Lili Lakick, 1983
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Doomed, Delusional, Divided and Corrupt: How the Democratic Party Became a Haunted House

Face to face with what looks an awful lot like the rise of American fascism, the Democratic Party has a historic opportunity — and a historic responsibility. It has repeatedly proven itself to be unequal to the task, to a comic and pathetic degree.

Democratic congressional leaders, Democratic presidential candidates and the party’s true-blue believers keep wandering through familiar patterns, like someone in a dream state out of a Kafka story or a surrealist film, clinging to the fading hope that this time around the nonsensical narrative will reach a satisfactory resolution. If you tried to design a center-left political party trapped between the traditions of social democracy and classical liberalism, unclear about its core beliefs and equally terrified by both its most vicious opponents and its most ardent supporters — in other words, a party perfectly positioned to capitulate to tyranny with nothing more than a few disapproving whimpers — I hardly think you could do better than the one we’ve got.

I’m not just talking about the endless, dispiriting dithering over whether or not to impeach the obvious criminal in the White House, although that has been both patronizing and cowardly, a combination most often achieved by parents with something to hide. (Something, of course, that the kids already know).

That particular failing was thrown into strong relief this week after reports that President Trump tried to arm-twist the president of Ukraine into digging up (or perhaps inventing) damaging information on Joe Biden, approximately the 10th scandal of Trump’s presidency that would have ended the career of any normative, old-school politician. Even mainstream congressional Democrats and sympathetic media commentators have begun complaining openly about the leadership’s inaction — but there is no serious indication anything will change. With the Iowa caucuses now 16 weeks away, Nancy Pelosi has pretty well accomplished her goal of running out the clock on impeachment.

I’m also not just talking about the party’s steadfast refusal to adopt coherent, progressive and broadly popular positions on issues like health care, gun control, marijuana legalization and electoral reform. But it’s important to grasp why Democrats in power won’t embrace those things — as opposed to embracing them on the campaign trail, which really doesn’t count — because the reasons go well beyond ideological confusion or political cowardice and into deeper, darker places.

Over the last 40 years, the Democrats have become an increasingly awkward coalition of affluent, cosmopolitan whites and urban people of color, and have largely abandoned their previous mistrust of corporate power, Wall Street and big capital in general. Go down the list of powerful congressional Democrats — especially the committee chairs and members of leadership — and pay attention to where and how they raise money, and who their major donors are. The corruption is widespread and deeply rooted, and it cannot be dislodged simply by anointing a reformer or “socialist” as the presidential nominee. If anything, that should be the end point of a renovation or redemption project that has not happened. (...)

But all such questions, when considered piece by piece, ignore the deeper underlying narrative that frames them in the first place. They all signal toward the Democratic Party’s remarkable ability to manufacture defeat, even (or perhaps especially) when objective conditions seem overwhelmingly favorable to victory. The real problem here, I’m afraid, admits of no easy solution: The Democratic Party comprises a wide range of views and voices, some of whom are vigorously trying to change its direction. But all of them are trapped inside a haunted house. Troubled by the ghosts of the past and clinging to useless rituals, Democrats appear largely unable to perceive actually existing reality or react to it appropriately.

This is not exactly a new idea. In political science, it’s expressed through the concept that the relationship between our two major parties has become asymmetrical: Democrats cling to norms and standards of a bygone era, Biden-style, and also, by their nature, are driven by principles of dialogue, reasoned discourse and compromise. LOL! Republicans are totally over that shit, and have gone full-on ruthless culture war, a dynamic explored by Salon's Amanda Marcotte in her book "Troll Nation": They know they can’t win a fair fight on issues and policies, but when it comes to semiotic battles rooted in racism, nationalism and cultural division, they consistently hold the upper hand.

That’s a useful construct, but I suspect it doesn’t go far enough, in that it still appears to rest on the assumption that our political system more or less works, or almost works, or at least could be made to work with some structural improvements that compel the Republicans to stop being so nasty. That’s the fundamental premise of virtually everyone in the Democratic Party. I believe it’s completely wrong. I believe it's not just wrong but dangerous, and not just dangerous but doomed. It threatens to sink democracy with passivity and politeness. (If, that is, democracy hasn’t been sunk already.)

I’m not sure whether to call the contention that democracy is kinda-sorta-maybe functioning normally — in the face of literally all the evidence, not just here but around the world — cynical or childish. I'm not sure whether it's driven by misguided faith or by a self-interested desire to preserve power and privilege. (Those things feed into each other, to be sure.) This article of faith or doctrine of blindness gets expressed in its most comic and pathetic form, of course, in Joe Biden's campaign. The former vice president has assured us that Donald Trump's presidency is an "aberrant moment in time": Apparently Trump came out of nowhere and has no history; once he is gone, Republicans will experience an "epiphany" and normal politics of bipartisan comity and compromise will be restored.

As I've observed before, this fails to answer the question of what kind of normalcy we are to imagine, and when or where it can be found. Fortunately, former Sen. Ted Kaufman, a longtime Biden adviser and surrogate, answered the question in a recent interview with Michael Scherer of the Washington Post. (Kaufman only served in the Senate as Biden's appointed successor, after the latter became vice president in 2009.)

“To get back to where we were on November 1, 2016, is going to be a herculean effort. You are going to need somebody who has a lot of experience, who has bold, realistic policies and who knows people around the world. ... After four years of Trump, we are going to face a really difficult time rebuilding the country.”

There you have it: Read it and weep, if you have tears left to spare. Kaufman’s warning about “a really difficult time” aside, November 2016 was apparently the lost golden age of American politics, or at least the only one Joe Biden is willing to promise. Now, as I recall that distant era, it featured total legislative paralysis, endless investigations of a minor foreign-policy debacle in Libya, a Supreme Court nominee under blockade by the Senate and the majority party in both houses of Congress gripped by paranoid conspiracy theories. But at least the president wasn't a racist, lying fuckwad trying to impose a discount-store police state. It's an inspiring vision!

Unfortunately, if understandably, a large proportion of the Democratic base has been so thoroughly abused and gaslit and terrorized — both by the ruthless, vicious opposition and by the self-abasing leadership of its own party — that it’s willing to settle for that. I mean, I get it: Democrats understand either consciously or instinctively that the odds are rigged against them, and the pragmatic response is to lower your expectations into the basement and pursue a short-term victory at almost any cost. So let’s at least get this terrifying idiot out of the White House and replace him with a vaguely normal adult; all that stuff about the dying planet and economic inequality and Medicare for All (not to mention trying to build or restore a functional democracy) will just have to wait.

If it’s easy to mock the Bidenites for their weird combination of delusional fantasy and defeatism, it’s harder and more painful to observe that this syndrome is found throughout the Democratic coalition, if in subtler form. As I suggested earlier, supporters of both Bernie Sanders and Elizabeth Warren have fallen into a top-down, shortcut-to-power fallacy, which is conceptually related to the Bidenite delusion. In this version of the future, electing a progressive reformer or a socialist “revolutionary,” as the case may be, will somehow be enough to uproot a deep-tentacled system of privilege and power, and make up for decades’ worth of Republican institutional conquest and Democratic capitulation.

by Andrew O'Hehir, Salon |  Read more:
[ed. See also: The President Needs to be Impeached (TPM); and Trump is Discovering New Powers (The Atlantic). It's not "new powers", it's an abuse of powers, and a Republican congress colluding with an executive branch to undermine the Constitution.]

Jean Genius: How Kojima Became Japan’s Denim Mecca

In a country where craftsmanship is so highly prized, it’s no surprise to learn that even a product as universal as jeans has been raised to an art form. Thanks to traditional production methods that create high-quality, long-lasting jeans, Japanese denim has iconic status among “connoisseur denim heads”, who are prepared to pay £250 or more for a pair.

Major Japanese brands, such as Momotoro, Pure Blue Japan and Studio d’Artisan, all have stores in the big cities, but arguably the best – and certainly the most interesting – place to buy jeans in Japan is hundreds of kilometres away from Tokyo, Kyoto and Osaka, in a sleepy coastal district on the southern coast of Honshu, the biggest of the four main islands.

An hour’s train ride south of Okayama city, Jeans Street in the port town of Kojima is a hub of 38 specialist denim shops. The “street” is actually four streets – each strung with lines of jeans as if someone has just hung them out to dry. Shopping here couldn’t be further from the big city experience of Japan – there are no crowds, no neon lights, no department stores and no subcultures on display. I strolled near-empty streets, and browsed quiet shops where I was left in peace to look around.

More than just a retail experience, Jeans Street is a homage to denim, with the hard-wearing blue fabric referenced in everything from vending machines to drain covers and signs to public loos. Some stores are traditional in style, with sliding screen doors, tatami mats and tranquil gardens; others are tiny modern boutiques. Inside they sell not just beautifully made jeans but shirts, jackets, skirts, coats, aprons and wallets.

To understand why one of the country’s most intriguing shopping experiences is in a small, unassuming town in Okayama prefecture, you have to rewind a few decades – to postwar Japan. One of the side-effects of the US occupation during the second world war was an obsession with Americana among Japanese youth, who embraced American pop culture and created a healthy black market in used Levi’s and Lee jeans.

In Kojima, textile factories that had for decades specialised in school uniforms and workwear saw a business opportunity. The first Japanese denim company chose the most American-sounding name it could come up with: Big John. And then it did the same for its women’s brand: Betty Smith. Initially, Big John used denim fabric and sewing machines imported from the US, but in the 1970s it started to produce its own denim using old shuttle looms and traditional indigo-dyeing techniques – and Japanese jeans were born.

by Isabel Choat, The Guardian |  Read more:

Image: uncredited

Shifting Baselines: When the Last Fish Dies

The devastation of the vast majority of the world's marine life is much closer than we think.

Picture a beach along the same vast ocean you know today—the same powerful waves and shifting tides, reflecting the same beautiful sunsets, even the same green-blue water. Now imagine a crowd gathered at the shoreline, standing in a big circle, gawking at something that just washed up. Kids tug on their parents’ shirt sleeves, asking questions about the dead creature lying on the sand. Reporters arrive. The story is momentous even if the takeaway isn’t much fun. Everyone knows there used to be fish in the oceans—kind of like the ones that still live in some rivers and lakes, except they could be much bigger, sometimes meaner, more diverse, more colorful, more everything. But those mythical ocean fish all died. Except maybe this one. This one was alive in there, and now it’s dead too.

According to Stanford University paleobiologist Jonathan Payne, an expert in marine mass-extinction events, a scenario where all the ocean's fish, mammals, and other creatures—even tiny animals like krill—are all gone is far from science fiction. The type of die-off that would lead to a largely lifeless ocean has happened before, and we're well on our way to seeing it happen again.

To get into Payne's frame of mind, we have to look at two areas of history. First, there's pre-dinosaur times, where we can find a precedent for the kind of huge-scale extinction we're seeing now. Then, we have to look at the past few hundred years, to understand why our fishless future kind of looks like, uh, the present.

We know that, about 250 million years ago, some extremely bad stuff happened, because almost everything on Earth that was alive at that time died very quickly, taking only a few million years to die off. This event is not to be confused with the meteorite impact that happened 65 million years ago—the one that supposedly wiped out the dinosaurs. That was nothing. A lot of those dinosaurs never went truly extinct; they're now known as "birds," and quite a few mammals made it, and evolved into humans, in pretty short order. This earlier event, the Permian–Triassic Extinction, is frequently called "the Great Dying" by paleontologists who like historical events to sound like Morrissey album titles. It made the Earth pretty quiet for a while—the oceans quietest of all.

In 2017, Payne and several colleagues looked into the source of the aforementioned extremely bad stuff that led to the Great Dying. They concluded that temperature-dependent hypoxia—loss of oxygen due to changes in temperature—caused about 70 percent of the losses. An oddly familiar culprit was fingered for this temperature change: "rapid and extreme climate warming." Payne and his pals weren't the first to draw comparisons between the events leading up to the Great Dying and the changes we're seeing today. A previous study had found that the Great Dying had resulted from rising carbon emissions—caused at that time by geothermal events—that occurred over the span of two to 20 millennia; in other words, the blink of a geological eye.

"The relevant thing we know from these recent results is that the patterns of warming, and loss of oxygen from the ocean that can account for the extinction at the end of the Permian are the same features we're starting to see right now," explained Curtis Deutsch, a chemical oceanographer at the University of Washington and one of Jonathan Payne's colleagues on that 2017 study.

Thanks to our species' multi-pronged and comprehensive approach, humanity's present day "Kill All the Marine Life" project is going extremely well. Here's a quick cheat sheet listing our main strategies:

• We dump several metric tons of plastic garbage into the oceans every year.

• Bottom trawling, or dragging fishing equipment across the seafloor, is turning "large portions of the deep continental slope into faunal deserts and highly degraded seascapes" according to a 2014 report on the long-term effects of this widespread practice.

• The planet is heating up really fast, and the resulting extinctions are happening in real time. (Although, for the record, at this rate it will take a few more centuries for this effect to reach the lifeforms at the deepest depths of the oceans.)

• Ocean acidification—the other major side effect of CO2 emissions besides global warming—is causing countless die-offs, most famously in corals, the backbone of coral reefs, the most biodiverse ecosystems on earth.

• Fertilizer and pesticides poison the ocean, and when combined with the above factors, they help create "dead zones," nearly oxygen-free patches of ocean where almost nothing can live. According to a 2018 paper published in Science magazine, dead zones make up four times as much of the oceans as they did in 1950.

• We eat the sea's living creatures—which is the number-one cause of their declining numbers. There are rates at which we can supposedly fish sustainably—meaning in such a way that we don't run out—but the fishing industry operates in volumes that meet, or surpass the peak equilibrium rate. (Right now, we're hauling up 90 percent of fish stocks globally, according to the UN.) In other words, we're killing as many fish as we possibly can as a byproduct of our industries, and then on top of that, we're also eating as many as we can.

To be clear, the Great Dying wasn't 100 percent caused by warming either. But whatever the cause, 286 out of 329 marine invertebrate genera we know of died back then. All the trilobites and blastoids died, for instance. Every single one! But no one mourns the trilobites and blastoids, and that actually helps illustrate why we fail to grasp that we're annihilating life in the oceans. There's actually a sociological term for this phenomenon: it's called a shifting baseline.

"Shifting baselines" have to do with everyone's gut-level perception of the natural world. The term refers to our tendency to perceive our own early experiences of ecology as the norm, in contrast to what we see later in life. To explain with a non-oceanic example, my own childhood memories of summers in California's Inland Empire include street gutters choked with thousands of California toads. Twenty years later, those toads are mostly gone—likely decimated by chytrid fungus infections. Their loss leaves me with the false impression that the natural order in Southern California has vanished in a very short time, when actually, the damage humanity has caused here is of much longer duration and much larger in scale than the loss of one species of toad (a species that arguably wasn't "supposed to be there" in the first place). Much more serious losses of biodiversity have been rolling out for centuries, but I don't miss animals like the Southern California kit fox, which went extinct over a century ago, because my own baseline never included them.

Similarly, according to Deutsch, we won't collectively care about the death of all the fish, because when it finally happens, our baselines will have shifted so much that the lack of fish will seem normal.

by Mike Pearl, Vice | Read more:
Image: Cathryn Virginia

"Hey, I just got my thousandth follower!"

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Mitch McConnell: The Man Who Sold America

Fittingly enough, it was hot as blazes in Kentucky when Mitch McConnell slunk back home for Congress’ annual summer recess. One week earlier, Robert Mueller had testified that Russia was meddling in the 2020 U.S. elections. McConnell, the Senate majority leader, responded by shooting down Democrats’ efforts to bring two election-security bills to a vote — bills that McConnell, in his familiar fashion, had previously sentenced to quiet deaths after they passed the House. In the hailstorm of opprobrium that followed, McConnell had been tagged by “Morning Joe” Scarborough with the indelible nickname “Moscow Mitch.” The Washington Post’s Dana Milbank called him a “Russian asset.” Twitter couldn’t decide whether he was #putinsbitch or #trumpsbitch. The Kentucky Democratic Party was selling red “Just Say Nyet to Moscow Mitch” T-shirts, emblazoned with an image of the senator’s jowly visage in a Cossack hat, as fast as they could print them up.

McConnell would undoubtedly have preferred to cool his heels in his Louisville home and let the storm subside. But he couldn’t afford that luxury. The biggest political event of the year in Kentucky, the Fancy Farm Picnic, happens on the first Saturday every August, and McConnell knew he had to show his face and speak. Fancy Farm, a 139-year tradition in the tiny western Kentucky town (population 458) it’s named for, is simultaneously one of America’s most charming political gatherings and one of its most brutal. On the one hand, it’s a pint-size Iowa State Fair in a prettier setting with better food, raising money for the local St. Jerome’s Catholic Church. The smoke from hundreds of pounds of pit-cooked mutton and pork barbecue wafts over a small carnival with bands plunking out bluegrass and country standards. Thousands of folks mingle, waving themselves with fans provided by the local candidates who glad-hand their way around the festivities.

But the mood shifts around 2 p.m., when the day’s main entertainment — the “political speaking” — begins. Under a big corrugated shelter, hooting and hollering Republican partisans assemble on the right, Democrats on the left, and candidates for office — joined, almost always, by McConnell — enter to cheers and jeers and seat themselves on a makeshift platform while trying to remember their most cutting quips about their opponents. Speakers at Fancy Farm aren’t supposed to persuade or inform; here, they’re expected to demonstrate, in the finest tradition of old-style Southern politics, that they can deliver zingers that cut the opposition down to size. Heather Henry, the Democrats’ candidate for secretary of state this year, puts it aptly when it’s her turn to face the mob: “It is no coincidence that Fancy Farm happens during Shark Week.”

It’s McConnell’s kind of event, in other words, and he’s done his part over the years to ramp up the partisan rancor. “My favorite year was 1994,” he once told a reporter. “I took a cardboard cutout of Bill Clinton onto the stage and defied the Democrats to come over and have their picture taken with it.” When a congressman took up the challenge, the photo ended up in Republican ads. He lost in November. Last summer, after months of waving through President Trump’s judicial nominees, McConnell opened his remarks with a typically pointed jab — “Father, I’ve been preparing for my visit to the parish by performing as many confirmations as I can” — then stood back, his thin lips curling up slightly into the look of smug satisfaction that happens whenever he’s gotten one over on the liberals.

This year, it was no use. Even before “Moscow Mitch” became a thing, Kentucky Democrats were smelling blood. McConnell has been unpopular in his home state for years, but his approval rating plunged in one poll to a rock-bottom 18 percent — with a re-election campaign looming in 2020. In January, he had raised red flags among Republicans and -Democrats alike when he took a key role in lifting sanctions on Russian oligarch Oleg Deripaska, a Putin ally under FBI investigation for his involvement in 2016 election-meddling; three months later, Deripaska’s aluminum company, Rusal, announced a $200 million investment in Kentucky. A billboard funded by a -liberal group was subsequently erected on a busy stretch of I-75: “Russian mob money . . . really, Mitch?”

More recently, reports emerged that McConnell’s wife, Transportation Secretary Elaine Chao, had set up a pipeline in her department to funnel grants to Kentucky to lift her husband’s political prospects. And as Trump’s trade war with China escalated, uncomfortable old stories began to recirculate about how McConnell “evolved” after he met his future wife in the early Nineties, going from being a fierce China hawk to a potent ally on Capitol Hill. Chao’s father, James — a Chinese American shipping magnate and close friend of former People’s Republic dictator Jiang Zemin — gave McConnell and his wife a huge gift in 2008 that boosted the senator’s net worth from less than $8 million to nearly $20 million. While “Beijing Mitch” doesn’t have quite the same ring as his new moniker, McConnell’s change of heart on Russia was hardly without precedent. (McConnell declined to comment for this story.)

Plus, McConnell made an unusual blunder in July. When a group of former coal miners suffering from black-lung disease caravaned to Washington to ask the senator for help, he met with them for only two minutes, leading to terrible headlines. As Fancy Farm got underway, coal miners in Harlan County were holding a protest that made news throughout the state. Their company had declared bankruptcy without warning and was refusing to pay their final paychecks, and the miners were blocking the tracks to prevent rail cars from shipping $1 million worth of the coal. As the protest stretched into late August, the site became a 24-hour encampment, attracting activists and food donations from around the country, and was visited by nearly every Kentucky politician except McConnell. Practically every story featured the miners cursing the senator. “He’s not pro-coal,” said miner Collin Cornette. “I don’t even think he’s pro-Kentucky.”

Not surprisingly, Democrats and progressive activists swarmed Fancy Farm this year, hopelessly outnumbering the Republicans. Even with a closely contested governor’s race in the offing, most folks came to taunt their senior senator and revel in his troubles. You can’t blame them: For almost four decades, McConnell has been ruthlessly mowing down his opponents with big-money negative campaigns and transforming the GOP into the state’s dominant party. And while many Kentuckians once took pride in having such a mighty mover-and-shaker in Washington, they’ve become increasingly appalled by what he’s done with his power: ensuring that big donors have undue influence in elections, turning Congress into a strictly partisan battlefield, and serving as the indispensable wingman for Trump. The crowd is teeming with Cossack hats and homemade signs with messages like “Putin for senator — cut out the middle man.” Before the speechifying, I run into Bennie J. Smith, a civil-rights activist and jazz musician making a long-shot bid for the Democratic nomination to unseat McConnell, and he assesses the mood: “I’d say the crowd is pretty evenly divided the way Kentucky is: Some don’t like him, and some hate him.”

by Bob Moser, Rolling Stone |  Read more:

Image: Victor Juhasz for Rolling Stone

Trade War Farm Bailout

Trade War Farm Bailout (The Big Picture)

According to Reuters, “the U.S. government will pay American farmers hurt by the trade war with China between $15 and $150 per acre as part of a $16 billion aid package.” Aid is going gone to mostly wealthy corporate farms.

In other words, the cost of the trade war is being borne first by farmers, who lose a major market for their crops, second by taxpayers, who are bailing out the farmers.

[ed. See also: Trump’s $28 Billion Bet That Rural America Will Stick With Him (Bloomberg): "At $28 billion so far, the farm rescue is more than twice as expensive as the 2009 bailout of Detroit’s Big Three automakers, which cost taxpayers $12 billion. And farmers expect the money to keep flowing: In an August survey by Purdue University and the CME Group, 58% said they anticipate another round of trade aid next year."

Marc Lester, ADN
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[ed. These guys are pretty scarce when September rolls around (hunting season).]

Bill Gates: If We Break Up Big Tech, We'll Just Have More Bad Companies

In an interview with Bloomberg, Bill Gates dismissed the idea of breakups as a remedy for Big Tech's monopolistic market concentration; Gates said that breaking up an abusive company will just produce more abusive companies. Instead, Gates believes that specific monopolistic activities should be banned.

Gates has some company in this position: For example EU competition commission Margrethe Vestager (recently blessed with a surprise reappointment) says that attempts to break up Facebook will turn into protracted litigation boondoggles, and instead, she just wants to go on extracting massive fines from tech companies that misbehave (though these fines are also the subject of high-stake litigation).

But it's not just Vestager and Gates: Mark Zuckerberg wants to see regulation for Facebook. He says that clear rules will help him steer his company without daily, ghastly scandals.

The problem with this model is that expensive, difficult-to-implement compliance rules are tantamount to permanent licenses to dominate the internet: if you have to be a giant to afford to comply with the law, then we'll only get giants.

The other problem is that giants who extract monopoly profits from their suppliers and customers have plenty of money left over to lobby governments to let them get away with progressively worse behavior (which improves their profitability, leaving more money to lobby with, lather, rinse, repeat). This is why the first trustbusters focused on breaking up the giant companies (which were run by executives who were no less wicked than Big Tech's supposedly benevolent dictators): they didn't just want to have fairer, more competitive markets, they wanted to hamstring the industries' ability to corrupt democratic governance.

Gates is practicing a form of tech exceptionalism here: implicit in his view is that tech is intrinsically corrupting, and that the companies behave badly because it is in their nature to do so, not because we let them get away with it.

But he should know better. Tech's rise coincided precisely with the decline of antitrust enforcement (literally: Ronald Reagan hit the campaign trail the same year the Apple ][+ went on sale, and one of his first acts after the election the next year was to gut antitrust enforcement).

Companies that had been around for a while either had first-hand experience of the truly unpleasant experience of being targeted for antitrust enforcement, or had watched it happen to others close up. Senior counsel for these companies trained juniors to warn execs that monopolistic behavior would produce brutal, extended legal trouble.

But not tech: the fresh Stanford Law grads who went to work for the startups their EE and Comp Sci colleagues had dropped out to found had not direct experience of antitrust, and when the execs they worked for proposed monopolistic conduct that would have been severely punished under pre-Reagan antitrust, these lawyers did not pump the breaks -- they hit the gas-pedal. And every time they did this, they were rewarded: the companies they worked for enhanced their profits by buying or crushing nascent competitors, by merging with major rivals, by cornering entire vertical markets. Corporate counsel went from being the adult supervision in board-rooms full of unexceptionally greedy and atavistic executives to being enthusiastic enablers of these execs' worst impulses.

Cue the Microsoft antitrust investigation. Bill Gates put in a legendarily terrible performance for his deposition, one of the first-ever corporate depositions to be video-recorded and released to the public, going viral as best as it could given the technology of the day. The sight of Gates, stimming and rocking and displaying belligerent arrogance with every word, was deeply traumatic to both Gates and Microsoft's executives.

Microsoft insider accounts claim that this traumatic experience, as well as the years and millions Microsoft spent fighting the DoJ (successfully, for the most part) changed the microeconomics of Microsoft's decision-making. Like every other large institution, Microsoft is (and was) composed of people with a variety of views on the wisdom and fairness of different courses of action, but the people who'd argued for monopolistic conduct had won every argument, because whenever the company followed their advice, it grew more profitable and faced no consequences.

But, after having faced lengthy antitrust action that was both personally and financially traumatizing, the naysayers in the board room gained a powerful new argument: "If we do this, they'll put Bill back on the stand."

Those same Microsoft insiders say that this caution is what allowed Google to emerge, without being crushed using the underhanded, unethical, monopolistic tactics Microsoft used on every other upstart that threatened its dominance.

This effect wasn't confined to Microsoft, either: for a brief moment in the early 2000s, the whole industry discovered a new forebearance, during which the ecosystem became more diverse, weirder, more interesting and more competitive than it had ever been, before or since.

(This same dynamic may be the reason that the IBM staffers who argued that the first PCs should be built from commodity components, and that Phoenix should be left in peace to clone its ROM chips won their arguments, despite IBM's usual practice of building systems out of proprietary components and subcomponents, and the bullying, monopolistic tactics that mired them in DoJ litigation for more than a decade, at the end of which the company produced its first PC)

Gates wants us to believe that Tech is Different, and that anyone who runs a tech company will be so intrinsically rapacious and villainous that they will behave as he did when he was growing Microsoft; but the reality is that Gates and his fellow monopolists past and present are totally unexceptional in their willingness to cheat and bully their way to dominance. They're no less and no more rotten than Carnegie or Rockefeller or the Sacklers. The thing that let these garden-variety sociopaths get away with their bad behavior was not their exceptional brilliance: it was the state's deliberate decision to let them get away with it.

Gates's prescription is for governments and tech companies to create state monopolies, a new kind of industrial constitutional monarchy, in which companies like Microsoft (and Apple, Google, Facebook, Amazon, Oracle, etc) are guaranteed eternal rule over their sectors, in exchange for suffering themselves to be draped in golden chains by a regulatory aristocracy drawn from their own executive ranks, who will ask them to exercise noblesse oblige and throw some crumbs to us peasants laboring in their digital fields.

But even if breakups take a long time and even fail in the end, they're still worth pursuing. DoJ antitrust litigation changes the way companies operate, puts them on their best behavior and puts a giant thumb on the scales for the internal angels of the companies' better natures when they joust with their amoral board-room rivals.

by Cory Doctorow, Boing Boing |  Read more:
Image: YouTube

Aliens Win Again

The secrets of Area 51, the highly classified Air Force facility long rumored to house extraterrestrial artifacts, remain unseen.

Despite millions responding to the public Facebook event "Storm Area 51, They Can't Stop All of Us," Nevada authorities say about 40 people gathered at the gates before being confronted and dispersed by law enforcement.

According to the Lincoln County Sheriff's office, one arrest was made — not for an attempt at freeing an alien, but for public urination.

'Storm Area 51' Fails To Materialize (NPR)

Image: John Locher/AP
[ed. See also: I 'stormed' Area 51 and it was even weirder than I imagined (The Guardian).]

Across the Globe, Millions Join Biggest Climate Protest Ever

Millions of people demonstrated across the world yesterday demanding urgent action to tackle global heating, as they united across timezones and cultures to take part in the biggest climate protest in history.

In an explosion of the youth movement started by the Swedish school striker Greta Thunberg just over 12 months ago, people protested from the Pacific islands, through Australia, across-south east Asia and Africa into Europe and onwards to the Americas.

For the first time since the school strikes for climate began last year, young people called on adults to join them – and they were heard. Trade unions representing hundreds of millions of people around the world mobilised in support, employees left their workplaces, doctors and nurses marched and workers at firms like Amazon, Google and Facebook walked out to join the climate strikes.

In the estimated 185 countries where demonstrations took place, the protests often had their individual targets; from rising sea levels in the Solomon Islands, toxic waste in South Africa, to air pollution and plastic waste in India and coal expansion in Australia.

But the overall message was unified – a powerful demand for an urgent step-change in action to cut emissions and stabilise the climate.

The demonstrations took place on the eve of a UN climate summit, called by the secretary general, António Guterres, to inject urgency into government action to restrict the rise in global temperatures to 1.5C, as agreed under the 2015 Paris agreement.

Carbon emissions climbed to a record high last year, despite a warning from the UN-backed Intergovernmental Panel on Climate Change that there is little more than a decade left to act to slash emissions and stabilise the climate.

Donald Trump will be at the UN headquarters during Monday’s key summit on the climate crisis – but will be there to take part in a meeting on religious freedom instead, in what will be seen by many as a snub.

On Friday, the voices of key political leaders were noticeable by their absence. Instead it was a day for people to set forth their demands, ranging from a ban on new mining in countries like South Africa and Australia, to a “green new deal” in the UK and US to better air quality and more trees in countries like India.

“We are out here to reclaim our right to live, our right to breathe and our right to exist, which is all being denied to us by an inefficient policy system that gives more deference to industrial and financial objectives rather than environmental standards,” said Avinash Chanchal, a young protester in Delhi.

Asia-Pacific

The action began in the Pacific Islands, where citizens have repeatedly asked wealthier nations to do more to prevent rising sea levels. Over the course of the day children and students from Fiji, Samoa, Vanuatu, Kiribati, Tuvalu, Marshall Islands, Tonga, New Caledonia, the Solomon Islands and Papua New Guinea took part in poetry performances, silent protests, sporting events and discussions. Students held placards in Kiribati and chanted: “We are not sinking, we are fighting.”

The demonstrations spread across Australia – the world’s biggest exporter of coal and liquid natural gas – where more than 300,000 people took to the streets in 100 rallies, prompting a tweet from Thunberg – awake in New York – that the “huge crowd” would set the standard.

The Australian finance minister, Mathias Cormann, had said on Thursday that students should stay in class rather than go on strike.

In a retort, Danielle Porepilliasana, a Sydney high school student said: “World leaders from everywhere are telling us that students need to be at school doing work. I’d like to see them at their parliaments doing their jobs for once.”

by Sandra Laville and Jonathan Watts, The Guardian| Read more:
Image: Asanka Ratnayake/Getty Images

[ed. Because adults won't lead on climate change, gun control, or anything else. See also: Trump to snub climate summit for religious freedom meeting at UN (The Guardian).]

Andrey Shpatak, Japanese Warbonnet (Chirolophis japonicus).
via:

Hans Hartung, T1936-2, 1936

via:

Crow Native Americans watching the rodeo at Crow fair in Montana, 1941
via:

David Byrne

Well the wind so strong, it’s blown us all around
Wind so strong, nobody settle down
Ev'ryday another apocalypse
Had a TV but I don’t know how deep it is

Lyrics

California’s Luxury Dining Circuit: Delicious and Dull

Late in the summer, late in the afternoon, I woke from a nap by a glittering pool. Over the last few days in California wine country, I had eaten macaroni and cheese out of a golden egg and broken into a juicy quenelle of caviar over softly set custard. I had drawn slices of aged beef, so tender it barely required chewing, through a sticky, peppery Cognac sauce and rinsed, after dessert, before petits fours, with a glug of Sauternes.

In other words, I had reached my final form and stepped into the old stereotype of the restaurant critic, driving a rental car through wine country, racking up the expenses. And I was feeling sedated by this ideal of luxury: technically flawless, incredibly expensive and, in the end, somewhat predictable.

For decades, the region’s hospitality business has grown alongside its wine industry, and tourists have come here for the small towns and extreme leisure — restaurants, golf courses, spas — and maybe the odd novelty magnet that says “Wine Time” in wiggly letters.

When I woke up and checked my schedule, it was, in fact, wine time. It was always wine time.

Few parts of the country have such a concentration of this nostalgic genre of fine dining: grand destination restaurants with big reputations, extravagant food and deep wine cellars. When Michelin released its 2019 guide to California dining in June, the tire company’s anonymous inspectors awarded three restaurants in the area three stars each, the highest rating, suggesting they were “worth a special journey.”

by Tejal Rao, NY Times | Read more:
Image: Preston Gannaway for The New York Times

The Black Swan Is a Drone

What was "possible" yesterday is now a low-cost proven capability, and the consequences are far from predictable.

Predictably, the mainstream media is serving up heaping portions of reassurances that the drone attacks on Saudi oil facilities are no big deal and full production will resume shortly. The obvious goal is to placate global markets fearful of an energy disruption that could tip a precarious global economy into recession.

The real impact isn't on short-term oil prices, it's on asymmetric warfare: the coordinated drone attack on Saudi oil facilities is a Black Swan event that is reverberating around the world, awakening copycats and exposing the impossibility of defending against low-cost drones of the sort anyone can buy.

(Some published estimates place the total cost of the 10 drones deployed in the strike at $15,000. Highly capable commercially available drones cost around $1,200 each.)

The attack's success should be a wake-up call to everyone tasked with defending highly flammable critical infrastructure: there really isn't any reliable defense against a coordinated drone attack, nor is there any reliable way to distinguish between an Amazon drone delivering a package and a drone delivering a bomb.

Whatever authentication protocol that could be required of drones in the future--an ID beacon or equivalent--can be spoofed. For example: bring down an authenticated drone (using nets, etc.), swap out the guidance and payload, and away it goes. Or steal authentication beacons from suppliers, or hack an authenticated drone in flight, land it, swap out the payload--the list of spoofing workaround options is extensive.

This is asymmetric warfare on a new scale: $20,000 of drones can wreak $20 million in damage and financial losses of $200 million--or $2 billion or $20 billion, if global markets are upended.

If it's impossible to defend against coordinated drone attacks, and impossible to differentiate "good" drones from "bad" drones, then the only reliable defense is to ban drones entirely from wide swaths of territory.

So much for the lightly regulated commercialization of drones.

What sort of light bulbs are going off in the minds of copycats? It doesn't take much imagination to see the potential for mayhem--and without sacrificing your own life. I won't elaborate on the possibilities here, but they're obvious to us all.

The range and payload of low-cost drones is limited. The big drones can fly hundreds of miles and carry hundreds of pounds of weaponry, but these can be targeted by radar and conventional ground-to-air missiles. So-called hobby drones skimming over the rooftops (or deserts or forests) are difficult to shoot down, especially if the attack is coordinated to arrive from multiple directions.

Small hobby drones may only carry 3 KG (roughly 6 pounds), but how much damage can 3 KG of high explosives cause? The answer is "considerable" if the target is flammable, or lightly shielded electronics.

Larger commercially available drones can carry up to 20 KG or 40 pounds--more than enough explosive capacity to take out any number of targets.

Defense and intelligence agencies have no doubt war-gamed the potential for coordinated drone attacks, and the world's advanced militaries are already exploring the potential for self-organizing "drone hordes" of hundreds or even thousands of drones overwhelming defenders with sheer numbers. The success of the oil facilities attack proves the effectiveness of much smaller scale drone attacks.

Put yourself in the shoes of those tasked with securing hundreds of miles of pipelines carrying oil and natural gas around the world. What's your defense against drone attacks? A.I.-controlled or remote-operated gun towers every few hundred yards, along thousands of miles of pipelines? Human patrols covering the entire pipeline 24/7? The cost of such defenses would burden the defenders with enormous costs without providing 100% reliable security.

by Charles Hugh Smith, Oftwominds.com |  Read more:
Image: via

Losing The Narrative Battle Over Iran

I’m expected to write something about the Trump administration’s warmongering against Iran over an attack on a Saudi oil refinery, because that’s typically what I do in this ongoing improvisational exercise of mine: I write about the behavior of the US war machine and the propaganda that is used to bolster it. It’s what my readers have come to expect. But honestly I find the whole thing extremely tedious and I’ve been putting off writing about it for two days.

This is because from a propaganda analysis point of view, there’s really not much to write about. The Trump administration has been making bumbling, ham-fisted attempts at manufacturing public support for increasing aggressions against Iran since it initiated withdrawal from the JCPOA a year and a half ago, yet according to a Gallup poll last month Americans still overwhelmingly support diplomatic solutions with Tehran over any kind of military aggression at all. In contrast, most Americans supported a full-scale ground invasion of Iraq according to Gallup polls taken in the lead-up to that 2003 atrocity. With the far less committed Libya intervention, it was 47 percent supportive of US military action versus 37 percent opposed.

That’s the kind of support it takes to get a US war off the ground these days. And it’s going to take a lot more than a busted Saudi oil refinery to get there, even in the completely unproven event that it was indeed Iran which launched the attack.

The reason I’m able to spend so much time writing about war propaganda as part of my job is because war propaganda is happening constantly, and the reason war propaganda is happening constantly is because it’s absolutely necessary for the perpetuation of the US-centralized empire’s slow-motion third world war against unabsorbed governments. In other words, the propaganda apparatus of the empire works constantly to manufacture consent for military aggressions because it absolutely requires that consent.

When I say that the imperial war machine requires public consent before it can initiate overt warfare, I’m not saying that the US government is physically or legally incapable of launching a war that the public disapproves of, I’m saying that it is absolutely essential for the drivers of empire to preserve the illusion of freedom and democracy in America. People need to feel like their government is basically acting in everyone’s best interest, and that it is answerable to the will of the electorate, otherwise the illusion of freedom and democracy is shattered and people lose all trust in their government and media. If people no longer trust the political/media class, they can’t be propagandized. Without the ability to propagandize the masses, the empire collapses.

So out of sheer self-interest, establishment power structures necessarily avoid overt warfare until they have successfully manufactured consent for it. If they didn’t do this and chose instead to take off the nice guy mask, say “Screw you we’re doing what we want,” and start butchering Iranians at many times the cost of Iraq in both money and in American lives lost, people would immediately lose trust in their institutions and the narrative matrix which holds the whole thing together would crack open like an egg. From there revolution would become an inevitability as people are no longer being successfully propagandized by the establishment narrative managers into believing that the system is working fine for everyone.

Think about it: why else would the mass media be churning out propaganda about disobedient governments like Iran, Venezuela, Syria, Russia and China if they didn’t need to? They need the citizenry they’re charged with manipulating to consent to important geostrategic imperialist maneuvers, or they’ll break the hypnotic trance of relentless narrative control. And make no mistake, maintaining narrative control is the single highest priority of establishment power structures, because it’s absolutely foundational to those structures.

This is why the warmongers have been favoring economic warfare over conventional warfare; it’s much easier to manufacture support for civilian-slaughtering starvation sanctions. It’s slower, it’s sloppier, and it’s surely a lot less fun for the psychopaths in charge, but because the public will consent to economic sanctions far more readily than ground invasions or air strikes, it’s been the favored method in bringing disobedient governments to their knees. That’s how important manufacturing consent is.

So a bunch of drama around a Saudi oil refinery isn’t going to do the trick. The US government is not going to leap into an all-out war which would inevitably be many times worse than Iraq based on that, because they can’t manufacture consent for it right now. All they’re trying to do is escalate things a bit further with the goal of eventually getting to a point where Iran either caves to Washington’s demands or launches a deadly attack, at which point the US can play victim and the mass media can spend days tearfully running photos of the slain US troops. If that happens they might gain their consent from the public. If not, we may see them get a little more creative with their “crisis initiation”.

Until then this is a whole lot of noise and very little signal, which is why I find this current circus uninteresting to write about. It seems like every week now the Trump administration is trotting out some new narrative with the help of the mass media explaining why the Iranian government is evil and must be toppled, and nobody buys it because it’s on the other side of the damn planet and it’s always about something silly like oil or broken drones. Their unappealing pestering about this is starting to remind me of a really awkward loser who’s constantly asking out the prettiest girl in the office over and over again; you just want to pull him aside and say dude, stop. She’s just not into you.

by Caitlin Johnstone, Medium |  Read more:

Against Against Pseudoaddiction

“Pseudoaddiction” is one of the standard beats every article on the opioid crisis has to hit. Pharma companies (the story goes) invented a concept called “pseudoaddiction”, which looks exactly like addiction, except it means you just need to give the patient more drugs. Bizarrely gullible doctors went along with this and increased prescriptions for their addicted patients. For example, from a letter in the Wall Street Journal:

Parroting Big Pharma’s excuses about FDA oversight and black-box warnings only discounts how companies like Johnson & Johnson engaged in pervasive misinformation campaigns and even promoted a theory of “pseudoaddiction” to encourage doctors to prescribe even more opioids for patients who displayed signs of addiction.

Or from CBS:

But amid skyrocketing addiction rates and overdoses related to OxyContin, Panara claimed the company taught a sales tactic she now considers questionable, saying some patients might only appear to be addicted when in fact they’re just in pain. In training, she was taught a term for this:“pseudoaddiction.” 

“So the cure for ‘pseudoaddiction,’ you were trained, is more opioids?” Dokoupil asked. 

“A higher dose, yes,” Panara said. 

“Did this concept of pseudoaddiction come with studies backing it up?” 

“We had no studies. We actually — we did not have any studies. That’s the thing that was kind of disturbing, was that we didn’t have studies to present to the doctors,” Panara responded. 

“You know how that sounds?” Dokoupil asked. 

“I know. I was naïve,” Panara said. (...)

Let me confess: I think pseudoaddiction is real. In fact, I think it’s obviously real. I think everyone should realize it’s real as soon as it’s explained properly to them. I think we should be terrified that any of our institutions – media, academia, whatever – think they could possibly get away with claiming pseudoaddiction isn’t real. I think people should be taking to the streets trying to overthrow a medical system that has the slightest doubt about whether pseudoaddiction is real. If you can think of more hyperbolic statements about pseudoaddiction, I probably believe those too.

Neuroscientists define addiction in terms of complicated brain changes, but ordinary doctors just go off behavior. The average doctor treats “addiction” and “drug-seeking behavior” as synonymous. This paper lists signs of drug-seeking behavior that doctors should watch out for, like:

– Aggressively complaining about a need for a drug
– Requesting to have the dose increased
– Asking for specific drugs by name
– Taking a few extra, unauthorised doses on occasion
– Frequently calling the clinic
– Unwilling to consider other drugs or non-drug treatments
– Frequent unauthorised dose escalations after being told that it is inappropriate
– Consistently disruptive behaviour when arriving at the clinic

You might notice that all of these are things people might do if they actually need the drug. Consider this classic case study of pseudoaddiction from Weissman & Haddox, summarized by Greene & Chambers:

The 1989 introduction of pseudoaddiction happened in the form a single case report of a 17-year-old man with acute leukemia, who was hospitalized with pneumonia and chest wall pain. The patient was initially given 5 mg of intravenous morphine every 4 to 6 h on an as-needed dosing schedule but received additional doses and analgesics over time. After a few days, the patient started engaging in behaviors that are frequently associated with opioid addiction, such as requesting medication prior to scheduled dosing, requesting specific opioids, and engaging in pain behaviors (e.g., moaning, crying, grimacing, and complaining about various aches and pains) to elicit drug delivery. The authors argued that this was not idiopathic opioid addiction but pseudoaddiction, which resulted from medical under-treatment (insufficient opioid dosing, utilization of opioids with inadequate potency, excessive dosing intervals) of the patient’s pain. In describing pseudoaddiction as an “iatrogenic” syndrome, Weissman and Haddox inverted the traditional usage of iatrogenic as harm caused by a medical intervention. In pseudoaddiction, iatrogenic harm was described as being caused by withholding treatment (opioids), not by providing it.

Greene & Chambers present this as some kind of exotic novel hypothesis, but think about this for a second like a normal human being. You have a kid with a very painful form of cancer. His doctor guesses at what the right dose of painkillers should be. After getting this dose of painkillers, the kid continues to “engage in pain behaviors ie moaning, crying, grimacing, and complaining about various aches and pains”, and begs for a higher dose of painkillers.

I maintain that the normal human thought process is “Since this kid is screaming in pain, looks like I guessed wrong about the right amount of painkillers for him, I should give him more.”

The official medical-system approved thought process, which Greene & Chambers are defending in this paper, is “Since he is displaying signs of drug-seeking behavior, he must be an addict trying to con you into giving him his next fix.” They never come out and say this. But they define pseudoaddiction as meaning not that, and end up saying “in conclusion, we find no empirical evidence yet exists to justify a clinical ‘diagnosis’ of pseudoaddiction.” More on this later.

The concept of “pseudoaddiction” was invented as a corrective to an all-too-common tendency for doctors to assume that anyone who seems too interested in getting more medications is necessarily an addict. It was invented not by pharma companies, but by doctors working with patients in pain, building upon a hundred-year-long history of other doctors and medical educators trying to explain the same point.

And in case you think this is a weird ivory tower debate that doesn’t influence real clinical practice, I offer you these cases from my own experience. Stories slightly changed or merged together to protect patient privacy:

Case 1: Mary is an elderly woman who undergoes a surgery known to have a painful recovery process. The surgeon prescribes a dose of painkillers once every six hours. The painkillers last four hours. From hours 4-6, Mary is in terrible pain. During one of these periods, she says that she wishes she was dead. The surgeon leaps into action by…calling the on-call psychiatrist and saying “Hey, there’s a suicidal person on my ward, you should do psychiatry to her or something.” I am the on call psychiatrist. After a brief evaluation, I tell the surgeon that Mary has no psychiatric illness but needs painkillers every four hours. The surgeon lectures me on how There Is An Opioid Crisis, Y’Know, and we can’t negotiate with addicts and drug-seekers. I am a consultant on the case and can’t overule the surgeon on his own ward, so I just hang out with Mary for a while and talk about things and distract her and listen to her scream during the worst part of the six-hour cycle. After a few days the surgery has healed to the point where Mary is only in excruciating pain rather than actively suicidal, and so we send her home.

Case 2: Juan is a middle-aged man with depression who is using Geodon for antidepressant augmentation. This is kind of a weird choice, and has theoretical potential to interact poorly with some of his other medications, but nothing else has worked for him and he’s done great for ten years. He switches psychiatrists. The new psychiatrist is really worried about the theoretical interaction, so he tells him that he can’t take Geodon anymore and switches him to something else. Juan falls into a deep depression. He asks to have Geodon back and the doctor says no. Juan yells at the psychiatrist and says he is ruining his life. The psychiatrist diagnoses him with a personality disorder and anger management problems, and tells him to attend therapy. Juan actually does this for a while, but eventually wises up and switches doctors to me. I put him back on Geodon and within a month he’s doing great again. Note that Juan displayed every sign of “drug-seeking behavior” even though Geodon is not addictive.

Case 3: This one courtesy of Zvi. Zvi’s friend is diabetic. He runs out of insulin and asks his doctor for more. The doctor wants to wait until his next free appointment in a few weeks before prescribing the insulin. Zvi’s friend points out that he will die unless he gets more insulin now. The doctor gets very angry about this and spends a long phone call haranguing Zvi’s friend about how inconvenient it is that he’s demanding the insulin now rather than at a more convenient time. Zvi’s friend has to threaten the doctor with a lawsuit before the doctor finally relents and gives him the insulin. I like this story because, again, insulin is not addictive, there is no way that the patient could possibly be doing anything wrong, but the patient still gets treated as a drug-seeker. The very act of wanting medication according to the logic of his own disease, rather than at the doctor’s convenience, is enough to make his request suspicious.

Case 4: John is a 70 year old man on opioids for 30 years due to a mining-related injury. He is doing very well. I am his outpatient psychiatrist but I only see him once every few months to renew meds. He gets some kind of infection, goes to the hospital, and due to normal hospital incompetence he doesn’t get his opioids. He demands his meds, and like many 70 year old ex-miners in terrible pain, he is not diligently polite the whole time. The hospital doctors are excited: they have caught an opioid addict! They tell his family and outpatient doctors he cannot have opioids from now on, then discharge him. He continues to be in terrible pain. At first he sneaks pills from an extra bottle of opioids he has at home, but eventually he uses all those up. After this, he is still in terrible pain with no reason to expect this to ever change, and so he quite reasonably shoots himself in the chest. This is the first point in this entire process at which anyone attempts to tell me any of this is going on, so I get a “HEY DID YOU KNOW YOUR PATIENT SHOT HIMSELF? DOESN’T SEEM LIKE YOU’RE DOING VERY GOOD PSYCHIATRIST-ING?” call. The patient miraculously survives, eventually finds a new pain doctor, and goes on to live a normal and happy life on the same dose of opioids he was using before.

Let’s look at those warning signs of addiction again:

– Aggressively complaining about a need for a drug
– Requesting to have the dose increased
– Asking for specific drugs by name
– Taking a few extra, unauthorised doses on occasion
– Frequently calling the clinic
– Unwilling to consider other drugs or non-drug treatments
– Frequent unauthorised dose escalations after being told that it is inappropriate
– Consistently disruptive behaviour when arriving at the clinic

In Case 1, Mary requested her dose of painkiller be increased (from once per six hours to once per four hours). In Case 2, Juan asked for a specific drug by name (Geodon), and was unwilling to consider other drugs. In Case 3, Zvi’s friend frequently called the clinic (to get them to refill his insulin). In Case 4, John showed consistently disruptive behavior in the hospital and took extra unauthorized doses. Etc.

All of these are drug-seeking behaviors. But I maintain that none of these patients were addicted. The correct action in all of these cases is to listen to the patient’s reasons for wanting the drug, realize that you (the doctor) screwed up, and give them the drug that they are asking for. Although the point that these behaviors can be signs of addiction is well-taken and important, it’s equally important to remember they can be signs of other things too.

Media portrayals of pseudoaddiction portray it as this bizarre contortion of logic: “A patient is displaying signs of addiction, so you should give them more of the drug! Haha, nice try, pharma companies!” But this is exactly what you should do! The real problem lies with anyone who conceptualizes pseudoaddiction as a novel hypothesis that requires proof, rather than as the obvious possibility you have to check for before accusing patients of addiction. (...)

As far as I can tell, the concept started off well-intentioned. But painkiller companies realized that the debate over when to diagnose addiction vs. pseudoaddiction was relevant to their bottom line, and started funding the pseudoaddiction side of it.

I’m not sure how substantial an effort this was. G&C note that of 224 papers mentioning pseudoaddiction, 22 were sponsored by pharma (but that means 202 weren’t). Of a stricter category of 12 papers that focused on arguing for the concept, 4 were sponsored by pharma (but 8 were not). Taking their numbers at face value, the majority of discussion of pseudoaddiction had no pharma company sponsorship. But the image of an expert getting up in front of a medical conference and telling doctors that the solution to opioid addiction was more opioids – something that certainly did happen, I’m not sure how often – was so lurid that it burned itself into the popular consciousness. The media exaggerated this from “basically good idea gets misused” to “doctors invent vicious lies to addict your loved ones” to get more clicks. Experts didn’t want to be the guy saying “well actually” in the middle of an Opioid Crisis, so they kept their mouths shut. Reporters copied each others’ denunciations of ‘pseudoaddiction’ without checking what the term really meant.

Into all this came the drug warriors. It’s hard for me to be angry at addictionologists, because they have a terrible job and are probably traumatized by it. But they really hate drugs and will say whatever it takes to make you hate drugs too. These are the people who gave us articles on how one hit of marijuana will get you addicted forever and definitely kill you, how one hit of LSD will make you go crazy and get addicted and probably kill you, how there can never be any legitimate medical reason for using cannabis, how e-cigarettes are deadly poison, and other similar classics. Sensing that they had the high ground, they wrote a couple of papers about how pseudoaddiction isn’t “empirically proven”, as if this were a meaningful claim. This gave the media the ammunition they needed to declare that pseudoaddiction was always pseudoscience and has now been debunked and well-refuted.

This is just my story, and it’s kind of bulverist. But if you think it’s plausible, I recommend the following lessons:

First, when the media decides to craft a narrative, and the government decides to hold a moral panic, arguments get treated as soldiers. Anything that might sound like it supports the “wrong” side will be mercilessly debunked, no matter how true it is. Anything that supports the “right” side will be celebrated and accepted as obvious, no matter how bad its arguments. Good scientists feel afraid to speak up and question the story, lest they be seen as “soft on the Opioid Crisis” or “stooges of Big Pharma”. This happens again and again on any issue people care about, and I want to reiterate for the nth time that you should treat reporting on medical, scientific, and social scientific topics as having almost zero credibility.

Second, you should stay cautious about bias arguments. Yes, some people pushed pseudoaddiction because they were shills of the opioid companies. But other people pushed pseudoaddiction because it was true. Just because you can generate the hypothesis “maybe people are just shills of the opioid companies” doesn’t mean you’ve disproven pseudoaddiction. And if you focus too hard on the opioid companies’ obvious financial bias, then you’ll miss less obvious but possibly more important biases like those of the drug warriors. Your best bet would have been to just stop worrying about biases and try to figure out what was actually true.

by Scott Alexander, Slate Star Codex |  Read more:
[ed. For an excellent up-to-the-minute example of the opioid hysteria (and political posturing) making people's lives miserable, see also: US attack on WHO 'hindering morphine drive in poor countries' (The Guardian).]

Moose Run Creek Course, AK
Image: markk