Friday, January 30, 2009

Harm Reduction Part 1: Addiction, Substance Abuse and Therapy

If you haven't already, I would like to strongly recommend that you listen to this podcast, or read through some of the transcript here. It will provide a very solid introduction to the Harm Reduction approach to addiction treatment. And please, do not take anything said in this post as an excuse for addictive patterns that lend themselves to self-abuse. This is something ideally discussed with a therapist. Short of that, discerning what any individual is really dealing with in their substance use requires a great deal of honest self assessment.

I am having some trouble with pushing on through this discussion. I want to warn you that one, I am using some strong language in this post and two, I am going to take a while to tie it all together. I expect to put two more posts into this discussion. I really am going somewhere with this and am arrogant enough to say that it's a point worth getting to. I really hope you will understand that while I am not afraid to discuss whats going into this, what I am talking about is rather painful - pain that I am dealing with right now. Bear with me, I like to think it will be worth it.

More...I am really glad that I decided to relax last night, instead of pushing through and finishing the post I was working on. Not only do I feel better now, I have a somewhat altered perspective to talk about. I had a rather busy morning and really have a fair amount to get done this evening and into tomorrow. But I think I need to take the time for this right now.

I just had a very intense session with my therapist. On top of my general neurological proclivities, on top of being in school for the first time in sixteen years, I am trying to muddle through the very worse experience of my life. And it's been fucking brutal. Not one to deal with stress and anxiety very well in the best of times, it takes a lot for me to simply stave off meltdown. Add to that, that I have been abstaining from cannabis, traditionally my warm comfort in times of extreme anxiety. For the first time in years, I'm really having the urge to drink and get trashed (as apposed to simply wanting a beer or good bourbon, because I enjoy them).

To make things worse, I have been trying to get in to see the doctor so I can get on meds. I set an appointment for the 20th, back in early December - only to have them call and cancel because they made a mistake. So I tried to reset, twice they've set then canceled, again, due to mistakes. This has not helped with my anxiety issues. All together it's everything I can do not to curl up in a corner and descend into fucking hysterics. The upshot, is that I have an appointment Monday, to see the doctor I grew up with. It will cost money I really don't have, but it will also help me succeed in school and make it easier to avoid losing it.

What the hell does any if this have to do with addiction you ask?

I am an addict, an abuser of substances. By most measures I'm an alcoholic, in spite of being capable of the occasional drink without falling into a binge. It wouldn't be inaccurate to call me a marijuana addict. No question I'm thoroughly addicted to cigarettes. I could go on, but I think you get the picture. I'm an addict, an addict who has a fairly high degree of success at manging his addictions - excepting the cigarettes. But according to the dominant addiction paradigm, I am an abysmal failure.

My measure of success is not that of the dominant addiction paradigm. I am not abstinent. Even though I am not drinking, it's because I know that if I have a drink right now, I could well lose it and fall into self-abusive behaviors. A year from now, hell maybe in a few months, it will probably be perfectly safe for me to have a drink. I like good beer and I love good bourbon, but my fondness is limited to a single drink, two at the most. Beyond that I don't like to drink.

My reasons for abstaining from the weed are a little different and will probably be a very long-term, if not permanent decision. It was no longer performing the function I wanted it to and in some cases was actually increasing my anxiety instead of reducing it, as it traditionally has. Beyond that I have other motivations for quitting that far outweigh the desire to get stoned.

How did I get here?

Several years ago, I had a fortuitous encounter with a cognitive psychology professor who busted me, sitting in on one of his lectures. We ended up spending more than an hour talking in his office and one of the topics that came up was my ADHD and a theory that's been floating around for a long time about it. He explained that it seems likely that ADHD is in part a dopamine deficit. This was ultimately pretty earth shattering for me, because it ended up having a profound effect on how I looked at my use of psychoactive drugs and even some of the things I love to do, like writing and playing music.

Over the course of the weeks, months and years after that conversation, I began to formulate a whole new personal drug use paradigm. The initial concept was simple and not necessarily well affected - it's ok to get high, the problem is getting wasted all the time. As time passed, I began to take increasing ownership of my drug use. Never having heard the term, I had stumbled upon the harm reduction approach to substance abuse, or as Dr. Denning puts it, substance use issues. I am far from unique in this. I don't have some special knowledge or brilliant fucking insight that no one else can have. I figured this out because with a bit of introspection it just makes sense.

I will continue this discussion a little later, maybe tomorrow. It was a productive day and a very good session in therapy, but it has also been a fucking brutal day in many regards.

Here I am, I am just a man
this is my life, starting all over again
nearing the end my last life was broken.....

Thursday, January 29, 2009

In The Meantime.....

I am working on a post about the research I am doing for my first paper. It involves the harm reduction approach to addiction, or as Patt Denning Phd puts it, substance use issues. The post I am working on is actually a discussion of Dr. Denning's terminology, which I heard in this podcast. Wherein Dr. Denning is interviewed by Dr. David Van Nuys and provides a wonderful introduction to harm reduction.

Unfortunately, I don't think I'll be finishing that post tonight. Surprise, surprise, I've gotten a little distracted. In part, I am distracted by Over the Influence by Patt Denning, Jeanie Little and Adina Glickman, which I picked up for the paper. But I'm also a bit distracted by a headache and will probably be putting Over the Influence down before long and maybe picking up a little brain candy to feed the geek inside me.

ADHD, Bipolar and other neurological issues: A Quick Note

To be clear before I go further, the information available to me about those hitting this site is very limited. But one of the things that my site meter tells me about, is the referring URL, i.e. where you clicked in. And when a google search brings someone here, while I don't know who that person is, I do know what the search string was.

I have noticed that I get fairly regular hits from searches on ADHD, bipolar and neurological disorders. Often included are methylphenidate, ampehtamine, adderall, ritalin, substance abuse, etc.

Please, let me make you welcome. If you are hitting this post, feel free to peruse the rest of the blog, but more importantly, please let me know what you are looking for. While I am painfully busy right now, I would very much like to provide links in the sidebar to help facilitate your search and the searches of others who come after you. I do have several links that I intend on posting, but school and, well, ADHD behaviors have kept me from getting to it. Meanwhile, there are links to some forums that may be of use. Discussing our problems with people who have similar issues can be a major help in itself. And some of the forums provide links to other information - and you can always post a request for links.....

More than just a place to foster interesting discussions, I want this blog to also be a place where information on topics that affect me and those I love can be found. I have rather severe ADHD and not so intense bipolar issues. I have many years of experience with substance abuse issues and am studying psychology with the intent of going into addiction research and clinical work.

If you happen to be looking for substance abuse links, please take a look to the right of this, you may have to scroll down. There are some links now and that list will be growing as I have time to get to it.

So please, if you don't see what you're looking for, let me know. You can post anonymous links or email me (just write confidential in the subject line). While I am not a therapist and cannot provide mental health care, I can point you in different directions and am often happy to talk. While there is no legal compunction for me to do so, I am very discreet and will never post or talk about you. If you give me permission, I may discuss things you share with me, but would make sure to keep your identity private.

Wednesday, January 28, 2009

An Open Letter to Graham Lawton

Mr. Lawton is a print journalist for the magazine The New Scientist. He has rather pissed off several science bloggers with his sensationalist cover story; Darwin Was Wrong. While he has found some support from folks in the "intelligent design" movement, actual scientists and science bloggers have gotten a little bit pissed off with him.

You seem to have a very bad attitude about blogs and an overinflated notion of your impact as a print journalist. Let me talk a little about the impact of blogs and science blogs in particular, on my own life.

I'm a thirty two year old high school dropout. Not because I'm stupid, but because I have a whole host of problems that brought me to this point in my life. I'm actually a rather bright fellow, with a wide range of interests that I tend to be rather well informed about. One of the biggest challenges I've faced, while trying to get back to school; I didn't know what I wanted to do.

A few years ago I discovered the blogosphere. Not terribly long after that, I discovered science bloggers. Joy of joys, I discovered that I could not only learn something, I could get involved in the conversation. And nobody cared about my educational background. As long as I was basing my own assertions on evidence, I was accepted as a valuable contributor to the conversation. Even better, I suddenly had some access to people with relevant background in fields that really interest me (even Bora here, was kind enough to answer some of my questions way back).

I had questions about genetics, a Phd geneticist was happy to take the time to answer. I had questions about drug interactions, a professor of pharmacology could help. I had questions about the workings of the human brain, there's a neurologist positively thrilled I was interested. I wanted to discuss addiction, there's an NIH funded addiction researcher glad I provided the insights of someone with substance abuse issues.

And now I'm in school and I have a direction. I'm in a position to incorporate several fields of interest, into a degree that will place me into a position to have a positive impact on my community and society. And I have the support and validation of a host of academics, some of whom are as excited as I am that I've begun this journey. People who have emailed me, to make sure that I know that they are a resource I have at my disposal. The same people who fostered discussions that helped me find my direction, also feel some compulsion to help me succeed.

What I have gotten out of a few years in the blogosphere and have every reason to expect I will continue to get, is something that just doesn't exist with print journalism. Not to say that it doesn't have it's place, but ours is a brave new world that values discussion over dictation, interaction over awe for the author's grasp of a concept. And above all, truth over sensationalism. Which is not to say that sensationalism doesn't have it's place, we're all human after all. But when the sensational takes precedence over honesty, folks will crawl out of the woodwork with the truth of things.

And it is more than truth, it's perception of truth. Your cover story chose the sensational over a reasonable perception of the truth. In a time when science has been under heavy fire from the forces of ignorance and darkness (and while the UK is doing better than my own nation, the difference is one of degree, not the problem itself), you just provided them with more fodder to attack reason.

And lest you find yourself pretending the internet forgets, just google society of homeopathy, or truth homeopathic. The latter won't get you as many critical hits as the former, but there I am at number two, for a post I wrote fifteen months ago. Google the former and you will discover why the UK's Society of Homeopathy probably regrets using a bullshit lawsuit threat, to silence criticism of homeopathy. Here's a hint; if you try to google them to find their site, you have to get through a couple pages of pieces on them, most of which post the article that offended them to the point of lawsuit.

Tuesday, January 27, 2009

My first Research Paper

I was a bit nervous about it, because I found out that we do have some restrictions on the paper. Mainly that the first one has to be a MLA format paper. Given that my topics tend towards being rather science oriented, I wasn't sure I could get them to fly. But my instructor told me today that writing about addiction was going to be fine. I made it clear that there would be a fair amount of science involved, but as I can focus it on our social and political addiction paradigm, she let it slide. I think it helped that I have an interesting take on it.

So now I am going to work on my topic proposal and start throwing myself into more formal research. So the posting may get a little more sporadic and will probably tend towards a definite theme, as my reading material gets more focused.

The major upshot of it is, this is going to be a theme throughout my education. While I am sure that as an undergrad, I will be required to right a lot of class specific papers, this will be the early and short version of writing that will be revisited several times over the next several years. It will be especially relevant when I get my undergrad and move upward from here. I think it will be interesting to compare this paper to the versions that will come out towards the final stretch of my education. I suspect that in the middle, it will get far heavier on the science. I also suspect that (unless I drastically change gears somewhere) that my final dissertation will come full circle to a much longer version of the paper I am about to write, tempered by the next several years of intensive, formal education.

Monday, January 26, 2009

Yerba Mate v Coffee

Warning: There is some evidence that Mate may have some MAOI characteristics. It may not be a good idea to drink Mate if you are taking MAOIs.

I recently managed to find loose leaf Mate at a semi-reasonable price locally and am taking a break from the coffee again. I really, really love the coffee, but find that it messes with my circulation and if I drink too much, it gives me the shakes.

Mate has a very solid stimulant effect without the shakes (at least for me). I actually feel a little more alert with it and feel better overall, than I do with coffee. While involved in a discussion at my brother's blog, I mentioned it to someone and they asked about it, so I thought that rather than posting about it there, I would do so here.

My preferred method of brewing, is to use a french press. Unfortunately, french presses don't seem to last long with me (and I can't afford my dream FP) so I am using my Malita #2 cone basket to filter. Another reasonable method is to use fill your own tea-bags. A method that I have never used and just wouldn't, is the regular drip coffee maker.


I am kind of weird about brewing beverages. Being relatively poor, I have always sought the pleasures that I can for the lowest price possible. One of my luxuries in life are my beverages.

As it pertains to coffee, I am pretty certain that I have managed to own every possible type of brewing system out there. I have used the traditional Tai brewing basket and once owned a fairly nice Turkish coffee set. Unfortunately, Turkish coffee done properly is very time consuming, especially if you use "real" cardamon (i.e. still in the hull), hull it and grind it with the coffee. The less said about Japanese brewing the better - most Japanese people who do coffee use western coffeemakers or buy it in a bottle. Suffice to say that I am a hardcore javaphile.

The best cup of simple coffee one can brew, is with the aforementioned Mellita filter basket. Grind your beans for each cup. For a real treat, either roast your own or get some that were fresh roasted about eight hours before you plan on brewing (trust me, you want that eight hours, otherwise the gas in the beans will make a huge mess when it comes into contact with hot water). If you're actually interested in roasting your own, which is relatively easy and not terribly expensive, either google it or ask me. So you now have your fresh ground coffee and put it in the filter, I like four tablespoons for one twelve to fourteen ounce cup. Boil your water to a hard boil and let the water sit at room temp for eight to ten minutes. Pour it through.

My favorite method is to use the same amount of coffee, but to put it together with cold or room temperature water and let it brew for about eight hours, then filter it. This is much easier in a french press.

For mate, you want to be very careful about the temperature of the water. If you are using hot water at all, it is a good idea to just cover the leaf with cold water. Mate has an interesting composition that is easily cooked off if the water is too hot. I brew it cold. This is why I don't care for the drip maker method.

Again, my favorite method is cold brewing. But with mate, you really don't need to let it brew for all that long. An hour is usually sufficient. And you can pour more water over it after the first run, some people like to after the second as well. If you are drinking it throughout the day, this is actually a very reasonable way to do it, as each subsequent run is milder than the last.

If you're lucky, I may take the time to really write a good piece that gets into tea as well. Because I really am a neurotic freak when it comes to the beverages.

Sunday, January 25, 2009

Autonomy, Coercion and Reproductive Decisions

There are a lot of directions I want to go on this topic, but I am finding my time sharply limited and if all goes well it will be even more limited soon. So I am going to have to let the flow of this discussion go where it will for the most part, rather than exerting much control over it. In that vein, Comrade PhysioProf has made a comment that rather nicely dovetails with the one right after it, made by Becca.

For me the key ethical distinction is between the autonomous reproductive choices of individuals coerced reproductive decision-making by the state.

Which sounds pretty good on it's face. But what about other coercive elements? And what about coercion for humane purposes. With these questions in mind, I would like to explore them through the consideration of Lysosomal Storage Diseases. Two key elements tie most LS diseases; They are almost always fatal, with few having any available treatment and exceptionally painful for the victim. And most of them can be found through prenatal testing. To make them perfect for this question, there are a few LS diseases that can be treated, but said treatments include some of the most expensive drugs ever created, running from $250,000 to $450, 000 per year for life. Also, it is possible to pre-test potential mates who have a heightened expectation for some LS diseases, such as Tays Sachs, for the recessive genes.

So to start, is it entirely unworthy of even asking if maybe it would be ok to require pregnant women who have a fetus that tests positive for infantile Tays Sachs terminate their pregnancy? Or is it unreasonable to require couples who both carry the recessive gene for TS not reproduce? To put it more bluntly; Is it unreasonable to restrict the reproductive rights of someone who is extremely likely to have an infant that is going to suffer horrendous pain and die before their third birthday? I don't have an easy answer, but I would argue that it's unethical not to consider these questions.

My next question would be one of financial coercion. One of my closest friends is married to a women who had a brother with Hunter syndrome. Their daughter is a very close friend to my son and a child I love very dearly. She is also entirely unaware of the terror her parents went through when they first learned they had conceived. Because there was a significant risk that is that lovely little girl had been a boy, that he would have had Hunter syndrome. At the time, there was absolutely no hope for a person with Hunter syndrome. Just pain, retardation and death by thirty - usually in adolescence.

But there is a new hope. The FDA approved the drug Eleprase for the treatment of Hunter syndrome in 2006. But this treatment isn't without significant drawbacks. It requires a weekly IV infusion and a risk of anaphylactic reaction requires it be provided in a facility capable of handling a serious medical emergency. It is also a maintenance drug, that must be continued for life.

Finally, we get to arguably the worse drawback. Eleprase treatments come at a cost of around $300,000 annually. So who should be required to pay for these treatments? Should the insurance company have a right to not cover the cost, for children who's parents knew there was a significant risk of Hunter syndrome and chose to have that child anyways? Should the state cover the cost? Who should lose out on care because the state is covering the cost? (i.e. where should the rationing be placed to cover it?)

Now you can tell me that LSD's are really quite rare and that I'm throwing hypotheticals out here that have little real world impact. First, let me be quite clear, this is not minimal real impact to those who experience these diseases first hand. But more importantly, we are learning more and more every day about the genetic predisposition for a lot of other diseases. These are questions that could well have a far more significant impact on more people in the future.

And please, lets not make any assumptions about anyone's motives or beliefs. This is a touchy topic for a lot of people, including me. I'm not a fucking monster trying to force anyone to kill their babies, nor am I a monster for deciding that my youngest wouldn't be with us today if he his amniotic had tested positive for down syndrome. The next nasty email I get about this will probably be published on the front page of this blog, with contact information.

Saturday, January 24, 2009

Big Excitement That I Can't Talk About Yet

I'm going to have to apologize, but I am not going to be getting the posts up today that I wanted to. I am suddenly very, very busy with something that is of the utmost importance in my life. If all goes well I will have some very exciting news to post in the next couple of days. I would explain, but if it does not work out, talking about it now could have negative legal repercussions.

Suffice to say that I am excited enough to pee myself.

I would like to wish Juniper a very happy birthday, while I am here for a moment. And I would like to just clarify that I have never had the urge to prance around in an Edwardian tea gown, I swear.......

Eugenics, eugenics and me.....

Sorry about the delay, but I have been much more busy than I intended. In the great frozen north, we have had enough snow that it has caused some problems on houses that have insulation issues. Among them is the home of a very good friends mother. Having several years experience dealing with roof and siding issues, I realized that there is a huge problem in the making due to the very strange weather we've been having. So I am helping said friend remove all the snow from the roof and melt off some major ice dams that are putting the eves at risk. I'm getting to old for this shit. (Not that I'm old, just that several years of roofing trashed my knees and lower back - vicodin will be my very close friend today)

So I would like to continue the discussion on eugenics, but it will have to wait until I have managed to get this roof in a better place. In the meantime, please feel free to jump into the conversation already going on here and read down the line for something of a preview of todays posting.

Thursday, January 22, 2009

It was my intent to get a post up today....

.....But I'm going out for coffee instead. Tomorrow is another day though and I'll have some time to kill. And kill it I will. Possibly with two interesting posts.

Wednesday, January 21, 2009

I won't be getting rid of open office any time soon....

I love google, I really do. I blog through them, I email through them, they host my family's photo albums, they give me a home page on which I can save all my links - and they host my wordprocessing. Even cooler - my school email is through google, which means I have a whole new google account just for school. It also means that I have a whole separate documents account for school. I use google documents already, have for a while now. And since google documents does all the other great things that most data processors do, I was considering uninstalling OpenOffice.

I also want to make it perfectly clear that I love OpenOffice, mainly because I love open source applications. I've actually sent them money - though admittedly less than I would have paid for Microsoft Office Suite. Which is why even though I don't actually use it anymore, when I got this brand new laptop, I downloaded and installed it yet again. In fact, this being a brand new laptop (I've never owned a brand new computer before), it had Microsoft Office pre-installed (even though they wanted me to pay for it after the trial ran out).

So here I've sat with OpenOffice, but I haven't used it - not once. I've had this computer for a month. I've written several different things, all on google documents, or if it's a quick note, on notepad. Never opened it until today, when I went to print my papers that are due tomorrow. I got the word count on one of them and realized that something wasn't right. I had realized it seemed rather voluminous while I was writing it, but I really didn't think much of it. So I opened OpenOffice and copied, then pasted.

The assigned paper was 2-4 pages, I had written 3. When I pasted it into OpenOffice, it was nine and a half damned pages. And let me tell you, it's not possible to just trim a nine page paper into four. Oh no it's not. So I got to rewrite it this afternoon. On the upside, I do feel better about my humanities paper. It was open ended, so I really didn't feel too bad about it, but I'm glad it went from less than a page to two. Now I just gotta figure out google documents......

Tuesday, January 20, 2009

In which I Discuss Student Stuff......

For the few folks reading this who may not be aware, I have recently re-embarked on my educational journey - becoming a formal student for the first time since I dropped out of high school sixteen years ago. As part of this journey, I am taking several classes that are prerequisites required to complete the program I am taking. I intend on discussing some of those classes here, because one, I'm spending a hella lot of time in them and two, because some of the things I am studying are relevant to discussions I am trying to foster here.

One of the ideas I am tossing around, is posting some of the papers I am writing at any given point. For the most part they will tend to be papers on topics that I am rather interested in, given that I am embarking on a course of study that I find interesting. At the moment, I am taking a college writing and research class and have managed to get an instructor who is allowing me to pick the topics I write will have to write two major papers on. And this is where you, my readers can come into my world.

I would like to know what you think I should pick as a first topic. I was originally thinking I would write a paper on harm reduction and a new addiction paradigm, but the recent discussion about eugenics (knowing that I am going to spend a fair amount of time researching and blogging about it) has led me to consider writing the paper on eugenics. And of course there is literally a world full of other topics to consider. I am definitely going to keep the topic within the realm of science, either psychology, neurology or genetics. But within those categories are a whole lot of options. So please weigh in. What would you like to see me write about? Given the same assignment, what would you choose as a topic? If you were restricted by the parameters I mentioned, what would you choose?

Also, would it be silly to post papers? I promise they will be nearly as edge of your seat exciting as the breathtakingly thrilling posts I write. Or more to the point, they will be no more boring than the sorts of stuff I write already. They will be longer though. Probably quite a bit longer. And it has been pointed out to me before, that I am certainly not going to gain a reputation in the blogosphere for my brevity.

I know most of the people reading have spent far more time in school in recent years than I have (especially those of you who are profs) and probably have more recent experience with this sort of thing. And now that I mention it, if you happen to be a prof, feel free to tell me what you like, or don't like to see in a paper. (And in case any of my profs stop by) Did I mention that I have the most remarkable and stimulating instructors ever?

I will probably soon be posting my first paper, in which I discuss;

To learn to think is to learn to question. Discuss a matter that you once thought that you knew "for sure" that you have now begun to question.
When reasonably possible, I will also try to bring into the discussion here, the things I am studying in school. Coincidentally, the discussion about eugenics and where it has gone thus far, in my humanities class today, we watched a video that I have seen before, from the Genographic project, something that my dad has taken part in and something I would take part in if I could afford to. Unfortunately the whole eating and not living in a box thing makes that impossible at the moment. But be assured, I am going to get around to blogging about it, in relation to our discussion on eugenics. I actually have had the video from today in mind since this conversation came up again.

Oh, and I am also hoping to get back into talking about talking to our kids about drugs. And sex. And other dangerous things. Keeping in mind that mine are one and seven and that we started the discussion with the seven year old, three years ago (albeit in a very general fashion). If this is an interest to anyone, please feel free to pressure me to hit on it sooner than later....

Sunday, January 18, 2009

Eugenics, Yes, I said Eugenics; Is there a problem?

Please check out and even contribute to the comments section. We have a decent discussion going and would love to hear from you too.

At this point if you're reading this, it is quite likely you've only recently discovered my blog. Mainly because I quite recently posted for the first time in a very long time. I'm really glad that I did, because someone managed to go back and hit on a post I wrote over a year ago (granted there weren't many posts between here and there). I'm glad, because I really think this is an important discussion to have - one that becomes more important by the day. And the comment left by Juniper Shoemaker is worth addressing. And to make it really fun, Juniper is a geneticist in training. (Juniper is also the bittering agent in the last beer I had, an awesome brew by my friend Mac back in Portland.)

For those who might not want to read the original post, I am basically making the argument that we need to get past the hysterics that almost inevitably ensue when the word eugenics is brought up. I would like to be clear that I am not advocating for or against eugenics, though there are certainly ideas involving eugenics that I am strongly against. All that I am advocating for is a rational discussion of eugenics, much like Richard Dawkins did a couple years ago.

The reason this is important right now, is that a lot of controversial things are happening that should be fostering important conversations. But those conversations aren't really happening and I suspect that the reason they aren't happening is because the term eugenics is so very loaded. So before I get into addressing Juniper's comment, I would like to point you to a very illustrative post that discusses eugenics. (without ever actually using the word)

Turns out that a couple had been searching for awhile to find an egg donor who looked like the mother and possessed certain attributes that clinics do not approve of as legitimate donor criteria.

Yup, that there is a shining example of eugenics in action. It's not abortion. It's not killing a flawed infant. It's not sterilization and it's not genocide. It's simply a couple who needs a little help having a child, a couple who wanted to exert a little control over the genes of their child to be. Not really very controversial, it's not much different than the decisions people make when choosing a mate they might reproduce with naturally. But on to Juniper's comment....

The problem with eugenicists is that they ignore the fact that the desirability of ANY trait is dependent on its environment. The environment always changes. Traits you cannot possibly conceive of as "desirable" today could prove desirable tomorrow for a myriad of reasons. For all we know, these traits could include hypertension, bipolar disorder, Down's syndrome and autism. Reality is bizarre and unpredictable.

I have no problem with that. I'm bipolar and also have very severe ADHD. And guess what? My son has been diagnosed with severe ADHD and probably has either some of my other neurological issues or those of his mom. I have very little doubt that my youngest will also exhibit something of our neurological issues too. I can even accept that there may well be some value in the propensity for DS as well.

I will also go as far as saying that the idea of aborting a fetus that has tested positive for DS is not a black and white decision or an absolute net positive. This, in spite of the fact that if our incredible one year old had tested positive as a fetus, he would not be with us today. No question, no discussion necessary. Had that test come back different, we would have terminated the pregnancy. Because while the idea is far from black and white, our ability to deal with it is absolutely clear. We already have a child who needs a lot of special attention. Under ideal circumstances, the sibling of a child with that level of disability is going to lose out. In the case of a sibling who has special needs of his own, it's a recipe for disaster.

But this statement of Juniper's is really the crux of the matter. She is presenting one of the best examples of why we really need to have this discussion. Because right now, it is possible to test for a variety of traits, invitro and make decisions to abort based on those tests.

Call me a hypocrite, because I will freely admit that in a sense I am one. I am fully aware that any child I produce is likely to carry certain traits of mine, that aren't all sunshine and roses. Having the neurological issues that I have is not an easy burden to bear. But I have reproduced and more than once. And I think that the value that comes from having neurochemiustry such as mine, is ultimately worth the hardship it entails. Honestly, if it becomes possible to test for ADHD invitro, I would have serious issues with the notion of trying to eliminate that trait.

Yet without question, I would have no problem with terminating the pregnancy of a fetus that has tested positively for DS. I'd like to say that this is only because of the child I already have. But being perfectly honest, I don't think my reaction would be much different if I was childless. Dealing with a child with that level of need is not something I think I am suited for.

And then we have a somewhat gray area for me (but not for a lot of people), autism. I suspect most people out there who would terminate a pregnancy for DS, would also terminate a pregnancy if there were a significant risk of autism. I'm not one of them, but that is because I have a fair number of autistic friends. At the same time, having the older child I do, I am not sure given the option, I could, in good conscience bring a fetus to term that carried a significant risk of severe autism.

These are not black and white questions, but they are well on there way to being a fact of life and are indicative of why we need to be talking about eugenics.

However, it irritates me when eugenicists assume that the only reason why people get pissed off with them is the "controversial" nature of the subject. That implies that people have to choose between a ringing endorsement of a loaded practice or a sheep-like unthinking aversion to the practice.

Honestly, I think that this is why we need to separate Eugenicists, from ownership of eugenics. Because I really don't think it's reasonable at all to allow anyone lay claim to a concept that is as broad as eugenics. Eugenicists, as Juniper is describing tend to fall into a fairly narrow range of beliefs. And those beliefs are not based on actual science, any more than the beliefs of the so called intelligent design movement, or evolutionary psychology.

I get pissed off because people who like the idea of eugenics usually have a shitty understanding of evolutionary theory.

I would take that one step further and say that eugenics only has a peripheral relationship to evolution at all. Because eugenics is really contra-evolution. Not that being contra-evolution makes eugenics inherently bad. But the claims made by Eugenicists are worse than ignorant, I believe that for the most part they are flat dishonest.

No matter how dishonest, no matter how ignorant their theories, I think it is long past time to take the concept of eugenics away from the Eugenics movement. It is also way past time to take the concept of eugenics away from the specter of the Nazis. Because like it or not, eugenics is a reality and the hysteria surrounding it is preventing us from having some very important discussions with very profound social implications.

Saturday, January 17, 2009

DrugMonkey Asks; Decriminalization: What would happen? Part 2

Or Why I am studying to become an Addiction Researcher......

So now I am going to talk about the drug users, both current and potential. But I am probably not going to get to the decriminalization/legalization aspect of the discussion until we get a ways into this. First I would like to discuss addiction, overt dependence and what I see as the failure of our current addiction paradigm.

I think it is important to make the distinction between addiction and overt dependence. I think a very good way of expressing this is to identify two different types of heroin junkies. You have most heroin junkies, who even after they detox from opiates, still have a driving need to use more heroin. Then you have a much rarer type of heroin junkie, the junkie who after detox, will have absolutely no desire to even look at heroin again, much less still want to use it.

Overt dependence (OD) is the specific chemical mechanism that is very different from substance to substance. It is what makes heroin detox very different from detoxing from crack, or meth from alcohol. Using a particular drug will cause specific changes in one's neurochemistry. While some of these mechanisms might be somewhat similar, they each have their own unique patterns, that are nonetheless going to be common to other people who have OD on the same substance.

Addiction on the other hand, has some common characteristics, no matter what the addiction in question. These are characteristics that you will find with heroin addiction, alcohol addiction and shopping addiction or sex addiction. It would be way oversimplifying and completely inaccurate to claim that this is the whole story, but there are factors that are common to all addictions, something you just won't find with OD.

The known neurological common denominator in addiction is one that I am personally very familiar with, dopamine. This is why substance abuse is so very common with people who have ADHD. We are always on the lookout for better ways of getting our dopamine fix, as one aspect of ADHD is a dopamine deficit. At the same time, I suspect that this very trait is what provides most people with ADHD, some immunity to OD.

I suspect that there are more common neurological threads, that wind their way through addiction, which is why I am going in the educational direction I am. Not to say that I am limiting myself to neuropsych. I am going to work my way through clinical psychology on the road to my goal, because I think that there is a great deal of value to be had by approaching this from multiple directions. But ultimately, I want to study the common elements of addiction and the human brain. At the same time, I also want to find some of the uncommon neurological elements. Because I suspect that in the quest for both, lies a better answer, or a better paradigm for treating addiction.

So what do I mean by uncommon elements? Let me use my own addiction to tobacco as an example. Nicotine dependency is but a tiny aspect of my addiction to cigarettes. As is my dopamine fix (though that is by no means negligible, as I suspect that the OD on nicotine really is). What is far more important to my driving need to smoke cigarettes, is what smoking means to me.

When I was fairly young, I left home and then left the state to wander the U.S. and even some outside the U.S. I hitchhiked nearly every state. During those years, I slept outside far more often than I slept in. I lost absolutely everything I had on multiple occasions, starting completely over - mind you all I had at any given point was what I could carry on my back. The only consistency I had in my life, was cigarettes and coffee. The only things that were absolutes in my life. Next to that, I almost always had marijuana and a copy of Huxley's Brave New World.

Of the things I've listed, the only elements that are still critical components of my life are cigarettes and trying to hang onto a copy of Brave New World. I usually drink the coffee, but at times I feel the need to detox. And I have for a few reasons, found it necessary to quit smoking or otherwise use marijuana. So smoking is a huge issue for me, because it is one of the very last threads that tie in important aspects of my life.

On top of that, I have made smoking more than just a fix. I really enjoy smoking. I enjoy trying new tobaccos and blends. I like how it tastes and because of the quality of tobacco I smoke, I actually like the way that it smells. So defeating my addiction to cigarettes, is going to take a lot of effort on my part.

I did warn you that it would take us a minute to get to my hypotheses to answer DM's question, didn't I? If you're still with me, take heart, because we're there baby! Kind of, sort of....

Here's the problem. I honestly doubt that with our current addiction paradigm, as addiction pertains to drug users, our society would look much different than it does now. This is accepting that many of the changes I detailed in part 1 would make some rather significant changes to society. But as far as drug users go, things don't really look a whole lot different.

The exception to that, is that I do believe that we would see a temporary spike in drug use and with it, a spike in addiction rates - also temporary. This is not to say that the addictions accrued during this time would be any more temporary than addictions are now, just that as use dropped back down, so would the rates of new addicts.

I suspect though, that in the long term, overall use of most drugs would ultimately drop below the levels we have now. Because I believe rather strongly that legalization would foster an environment that encourages us to explore new addiction paradigms and that it would also foster new approaches to prevention/education.

I am honestly not that sure about what a new addiction paradigm should encompass. But I certainly have some ideas. First and foremost, I would love to see our society gain a much better picture of what addiction really is and accept that while addiction can be and all too often is a very ugly existence, addiction can not only be benign, but can even be an unmitigated positive. That it is ok to tell a drug addict that they are always likely to be an addict, with the caveat that they need not always manifest their addiction in the use of harmful substances or destructive behaviors.

I have mentioned that I have ADHD. Not only do I have ADHD, I have very severe ADHD. I have also been diagnosed with bipolar disorder and have been an insomniac since birth (seriously, I slept less than ten of my first twenty-four hours outside the womb - it was downhill from there). I know about dopamine deficiencies and have spent a rather large percentage of my life trying to compensate. When I was younger, that led me to using a lot of different substances for such compensation, but it also led me in other, unexpected directions.

I love to write and perform music. Performance in itself isn't the key though, what really gets the dopamine squirting, is when I am effectively influencing the emotions of my audience, making them feel what I feel or want them to feel. The stronger the effect I have on someones emotional state, the more intense the experience is for me. Given my Christian upbringing, this made the next step in my musical addiction a natural; writing worship music and leading worship. Because this brought the emotional intensity to a whole new level, making the effect could garner so much more intense.

I am not going to go into the interchange that brought me to that place right now, though I may address it another time. Suffice to say that in this process, I managed to do what a lot of addicts do. I lied to myself to make me believe this was ok, and by extension lied to others. That in itself isn't the worse, my addiction led me to stick with it after I had realized the lies I had told myself. To be sure, I was encouraged by some folks in the church who knew where I was at, for a variety of reasons, but when it came down to it, I stuck with it because of what it did for me. Because of my addiction.

The thing is, it could have been and has become an honest, benign addiction again. I stick to writing music that I believe in and while I'm not performing now, I know that when I am able to share my music with others, it will affect them. No lying and no harming anyone - least of all myself. Yet addiction it most certainly remains. The act of creating beauty with one of my favorite mediums, words, gets the dopamine moving. Even sitting here right now, putting these words on this page is making it happen. It's an addiction, but quite arguably a very positive one. After all, I believe what I am saying. I believe it strongly enough, that I want to direct my education so that I can either prove it, or discover that I am wrong - either of which is fine with me, because either result will still be a step in the right direction. That direction being furthering our understanding of the world, specifically addiction.

And if I can convince others that I might well be right, that may encourage them in a positive way. Or this may encourage people to challenge me and maybe even make a cohesive argument that encourages me to change my position. Or their challenge may encourage me to think more and develop a more cohesive position of my own. Hell, their challenge may be so ridiculous that it fills me with righteous indignation. Any and all of these possible results, will produce yet more dopamine spikes and feed my addiction even more. All without me resorting to the use of destructive chemicals or other destructive behaviors.

There is a lot more I could say and maybe I will. But I think I have provided about as much a overview as I can for now. I realize that much of this seems quite tangential to the issue of what decriminalization or legalization might look like, but it's all interconnected - or should be. I think that it is quite reasonable to say that both the prohibition and war on drugs have been abysmal failures. But that is not the only failure. Our entire drug paradigm is an absolute, categorical failure. Our entire addiction paradigm is an absolute, categorical failure.

Therefore, I think it is rather unreasonable to attempt to discuss any of these in a vacuum.

Friday, January 16, 2009

DrugMonkey asks; Decriminalization: What would happen?

I am happy to answer. Accepting of course, that I have no special knowledge of the future and what it will actually look like. But I can make some pretty reasonable hypotheses.

First, I will note that I think decriminalization would be about the stupidest thing we could do. It ignores too many of the reasons we have made it illicit in the first place and creates an environment in which regulation is far more of a challenge.

Legalization is a great way to solve a lot more problems and create a much greater tax base. And I believe that from a harm reduction standpoint, it is a win, even when dealing with addiction. But I would like to step back from that, onto a point that applies to both legalization and decriminalization. Please bear with me, as to fully extend my hypothesis requires throwing prostitution and even gambling into the mix - though it's not absolutely necessary.

I would argue that just as important as the discussion of drug users and potential new drug users, is the cost of the illegal nature of drugs to society as a whole. We'll split it up into it's different aspects, though there is some overlap.

First factor is the direct financial cost. We are spending untold billions every year, both in fighting the war on drugs and imprisoning offenders. Several states are spending significant percentages of their budgets on maintaining our massive prison and jail populations. In a lot of states, drug offenses account for better than half the incarcerations at any given time. The state of MI for example, spends better than sixty percent of it's budget on incarcerations. This does not include what we spend on addiction treatment and research. On top of that, we spend billions every year, just on prosecuting the war on drugs.

By ending the war on drugs, we could save a lot of that money and move some of it into the realms of treatment and research. By ending the overarching war on vice, we could reduce the incarcerated population even more and save even more money.

Second, doing so would help foment stability in some notoriously unstable regions of the world. While I have no illusions that legalization would put cocaine lords in Columbia out of business, it would legitimize their business and remove much of the impetus to maintain the volatile status quo. And in the poppy fields of the mid east it would do wonders for farmers, while possibly making it easier to dislodge some of the local warlords who are in turn, supporting or directly engaged in terrorism. Which brings us headlong into my next point.

Third, we would be decimating a major source of funding for terrorists of all stripes. It's not just Jihadis who fund their activities through the illicit drug trade. The IRA did it, the PLO has and probably still does it. Hamas has had it's hands in it and probably still does. German national socialist groups do it. White supremacist groups in the U.S. do it, in the hopes of committing attacks on U.S. soil. Anyone who wants to have a hidden source of ready cash, can and often does turn to illicit drug dealing. And terrorists top the list of folks who need ready cash they don't have to account for (maybe behind our own intelligence organizations).

Finally, we get to crime. Not the specific crime of using/dealing illicit drugs - we're ignoring that in this point. I'm talking about related crime and this is where prostitution and gambling come into play. Because the vast majority of violent crime in the U.S. is related to one of those three trades.

I won't try to pretend that decrim or legalization is going to eliminate it. I won't even claim that everyone who engages in vice related violent crime will stop using violence. But the fact of the matter is, that there will be an inevitable and significant reduction in violent crime, when the war on vice is ended and vice is legal and safe. The majority of people who get into the illicit trades and by default end up involved in violent crime, would not go there is there wasn't a significant profit to be had from it.

You don't see the guy who owns the convenience store up the street, shooting it out with his dairy supplier, because he got a load of rotten milk. Why not? I mean if the crack dealer at the other end of the block gets a bunk supply, he's likely to go out ready to kick some serious ass, if he doesn't go out with a loaded gun. Well, the convenience store owner has the law on his side. He has legitimate venues in which to seek redress. The crack dealer simply doesn't and violent crime happens.

I realize that I'm ignoring the factor of how this affects the drug users themselves. I will try to get to it, but anyone who's read my blog knows to take that with a grain of salt. Ultimately, I don't believe that the affect on users and abusers is as important as the affect on the rest of society. As it stands, we all are paying a massive price for a proven abysmal failure and the users and abusers are suffering for it too. Bottom line, we're at a point where it can only get better from here.