wouldn't be here, AGAIN AGAIN, to dribble and spew his verbosely inarticulate, self deluded, thread hijacking diatribes.

Is it not glaring, amazing, and ironic that so much of the vitriol choggie levies is unconsciously self-referential? Defining symptom of Multiple Profile Disorder.

Milton Friedman puts a young Michael Moore in his place

RedSky says...

@enoch

I'd agree Friedman wasn't directly responsible, but served more as an academic influence and a proponent of a particular approach because many of the Chilean economists who influenced policy had studies in Chicago.

As far as exploiting a crisis, arguably the crisis itself warranted dramatic action. High levels of inflation caused by Allende's money printing to support wholesale nationalisation of industries pretty much required this.

As inflation is self perpetuation by its continuous expectation and can continue even after the original stimulus is gone, there was little choice here. After all it took Volker nearly half a decade of high interest rates to tame it in the US in the early 80s, to do that after an economic and political crisis in a undeveloped country was an entirely different scale of difficult.

Successive governments likely reversed some of the economic policies enacted under his regime, but the foundation I meant was particularly the budgetary position, free trade, and a competitive cadre of private sector exporters. The welfare, health and educational spending were all made possible by this. Without a credible tax base, trying to enact spending on this level while also raising the tax rises would have just precipitated another crisis.

Coming back to inflation and economics, I believe policies against inflation especially, are generally misunderstood in the short term and their benefits unrecognised in the long term. I would probably say the reverse of what you said, economic policy rarely shows tangible results in the short term but almost always in the long term.

It's certainly not perfect. After all economics has the unfavourable position of being the combination of social science, lacking the ability to test results in clinical conditions isolating a single factor and yet requiring highly specific answers to solve its questions. At its best, it offers answers based on the cumulative knowledge accrued from iterative policies, at each point being based on the 'best available knowledge at the time'.

But it has worked, as I like to often mention, with independent central banks, essentially the most technocratic and pure application of economic theory, inflation has become a thing of the past in those countries that have adopted it.

Then again I'm biased as I majored in it at uni

Health Care: U.S. vs. Canada

SpeveO says...

Here is a longer 18 minute video of more of Senator Burr's questions to the witnesses. I wish I could find the full hearing.

https://www.youtube.com/watch?v=G1m0Gxtsz1A

It includes this little gem from Senator Burr, "The American system HAS access to healthcare for everybody, it's called the Emergency Room. Now we don't admit that because clearly we are lobbying for a particular angle, but every American can access healthcare."

Nice slight of hand there Senator, only difference is whenever I go to the emergency room (I live in Canada), I don't get a bill in the mail a few weeks later that I have to pay.

The average American ER visit costs $600 dollars in 2009, today it's probably well more than that, and that's just for simple problems. Anything more serious than a urinary tract infection and you are going to be paying thousands of dollars.

I'm a bit late to the party, but I'll give my 2 cents on my experiences with the Healthcare system in Quebec.

I use the public system and private system and constantly dabble between the two. Wait times can be long for sure. I've had a long running ankle problem since my teens, and to get my first appointment with an ankle specialist here took 1 year and 3 months!

My MRI was covered by private insurance, so it only took a couple days to have the scan done. I was put on a surgery waiting list for just over 2 years. The Dr let me know that he operated at a private clinic in Montreal. I could have had the surgery in only 2 weeks, at a cost of around $5000, but because my pain was minimal and I could still walk, I opted to wait.

Post surgery access to follow up appointments was swift. I could easily see the Dr in a week or two, with very little advanced notice. Follow up MRI's weren't covered by my new private insurance, so I had to wait for an MRI scan, which took around 2 months. I was supposed to have an MRI arthrogram, but the waiting list for that procedure is about twice as long, so the Dr just opted for a regular MRI. Cost for an MRI arthrogram is $875 in private. Again I just waited it out.

I've only needed to go to the emergency room twice, since I've been here, both times I was in and out in under an hour and a half.

I've been to many walk-in clinic's. These are a crapshoot, sometimes they're incredibly fast, sometimes incredibly slow.

I don't have a family Dr, so I opt to go to a Dr at a private clinic for my annual checkups. Even private clinics are a grey zone sometimes, as some services are covered by the provincial plans, so visits to the GP cost out of pocket, but visits to specialists within the same clinic are free.

Finding a family Dr is definitely plausible, it just involves phoning around every clinic and/or Dr in Montreal asking if they have space, but I just haven't invested the time yet. Some people get lucky this way, but even then, getting an appointment with your family Dr can take many weeks, appointment times can be inconvenient (mid afternoon, etc), so I'd rather make the investment of seeing someone at a private clinic, where I can have an appointment at 8:30am within a couple days.

I contrast all this with the fact that I was born and lived in South Africa well into my mid 20's. South Africa has abysmal public healthcare, and being born into a white middle class family, thanks to my parents I had access to private healthcare.

Private insurance in South Africa is less exploitative than in the U.S. Much less fighting with insurers to pay for coverage etc. Access to most Dr's is swift, and most procedure's are well covered. Obviously the overall experience compared to Canadian healthcare was much better, but the S.A private system only barely covers 20% of the population's needs and even with the disparity in wait times for service, the Canadian healthcare system at 100% coverage feels like an undeniable success, and a model that needs to be improved and iterated upon.

The debate around healthcare is tough here. Health issues and frustration with waiting can easily escalate the egocentric side of our human nature, but even with my negative experiences I would never denounce this system, because the broader social contract that has been written is valiant, and the price paid for this is worth it.

Nobody should be financially ruined because of health issues.

Cat Breaks Out of Prison

Cat Breaks Out of Prison



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