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Social evils- Causes and eradication
Zuifikar Ali Shah Zulfi
President shia imami and ismaili local council Booni has
given me this tough job to write an assignment on the causes and solutions of social evils which are in one form or the other crippling in our society particularly among our jamat. Though it is a very difficult task for me to tell about things that I am not aware of. As a student of science I have no approach to the subject concerned__sociology or social sciences but as a member of the society I have the responsibility to study social events around me. I have tried my best to pinpoint the causes and solutions of social evils up to some extent.
I think that to some extent this assignment will benefit in making further plans and strategies to eradicate these evils from the society.
Social evils are the acts which are undesired and harmful to the society. It is an instinct of the human nature to adopt them readily. The history of social evils is as old as human history itself. They are prevailing in every nook and corner of the world from time immemorial. Some acts which are considered as evil today were the part of human civilization. Alcoholism , smoking , illicit relation with women or men are some of them. Even today in some societies of the world there are many evils which are considered as legal. In Britain, Germany and many other European countries marriage between the men and men and women and
women are allowed on government levels. Lesbians and gays are demanding their basic rights. Alcoholism and sexual freedom are not the crimes at all in many non Muslim countries. In Islam all those acts are unlawful and those who are committing these are criminals.
There are many factors which are involved in creating various kind of social evils. Drug abuse is one among many types of social evils. Islam and other systems of life prohibit this evil but, unfortunately, this land and it’s people are being gradually involved by one of the worst social evil that of drug abuse.
In medical science drugs are those chemical substances which are abused or taken for the sake of just getting euphoric. They cause many physiological disorders in men and animals. Nicotine in tobacco, morphine in opium codeine and alcoholic barbiturates are all categorized as drugs. In the long run they effect the entire body of an organism.
CAUSES OF DRUG ABUSE
1. Increase availability of drugs in market.
2. Socioeconomic factors.
3. Changes in attitude and values towards society, family, community, religion
and morality.
4. Poverty and unemployment.
ADVERSE EFFECTS OF DRUG ABUSE
1. Reduction in life expectancy.
2. Premature birth.
3. Heart attack and other cardiovascular disease.
4. Lung and liver cancer.
5. Rise in blood pressure and contraction of blood vessels.
6. Road accidents by drunken drivers.
7. Loss of memory and other neurological diseases.
Drug abuse or substance abuse can be minimized of completely eradicated if substantial measures are taken. This responsibilities fall on each and every member of the society especially those who are responsible. Our jamati leaders, religious scholars, teachers and educated member of the community can play their role in this regard. The most important thing is awareness among the people especially the young generation who are vulnerable. But the important thing is the individual itself. No law or rule is forcibly imposed unless an individual itself has no sense.
Those who are involved in such business pretend that they have no alternate way earn money. Such peoples should be kept busy and provided them with the basic needs of daily life like food, shelter and home.
Secondly the availability of drugs in local markets should be discouraged. If someone are found guilty they must be punished according to the law. It is a common practice here in our area that after arresting some criminals the influential peoples go to the police station and get them free on their personal guarantee. This practice gives a bad impression and the peoples doubt about the involvement of these individuals in such crimes.
Another point in this regard is that people should be persuaded not to use drug and this impression should be established that our body is the temple or dwelling place of the holy spirit and this holy place should not be contaminated with drugs or any other sin. “Alcohol promises heaven, alcohol bestows hell.”
EXPENSIVE WEDDING
In our society even those who are religious minded, get caught up in this
problem. They do not want to do it , but feel they have to do it to be accepted socially.
The bride and bridegroom wear their bridal attire for a few hours on one day , and never wear the outfits again and yet so much money is spent on their wedding. Wedding these days has become exorbitant function. The rich exhibit their wealth and opulence on such occasion. Every such occasion tremors among the deprived class of the society. As it is observed that the poor class of our society totally depends on bank loan to perform such ceremonies. This depicts how wrong we peoples in setting our priorities, and how our values have changed. Even our leaders (religious, social and political) find it difficult to follow the spirit of Islam.
As the followers of one imam we have diverted from our real path and there is no destiny at last. When it comes to social custom and tradition we forget every command and order of our beloved imam e zaman. Islam
discourages all activities in which money is spent needlessly.
Since social functions in particular set trends, they should be as simple as possible. Wedding foods, gift, apparels, bridal dresses should all be within reasonable limit. If they remain in such limits, they add to the beauty of the occasion, and if they exceed their bounds, they become symbols of human greed and arrogance.
The best define able point of needless expenses and overspendings in such ceremonies is a person’s own conscience. No one else is better judge. The ismaili council can also legislate in this regard. However all large scale social evils should be tackled through educating peoples and changing their mindset. Law are just preventive measures. They do not change the people’s mind.
Education is the treatment of all social evils. We are at war against illiteracy and ignorance.
SOLUTIONS TO THE SOCIAL PROBLEMS
A perusal of the social problem that effect mankind today indicates that it is not the nature of social problem itself , but the level of their operation which causes the changes. The exploitation of man by man. The root cause being the same no matter what may be the level of any particular social evil. The root cause for the imperfect weaving of the social web is irresponsible conduct on the part of the man.
The responsible government , at any level , can never develop unless there are responsible citizens. The institution which constitute the government represent only a small part , other institution like schools, homes, religious centres, voluntary organizations etc form a much greater part of the social activities.
The truth is that every individual is responsible in his own sphere for the
welfare of the community at large. The holy prophet(PBUH) has put the whole matter in a nutshell. “Every one of you is a steward and is accountable for that which is committed to his charge.”
The solution, accordingly , requires two things: first purification of man’s
ego and second the indoctrination of the sense of responsibility for the welfare of all. The real solution therefore lies in the unfolding of true human nature and in educating the masses in the truth that universal brotherhood can be established by virtue of mankind’s relationship with one another through God.
Zuifikar Ali Shah Zulfi
VILLAGE DOKANDEH,
BOONI, CHITRAL.
phone#0933-470232
[email protected]
Social Evils
Wasteful Expenditure
It is a very illuminating analysis of the problems and solutions of the Jamat in the Northern Areas of Pakistan and indeed of Jamat in Central Asia. What particularly surprises me is the wasteful expenditure on weddings inspite of the widespread poverty and suffering around. This clearly demonstrates that the attraction to materialism,greed, pride, desire to showoff wealth is not really a function of external environment, rather, it is an attitude of mind. On the one hand, one could have the most materialistic outlook of life while living in a deprived circumstance whereas on the other, one could be totally detached and austere inspite of living in material abundance (which in my opinion is real Sufism).
The Science of Addiction
by Elaine Gottleib
The United States is a nation of addicts. According to a 2001 survey conducted by the Substance Abuse and Mental Health Services Administration (SAMHSA), there are 16 million drug users, 13 million heavy drinkers, and 66 million smokers in the United States. That doesn't include the overeaters, gamblers, compulsive exercisers, and the sex obsessed. Yet most people are able to eat, drink, and exercise without becoming addicted to those activities. Why?
Defining Addiction
Neuroscientists define addiction in medical terms as "a brain disease….a chronic, relapsing disease." Addiction is considered a brain disease because it alters the brain in fundamental, long-lasting ways. That's not surprising when you consider that the brain changes constantly in response to our everyday experiences. For instance, when a student learns that the Pilgrims landed in 1620, the brain is affected by just that simple piece of information. Imagine the more dramatic changes produced by powerful substances like alcohol and heroin!
Neuro-imaging techniques like PET scans and MRIs have documented actual changes in the size and shape of nerve cells in the brains of addicts. Networks of nerve cells determine our feelings and behavior. Drugs influence behavior by transforming the way these networks function, according to Dr. Stephen Hyman, former director of the National Institute of Mental Health.
The Dopamine Connection
The biological link among all addictions is dopamine. This brain chemical is released during pleasurable activities ranging from sex and eating to more detrimental behaviors such as drinking and drug taking. "If a drug or an activity produces a sharp spike in dopamine, the odds are phenomenal that people will like it, they'll experience it as pleasurable, and it will be addictive," says Alan Leshner, PhD, of the National Institute on Drug Abuse.
A powerful drug like crack cocaine elevates dopamine levels much faster than normal pleasurable activities. It creates the classic drug-induced feelings of exhilaration and power. In a landmark 1950s experiment, scientists stimulated rodent brains and found that the animals kept returning to the place where they received the stimulation.
Getting—and Staying—Hooked
Coming down from a drug high is caused by a decrease in dopamine levels. If you force brain cells to produce excessive dopamine on a regular basis, they become stressed and produce less dopamine. Over time, addicts become depressed and need drugs just to stimulate dopamine to normal levels. They become trapped in a cycle of cravings and addiction to avoid withdrawal symptoms and depression.
Leshner believes that once a person crosses the line from user to addict, the brain is so changed that he can no longer control his behavior. "... the truth is, addiction is not a voluntary behavior. It's actually a different state," he explains. "It's hard for people to understand that, but if you take drugs to the point of addiction, functionally you move into a different state. A state of compulsive, uncontrollable drug use."
This transformation helps explain why it's so difficult to break an addiction. "There is no motivator more powerful than the drug craving and the need for them," says Leshner. Cravings are more significant than physical withdrawal in keeping an addict hooked. Drugs like cocaine and methamphetamine, unlike heroin and alcohol, don't produce intense physical withdrawal symptoms, but they do produce overpowering cravings. These cravings can be aroused by external or internal stimuli that are as innocuous as walking by a pub or feeling sad, according to Patricia Owen, PhD, director of Research and Development at the Hazelden Foundation in Minnesota.
An Addictive Personality?
Although researchers have tried to determine the type of person who becomes an addict, they have failed to identify an "addictive personality," according to Owen. It is only after people become addicts that certain common personality traits emerge, like "difficulty delaying gratification, self-centeredness, lack of concentration and impatience," says Owen.
Sol, a former alcoholic and drug addict turned addiction counselor and administrator at a major treatment facility, feels that using a term like addictive personality "paints a hopeless picture. Some people are very compulsive but they can change," he says. Indeed, according to Owen, 60% of addicts use both alcohol and drugs and 80% of alcoholics also smoke.
Many addiction professionals believe addiction stems from a combination of biological, psychological, and environmental factors. "The Alcoholics Anonymous 'Big Book' describes alcoholism as a physical, emotional and spiritual disease. They were aware of the physiological affects before we were able to do PET scans to actually see the changes," says Owen.
The progression to addiction can develop this way: Sue may have a genetic or biological predisposition to an addiction. If she grows up in a family and environment without addiction or stress, she may never begin even casual use. However, if Sue grows up in a stressful family or an environment where substance abuse is common and encounters more stresses as an adult and over time, she may move from casual to regular use to full-blown addiction.
We know that children of alcoholics have a four times higher risk of becoming alcoholics themselves than the offspring of non-alcoholics. Scientists are also studying whether addicts are born with inadequate endorphins, the brain chemicals that regulate stress.
Quitting
To be an addict means that addiction has overwhelmed your entire existence. "When you speak to drug addicts about their experiences, they'll tell you that there is nothing in their life but drugs," says Leshner. So breaking an addiction often involves major lifestyle changes. For Sol, it meant losing most of his friends who were also addicts. He also had to cope with feelings that he had suppressed for years with drugs. "Using drugs prevents you from learning to handle emotions. You don't go through the maturation process," he explains.
Willpower is not a factor in quitting since addiction also impairs that faculty. That is why Leshner calls it a "relapsing disease." Most addicts who seek treatment relapse several times before they kick the habit.
New Treatments
For years, heroin and narcotics addictions have been treated successfully with methadone, which eases withdrawal and blocks the effect of drugs. Naltrexone is another drug commonly used for alcohol and narcotics addiction.
A new experimental drug, buprenorphine, has shown promising results in tests on narcotics addicts. Scientists are also working on a cocaine "vaccine," which could be used to inoculate addicts who relapse.
It is unlikely, however, that a magic pill will ever be found that "cures" addiction. "No matter what you do with medication, I believe that you will always need psychological treatment to provide support and manage behavior," says Jan Kaufman, Director of Substance Abuse Treatment at the North Charles Foundation in Cambridge, Massachusetts.
On the other hand, aerobic exercise offers a simple and natural way to help combat addiction. During aerobic exercise dopamine levels are increased in the areas of the brain involved with addiction, and feelings of depression and anxiety are decreased.
Diagnosing Addiction
Drug and alcohol problems can affect every one of us regardless of age, sex, race, marital status, place of residence, income level, or lifestyle.
You may have a problem with drugs or alcohol, if:
You can't predict whether or not you will use drugs or get drunk.
You believe that you need to drink and/or use drugs in order to have fun.
You turn to alcohol and/or drugs after a confrontation or argument, or to relieve uncomfortable feelings.
You need to drink more or use more drugs to get the same effect as previously.
You drink and/or use drugs by yourself.
You have periods of memory loss.
You have trouble at work, in school, or in your personal relationships because of drinking or using drugs.
You make promises to yourself or others that you'll stop getting drunk or using drugs but are unable to keep them.
You feel alone, scared, miserable, and depressed.
Adapted from "Just the Facts" published by the U.S. Substance Abuse and Mental Health Services Administration.
RESOURCES:
Drug Abuse: How to Break the Habit
American Academy of Family Physicians
http://familydoctor.org/
National Institute on Drug Abuse
http://www.nida.nih.gov/
The National Clearinghouse for Alcohol and Drug Information
www.health.org
References:
Substance Abuse and Mental Health Services Administration. Available at: http://www.samhsa.gov/. Accessed on June 20, 2003.
by Elaine Gottleib
The United States is a nation of addicts. According to a 2001 survey conducted by the Substance Abuse and Mental Health Services Administration (SAMHSA), there are 16 million drug users, 13 million heavy drinkers, and 66 million smokers in the United States. That doesn't include the overeaters, gamblers, compulsive exercisers, and the sex obsessed. Yet most people are able to eat, drink, and exercise without becoming addicted to those activities. Why?
Defining Addiction
Neuroscientists define addiction in medical terms as "a brain disease….a chronic, relapsing disease." Addiction is considered a brain disease because it alters the brain in fundamental, long-lasting ways. That's not surprising when you consider that the brain changes constantly in response to our everyday experiences. For instance, when a student learns that the Pilgrims landed in 1620, the brain is affected by just that simple piece of information. Imagine the more dramatic changes produced by powerful substances like alcohol and heroin!
Neuro-imaging techniques like PET scans and MRIs have documented actual changes in the size and shape of nerve cells in the brains of addicts. Networks of nerve cells determine our feelings and behavior. Drugs influence behavior by transforming the way these networks function, according to Dr. Stephen Hyman, former director of the National Institute of Mental Health.
The Dopamine Connection
The biological link among all addictions is dopamine. This brain chemical is released during pleasurable activities ranging from sex and eating to more detrimental behaviors such as drinking and drug taking. "If a drug or an activity produces a sharp spike in dopamine, the odds are phenomenal that people will like it, they'll experience it as pleasurable, and it will be addictive," says Alan Leshner, PhD, of the National Institute on Drug Abuse.
A powerful drug like crack cocaine elevates dopamine levels much faster than normal pleasurable activities. It creates the classic drug-induced feelings of exhilaration and power. In a landmark 1950s experiment, scientists stimulated rodent brains and found that the animals kept returning to the place where they received the stimulation.
Getting—and Staying—Hooked
Coming down from a drug high is caused by a decrease in dopamine levels. If you force brain cells to produce excessive dopamine on a regular basis, they become stressed and produce less dopamine. Over time, addicts become depressed and need drugs just to stimulate dopamine to normal levels. They become trapped in a cycle of cravings and addiction to avoid withdrawal symptoms and depression.
Leshner believes that once a person crosses the line from user to addict, the brain is so changed that he can no longer control his behavior. "... the truth is, addiction is not a voluntary behavior. It's actually a different state," he explains. "It's hard for people to understand that, but if you take drugs to the point of addiction, functionally you move into a different state. A state of compulsive, uncontrollable drug use."
This transformation helps explain why it's so difficult to break an addiction. "There is no motivator more powerful than the drug craving and the need for them," says Leshner. Cravings are more significant than physical withdrawal in keeping an addict hooked. Drugs like cocaine and methamphetamine, unlike heroin and alcohol, don't produce intense physical withdrawal symptoms, but they do produce overpowering cravings. These cravings can be aroused by external or internal stimuli that are as innocuous as walking by a pub or feeling sad, according to Patricia Owen, PhD, director of Research and Development at the Hazelden Foundation in Minnesota.
An Addictive Personality?
Although researchers have tried to determine the type of person who becomes an addict, they have failed to identify an "addictive personality," according to Owen. It is only after people become addicts that certain common personality traits emerge, like "difficulty delaying gratification, self-centeredness, lack of concentration and impatience," says Owen.
Sol, a former alcoholic and drug addict turned addiction counselor and administrator at a major treatment facility, feels that using a term like addictive personality "paints a hopeless picture. Some people are very compulsive but they can change," he says. Indeed, according to Owen, 60% of addicts use both alcohol and drugs and 80% of alcoholics also smoke.
Many addiction professionals believe addiction stems from a combination of biological, psychological, and environmental factors. "The Alcoholics Anonymous 'Big Book' describes alcoholism as a physical, emotional and spiritual disease. They were aware of the physiological affects before we were able to do PET scans to actually see the changes," says Owen.
The progression to addiction can develop this way: Sue may have a genetic or biological predisposition to an addiction. If she grows up in a family and environment without addiction or stress, she may never begin even casual use. However, if Sue grows up in a stressful family or an environment where substance abuse is common and encounters more stresses as an adult and over time, she may move from casual to regular use to full-blown addiction.
We know that children of alcoholics have a four times higher risk of becoming alcoholics themselves than the offspring of non-alcoholics. Scientists are also studying whether addicts are born with inadequate endorphins, the brain chemicals that regulate stress.
Quitting
To be an addict means that addiction has overwhelmed your entire existence. "When you speak to drug addicts about their experiences, they'll tell you that there is nothing in their life but drugs," says Leshner. So breaking an addiction often involves major lifestyle changes. For Sol, it meant losing most of his friends who were also addicts. He also had to cope with feelings that he had suppressed for years with drugs. "Using drugs prevents you from learning to handle emotions. You don't go through the maturation process," he explains.
Willpower is not a factor in quitting since addiction also impairs that faculty. That is why Leshner calls it a "relapsing disease." Most addicts who seek treatment relapse several times before they kick the habit.
New Treatments
For years, heroin and narcotics addictions have been treated successfully with methadone, which eases withdrawal and blocks the effect of drugs. Naltrexone is another drug commonly used for alcohol and narcotics addiction.
A new experimental drug, buprenorphine, has shown promising results in tests on narcotics addicts. Scientists are also working on a cocaine "vaccine," which could be used to inoculate addicts who relapse.
It is unlikely, however, that a magic pill will ever be found that "cures" addiction. "No matter what you do with medication, I believe that you will always need psychological treatment to provide support and manage behavior," says Jan Kaufman, Director of Substance Abuse Treatment at the North Charles Foundation in Cambridge, Massachusetts.
On the other hand, aerobic exercise offers a simple and natural way to help combat addiction. During aerobic exercise dopamine levels are increased in the areas of the brain involved with addiction, and feelings of depression and anxiety are decreased.
Diagnosing Addiction
Drug and alcohol problems can affect every one of us regardless of age, sex, race, marital status, place of residence, income level, or lifestyle.
You may have a problem with drugs or alcohol, if:
You can't predict whether or not you will use drugs or get drunk.
You believe that you need to drink and/or use drugs in order to have fun.
You turn to alcohol and/or drugs after a confrontation or argument, or to relieve uncomfortable feelings.
You need to drink more or use more drugs to get the same effect as previously.
You drink and/or use drugs by yourself.
You have periods of memory loss.
You have trouble at work, in school, or in your personal relationships because of drinking or using drugs.
You make promises to yourself or others that you'll stop getting drunk or using drugs but are unable to keep them.
You feel alone, scared, miserable, and depressed.
Adapted from "Just the Facts" published by the U.S. Substance Abuse and Mental Health Services Administration.
RESOURCES:
Drug Abuse: How to Break the Habit
American Academy of Family Physicians
http://familydoctor.org/
National Institute on Drug Abuse
http://www.nida.nih.gov/
The National Clearinghouse for Alcohol and Drug Information
www.health.org
References:
Substance Abuse and Mental Health Services Administration. Available at: http://www.samhsa.gov/. Accessed on June 20, 2003.
Seven Sizzling Ways to Stop Smoking
by Jeff Siegel
Quitting smoking is one of the most daunting challenges you'll face in your life. It's an addiction that is both physical and psychological, but quitting smoking can be done. In fact, you'll have plenty of company: 1 million Americans quit every year, and almost 50 million Americans are former smokers.
You've seen the warnings. Heard the discussions. Received the advice. Listened to your kids nag you about it. You know you should quit smoking, but you never seem to get around to it.
Well, now is the time to get around to it.
"You know, there's no magic bullet, no device that will make it easy," says Jenny Duffey, who smoked for 13 years before quitting in 1989, and has written a book and taught seminars on quitting. "You have to want to quit—really want to quit—before you can do it."
There are certainly plenty of reasons to quit when you consider smoking's fatal link with lung cancer, emphysema, and heart disease, and the harmful effects of second-hand smoke on your family. Even the tobacco companies admit that there might be a relationship between smoking and death.
Yet quitting is one of the most daunting challenges you'll face in your life.
The Mind and Body Connection
That's because smoking is addictive—both physically and psychologically. The physical addiction can be traced to the nicotine in each cigarette. It hooks you just as completely as its more disreputable cousins, such as heroin and cocaine, say researchers, and the withdrawal symptoms—cravings, anxiety, nausea, cramps, depression, and dizziness—are similar.
Like these other drugs, nicotine surges through the bloodstream and gives smokers a high—a quick jolt that makes them think they feel better. But, in the meantime, what really happens is that smokers develop a tolerance for nicotine, which is why they go from a couple of butts a day as a teenager to 2 1/2 packs a day as an adult.
The psychological addiction is, in its own way, just as bad. Smoking becomes second nature, like blinking or breathing. If you consider that one pack of cigarettes can turn into 150 to 200 puffs a day, seven days a week, 52 weeks a year, you'll see how hard it is to de-program yourself.
The Key to Quitting
But you can quit. In fact, one million Americans quit smoking every year, and almost 50 million Americans are former smokers.
"The thing to keep in mind is that almost everyone who quits has to try more than once," says Anne Davis, M.D., a past president of the American Lung Association. "You shouldn't be discouraged. It's more rare to quit on the first try than on the fifth. Some people have to try as many as 10 or 11 times."
The key to quitting, say the experts, is patience and perseverance.
How to Do It
Keep these points in mind when you quit:
Know why you're quitting
Pick a reason that you believe in, be it for your family or for yourself. If you don't believe in your reason, it's that much harder to stop.
Change your environment
Worry about not smoking for just one day, and not for the rest of your life. Besides, it gets easier to stave off the desire the longer you don't smoke. The nicotine will be gone from your system in three to five days, and after about a month the worst of the withdrawal symptoms will go away.
Taper off
People have quit cold turkey, and it's certainly possible. But it doesn't make you any less of a man, says Dr. Davis, to try tapering off instead. "It doesn't mean you are weak, and don't have will power," she says. "What it means is that you realize there are other approaches that will work better."
The key to tapering off is to cut down the number of cigarettes you smoke each day. One way to do this, says Duffey, is to delay the first cigarette of the day. She recommends the two-hour approach. If you have your first smoke at 7 a.m., try holding out until 9 for a couple of days. Then, push it back until 11, and so on. By the end of four weeks, you won't be smoking at all.
Overwhelm the addiction
Think about the things that lead to lighting up, and don't do them. Get rid of the ashtrays at home. Don't pick up matches at a restaurant. Don't come back from lunch 15 minutes early to sneak in a cigarette break. Avoid places, like bars, where smoking is part of the atmosphere.
Practice the three D's
When you feel like a smoke, delay. Try to think of something else. Breathe deeply, and count to ten slowly as you do so. Drink water; aim for eight eight-ounce glasses a day, which helps flush the nicotine out of your system. Do something else: chew gum, tap a pencil or crack your knuckles until the craving passes.
Keep a diary
This technique, which has also been used effectively with people who eat too much, is surprisingly effective. Each time you feel like a cigarette, write down the time of day, what you're doing, and how badly you want a drag on a scale of 1 to 3, with 1 for the worst craving. A diary, says Dr. Davis, helps you to learn to unlearn the almost Pavlovian responses that make you want to smoke.
"Just because you fail once doesn't mean you can't quit smoking," says Dr. Davis. "Half the battle is knowing that it may require several attempts, and feeling confident that you'll eventually succeed."
Work with your healthcare provider
For best results in your plan to stop smoking, work with your healthcare provider. Studies show that measures such as over-the-counter nicotine patches, over-the-counter nicotine gum, prescription nicotine inhalers or nasal sprays, the prescription antidepressant bupropion, hypnosis, acupuncture, smoking cessation classes, support groups, and the like are the most effective when used in combination. So if you're going to use the patch, it's a good idea to find a support group, such as classes sponsored by the lung or heart associations.
Resources
American Lung Association
http://www.lungusa.org
by Jeff Siegel
Quitting smoking is one of the most daunting challenges you'll face in your life. It's an addiction that is both physical and psychological, but quitting smoking can be done. In fact, you'll have plenty of company: 1 million Americans quit every year, and almost 50 million Americans are former smokers.
You've seen the warnings. Heard the discussions. Received the advice. Listened to your kids nag you about it. You know you should quit smoking, but you never seem to get around to it.
Well, now is the time to get around to it.
"You know, there's no magic bullet, no device that will make it easy," says Jenny Duffey, who smoked for 13 years before quitting in 1989, and has written a book and taught seminars on quitting. "You have to want to quit—really want to quit—before you can do it."
There are certainly plenty of reasons to quit when you consider smoking's fatal link with lung cancer, emphysema, and heart disease, and the harmful effects of second-hand smoke on your family. Even the tobacco companies admit that there might be a relationship between smoking and death.
Yet quitting is one of the most daunting challenges you'll face in your life.
The Mind and Body Connection
That's because smoking is addictive—both physically and psychologically. The physical addiction can be traced to the nicotine in each cigarette. It hooks you just as completely as its more disreputable cousins, such as heroin and cocaine, say researchers, and the withdrawal symptoms—cravings, anxiety, nausea, cramps, depression, and dizziness—are similar.
Like these other drugs, nicotine surges through the bloodstream and gives smokers a high—a quick jolt that makes them think they feel better. But, in the meantime, what really happens is that smokers develop a tolerance for nicotine, which is why they go from a couple of butts a day as a teenager to 2 1/2 packs a day as an adult.
The psychological addiction is, in its own way, just as bad. Smoking becomes second nature, like blinking or breathing. If you consider that one pack of cigarettes can turn into 150 to 200 puffs a day, seven days a week, 52 weeks a year, you'll see how hard it is to de-program yourself.
The Key to Quitting
But you can quit. In fact, one million Americans quit smoking every year, and almost 50 million Americans are former smokers.
"The thing to keep in mind is that almost everyone who quits has to try more than once," says Anne Davis, M.D., a past president of the American Lung Association. "You shouldn't be discouraged. It's more rare to quit on the first try than on the fifth. Some people have to try as many as 10 or 11 times."
The key to quitting, say the experts, is patience and perseverance.
How to Do It
Keep these points in mind when you quit:
Know why you're quitting
Pick a reason that you believe in, be it for your family or for yourself. If you don't believe in your reason, it's that much harder to stop.
Change your environment
Worry about not smoking for just one day, and not for the rest of your life. Besides, it gets easier to stave off the desire the longer you don't smoke. The nicotine will be gone from your system in three to five days, and after about a month the worst of the withdrawal symptoms will go away.
Taper off
People have quit cold turkey, and it's certainly possible. But it doesn't make you any less of a man, says Dr. Davis, to try tapering off instead. "It doesn't mean you are weak, and don't have will power," she says. "What it means is that you realize there are other approaches that will work better."
The key to tapering off is to cut down the number of cigarettes you smoke each day. One way to do this, says Duffey, is to delay the first cigarette of the day. She recommends the two-hour approach. If you have your first smoke at 7 a.m., try holding out until 9 for a couple of days. Then, push it back until 11, and so on. By the end of four weeks, you won't be smoking at all.
Overwhelm the addiction
Think about the things that lead to lighting up, and don't do them. Get rid of the ashtrays at home. Don't pick up matches at a restaurant. Don't come back from lunch 15 minutes early to sneak in a cigarette break. Avoid places, like bars, where smoking is part of the atmosphere.
Practice the three D's
When you feel like a smoke, delay. Try to think of something else. Breathe deeply, and count to ten slowly as you do so. Drink water; aim for eight eight-ounce glasses a day, which helps flush the nicotine out of your system. Do something else: chew gum, tap a pencil or crack your knuckles until the craving passes.
Keep a diary
This technique, which has also been used effectively with people who eat too much, is surprisingly effective. Each time you feel like a cigarette, write down the time of day, what you're doing, and how badly you want a drag on a scale of 1 to 3, with 1 for the worst craving. A diary, says Dr. Davis, helps you to learn to unlearn the almost Pavlovian responses that make you want to smoke.
"Just because you fail once doesn't mean you can't quit smoking," says Dr. Davis. "Half the battle is knowing that it may require several attempts, and feeling confident that you'll eventually succeed."
Work with your healthcare provider
For best results in your plan to stop smoking, work with your healthcare provider. Studies show that measures such as over-the-counter nicotine patches, over-the-counter nicotine gum, prescription nicotine inhalers or nasal sprays, the prescription antidepressant bupropion, hypnosis, acupuncture, smoking cessation classes, support groups, and the like are the most effective when used in combination. So if you're going to use the patch, it's a good idea to find a support group, such as classes sponsored by the lung or heart associations.
Resources
American Lung Association
http://www.lungusa.org
Crack goes mainstream
More and more Calgarians, from the streets to executive suites, fall prey to a fast-addicting drug
Valerie Fortney
Calgary Herald
Saturday, February 17, 2007
CREDIT: Ted Jacob, Calgary Herald
Drug unit Det. Doug Hudacin of the Calgary Police Service holds a crack pipe and crack rocks at CPS headquarters.
CREDIT: Ted Jacob, Calgary Herald
Crack users' tools of the trade are shown at Calgary police headquarters.
More Columns By This Writer
:: Shower star to Idol also-ran in one song
As young undercover officers trying to infiltrate Calgary's drug world in the mid-1990s, Monty Sparrow and Doug Hudacin bought whatever illicit drugs they could get their hands on.
For four years, the pair purchased everything from heroin to marijuana to prescription drugs. Over time they noticed a disturbing trend: crack cocaine, a drug once relegated to the ghettos of big cities like New York and Chicago, was becoming more and more plentiful on this city's streets.
By 1999, says Sparrow, "all we were buying was crack."
Eight years later, the crack cocaine trade shows no signs of slowing down.
"The amount of crack out there today is even higher," says Sparrow, now staff sergeant of the Calgary Police Service's drug unit.
"Nobody can say for sure" how much crack cocaine is entering our city, says Hudacin, a detective and the force's resident drug expert.
One thing is certain: the trafficking of illicit drugs in Calgary has soared over the past few years.
"A decade ago, one officer said five kilos of cocaine were coming into town in a month. But now it's probably well over 100 kilos of coke that will be converted to crack cocaine, coming to Calgary every month. It's hard to attach a concrete number to it -- it's an educated guess."
The police service's most recent annual statistical report, for 2005, showed drug offences increasing by 30 per cent over the past six years, trafficking offences up 49 per cent and crack cocaine offences up 113 per cent.
The two veteran officers don't need hard and fast numbers to convince them that crack cocaine is a growing problem in our city. Even
Alberta's smaller communities are seeing the trend.
Others on the front lines of the drug wars support this view: academics, psychologists, counsellors -- and the addicts themselves.
Not only is crack cocaine more prevalent than ever, they say, its influence is cutting across socioeconomic lines. While many of its users are society's most marginalized -- its presence obvious on the city's streets and hooker strolls -- it's also increasingly becoming the drug of choice for an upscale clientele.
Some observers see it as another symptom of the "affluenza" epidemic: one more unanticipated downside of the current economic boom.
Crack -- a drug made by mixing and cooking cocaine, water and baking soda until it forms a rock that is smoked to produce a high -- has never before experienced such an elevated position in our society.
But it wasn't that long ago that crack had the seediest of reputations.
First showing up in U.S. urban centres in the 1980s, the drug became such a scourge among the lower classes that in 1989 half of all felony arrests in New York City were crack-related.
By 1986, Time Magazine had declared crack addiction the No. 1 issue facing America. Newsweek would later call crack the most significant story in the United States since Vietnam and Watergate.
An ABC News special called it a plague "eating away at the fabric of America," while NBC labelled crack "America's drug of choice."
The outrage over crack's grip on society led to an overhaul of U.S. drug laws.
By 2000, however, the New York Times declared crack cocaine no longer a societal threat with a series entitled The War on Crack Retreats. The combination of tougher policing and laws, along with a tarnished reputation as a drug for losers, it said, were to blame. The term "crack head" was deemed the highest insult, even on the mean streets of urban America.
So how, in 2007, has crack resurfaced in cities like Calgary as a drug of choice for some members of mainstream society?
"Gangs should be given PhDs in marketing," says Dr. Louis Pagliaro. "Somehow in the last few years, they've convinced people that meth is the poor man's drug and crack is the new Cadillac, the rich man's drug."
Pagliaro, a professor in educational psychology at the University of Alberta, has been tracking drug trends for more than 30 years and was the RCMP's key expert witness during a landmark crack trial in Alberta in 1995. He just finished his 14th book with his wife and fellow professor Ann Marie Pagliaro, called Gangs, Drugs and Violent Crime Among Canadian Youth.
He won't use the word epidemic when it comes to crack use, only because "I've been chastised for saying that. But call it what you want."
He says our province is ripe for such a development. "Albertans are working the longest hours in the country, calls to your city's distress lines are hitting record numbers," he says. "A boom can create a lot of unhappiness."
Where there are unhappy people, there is always substance abuse. "I've treated everyone from multiple murderers to Hollywood movie stars, and they all have one thing in common -- unhappiness. They use drugs to alter that state of unhappiness."
But why crack?
Pagliaro says so-called drugs of choice are anything but. Organized crime, he says, has the biggest influence by flooding the market withcertain narcotics.
"Cocaine is the major lifeblood of these gangs," says Pagliaro, who adds that alcohol is still king when it comes to abused substances. "It's the way they support any and all of their criminal activities."
While crack cocaine appears to be cheap at first glance -- a rock can cost anywhere from $5 to $20 -- its short high (about 10 minutes) means the addict will often need 20 or more hits a day. Some hard-core users report taking from 50 to 100 hits.
"They're making a lot of money off one drug," says Pagliaro. "These days, you can hardly find any powdered cocaine on the streets, because the gangs have decided they'd rather sell crack."
Despite crack's emergence as a popular drug, it's impossible to find accurate statistics on its use. Health Canada states on its website that "because cocaine is an illicit drug, the number of users can never be determined definitively. Not everyone who uses cocaine will admit use if asked in a survey, or will accurately recall consumption."
Some critics say that because crack also has the distinction of creating poverty in its users more quickly than most other drugs, self-reporting will never give an accurate picture. That's because crack users deep into their addictions rarely even have homes anymore, let alone telephones.
Add to that the fact that most government surveys here and in other parts of the world group crack together with powdered cocaine, which is snorted.
Still, studies like the Canadian Addiction Survey, published in 2004, found that more than 14 per cent of males, and 10.6 per cent of the total population, reported having tried cocaine.
Dr. Ron Lim doesn't need spreadsheets or polls to convince him of crack's growing prevalence. A professor with the University of Calgary's faculty of medicine, Lim is involved in the addictions field on a number of fronts, from consulting with the Foothills Addiction Centre in Calgary and a private facility in B.C., to helping out at the Renfrew Recovery Centre, a detox centre in the city run by the Alberta Alcohol and Drug Abuse Commission.
"In every aspect of what I am doing, I am seeing more cocaine and crack cocaine," he says. "At Renfrew, crack addiction is now second only to alcohol."
Another problem with this highly addictive drug, Lim points out, is that dealers often add other dangerous substances into the mix, so the user isn't getting pure cocaine. "They cut it with everything from Tylenol to Procaine (a topical anesthetic) to maybe even a bit of crystal meth and heroine. You really have no guarantee what you're getting."
While he acknowledges an increase in professionals joining the ranks of the crack addicted, Lim says he rarely treats them. "The waiting list in Alberta is four to eight weeks, and it's almost all government-run," he says. "People with money don't want to wait, and they don't want to sit beside a homeless person in treatment. They're heading to private treatment centres in British Columbia."
Cocaine and crack cocaine, he says, are psychologically, not physically, addictive. That makes it one of the toughest addictions to treat.
"Cocaine is extremely difficult to quit," he says, adding that if you took 100 people and gave them alcohol, statistically 10 per cent would become addicted. "For cocaine, it would be around 17 to 20 per cent. It is such a dangerous drug to try."
"If you take a drug, you can become addicted," says Dr. Perry Sirota, director of Serenity House Drug & Alcohol Treatment Centre in Calgary. "It doesn't matter how much money you make, how educated you are."
Sirota understands why there has been much media coverage and government interest in methamphetamines -- the Premier's Task Force on Crystal Meth, for instance -- because "meth is a pretty horrible drug, with permanent effects." But he can't understand why crack isn't getting at least equal attention.
"There are a heck of a lot more people in this province using crack than crystal meth."
Sirota says that he's seeing a lot more middle and upper middle income crack addicts, partly because "they were using powder, but then found that was harder and harder to get. They won't think about the fact crack is worse, they just think about replacing that high."
His clientele has extended to include professionals in the finance and legal fields, people in positions of trust with easy access to cash. Fraud cases, where businesspeople have dipped into company and client funds, he says, can almost always be traced to either a drug or gambling addiction.
"I treat sex workers who tell me they can point to any high-end office building in the downtown core and say that's where they go at night with professionals to party and smoke crack."
When the average person thinks of a crack addict, says Neal Berger, "I'll bet they see a male from 18 to 35, who has long, straggly dark hair and looks like he just got out of the criminal justice system.
"They don't picture a guy with a Porsche or a middle-aged homemaker."
But Berger, who has been treating addicts for 30 years and is executive director of the Cedars at Cobble Hill, a residential treatment centre near Duncan, B.C., says that's what he's seeing more and more of every day. And a growing number of Albertans are using his centre's services.
Berger says Alberta's runaway economy has created a unique set of problems among its workforce.
"Dealing with places like Fort McMurray," says Berger, who regularly consults with the province's oil and gas industry, "is like trying to change an entire nation."
He says the growth of illicit drugs like crack among the ranks of the employed is one of the biggest workplace issues today.
"The cost to business and industry is astronomical," he says. Not to mention the risks to safety. "You have addicts who are operating heavy machinery and other equipment that requires a lot of attention."
If crack users and addicts aren't prone to confessing their proclivities to government canvassers, one place some feel comfortable is an organization like Cocaine Anonymous (CA).
"We don't ask them what you do for a living," says John, a representative
of the Calgary chapter of CA. (In keeping with CA's anonymity policy, he won't divulge his real name.) "But you can tell when someone's in a nice business suit that they're not your stereotypical crack user."
In his dozen years counselling fellow crack addicts, he's seen a huge shift from the use of powdered cocaine to crack.
"You never hear the term freebasing now," says John. "It's all crack, and it's so easy to get it. You just have to know who to ask."
John, who has been clean from his crack addiction for 12 years and has a construction business, says he understands how difficult it is to shake the drug, despite his own long-term success.
"It's psychologically addictive, so it becomes a mental obsession," he says. "Just trying to say no, it seems physically impossible for an addict. The rush is so good, but so short, so it just leaves you wanting more."
For Calgary police, how much money a crack addict may have in his or her bank account is of no interest. "We're not targeting the millionaires, or any other addict," says Sparrow, of the CPS drug unit.
"Our emphasis is on the traffickers, the guys making the money off of the addicts."
By introducing illicit drugs into the community, the producers and dealers are causing more harm than just to those ingesting their product. "Anywhere drugs are present, every kind of crime goes up," says Sparrow.
"Violence, petty crimes, burglaries, robberies, murders."
But while finding down-and-out crack addicts such as prostitutes and street people is easy, the increasing numbers of addicts with money and a fixed address can go undercover for a long time -- long enough to use up all their savings and eventually lose everything.
"Everybody has an image of what a crack addict looks like," says Hudacin, Sparrow's partner.
"They'd be pretty surprised to see some of them. Crack addiction runs the full socioeconomic spectrum in Calgary."
[email protected]
COCAINE AND CRACK: A PRIMER
- Cocaine is a powerful drug made from the South American coca bush. Its street names include coke, C, snow and flake.
- Cocaine is sold as a fine white powder. Street dealers sometimes dilute it with substances like cornstarch or sugar, or local painkillers like benzocaine. Users often snort cocaine. They also
dissolve it in water and inject it into their veins.
- Heating cocaine hydrochloride with baking soda makes crack. The mixture forms a solid chunk composed of chemicals that
include freebase cocaine. It gets its name from the crackling sound it makes when being cooked. Crack chunks are also known as "rock." Freebase is a pure form of cocaine that can also be smoked. Some crack and freebase users inhale the vapours from heated glass pipes. Others add them to tobacco or marijuana cigarettes.
- All forms of cocaine have the same effects. But injecting produces these effects more quickly and intensely than snorting. Smoking it causes the most intense
and addictive high.
COCAINE AND CRACK'S EFFECTS:
- Cocaine can make you feel intense pleasure. You can feel alert, energetic and confident. Using cocaine
increases your breathing, heart rate and blood pressure. It dilates your pupils, decreases your appetite and reduces your need to sleep.
- Large doses of cocaine can produce euphoria, severe
agitation, anxiety,erratic and violent behaviour, twitching, hallucinations, blurred vision, headaches, chest pains, rapid shallow breathing, muscle spasms, nausea and fever.
- Overdose can cause seizures, strokes, heart
attacks, kidney failure, coma and death. Use is linked with suicides, murder and fatal accidents.
- A cocaine high can last from five minutes to two hours. When users "crash" they feel very depressed, anxious and irritable. Many users take repeated doses to maintain the high and avoid the crash. Some users try to modify the effects or stop binges with drugs like alcohol, tranquilizers or heroin. Respiratory arrest is a common cause of death from cocaine overdose.
- Heavy cocaine users can feel depressed, restless, agitated and nervous. They can have sleeping, eating and sexual problems. They can have dramatic mood swings, delusions, hallucinations and paranoia. High blood pressure and irregular heartbeats occur. Repeated use may cause long-lasting problems with memory, attention and behaviour.
- Possessing, producing
and trafficking in cocaine can result in fines, prison sentences and a criminal record.
COCAINE AND ADDICTION:
- People who use cocaine heavily over a long period, or binge for several days, develop a tolerance. They need to take more of the drug to feel the same effects.
- Regular users can develop powerful psychological dependence, a relentless craving for the drug. They continue to use the drug even when it causes overwhelming physical, mental and social problems.
WITHDRAWAL:
- Withdrawal from cocaine causes few physical effects, but the psychological effects, including loss of pleasure,
depression and low energy, are severe. Three phases of withdrawal have been
described. Phase 1, the "crash," follows the end of the binge and lasts for up to four days. The user has very low energy, may sleep for days and may eat large amounts of food.
- During Phase 2, which lasts for two to 12 weeks, the user feels little initiative, intense boredom, and minimal pleasure from life. This limited existence, as compared with the memories of drug-induced euphoria, can lead to severe craving, resumption of cocaine use and cycles of recurrent binges.
- Phase 3, "extinction," gradually follows if no drug is taken for many months. Normal function returns and eventually craving
decreases, or at least is not associated with a relapse to drug use.
Source: Alberta Alcohol and Drug Abuse Commission
Calgary's runaway economy is creating an "affluenza" epidemic.
One of its manifestations is the rising use of crack cocaine. Calgary Herald columnist Valerie Fortney investigates why this is happening and who are its new victims.
THE CHANGING FACE OF CRACK ADDICTION
Today:
- Market-savvy gangs are driving the new addiction, says one expert.
- Crack's new clientele: The compelling stories of two crack addicts.
Sunday:
- Calgarians are turning to expensive treatment centres on the West Coast.
- Stories of recovery: A stockbroker and the wife of a prominent businessman.
This story features factboxes "Cocaine and Crack: A Primer" and "The Changing Face of Crack Addiction".
© The Calgary Herald 2007
More and more Calgarians, from the streets to executive suites, fall prey to a fast-addicting drug
Valerie Fortney
Calgary Herald
Saturday, February 17, 2007
CREDIT: Ted Jacob, Calgary Herald
Drug unit Det. Doug Hudacin of the Calgary Police Service holds a crack pipe and crack rocks at CPS headquarters.
CREDIT: Ted Jacob, Calgary Herald
Crack users' tools of the trade are shown at Calgary police headquarters.
More Columns By This Writer
:: Shower star to Idol also-ran in one song
As young undercover officers trying to infiltrate Calgary's drug world in the mid-1990s, Monty Sparrow and Doug Hudacin bought whatever illicit drugs they could get their hands on.
For four years, the pair purchased everything from heroin to marijuana to prescription drugs. Over time they noticed a disturbing trend: crack cocaine, a drug once relegated to the ghettos of big cities like New York and Chicago, was becoming more and more plentiful on this city's streets.
By 1999, says Sparrow, "all we were buying was crack."
Eight years later, the crack cocaine trade shows no signs of slowing down.
"The amount of crack out there today is even higher," says Sparrow, now staff sergeant of the Calgary Police Service's drug unit.
"Nobody can say for sure" how much crack cocaine is entering our city, says Hudacin, a detective and the force's resident drug expert.
One thing is certain: the trafficking of illicit drugs in Calgary has soared over the past few years.
"A decade ago, one officer said five kilos of cocaine were coming into town in a month. But now it's probably well over 100 kilos of coke that will be converted to crack cocaine, coming to Calgary every month. It's hard to attach a concrete number to it -- it's an educated guess."
The police service's most recent annual statistical report, for 2005, showed drug offences increasing by 30 per cent over the past six years, trafficking offences up 49 per cent and crack cocaine offences up 113 per cent.
The two veteran officers don't need hard and fast numbers to convince them that crack cocaine is a growing problem in our city. Even
Alberta's smaller communities are seeing the trend.
Others on the front lines of the drug wars support this view: academics, psychologists, counsellors -- and the addicts themselves.
Not only is crack cocaine more prevalent than ever, they say, its influence is cutting across socioeconomic lines. While many of its users are society's most marginalized -- its presence obvious on the city's streets and hooker strolls -- it's also increasingly becoming the drug of choice for an upscale clientele.
Some observers see it as another symptom of the "affluenza" epidemic: one more unanticipated downside of the current economic boom.
Crack -- a drug made by mixing and cooking cocaine, water and baking soda until it forms a rock that is smoked to produce a high -- has never before experienced such an elevated position in our society.
But it wasn't that long ago that crack had the seediest of reputations.
First showing up in U.S. urban centres in the 1980s, the drug became such a scourge among the lower classes that in 1989 half of all felony arrests in New York City were crack-related.
By 1986, Time Magazine had declared crack addiction the No. 1 issue facing America. Newsweek would later call crack the most significant story in the United States since Vietnam and Watergate.
An ABC News special called it a plague "eating away at the fabric of America," while NBC labelled crack "America's drug of choice."
The outrage over crack's grip on society led to an overhaul of U.S. drug laws.
By 2000, however, the New York Times declared crack cocaine no longer a societal threat with a series entitled The War on Crack Retreats. The combination of tougher policing and laws, along with a tarnished reputation as a drug for losers, it said, were to blame. The term "crack head" was deemed the highest insult, even on the mean streets of urban America.
So how, in 2007, has crack resurfaced in cities like Calgary as a drug of choice for some members of mainstream society?
"Gangs should be given PhDs in marketing," says Dr. Louis Pagliaro. "Somehow in the last few years, they've convinced people that meth is the poor man's drug and crack is the new Cadillac, the rich man's drug."
Pagliaro, a professor in educational psychology at the University of Alberta, has been tracking drug trends for more than 30 years and was the RCMP's key expert witness during a landmark crack trial in Alberta in 1995. He just finished his 14th book with his wife and fellow professor Ann Marie Pagliaro, called Gangs, Drugs and Violent Crime Among Canadian Youth.
He won't use the word epidemic when it comes to crack use, only because "I've been chastised for saying that. But call it what you want."
He says our province is ripe for such a development. "Albertans are working the longest hours in the country, calls to your city's distress lines are hitting record numbers," he says. "A boom can create a lot of unhappiness."
Where there are unhappy people, there is always substance abuse. "I've treated everyone from multiple murderers to Hollywood movie stars, and they all have one thing in common -- unhappiness. They use drugs to alter that state of unhappiness."
But why crack?
Pagliaro says so-called drugs of choice are anything but. Organized crime, he says, has the biggest influence by flooding the market withcertain narcotics.
"Cocaine is the major lifeblood of these gangs," says Pagliaro, who adds that alcohol is still king when it comes to abused substances. "It's the way they support any and all of their criminal activities."
While crack cocaine appears to be cheap at first glance -- a rock can cost anywhere from $5 to $20 -- its short high (about 10 minutes) means the addict will often need 20 or more hits a day. Some hard-core users report taking from 50 to 100 hits.
"They're making a lot of money off one drug," says Pagliaro. "These days, you can hardly find any powdered cocaine on the streets, because the gangs have decided they'd rather sell crack."
Despite crack's emergence as a popular drug, it's impossible to find accurate statistics on its use. Health Canada states on its website that "because cocaine is an illicit drug, the number of users can never be determined definitively. Not everyone who uses cocaine will admit use if asked in a survey, or will accurately recall consumption."
Some critics say that because crack also has the distinction of creating poverty in its users more quickly than most other drugs, self-reporting will never give an accurate picture. That's because crack users deep into their addictions rarely even have homes anymore, let alone telephones.
Add to that the fact that most government surveys here and in other parts of the world group crack together with powdered cocaine, which is snorted.
Still, studies like the Canadian Addiction Survey, published in 2004, found that more than 14 per cent of males, and 10.6 per cent of the total population, reported having tried cocaine.
Dr. Ron Lim doesn't need spreadsheets or polls to convince him of crack's growing prevalence. A professor with the University of Calgary's faculty of medicine, Lim is involved in the addictions field on a number of fronts, from consulting with the Foothills Addiction Centre in Calgary and a private facility in B.C., to helping out at the Renfrew Recovery Centre, a detox centre in the city run by the Alberta Alcohol and Drug Abuse Commission.
"In every aspect of what I am doing, I am seeing more cocaine and crack cocaine," he says. "At Renfrew, crack addiction is now second only to alcohol."
Another problem with this highly addictive drug, Lim points out, is that dealers often add other dangerous substances into the mix, so the user isn't getting pure cocaine. "They cut it with everything from Tylenol to Procaine (a topical anesthetic) to maybe even a bit of crystal meth and heroine. You really have no guarantee what you're getting."
While he acknowledges an increase in professionals joining the ranks of the crack addicted, Lim says he rarely treats them. "The waiting list in Alberta is four to eight weeks, and it's almost all government-run," he says. "People with money don't want to wait, and they don't want to sit beside a homeless person in treatment. They're heading to private treatment centres in British Columbia."
Cocaine and crack cocaine, he says, are psychologically, not physically, addictive. That makes it one of the toughest addictions to treat.
"Cocaine is extremely difficult to quit," he says, adding that if you took 100 people and gave them alcohol, statistically 10 per cent would become addicted. "For cocaine, it would be around 17 to 20 per cent. It is such a dangerous drug to try."
"If you take a drug, you can become addicted," says Dr. Perry Sirota, director of Serenity House Drug & Alcohol Treatment Centre in Calgary. "It doesn't matter how much money you make, how educated you are."
Sirota understands why there has been much media coverage and government interest in methamphetamines -- the Premier's Task Force on Crystal Meth, for instance -- because "meth is a pretty horrible drug, with permanent effects." But he can't understand why crack isn't getting at least equal attention.
"There are a heck of a lot more people in this province using crack than crystal meth."
Sirota says that he's seeing a lot more middle and upper middle income crack addicts, partly because "they were using powder, but then found that was harder and harder to get. They won't think about the fact crack is worse, they just think about replacing that high."
His clientele has extended to include professionals in the finance and legal fields, people in positions of trust with easy access to cash. Fraud cases, where businesspeople have dipped into company and client funds, he says, can almost always be traced to either a drug or gambling addiction.
"I treat sex workers who tell me they can point to any high-end office building in the downtown core and say that's where they go at night with professionals to party and smoke crack."
When the average person thinks of a crack addict, says Neal Berger, "I'll bet they see a male from 18 to 35, who has long, straggly dark hair and looks like he just got out of the criminal justice system.
"They don't picture a guy with a Porsche or a middle-aged homemaker."
But Berger, who has been treating addicts for 30 years and is executive director of the Cedars at Cobble Hill, a residential treatment centre near Duncan, B.C., says that's what he's seeing more and more of every day. And a growing number of Albertans are using his centre's services.
Berger says Alberta's runaway economy has created a unique set of problems among its workforce.
"Dealing with places like Fort McMurray," says Berger, who regularly consults with the province's oil and gas industry, "is like trying to change an entire nation."
He says the growth of illicit drugs like crack among the ranks of the employed is one of the biggest workplace issues today.
"The cost to business and industry is astronomical," he says. Not to mention the risks to safety. "You have addicts who are operating heavy machinery and other equipment that requires a lot of attention."
If crack users and addicts aren't prone to confessing their proclivities to government canvassers, one place some feel comfortable is an organization like Cocaine Anonymous (CA).
"We don't ask them what you do for a living," says John, a representative
of the Calgary chapter of CA. (In keeping with CA's anonymity policy, he won't divulge his real name.) "But you can tell when someone's in a nice business suit that they're not your stereotypical crack user."
In his dozen years counselling fellow crack addicts, he's seen a huge shift from the use of powdered cocaine to crack.
"You never hear the term freebasing now," says John. "It's all crack, and it's so easy to get it. You just have to know who to ask."
John, who has been clean from his crack addiction for 12 years and has a construction business, says he understands how difficult it is to shake the drug, despite his own long-term success.
"It's psychologically addictive, so it becomes a mental obsession," he says. "Just trying to say no, it seems physically impossible for an addict. The rush is so good, but so short, so it just leaves you wanting more."
For Calgary police, how much money a crack addict may have in his or her bank account is of no interest. "We're not targeting the millionaires, or any other addict," says Sparrow, of the CPS drug unit.
"Our emphasis is on the traffickers, the guys making the money off of the addicts."
By introducing illicit drugs into the community, the producers and dealers are causing more harm than just to those ingesting their product. "Anywhere drugs are present, every kind of crime goes up," says Sparrow.
"Violence, petty crimes, burglaries, robberies, murders."
But while finding down-and-out crack addicts such as prostitutes and street people is easy, the increasing numbers of addicts with money and a fixed address can go undercover for a long time -- long enough to use up all their savings and eventually lose everything.
"Everybody has an image of what a crack addict looks like," says Hudacin, Sparrow's partner.
"They'd be pretty surprised to see some of them. Crack addiction runs the full socioeconomic spectrum in Calgary."
[email protected]
COCAINE AND CRACK: A PRIMER
- Cocaine is a powerful drug made from the South American coca bush. Its street names include coke, C, snow and flake.
- Cocaine is sold as a fine white powder. Street dealers sometimes dilute it with substances like cornstarch or sugar, or local painkillers like benzocaine. Users often snort cocaine. They also
dissolve it in water and inject it into their veins.
- Heating cocaine hydrochloride with baking soda makes crack. The mixture forms a solid chunk composed of chemicals that
include freebase cocaine. It gets its name from the crackling sound it makes when being cooked. Crack chunks are also known as "rock." Freebase is a pure form of cocaine that can also be smoked. Some crack and freebase users inhale the vapours from heated glass pipes. Others add them to tobacco or marijuana cigarettes.
- All forms of cocaine have the same effects. But injecting produces these effects more quickly and intensely than snorting. Smoking it causes the most intense
and addictive high.
COCAINE AND CRACK'S EFFECTS:
- Cocaine can make you feel intense pleasure. You can feel alert, energetic and confident. Using cocaine
increases your breathing, heart rate and blood pressure. It dilates your pupils, decreases your appetite and reduces your need to sleep.
- Large doses of cocaine can produce euphoria, severe
agitation, anxiety,erratic and violent behaviour, twitching, hallucinations, blurred vision, headaches, chest pains, rapid shallow breathing, muscle spasms, nausea and fever.
- Overdose can cause seizures, strokes, heart
attacks, kidney failure, coma and death. Use is linked with suicides, murder and fatal accidents.
- A cocaine high can last from five minutes to two hours. When users "crash" they feel very depressed, anxious and irritable. Many users take repeated doses to maintain the high and avoid the crash. Some users try to modify the effects or stop binges with drugs like alcohol, tranquilizers or heroin. Respiratory arrest is a common cause of death from cocaine overdose.
- Heavy cocaine users can feel depressed, restless, agitated and nervous. They can have sleeping, eating and sexual problems. They can have dramatic mood swings, delusions, hallucinations and paranoia. High blood pressure and irregular heartbeats occur. Repeated use may cause long-lasting problems with memory, attention and behaviour.
- Possessing, producing
and trafficking in cocaine can result in fines, prison sentences and a criminal record.
COCAINE AND ADDICTION:
- People who use cocaine heavily over a long period, or binge for several days, develop a tolerance. They need to take more of the drug to feel the same effects.
- Regular users can develop powerful psychological dependence, a relentless craving for the drug. They continue to use the drug even when it causes overwhelming physical, mental and social problems.
WITHDRAWAL:
- Withdrawal from cocaine causes few physical effects, but the psychological effects, including loss of pleasure,
depression and low energy, are severe. Three phases of withdrawal have been
described. Phase 1, the "crash," follows the end of the binge and lasts for up to four days. The user has very low energy, may sleep for days and may eat large amounts of food.
- During Phase 2, which lasts for two to 12 weeks, the user feels little initiative, intense boredom, and minimal pleasure from life. This limited existence, as compared with the memories of drug-induced euphoria, can lead to severe craving, resumption of cocaine use and cycles of recurrent binges.
- Phase 3, "extinction," gradually follows if no drug is taken for many months. Normal function returns and eventually craving
decreases, or at least is not associated with a relapse to drug use.
Source: Alberta Alcohol and Drug Abuse Commission
Calgary's runaway economy is creating an "affluenza" epidemic.
One of its manifestations is the rising use of crack cocaine. Calgary Herald columnist Valerie Fortney investigates why this is happening and who are its new victims.
THE CHANGING FACE OF CRACK ADDICTION
Today:
- Market-savvy gangs are driving the new addiction, says one expert.
- Crack's new clientele: The compelling stories of two crack addicts.
Sunday:
- Calgarians are turning to expensive treatment centres on the West Coast.
- Stories of recovery: A stockbroker and the wife of a prominent businessman.
This story features factboxes "Cocaine and Crack: A Primer" and "The Changing Face of Crack Addiction".
© The Calgary Herald 2007
November 29, 2007
Six Killers: Lung Disease
From Smoking Boom, a Major Killer of Women
By DENISE GRADY
For Jean Rommes, the crisis came five years ago, on a Monday morning when she had planned to go to work but wound up in the hospital, barely able to breathe. She was 59, the president of a small company in Iowa. Although she had quit smoking a decade earlier, 30 years of cigarettes had taken their toll.
After several days in the hospital, she was sent home tethered to an oxygen tank, with a raft of medicines and a warning: “If I didn’t do something, life was going to continue to be a pretty scary experience.”
Ms. Rommes has chronic obstructive pulmonary disease, or C.O.P.D., a progressive illness that permanently damages the lungs and is usually caused by smoking. Once thought of as an old man’s disease, this disorder has become a major killer in women as well, the consequence of a smoking boom in the 1950s, ’60s and ’70s. The death rate in women nearly tripled from 1980 to 2000, and since 2000, more women than men have died or been hospitalized every year because of the disease.
“Women started smoking in what I call the Virginia Slims era, when they started sponsoring sporting events,” said Dr. Barry J. Make, a lung specialist at National Jewish Medical and Research Center in Denver. “It’s now just catching up to them.”
Chronic obstructive pulmonary disease actually comprises two illnesses: one, emphysema, destroys air sacs deep in the lungs; the other, chronic bronchitis, causes inflammation, congestion and scarring in the airways. The disease kills 120,000 Americans a year, is the fourth leading cause of death and is expected to be third by 2020. About 12 million Americans are known to have it, including many who have long since quit smoking, and studies suggest that 12 million more cases have not been diagnosed. Half the patients are under 65. The disease has left some 900,000 working-age people too sick to work and costs $42 billion a year in medical bills and lost productivity.
“It’s the largest uncontrolled epidemic of disease in the United States today,” said Dr. James Crapo, a professor at the National Jewish Medical and Research Center.
Experts consider the statistics a national disgrace. They say chronic lung disease is misdiagnosed, neglected, improperly treated and stigmatized as self-induced, with patients made to feel they barely deserve help, because they smoked. The disease is mired in a bog of misconception and prejudice, doctors say. It is commonly mistaken for asthma, especially in women, and treated with the wrong drugs.
Although incurable, it is treatable, but many patients, and some doctors, mistakenly think little can be done for it. As a result, patients miss out on therapies that could help them feel better and possibly live longer. The therapies vary, but may include drugs, exercise programs, oxygen and lung surgery.
Incorrectly treated, many fall needlessly into a cycle of worsening illness and disability, and wind up in the emergency room over and over again with pneumonia and other exacerbations — breathing crises like the one that put Ms. Rommes in the hospital — that might have been averted.
“Patients often come to me with years of being under treated,” said Dr. Byron Thomashow, the director of the Center for Chest Disease at NewYork-Presbyterian/Columbia hospital.
Still others are overtreated for years with steroids like prednisone, which is meant for short-term use and if used too much can thin the bones, weaken muscles and raise the risk of cataracts.
Adequate treatment means drugs, usually inhaled, that open the airways and quell inflammation — preventive medicines that must be used daily, not just in emergencies. It is essential to quit smoking.
Patients also need antibiotics to fight lung infections, vaccines to prevent flu and pneumonia and lessons on special breathing techniques that can help them make the most of their diminished lungs. Some need oxygen, which can help them be more active and prolong life in severe cases. Many need dietary advice: obesity can worsen symptoms, but some with advanced disease lose so much weight that their muscles begin to waste. Some people with emphysema benefit from surgery to remove diseased parts of their lungs.
Above all, patients need exercise, because shortness of breath drives many to become inactive, and they become increasingly weak, homebound, disabled and depressed. Many could benefit from therapy programs called pulmonary rehabilitation, which combine exercise with education about the disease, drugs and nutrition, but the programs are not available in all parts of the country, and insurance coverage for them varies.
“I have a complicated, severe group of patients, but I will swear to you that very few wind up in hospitals,” Dr. Thomashow said. “I treat aggressively. I use the medicines, I exercise all of them. You can make a difference here. This is an example of how we’re undertreating this entire disease.”
Little-Known Epidemic
Researchers say there is so little public awareness of how common and serious C.O.P.D. is that the O might as well stand for “obscure” or “overlooked.”
The disease may not be well known, but people who have it are a familiar sight. They are the ones who cannot climb half a flight of stairs without getting winded, who have a perpetual smoker’s cough or wheeze, who need oxygen to walk down the block or push a cart through the supermarket. Some grow too weak and short of breath to leave the house. The flu or even a cold can put them in the hospital. In advanced stages, the lung disease can lead to heart failure.
“This is a disease where people eventually fade away because they can no longer cope with life,” said Grace Anne Dorney Koppel, who has chronic lung disease. (Ms. Dorney Koppel, a lawyer, is married to Ted Koppel.) “My God, if you don’t have breath, you don’t have anything.”
Most cases, about 85 percent, are caused by smoking, and symptoms usually start after age 40, in people who have smoked a pack a day for 10 years or more. In the United States, 45 million people smoke, 21 percent of adults. Only about 20 percent of smokers develop chronic lung disease.
The illness is not the same as asthma, but some patients have asthma along with their other lung problems. Most have a combination of emphysema and chronic bronchitis. In about one-sixth of cases, emphysema is the main problem. Women are far more likely than men to develop chronic bronchitis, and are less prone to emphysema. Some studies have suggested that women’s lungs are more sensitive than men’s to the toxins in smoke.
Worldwide, these lung diseases kill 2.5 million people a year. An article in September in The Lancet, a medical journal, said that “if every smoker in the world were to stop smoking today, the rates of C.O.P.D. would probably continue to increase for the next 20 years.” The reason is that although quitting slows the disease, it can develop later.
Cigarettes are the major cause worldwide, but other sources are important in developing countries, especially smoke from indoor fires that burn wood, coal, straw or dung for heating and cooking. Women and children are most likely to be exposed. Outdoor air pollution plays less of a part: it can aggravate existing disease, but is believed to cause only 1 percent of cases in rich countries and 2 percent in poorer ones. Occupational exposures in cotton mills and mines may contribute.
Researchers have differed about whether passive smoking plays a role, but a Lancet article in September predicted that in China, among the 240 million people who are now over 50, 1.9 million who never smoked will die from chronic lung disease — just from exposure to other people’s smoke.
Many patients with lung disease have other illnesses as well, like heart disease, acid reflux, hypertension, high cholesterol, sinus problems or diabetes. Compared with other smokers, those with C.O.P.D. are more likely to develop lung cancer as well. Researchers suspect that all the ailments stem partly from the same underlying condition, widespread inflammation, a reaction by the immune system that can affect blood vessels, organs and tissues all over the body.
Lung disease can creep up insidiously, because human beings have lung power to spare. Millions of airways, with enough surface area to cover a tennis court, provide so much reserve that most people would not notice it if they lost the use of a third or even half of a lung. But all that extra capacity can hide an impending disaster.
“If it comes on gradually, the body can adjust,” said Dr. Neil Schachter, a lung specialist and professor at Mount Sinai Medical Center in New York. “Some of these patients are at oxygen levels where you and I would be gasping for breath.”
People adjust psychologically as well, cutting back their activities, deciding perhaps that they just do not enjoy sports anymore, that they are getting older, gaining weight or a bit out of shape. But at some point the body can no longer compensate, and denial does not work anymore.
“It’s like trying to breathe through a straw,” Dr. Schachter said. “It’s very uncomfortable.”
By then, half a lung might be ruined. On a CT scan, he said, the lungs may look “moth-eaten,” full of holes where tissue has been destroyed.
Often, the diagnosis is not made until the disease is advanced. Even though breathing tests are easy to perform and recommended for high-risk patients like former and current smokers, many doctors do not bother. People who do get a diagnosis frequently are not taught how to use the inhalers that are the mainstay of treatment. Access to pulmonary rehabilitation is limited because Medicare has left coverage decisions to the states. Some programs have shut down, and there are bills in the House and Senate that would require pulmonary rehabilitation to be covered by Medicare. Medicare may also reduce coverage for home oxygen.
Meanwhile, billions are spent on treating exacerbations, episodes of severe breathing trouble that are often caused by colds, flu or other respiratory infections.
A recent study of 1,600 consecutive hospitalizations for chronic lung disease in five New York hospitals found that once patients were in the hospital, their treatment was generally correct, Dr. Thomashow said. But “most upsetting,” he said, was that the majority had been incorrectly treated before going to the hospital.
For many, trying to control the disease, rather than be controlled by it, is a daily struggle. Diane Williams Hymons, 57, a social service consultant and therapist in Silver Spring, Md., has had lifelong problems with bronchitis, allergies and asthma. In the last five or 10 years, her breathing difficulties have worsened, but she was told only three years ago that she had C.O.P.D. It motivated her to give up cigarettes, after smoking for more than 30 years.
“I have good days, and days that aren’t as great,” she said. “I sometimes have trouble walking up steps. I have to stop and catch my breath.”
She is “usually fine” when sitting, she said.
Her mother, also a former smoker with chronic lung disease, has been in a pulmonary rehabilitation program. Ms. Williams Hymons’s doctor has not recommended such a program for her, but she has no idea why. They have discussed surgery to remove part of her lungs, which helps some people with emphysema, but she said no decision had been made yet because it is not clear whether her main problem is emphysema or asthma. She is not sure what her prognosis is.
A Risky Approach
Ms. Williams Hymons has been taking prednisone pills for years, something both she and her doctor know is risky. But when she tries to cut back, the disease flares up. She has many side effects from the drug.
“My bone density is not looking real good,” she said. “I have cramps in my hands and feet, weight gain and bloating, the moon face, excess facial hair, fat deposits between my shoulder blades. Yes, I have those.”
She has broken two ribs just from coughing, probably because the prednisone has thinned her bones, she said. She went to a hospital for the rib pain last year and was given so much asthma medication to stop the coughing that it caused abnormal heart rhythms. She wound up in the cardiac unit for five days, and now says “never again” to being hospitalized.
Her doctor orders regular bone density tests.
“I know he’s concerned, like I’m concerned,” Ms. Williams Hymons said, “but we can’t seem to kind of get things under control.”
A recent study of 25 primary care practices around the United States treating chronic lung disease found that most did not perform spirometry, a simple breathing test used to diagnose or monitor the disease, even when they had the equipment to do so. The test takes only a few minutes, but doctors said there was not enough time during the usual 15-minute visit. Similarly, the practices did not offer much help with smoking cessation.
The author of the study (published in August in The American Journal of Medicine), Pamela L. Moore, said many of the doctors felt unable to help smokers quit, and believed that as long as patients kept smoking, treatments for lung disease would be for nought. But Dr. Moore said research had found that people are more likely to quit or start cutting back if doctors recommend it.
Labeling the disease self-induced is “an unbelievably painful concept,” Dr. Thomashow said. “Patients blame themselves, their family blames them, we even have evidence that health providers blame them.”
Shame and Blame
Indeed, a patient at a clinic in Manhattan, with nasal oxygen tubing attached to equipment in a backpack, said, “This is one of the evils you must suffer for the things we did in our life.”
Smoking also contributes to heart disease, Dr. Thomashow said, and yet people “don’t waste time blaming the patient.”
“This disease quite frankly has an image problem,” said Dr. James Kiley, the director of lung research at the National Heart, Lung and Blood Institute, which started a campaign last January to educate people about the disease.
In one way or another every patient seems to have encountered what John Walsh, president of the C.O.P.D. Foundation, calls the “shame and blame” attached to this disease.
It is a familiar theme to Ms. Dorney Koppel, who agreed to become a spokeswoman for the institute’s education campaign. She was surprised to be asked to help, she said, because the campaign needed a celebrity, and she is merely married to one. She asked the person who invited her, whether there were no famous people with C.O.P.D.
“I was told, ‘None who will admit it,’” she said.
Ms. Dorney Koppel, who is candid about being a former smoker, calls the illness the Rodney Dangerfield of diseases.
“You don’t get no respect,” she said. “I have to pay publicly for my sins. I have paid.”
Like many patients, Ms. Rommes has both emphysema and chronic bronchitis, along with asthma. She had symptoms for years before receiving the correct diagnosis.
She began smoking in college during the 1960s, when she was 18. People whom she admired smoked, and it seemed cool. She smoked for 30 years.
When she quit in 1992, it was not because she thought she was ill, but because she realized that she was organizing her day around chances to smoke. But she almost certainly was ill. She was only 50, but climbing a flight of stairs left her winded. From what she found in medical dictionaries, she began to suspect she had lung disease.
By 2000 she was so short of breath that she consulted her doctor about it.
He gave her a spirometry test. In one second, healthy adults should be able to blow out 80 percent of the total they can exhale; her score was 34 percent, which, she knows now, indicated moderate to severe lung disease.
“I honestly don’t know whether he knew,” she said of her doctor. “I suspect he did, but he didn’t call it emphysema.”
“He put me on a couple of inhalers and he called it asthma,” Ms. Rommes said. “I sort of ignored the whole thing, because the inhalers did make me feel better. I started to gain some weight, and things got progressively worse.”
She cannot help wondering now if she could have avoided becoming so desperately ill, if she had only known sooner what a dangerous illness she had.
The turning point came in February 2003 when she tried to take a shower and found that she could not breathe. The steam all but suffocated her. She managed to drive from her home in Osceola, Iowa, to her doctor’s office, struggle across the parking lot like someone climbing a mountain and collapse, gasping, onto a couch inside the clinic. Her blood oxygen was perilously low, two-thirds of normal, even when she was given oxygen. The hospital was next door, and her doctor had her admitted immediately.
Fear and Anger
She had Type 2 diabetes as well as lung disease, and her doctor told her that losing weight would help both illnesses. But she said, “He made it pretty clear that he didn’t think I would or could.”
Motivated by fear and anger, she began riding an exercise bike, walking on a treadmill, lifting weights at a gym and eating only 1,200 to 1,500 calories a day, mostly lean meat with plenty of vegetables and fruit.
“I kind of came to the conclusion that if I didn’t, I probably wasn’t going to be around,” Ms. Rommes said. “I wasn’t ready to check out. And my husband was beginning to show the signs of Alzheimer’s disease. I knew that if I couldn’t continue to manage our affairs, it wasn’t going to work out.”
By December 2003, her efforts were starting to pay off. She went from needing oxygen around the clock to using it only for sleeping, and by January 2005 she no longer needed it at all. She was able to lower the doses of her inhalers and diabetes medicines. By February 2005, she had lost 100 pounds.
The daily exercise also helped her deal with the stress of her husband’s illness. He died in June.
“I had no clue that exercise would do as much for ability to breathe as it did,” she said, adding that it helped more than the drugs, which she described as “really pretty minimal.”
She is hooked on exercise now, getting up every morning at 5 a.m. to walk for 45 minutes on the treadmill. She goes at it hard enough to break a sweat, wearing a blood oxygen monitor to make sure her level does not dip too low (if it does, she slows down or uses special breathing techniques to bring it up). She walks outdoors, as well, and three times a week, she works out with weights at a gym.
“Exercise is absolutely essential, and it’s essential to start it as soon as you know you have C.O.P.D.,” she said.
Exercise does not heal or strengthen the lungs themselves, but it improves overall fitness, which people with lung disease need desperately because their shortness of breath leads to inactivity, muscle wasting and loss of stamina.
“Both my pulmonologist and my regular doctor have made it really, really clear to me that I have not increased my lung capacity at all,” Ms. Rommes said. “But I’ve improved the mechanics. I’ve done everything I know how to do to make the lung capacity as efficient as possible. That’s the key for me; I know there are lots of people with this disease who don’t exercise, who I guess just give up.”
She realizes that she has two serious chronic diseases that could shorten her life. But it does not worry her much, she said, because she figures she is doing everything she can to take care of herself, and would rather spend her time enjoying life — work, reading, opera, traveling, children and grandchildren.
“I will tell pretty much anybody that I have emphysema,” Ms. Rommes said. “They say, ‘Did you smoke?’ I say, ‘Yes I did, for 30 years, and I quit in 1992.’ Maybe it’s why I’ve attacked this the way I did. O.K., I did it to myself, and so I better do everything I can to get out of it. We all do things in our lives that are stupid, and then you do what you can to fix it.”
Six Killers: Lung Disease
From Smoking Boom, a Major Killer of Women
By DENISE GRADY
For Jean Rommes, the crisis came five years ago, on a Monday morning when she had planned to go to work but wound up in the hospital, barely able to breathe. She was 59, the president of a small company in Iowa. Although she had quit smoking a decade earlier, 30 years of cigarettes had taken their toll.
After several days in the hospital, she was sent home tethered to an oxygen tank, with a raft of medicines and a warning: “If I didn’t do something, life was going to continue to be a pretty scary experience.”
Ms. Rommes has chronic obstructive pulmonary disease, or C.O.P.D., a progressive illness that permanently damages the lungs and is usually caused by smoking. Once thought of as an old man’s disease, this disorder has become a major killer in women as well, the consequence of a smoking boom in the 1950s, ’60s and ’70s. The death rate in women nearly tripled from 1980 to 2000, and since 2000, more women than men have died or been hospitalized every year because of the disease.
“Women started smoking in what I call the Virginia Slims era, when they started sponsoring sporting events,” said Dr. Barry J. Make, a lung specialist at National Jewish Medical and Research Center in Denver. “It’s now just catching up to them.”
Chronic obstructive pulmonary disease actually comprises two illnesses: one, emphysema, destroys air sacs deep in the lungs; the other, chronic bronchitis, causes inflammation, congestion and scarring in the airways. The disease kills 120,000 Americans a year, is the fourth leading cause of death and is expected to be third by 2020. About 12 million Americans are known to have it, including many who have long since quit smoking, and studies suggest that 12 million more cases have not been diagnosed. Half the patients are under 65. The disease has left some 900,000 working-age people too sick to work and costs $42 billion a year in medical bills and lost productivity.
“It’s the largest uncontrolled epidemic of disease in the United States today,” said Dr. James Crapo, a professor at the National Jewish Medical and Research Center.
Experts consider the statistics a national disgrace. They say chronic lung disease is misdiagnosed, neglected, improperly treated and stigmatized as self-induced, with patients made to feel they barely deserve help, because they smoked. The disease is mired in a bog of misconception and prejudice, doctors say. It is commonly mistaken for asthma, especially in women, and treated with the wrong drugs.
Although incurable, it is treatable, but many patients, and some doctors, mistakenly think little can be done for it. As a result, patients miss out on therapies that could help them feel better and possibly live longer. The therapies vary, but may include drugs, exercise programs, oxygen and lung surgery.
Incorrectly treated, many fall needlessly into a cycle of worsening illness and disability, and wind up in the emergency room over and over again with pneumonia and other exacerbations — breathing crises like the one that put Ms. Rommes in the hospital — that might have been averted.
“Patients often come to me with years of being under treated,” said Dr. Byron Thomashow, the director of the Center for Chest Disease at NewYork-Presbyterian/Columbia hospital.
Still others are overtreated for years with steroids like prednisone, which is meant for short-term use and if used too much can thin the bones, weaken muscles and raise the risk of cataracts.
Adequate treatment means drugs, usually inhaled, that open the airways and quell inflammation — preventive medicines that must be used daily, not just in emergencies. It is essential to quit smoking.
Patients also need antibiotics to fight lung infections, vaccines to prevent flu and pneumonia and lessons on special breathing techniques that can help them make the most of their diminished lungs. Some need oxygen, which can help them be more active and prolong life in severe cases. Many need dietary advice: obesity can worsen symptoms, but some with advanced disease lose so much weight that their muscles begin to waste. Some people with emphysema benefit from surgery to remove diseased parts of their lungs.
Above all, patients need exercise, because shortness of breath drives many to become inactive, and they become increasingly weak, homebound, disabled and depressed. Many could benefit from therapy programs called pulmonary rehabilitation, which combine exercise with education about the disease, drugs and nutrition, but the programs are not available in all parts of the country, and insurance coverage for them varies.
“I have a complicated, severe group of patients, but I will swear to you that very few wind up in hospitals,” Dr. Thomashow said. “I treat aggressively. I use the medicines, I exercise all of them. You can make a difference here. This is an example of how we’re undertreating this entire disease.”
Little-Known Epidemic
Researchers say there is so little public awareness of how common and serious C.O.P.D. is that the O might as well stand for “obscure” or “overlooked.”
The disease may not be well known, but people who have it are a familiar sight. They are the ones who cannot climb half a flight of stairs without getting winded, who have a perpetual smoker’s cough or wheeze, who need oxygen to walk down the block or push a cart through the supermarket. Some grow too weak and short of breath to leave the house. The flu or even a cold can put them in the hospital. In advanced stages, the lung disease can lead to heart failure.
“This is a disease where people eventually fade away because they can no longer cope with life,” said Grace Anne Dorney Koppel, who has chronic lung disease. (Ms. Dorney Koppel, a lawyer, is married to Ted Koppel.) “My God, if you don’t have breath, you don’t have anything.”
Most cases, about 85 percent, are caused by smoking, and symptoms usually start after age 40, in people who have smoked a pack a day for 10 years or more. In the United States, 45 million people smoke, 21 percent of adults. Only about 20 percent of smokers develop chronic lung disease.
The illness is not the same as asthma, but some patients have asthma along with their other lung problems. Most have a combination of emphysema and chronic bronchitis. In about one-sixth of cases, emphysema is the main problem. Women are far more likely than men to develop chronic bronchitis, and are less prone to emphysema. Some studies have suggested that women’s lungs are more sensitive than men’s to the toxins in smoke.
Worldwide, these lung diseases kill 2.5 million people a year. An article in September in The Lancet, a medical journal, said that “if every smoker in the world were to stop smoking today, the rates of C.O.P.D. would probably continue to increase for the next 20 years.” The reason is that although quitting slows the disease, it can develop later.
Cigarettes are the major cause worldwide, but other sources are important in developing countries, especially smoke from indoor fires that burn wood, coal, straw or dung for heating and cooking. Women and children are most likely to be exposed. Outdoor air pollution plays less of a part: it can aggravate existing disease, but is believed to cause only 1 percent of cases in rich countries and 2 percent in poorer ones. Occupational exposures in cotton mills and mines may contribute.
Researchers have differed about whether passive smoking plays a role, but a Lancet article in September predicted that in China, among the 240 million people who are now over 50, 1.9 million who never smoked will die from chronic lung disease — just from exposure to other people’s smoke.
Many patients with lung disease have other illnesses as well, like heart disease, acid reflux, hypertension, high cholesterol, sinus problems or diabetes. Compared with other smokers, those with C.O.P.D. are more likely to develop lung cancer as well. Researchers suspect that all the ailments stem partly from the same underlying condition, widespread inflammation, a reaction by the immune system that can affect blood vessels, organs and tissues all over the body.
Lung disease can creep up insidiously, because human beings have lung power to spare. Millions of airways, with enough surface area to cover a tennis court, provide so much reserve that most people would not notice it if they lost the use of a third or even half of a lung. But all that extra capacity can hide an impending disaster.
“If it comes on gradually, the body can adjust,” said Dr. Neil Schachter, a lung specialist and professor at Mount Sinai Medical Center in New York. “Some of these patients are at oxygen levels where you and I would be gasping for breath.”
People adjust psychologically as well, cutting back their activities, deciding perhaps that they just do not enjoy sports anymore, that they are getting older, gaining weight or a bit out of shape. But at some point the body can no longer compensate, and denial does not work anymore.
“It’s like trying to breathe through a straw,” Dr. Schachter said. “It’s very uncomfortable.”
By then, half a lung might be ruined. On a CT scan, he said, the lungs may look “moth-eaten,” full of holes where tissue has been destroyed.
Often, the diagnosis is not made until the disease is advanced. Even though breathing tests are easy to perform and recommended for high-risk patients like former and current smokers, many doctors do not bother. People who do get a diagnosis frequently are not taught how to use the inhalers that are the mainstay of treatment. Access to pulmonary rehabilitation is limited because Medicare has left coverage decisions to the states. Some programs have shut down, and there are bills in the House and Senate that would require pulmonary rehabilitation to be covered by Medicare. Medicare may also reduce coverage for home oxygen.
Meanwhile, billions are spent on treating exacerbations, episodes of severe breathing trouble that are often caused by colds, flu or other respiratory infections.
A recent study of 1,600 consecutive hospitalizations for chronic lung disease in five New York hospitals found that once patients were in the hospital, their treatment was generally correct, Dr. Thomashow said. But “most upsetting,” he said, was that the majority had been incorrectly treated before going to the hospital.
For many, trying to control the disease, rather than be controlled by it, is a daily struggle. Diane Williams Hymons, 57, a social service consultant and therapist in Silver Spring, Md., has had lifelong problems with bronchitis, allergies and asthma. In the last five or 10 years, her breathing difficulties have worsened, but she was told only three years ago that she had C.O.P.D. It motivated her to give up cigarettes, after smoking for more than 30 years.
“I have good days, and days that aren’t as great,” she said. “I sometimes have trouble walking up steps. I have to stop and catch my breath.”
She is “usually fine” when sitting, she said.
Her mother, also a former smoker with chronic lung disease, has been in a pulmonary rehabilitation program. Ms. Williams Hymons’s doctor has not recommended such a program for her, but she has no idea why. They have discussed surgery to remove part of her lungs, which helps some people with emphysema, but she said no decision had been made yet because it is not clear whether her main problem is emphysema or asthma. She is not sure what her prognosis is.
A Risky Approach
Ms. Williams Hymons has been taking prednisone pills for years, something both she and her doctor know is risky. But when she tries to cut back, the disease flares up. She has many side effects from the drug.
“My bone density is not looking real good,” she said. “I have cramps in my hands and feet, weight gain and bloating, the moon face, excess facial hair, fat deposits between my shoulder blades. Yes, I have those.”
She has broken two ribs just from coughing, probably because the prednisone has thinned her bones, she said. She went to a hospital for the rib pain last year and was given so much asthma medication to stop the coughing that it caused abnormal heart rhythms. She wound up in the cardiac unit for five days, and now says “never again” to being hospitalized.
Her doctor orders regular bone density tests.
“I know he’s concerned, like I’m concerned,” Ms. Williams Hymons said, “but we can’t seem to kind of get things under control.”
A recent study of 25 primary care practices around the United States treating chronic lung disease found that most did not perform spirometry, a simple breathing test used to diagnose or monitor the disease, even when they had the equipment to do so. The test takes only a few minutes, but doctors said there was not enough time during the usual 15-minute visit. Similarly, the practices did not offer much help with smoking cessation.
The author of the study (published in August in The American Journal of Medicine), Pamela L. Moore, said many of the doctors felt unable to help smokers quit, and believed that as long as patients kept smoking, treatments for lung disease would be for nought. But Dr. Moore said research had found that people are more likely to quit or start cutting back if doctors recommend it.
Labeling the disease self-induced is “an unbelievably painful concept,” Dr. Thomashow said. “Patients blame themselves, their family blames them, we even have evidence that health providers blame them.”
Shame and Blame
Indeed, a patient at a clinic in Manhattan, with nasal oxygen tubing attached to equipment in a backpack, said, “This is one of the evils you must suffer for the things we did in our life.”
Smoking also contributes to heart disease, Dr. Thomashow said, and yet people “don’t waste time blaming the patient.”
“This disease quite frankly has an image problem,” said Dr. James Kiley, the director of lung research at the National Heart, Lung and Blood Institute, which started a campaign last January to educate people about the disease.
In one way or another every patient seems to have encountered what John Walsh, president of the C.O.P.D. Foundation, calls the “shame and blame” attached to this disease.
It is a familiar theme to Ms. Dorney Koppel, who agreed to become a spokeswoman for the institute’s education campaign. She was surprised to be asked to help, she said, because the campaign needed a celebrity, and she is merely married to one. She asked the person who invited her, whether there were no famous people with C.O.P.D.
“I was told, ‘None who will admit it,’” she said.
Ms. Dorney Koppel, who is candid about being a former smoker, calls the illness the Rodney Dangerfield of diseases.
“You don’t get no respect,” she said. “I have to pay publicly for my sins. I have paid.”
Like many patients, Ms. Rommes has both emphysema and chronic bronchitis, along with asthma. She had symptoms for years before receiving the correct diagnosis.
She began smoking in college during the 1960s, when she was 18. People whom she admired smoked, and it seemed cool. She smoked for 30 years.
When she quit in 1992, it was not because she thought she was ill, but because she realized that she was organizing her day around chances to smoke. But she almost certainly was ill. She was only 50, but climbing a flight of stairs left her winded. From what she found in medical dictionaries, she began to suspect she had lung disease.
By 2000 she was so short of breath that she consulted her doctor about it.
He gave her a spirometry test. In one second, healthy adults should be able to blow out 80 percent of the total they can exhale; her score was 34 percent, which, she knows now, indicated moderate to severe lung disease.
“I honestly don’t know whether he knew,” she said of her doctor. “I suspect he did, but he didn’t call it emphysema.”
“He put me on a couple of inhalers and he called it asthma,” Ms. Rommes said. “I sort of ignored the whole thing, because the inhalers did make me feel better. I started to gain some weight, and things got progressively worse.”
She cannot help wondering now if she could have avoided becoming so desperately ill, if she had only known sooner what a dangerous illness she had.
The turning point came in February 2003 when she tried to take a shower and found that she could not breathe. The steam all but suffocated her. She managed to drive from her home in Osceola, Iowa, to her doctor’s office, struggle across the parking lot like someone climbing a mountain and collapse, gasping, onto a couch inside the clinic. Her blood oxygen was perilously low, two-thirds of normal, even when she was given oxygen. The hospital was next door, and her doctor had her admitted immediately.
Fear and Anger
She had Type 2 diabetes as well as lung disease, and her doctor told her that losing weight would help both illnesses. But she said, “He made it pretty clear that he didn’t think I would or could.”
Motivated by fear and anger, she began riding an exercise bike, walking on a treadmill, lifting weights at a gym and eating only 1,200 to 1,500 calories a day, mostly lean meat with plenty of vegetables and fruit.
“I kind of came to the conclusion that if I didn’t, I probably wasn’t going to be around,” Ms. Rommes said. “I wasn’t ready to check out. And my husband was beginning to show the signs of Alzheimer’s disease. I knew that if I couldn’t continue to manage our affairs, it wasn’t going to work out.”
By December 2003, her efforts were starting to pay off. She went from needing oxygen around the clock to using it only for sleeping, and by January 2005 she no longer needed it at all. She was able to lower the doses of her inhalers and diabetes medicines. By February 2005, she had lost 100 pounds.
The daily exercise also helped her deal with the stress of her husband’s illness. He died in June.
“I had no clue that exercise would do as much for ability to breathe as it did,” she said, adding that it helped more than the drugs, which she described as “really pretty minimal.”
She is hooked on exercise now, getting up every morning at 5 a.m. to walk for 45 minutes on the treadmill. She goes at it hard enough to break a sweat, wearing a blood oxygen monitor to make sure her level does not dip too low (if it does, she slows down or uses special breathing techniques to bring it up). She walks outdoors, as well, and three times a week, she works out with weights at a gym.
“Exercise is absolutely essential, and it’s essential to start it as soon as you know you have C.O.P.D.,” she said.
Exercise does not heal or strengthen the lungs themselves, but it improves overall fitness, which people with lung disease need desperately because their shortness of breath leads to inactivity, muscle wasting and loss of stamina.
“Both my pulmonologist and my regular doctor have made it really, really clear to me that I have not increased my lung capacity at all,” Ms. Rommes said. “But I’ve improved the mechanics. I’ve done everything I know how to do to make the lung capacity as efficient as possible. That’s the key for me; I know there are lots of people with this disease who don’t exercise, who I guess just give up.”
She realizes that she has two serious chronic diseases that could shorten her life. But it does not worry her much, she said, because she figures she is doing everything she can to take care of herself, and would rather spend her time enjoying life — work, reading, opera, traveling, children and grandchildren.
“I will tell pretty much anybody that I have emphysema,” Ms. Rommes said. “They say, ‘Did you smoke?’ I say, ‘Yes I did, for 30 years, and I quit in 1992.’ Maybe it’s why I’ve attacked this the way I did. O.K., I did it to myself, and so I better do everything I can to get out of it. We all do things in our lives that are stupid, and then you do what you can to fix it.”
Critics sour on sweeter smelling smokes
William Marsden
CanWest News Service
Friday, December 28, 2007
What's your poison? A little Grand Marnier? How about whisky? Or maybe you like the gentle aroma of vanilla.
Alcohol and food flavours, as well as their often enticing aromas, are the new "technology," as one tobacco company calls these additives, used to help flog cigarettes to an increasingly reluctant public.
Drown the tobacco taste in alcohol or hide the smell with vanilla. The idea is the same: Make tobacco more pleasant and you'll please smokers and non-smokers alike.
Not the anti-smoking lobby, however.
"We are asking the health minister immediately to ban these ads," said Louis Gauvin, spokesman for the Quebec Coalition for Tobacco Control.
He claims the ads violate federal laws that ban tobacco ads geared to young people and forbid any message that attempts to make smoking glamorous or diminish its health risks.
The new liquor-flavoured cigarettes are the products of JTI Macdonald Corp., part of Japan Tobacco Inc.
JTI Macdonald, which is in bankruptcy proceedings after a $1.36-billion Quebec tax assessment in 2004 claiming the company aided and abetted smuggling, has recently targeted the predominantly young readership of alternative newspapers.
In full-page ads, JTI extols the alcohol-like benefits of the newest addition to its More brand.
One ad introduces "A new member of the more international family, subtly aromatized with whisky flavouring."
Another trumpets the kindlier second-hand smoke offered by Mirage: "First in Canada with unique Less Smoke Smell (LSS) Technology."
Mirage's cigarette paper is coated in vanilla.
"If I was a smoker, my reaction might be that this is less harmful second-hand smoke to my friends," Gauvin said. "They will smell vanilla and it will be more agreeable.
"For us, this is trickery."
JTI officials were unavailable for comment. Their Toronto head office is closed until the new year.
© The Calgary Herald 2007
William Marsden
CanWest News Service
Friday, December 28, 2007
What's your poison? A little Grand Marnier? How about whisky? Or maybe you like the gentle aroma of vanilla.
Alcohol and food flavours, as well as their often enticing aromas, are the new "technology," as one tobacco company calls these additives, used to help flog cigarettes to an increasingly reluctant public.
Drown the tobacco taste in alcohol or hide the smell with vanilla. The idea is the same: Make tobacco more pleasant and you'll please smokers and non-smokers alike.
Not the anti-smoking lobby, however.
"We are asking the health minister immediately to ban these ads," said Louis Gauvin, spokesman for the Quebec Coalition for Tobacco Control.
He claims the ads violate federal laws that ban tobacco ads geared to young people and forbid any message that attempts to make smoking glamorous or diminish its health risks.
The new liquor-flavoured cigarettes are the products of JTI Macdonald Corp., part of Japan Tobacco Inc.
JTI Macdonald, which is in bankruptcy proceedings after a $1.36-billion Quebec tax assessment in 2004 claiming the company aided and abetted smuggling, has recently targeted the predominantly young readership of alternative newspapers.
In full-page ads, JTI extols the alcohol-like benefits of the newest addition to its More brand.
One ad introduces "A new member of the more international family, subtly aromatized with whisky flavouring."
Another trumpets the kindlier second-hand smoke offered by Mirage: "First in Canada with unique Less Smoke Smell (LSS) Technology."
Mirage's cigarette paper is coated in vanilla.
"If I was a smoker, my reaction might be that this is less harmful second-hand smoke to my friends," Gauvin said. "They will smell vanilla and it will be more agreeable.
"For us, this is trickery."
JTI officials were unavailable for comment. Their Toronto head office is closed until the new year.
© The Calgary Herald 2007
January 14, 2008
Editorial
H.I.V. Rises Among Young Gay Men
AIDS appears to be making an alarming comeback. The Journal of the American Medical Association reports that the incidence of H.I.V. infection among gay men is shooting up, following an encouraging period of decline. The rise of infections among younger gay men, especially black and Hispanic men, is troubling, and the study carries the clear implication that people at high risk of contracting the disease are becoming less cautious.
Statistics gathered by New York City health officials show that new diagnoses of H.I.V. infection — the virus that causes AIDS — in gay men under age 30 rose 32 percent between 2001 and 2006. Among black and Hispanic men, the figure was 34 percent. Most troubling, the number of new diagnoses among the youngest men in the study, those between ages 13 and 19, doubled.
New York officials say increased alcohol and drug use may be partly responsible since they make unprotected sex more likely. Other basic precautions, including finding out whether a potential partner is infected, are also apparently being ignored.
The one bright spot in this bleak picture was the 22 percent decline in infections among men over 30 in the New York study. Awareness of the disease’s devastating effects, as much as maturity, may explain the difference. A large number of these older men came of age when AIDS was all but untreatable. They may have buried friends who died after being horribly ill.
When the disease was new and terrifying, the gay community helped change behavior by preaching loudly against taking sexual risks. From San Francisco to New York, bathhouses notorious for promoting casual sex changed the way they did business or closed down. Condoms were encouraged, and so was H.I.V. testing. “Silence equals death” was the motto of the day.
Silence now seems to be winning the day. Nearly 6,000 gay men died of AIDS in the United States in 2005; still, many young men appear to have persuaded themselves that the infection is no longer such a big deal. It is true that antiretroviral therapy has improved the outlook for anyone who becomes infected. But the treatments are still too new to know whether they can work much beyond a decade. Public health officials need to continue to distribute condoms, encourage testing and treat those who are ill. Leaders in the hardest-hit communities need to start speaking out again. The fight against AIDS is far from over.
Editorial
H.I.V. Rises Among Young Gay Men
AIDS appears to be making an alarming comeback. The Journal of the American Medical Association reports that the incidence of H.I.V. infection among gay men is shooting up, following an encouraging period of decline. The rise of infections among younger gay men, especially black and Hispanic men, is troubling, and the study carries the clear implication that people at high risk of contracting the disease are becoming less cautious.
Statistics gathered by New York City health officials show that new diagnoses of H.I.V. infection — the virus that causes AIDS — in gay men under age 30 rose 32 percent between 2001 and 2006. Among black and Hispanic men, the figure was 34 percent. Most troubling, the number of new diagnoses among the youngest men in the study, those between ages 13 and 19, doubled.
New York officials say increased alcohol and drug use may be partly responsible since they make unprotected sex more likely. Other basic precautions, including finding out whether a potential partner is infected, are also apparently being ignored.
The one bright spot in this bleak picture was the 22 percent decline in infections among men over 30 in the New York study. Awareness of the disease’s devastating effects, as much as maturity, may explain the difference. A large number of these older men came of age when AIDS was all but untreatable. They may have buried friends who died after being horribly ill.
When the disease was new and terrifying, the gay community helped change behavior by preaching loudly against taking sexual risks. From San Francisco to New York, bathhouses notorious for promoting casual sex changed the way they did business or closed down. Condoms were encouraged, and so was H.I.V. testing. “Silence equals death” was the motto of the day.
Silence now seems to be winning the day. Nearly 6,000 gay men died of AIDS in the United States in 2005; still, many young men appear to have persuaded themselves that the infection is no longer such a big deal. It is true that antiretroviral therapy has improved the outlook for anyone who becomes infected. But the treatments are still too new to know whether they can work much beyond a decade. Public health officials need to continue to distribute condoms, encourage testing and treat those who are ill. Leaders in the hardest-hit communities need to start speaking out again. The fight against AIDS is far from over.
September 2, 2008
Essay
Addiction Doesn’t Discriminate? Wrong
By SALLY SATEL, M.D
We’ve heard it before. “Drug abuse is an equal opportunity destroyer.” “Drug addiction is a bipartisan illness.” “Addiction does not discriminate; it doesn’t care if you are rich or poor, famous or unknown, a man or woman, or even a child.”
The phrase “addiction doesn’t care” is not meant to remind us that addiction casts a long shadow — everyone knows that. Rather, it is supposed to suggest that any individual, no matter who, is vulnerable to the ravages of drugs and alcohol.
The same rhetoric has been applied to other problems, including child abuse, domestic violence, alcoholism — even suicide. Don’t stigmatize the afflicted, it cautions; you could be next. Be kind, don’t judge.
The democratization of addiction may be an appealing message, but it does not reflect reality. Teenagers with drug problems are not like those who never develop them. Adults whose problems persist for decades manifest different traits from those who get clean.
So while anyone can theoretically become an addict, it is more likely the fate of some, among them women sexually abused as children; truant and aggressive young men; children of addicts; people with diagnosed depression and bipolar illness; and groups including American Indians and poor people.
Attitudes, values and behaviors play a potent role as well.
Imagine two people trying cocaine, just to see what it is like. Both are 32-year-old men with jobs and families. One snorts a line, loves it and asks for more. The other also loves it but pushes it away, leaves the party and never touches it again. Different values? Different tolerance for risk? Many factors may distinguish the two cocaine lovers, but only one is at risk for a problem.
Asking for more drug is no guarantee of being seduced into routine use. But what if it happens? Jacob Sullum, a senior editor at Reason magazine, has interviewed many users who became aware that they were sliding down the path to addiction.
“It undermined their sense of themselves as individuals in control of their own destinies,” Mr. Sullum wrote in his 2003 book, “Saying Yes: In Defense of Drug Use.” “And so they stopped.”
I only read about these people. Patients who come to our methadone clinic are there, obviously, because they’re using. The typical patient is someone who has been off heroin for a while (maybe because life was good for while, maybe because there was no access to drugs, maybe because the boss did urine testing) and then resumed.
But the road to resumption was not unmarked. There were signs and exit ramps all along the way. Instead of heeding them, our patients made small, deliberate choices many times a day — to be with other users, to cop drugs for friends, to allow themselves to become bored — and soon there was no turning back.
Addiction does indeed discriminate. It “selects” for people who are bad at delaying gratification and gauging consequences, who are impulsive, who think they have little to lose, have few competing interests, or are willing to lie to a spouse.
Though the National Institute on Drug Abuse describes addiction as a “chronic and relapsing disease,” my patients, seeking help, are actually the exception. Addiction is not an equal opportunity destroyer even among addicts because, thankfully, most eventually extricate themselves from the worst of it.
Gene Heyman, a lecturer and research psychologist at Harvard Medical School and McLean Hospital, said in an interview that “between 60 and 80 percent of people who meet criteria for addiction in their teens and 20s are no longer heavy, problem users by their 30s.” His analysis of large national surveys revealed that those who kept using were almost twice as likely to have a concurrent psychiatric illness.
None of this is to deny that brain physiology plays a meaningful role in becoming and staying addicted, but that is not the whole story.
“The culture of drink endures because it offers so many rewards: confidence for the shy, clarity for the uncertain, solace to the wounded and lonely,” wrote Pete Hamill in his memoir, “A Drinking Life.” Heroin and speed helped the screenwriter Jerry Stahl, author of “Permanent Midnight,” attain the “the soothing hiss of oblivion.”
If addiction were a random event, there would be no logic to it, no desperate reason to keep going back to the bottle or needle, no reason to avoid treatment.
The idea that addiction doesn’t discriminate may be a useful story line for the public — if we are all under threat then we all should urge our politicians to support more research and treatment for addiction. There are good reasons to campaign for those things, but not on the basis of a comforting fiction.
Sally Satel is a psychiatrist and a resident scholar at the American Enterprise Institute.
http://www.nytimes.com/2008/09/02/healt ... nted=print
Essay
Addiction Doesn’t Discriminate? Wrong
By SALLY SATEL, M.D
We’ve heard it before. “Drug abuse is an equal opportunity destroyer.” “Drug addiction is a bipartisan illness.” “Addiction does not discriminate; it doesn’t care if you are rich or poor, famous or unknown, a man or woman, or even a child.”
The phrase “addiction doesn’t care” is not meant to remind us that addiction casts a long shadow — everyone knows that. Rather, it is supposed to suggest that any individual, no matter who, is vulnerable to the ravages of drugs and alcohol.
The same rhetoric has been applied to other problems, including child abuse, domestic violence, alcoholism — even suicide. Don’t stigmatize the afflicted, it cautions; you could be next. Be kind, don’t judge.
The democratization of addiction may be an appealing message, but it does not reflect reality. Teenagers with drug problems are not like those who never develop them. Adults whose problems persist for decades manifest different traits from those who get clean.
So while anyone can theoretically become an addict, it is more likely the fate of some, among them women sexually abused as children; truant and aggressive young men; children of addicts; people with diagnosed depression and bipolar illness; and groups including American Indians and poor people.
Attitudes, values and behaviors play a potent role as well.
Imagine two people trying cocaine, just to see what it is like. Both are 32-year-old men with jobs and families. One snorts a line, loves it and asks for more. The other also loves it but pushes it away, leaves the party and never touches it again. Different values? Different tolerance for risk? Many factors may distinguish the two cocaine lovers, but only one is at risk for a problem.
Asking for more drug is no guarantee of being seduced into routine use. But what if it happens? Jacob Sullum, a senior editor at Reason magazine, has interviewed many users who became aware that they were sliding down the path to addiction.
“It undermined their sense of themselves as individuals in control of their own destinies,” Mr. Sullum wrote in his 2003 book, “Saying Yes: In Defense of Drug Use.” “And so they stopped.”
I only read about these people. Patients who come to our methadone clinic are there, obviously, because they’re using. The typical patient is someone who has been off heroin for a while (maybe because life was good for while, maybe because there was no access to drugs, maybe because the boss did urine testing) and then resumed.
But the road to resumption was not unmarked. There were signs and exit ramps all along the way. Instead of heeding them, our patients made small, deliberate choices many times a day — to be with other users, to cop drugs for friends, to allow themselves to become bored — and soon there was no turning back.
Addiction does indeed discriminate. It “selects” for people who are bad at delaying gratification and gauging consequences, who are impulsive, who think they have little to lose, have few competing interests, or are willing to lie to a spouse.
Though the National Institute on Drug Abuse describes addiction as a “chronic and relapsing disease,” my patients, seeking help, are actually the exception. Addiction is not an equal opportunity destroyer even among addicts because, thankfully, most eventually extricate themselves from the worst of it.
Gene Heyman, a lecturer and research psychologist at Harvard Medical School and McLean Hospital, said in an interview that “between 60 and 80 percent of people who meet criteria for addiction in their teens and 20s are no longer heavy, problem users by their 30s.” His analysis of large national surveys revealed that those who kept using were almost twice as likely to have a concurrent psychiatric illness.
None of this is to deny that brain physiology plays a meaningful role in becoming and staying addicted, but that is not the whole story.
“The culture of drink endures because it offers so many rewards: confidence for the shy, clarity for the uncertain, solace to the wounded and lonely,” wrote Pete Hamill in his memoir, “A Drinking Life.” Heroin and speed helped the screenwriter Jerry Stahl, author of “Permanent Midnight,” attain the “the soothing hiss of oblivion.”
If addiction were a random event, there would be no logic to it, no desperate reason to keep going back to the bottle or needle, no reason to avoid treatment.
The idea that addiction doesn’t discriminate may be a useful story line for the public — if we are all under threat then we all should urge our politicians to support more research and treatment for addiction. There are good reasons to campaign for those things, but not on the basis of a comforting fiction.
Sally Satel is a psychiatrist and a resident scholar at the American Enterprise Institute.
http://www.nytimes.com/2008/09/02/healt ... nted=print
-
haroon_adel
- Posts: 125
- Joined: Tue Mar 18, 2008 8:55 am
- Location: USA
Re: Social Evils
Dear Brother Nagib,nagib wrote:http://www.chitralnews.com/Articles%2015.htm
Social evils- Causes and eradication
Zuifikar Ali Shah Zulfi
President shia imami and ismaili local council Booni has
given me this tough job to write an assignment on the causes and solutions of social evils which are in one form or the other crippling in our society particularly among our jamat. Though it is a very difficult task for me to tell about things that I am not aware of. As a student of science I have no approach to the subject concerned__sociology or social sciences but as a member of the society I have the responsibility to study social events around me. I have tried my best to pinpoint the causes and solutions of social evils up to some extent.
I think that to some extent this assignment will benefit in making further plans and strategies to eradicate these evils from the society.
Social evils are the acts which are undesired and harmful to the society. It is an instinct of the human nature to adopt them readily. The history of social evils is as old as human history itself. They are prevailing in every nook and corner of the world from time immemorial. Some acts which are considered as evil today were the part of human civilization. Alcoholism , smoking , illicit relation with women or men are some of them. Even today in some societies of the world there are many evils which are considered as legal. In Britain, Germany and many other European countries marriage between the men and men and women and
women are allowed on government levels. Lesbians and gays are demanding their basic rights. Alcoholism and sexual freedom are not the crimes at all in many non Muslim countries. In Islam all those acts are unlawful and those who are committing these are criminals.
There are many factors which are involved in creating various kind of social evils. Drug abuse is one among many types of social evils. Islam and other systems of life prohibit this evil but, unfortunately, this land and it’s people are being gradually involved by one of the worst social evil that of drug abuse.
In medical science drugs are those chemical substances which are abused or taken for the sake of just getting euphoric. They cause many physiological disorders in men and animals. Nicotine in tobacco, morphine in opium codeine and alcoholic barbiturates are all categorized as drugs. In the long run they effect the entire body of an organism.
CAUSES OF DRUG ABUSE
1. Increase availability of drugs in market.
2. Socioeconomic factors.
3. Changes in attitude and values towards society, family, community, religion
and morality.
4. Poverty and unemployment.
ADVERSE EFFECTS OF DRUG ABUSE
1. Reduction in life expectancy.
2. Premature birth.
3. Heart attack and other cardiovascular disease.
4. Lung and liver cancer.
5. Rise in blood pressure and contraction of blood vessels.
6. Road accidents by drunken drivers.
7. Loss of memory and other neurological diseases.
Drug abuse or substance abuse can be minimized of completely eradicated if substantial measures are taken. This responsibilities fall on each and every member of the society especially those who are responsible. Our jamati leaders, religious scholars, teachers and educated member of the community can play their role in this regard. The most important thing is awareness among the people especially the young generation who are vulnerable. But the important thing is the individual itself. No law or rule is forcibly imposed unless an individual itself has no sense.
Those who are involved in such business pretend that they have no alternate way earn money. Such peoples should be kept busy and provided them with the basic needs of daily life like food, shelter and home.
Secondly the availability of drugs in local markets should be discouraged. If someone are found guilty they must be punished according to the law. It is a common practice here in our area that after arresting some criminals the influential peoples go to the police station and get them free on their personal guarantee. This practice gives a bad impression and the peoples doubt about the involvement of these individuals in such crimes.
Another point in this regard is that people should be persuaded not to use drug and this impression should be established that our body is the temple or dwelling place of the holy spirit and this holy place should not be contaminated with drugs or any other sin. “Alcohol promises heaven, alcohol bestows hell.”
EXPENSIVE WEDDING
In our society even those who are religious minded, get caught up in this
problem. They do not want to do it , but feel they have to do it to be accepted socially.
The bride and bridegroom wear their bridal attire for a few hours on one day , and never wear the outfits again and yet so much money is spent on their wedding. Wedding these days has become exorbitant function. The rich exhibit their wealth and opulence on such occasion. Every such occasion tremors among the deprived class of the society. As it is observed that the poor class of our society totally depends on bank loan to perform such ceremonies. This depicts how wrong we peoples in setting our priorities, and how our values have changed. Even our leaders (religious, social and political) find it difficult to follow the spirit of Islam.
As the followers of one imam we have diverted from our real path and there is no destiny at last. When it comes to social custom and tradition we forget every command and order of our beloved imam e zaman. Islam
discourages all activities in which money is spent needlessly.
Since social functions in particular set trends, they should be as simple as possible. Wedding foods, gift, apparels, bridal dresses should all be within reasonable limit. If they remain in such limits, they add to the beauty of the occasion, and if they exceed their bounds, they become symbols of human greed and arrogance.
The best define able point of needless expenses and overspendings in such ceremonies is a person’s own conscience. No one else is better judge. The ismaili council can also legislate in this regard. However all large scale social evils should be tackled through educating peoples and changing their mindset. Law are just preventive measures. They do not change the people’s mind.
Education is the treatment of all social evils. We are at war against illiteracy and ignorance.
SOLUTIONS TO THE SOCIAL PROBLEMS
A perusal of the social problem that effect mankind today indicates that it is not the nature of social problem itself , but the level of their operation which causes the changes. The exploitation of man by man. The root cause being the same no matter what may be the level of any particular social evil. The root cause for the imperfect weaving of the social web is irresponsible conduct on the part of the man.
The responsible government , at any level , can never develop unless there are responsible citizens. The institution which constitute the government represent only a small part , other institution like schools, homes, religious centres, voluntary organizations etc form a much greater part of the social activities.
The truth is that every individual is responsible in his own sphere for the
welfare of the community at large. The holy prophet(PBUH) has put the whole matter in a nutshell. “Every one of you is a steward and is accountable for that which is committed to his charge.”
The solution, accordingly , requires two things: first purification of man’s
ego and second the indoctrination of the sense of responsibility for the welfare of all. The real solution therefore lies in the unfolding of true human nature and in educating the masses in the truth that universal brotherhood can be established by virtue of mankind’s relationship with one another through God.
Zuifikar Ali Shah Zulfi
VILLAGE DOKANDEH,
BOONI, CHITRAL.
phone#0933-470232
[email protected]
Very well said. I couldn't agree more with your analysis on these topics. I wouldn like to add my comments on "Expensive Wedding".
It's true that un-necessary waste of money should not be excercised in any occasions and not only in weddings.
On the other hand, Marriage is (should be) a very significant event for all of us (I hope). When someone wants to make it more memorable by spending a little more money (If s/he can afford), I think is alright--Not by getting loan from bank and going in debth or borrwoing it. We get married once in a life time, and it is a very special and memorable event for the persons who's getting married.
So, I believe if one who can afford it, there's nothing wrong with that. Others on the other hand, who can't afford it, and tries to spend as much, by going into debth is not a clever idea, and should not be excercised.
My two cents.
Haroon.
Smoking parents can hook kids on nicotine
Charlie Fidelman
Canwest News Service
Tuesday, September 30, 2008
You know smoking sets a bad example for the kids and second-hand smoke is harmful. As if that wasn't warning enough, a strongly worded Montreal study shows someone else's smoke can lead to nicotine addiction in children.
"Increased exposure to second-hand smoke, both in cars and homes, was associated with an increased likelihood of children reporting nicotine dependence symptoms -- even though these kids had never put a cigarette in their mouths," said epidemiologist Jennifer O'Loughlin, senior author of the study and a professor at the Universite de Montreal.
Published in the September edition of the journal Addictive Behaviors, the study, involving nine Canadian institutions, builds on previous findings on second-hand smoke in non-smokers and withdrawal symptoms including depression, anxiety and trouble concentrating.
The physiological consequences of second-hand smoke have already been shown, O'Loughlin said of bar and restaurant workers (before the cigarette ban) with nicotine metabolites in their urine and saliva as if they had smoked.
Also, it is known that children exposed to second-hand smoke started smoking earlier than other children, said O'Loughlin who, in a previous study, mapped the stepping stones to tobacco addiction, showing it can take one puff to turn a teenager into a smoker.
The study looked at students age 10 and 11 from 29 Montreal area schools. It found an association between exposure to second-hand smoke and nicotine dependence.
Five per cent of 1,488 children who never smoked but were exposed to second-hand smoke reported symptoms of nicotine addiction.
"They told us, 'I want it, I need it,' and that they are physically and mentally addicted," O'Loughlin said. "Why would a kid do that?"
Lead investigator Mathieu Belanger said he was surprised to see evidence of nicotine dependence in children as young as 10, even though they had never smoked.
"But we were not surprised to see it was related to second-hand smoke," said Belanger, research director of the Centre de Formation Medicale du Nouveau Brunswick.
Researchers did not make a direct link between cause and effect, Belanger said.
"More studies are needed. But there's a lesson for parents," he added.
"Most (of those reporting nicotine dependence) came from homes of smokers," Belanger said, or they had friends that already smoked. "Maybe there's a genetic path we're not yet exploring."
While it may seem unconventional that non-smokers are reporting cigarette cravings, Belanger also noted tobacco studies have found toddlers with carcinogens in their blood related to second-hand smoke.
The next step will focus on following these children to see whether they pick up smoking faster than others, he said.
The study was funded by the Canadian Tobacco Control Research Initiative, the Institut national de sante publique du Quebec and the Canadian Institutes of Health Research.
© The Calgary Herald 2008
Charlie Fidelman
Canwest News Service
Tuesday, September 30, 2008
You know smoking sets a bad example for the kids and second-hand smoke is harmful. As if that wasn't warning enough, a strongly worded Montreal study shows someone else's smoke can lead to nicotine addiction in children.
"Increased exposure to second-hand smoke, both in cars and homes, was associated with an increased likelihood of children reporting nicotine dependence symptoms -- even though these kids had never put a cigarette in their mouths," said epidemiologist Jennifer O'Loughlin, senior author of the study and a professor at the Universite de Montreal.
Published in the September edition of the journal Addictive Behaviors, the study, involving nine Canadian institutions, builds on previous findings on second-hand smoke in non-smokers and withdrawal symptoms including depression, anxiety and trouble concentrating.
The physiological consequences of second-hand smoke have already been shown, O'Loughlin said of bar and restaurant workers (before the cigarette ban) with nicotine metabolites in their urine and saliva as if they had smoked.
Also, it is known that children exposed to second-hand smoke started smoking earlier than other children, said O'Loughlin who, in a previous study, mapped the stepping stones to tobacco addiction, showing it can take one puff to turn a teenager into a smoker.
The study looked at students age 10 and 11 from 29 Montreal area schools. It found an association between exposure to second-hand smoke and nicotine dependence.
Five per cent of 1,488 children who never smoked but were exposed to second-hand smoke reported symptoms of nicotine addiction.
"They told us, 'I want it, I need it,' and that they are physically and mentally addicted," O'Loughlin said. "Why would a kid do that?"
Lead investigator Mathieu Belanger said he was surprised to see evidence of nicotine dependence in children as young as 10, even though they had never smoked.
"But we were not surprised to see it was related to second-hand smoke," said Belanger, research director of the Centre de Formation Medicale du Nouveau Brunswick.
Researchers did not make a direct link between cause and effect, Belanger said.
"More studies are needed. But there's a lesson for parents," he added.
"Most (of those reporting nicotine dependence) came from homes of smokers," Belanger said, or they had friends that already smoked. "Maybe there's a genetic path we're not yet exploring."
While it may seem unconventional that non-smokers are reporting cigarette cravings, Belanger also noted tobacco studies have found toddlers with carcinogens in their blood related to second-hand smoke.
The next step will focus on following these children to see whether they pick up smoking faster than others, he said.
The study was funded by the Canadian Tobacco Control Research Initiative, the Institut national de sante publique du Quebec and the Canadian Institutes of Health Research.
© The Calgary Herald 2008
Second-hand smoke causes fertility problems: Study
December 5, 2008
http://www.calgaryherald.com/health/Sec ... story.html
New research suggests second-hand smoke may cause women to have trouble getting pregnant.
Photograph by : Don Healy/Regina Leader-Post
WASHINGTON - Women who breathed in second-hand smoke as children or young adults were later more likely to have trouble getting pregnant and suffer more miscarriages than women not exposed to smoke, U.S. researchers reported Thursday.
They said toxins in the smoke could have permanently damaged the women's bodies, causing the later problems, and said their finding support restrictions on smoking.
Luke Peppone at the University of Rochester in New York, Dr. Kenneth Piazza of the Roswell Park Cancer Institute in Buffalo, New York, and colleagues studied 4,800 women treated at Roswell Park.
They were asked to give details of all pregnancies, attempts to get pregnant, and miscarriages, as well as their history of smoking and breathing second-hand smoke.
Overall, 11 per cent of the women reported difficulty becoming pregnant, and about a third lost one or more babies, the researchers wrote in the journal Tobacco Control.
"Forty per cent reported any prenatal pregnancy difficulty (fetal loss and/or difficulty becoming pregnant)," they said.
Women who remembered their parents smoking around them were 26 per cent more likely to have had difficulty becoming pregnant and women exposed to any second-hand smoke were 39 per cent more likely to have had a miscarriage, Peppone's team reported.
Four out of five of the women reported exposure to second-hand smoke during their lifetimes and half grew up in a home with smoking parents.
"These statistics are breathtaking and certainly points to yet another danger of second-hand smoke exposure," Peppone said in a statement.
Other studies have linked smoking with miscarriage, birth defects and sudden infant death syndrome, also known as cot death or crib death.
"The effects of tobacco usage and exposure on pregnancy outcomes remain a public health priority because 15 per cent of mothers continue to smoke throughout pregnancy, and an estimated 43 million women in the United States are exposed to cigarette smoke from others," they said.
It is possible that second-hand smoke interferes with normal hormone action involved in fertility and pregnancy, the researchers said. It can also affect the woman's cervix, the opening in the uterus through which sperm passes to fertilize the egg.
© Copyright (c) Reuters
December 5, 2008
http://www.calgaryherald.com/health/Sec ... story.html
New research suggests second-hand smoke may cause women to have trouble getting pregnant.
Photograph by : Don Healy/Regina Leader-Post
WASHINGTON - Women who breathed in second-hand smoke as children or young adults were later more likely to have trouble getting pregnant and suffer more miscarriages than women not exposed to smoke, U.S. researchers reported Thursday.
They said toxins in the smoke could have permanently damaged the women's bodies, causing the later problems, and said their finding support restrictions on smoking.
Luke Peppone at the University of Rochester in New York, Dr. Kenneth Piazza of the Roswell Park Cancer Institute in Buffalo, New York, and colleagues studied 4,800 women treated at Roswell Park.
They were asked to give details of all pregnancies, attempts to get pregnant, and miscarriages, as well as their history of smoking and breathing second-hand smoke.
Overall, 11 per cent of the women reported difficulty becoming pregnant, and about a third lost one or more babies, the researchers wrote in the journal Tobacco Control.
"Forty per cent reported any prenatal pregnancy difficulty (fetal loss and/or difficulty becoming pregnant)," they said.
Women who remembered their parents smoking around them were 26 per cent more likely to have had difficulty becoming pregnant and women exposed to any second-hand smoke were 39 per cent more likely to have had a miscarriage, Peppone's team reported.
Four out of five of the women reported exposure to second-hand smoke during their lifetimes and half grew up in a home with smoking parents.
"These statistics are breathtaking and certainly points to yet another danger of second-hand smoke exposure," Peppone said in a statement.
Other studies have linked smoking with miscarriage, birth defects and sudden infant death syndrome, also known as cot death or crib death.
"The effects of tobacco usage and exposure on pregnancy outcomes remain a public health priority because 15 per cent of mothers continue to smoke throughout pregnancy, and an estimated 43 million women in the United States are exposed to cigarette smoke from others," they said.
It is possible that second-hand smoke interferes with normal hormone action involved in fertility and pregnancy, the researchers said. It can also affect the woman's cervix, the opening in the uterus through which sperm passes to fertilize the egg.
© Copyright (c) Reuters
December 13, 2008
Op-Ed Columnist
The Demise of Dating
By CHARLES M. BLOW
The paradigm has shifted. Dating is dated. Hooking up is here to stay.
(For those over 30 years old: hooking up is a casual sexual encounter with no expectation of future emotional commitment. Think of it as a one-night stand with someone you know.)
According to a report released this spring by Child Trends, a Washington research group, there are now more high school seniors saying that they never date than seniors who say that they date frequently. Apparently, it’s all about the hookup.
When I first heard about hooking up years ago, I figured that it was a fad that would soon fizzle. I was wrong. It seems to be becoming the norm.
I should point out that just because more young people seem to be hooking up instead of dating doesn’t mean that they’re having more sex (they’ve been having less, according to the Centers for Disease Control and Prevention) or having sex with strangers (they’re more likely to hook up with a friend, according to a 2006 paper in the Journal of Adolescent Research).
To help me understand this phenomenon, I called Kathleen Bogle, a professor at La Salle University in Philadelphia who has studied hooking up among college students and is the author of the 2008 book, “Hooking Up: Sex, Dating and Relationships on Campus.”
It turns out that everything is the opposite of what I remember. Under the old model, you dated a few times and, if you really liked the person, you might consider having sex. Under the new model, you hook up a few times and, if you really like the person, you might consider going on a date.
I asked her to explain the pros and cons of this strange culture. According to her, the pros are that hooking up emphasizes group friendships over the one-pair model of dating, and, therefore, removes the negative stigma from those who can’t get a date. As she put it, “It used to be that if you couldn’t get a date, you were a loser.” Now, she said, you just hang out with your friends and hope that something happens.
The cons center on the issues of gender inequity. Girls get tired of hooking up because they want it to lead to a relationship (the guys don’t), and, as they get older, they start to realize that it’s not a good way to find a spouse. Also, there’s an increased likelihood of sexual assaults because hooking up is often fueled by alcohol.
That’s not good. So why is there an increase in hooking up? According to Professor Bogle, it’s: the collapse of advanced planning, lopsided gender ratios on campus, delaying marriage, relaxing values and sheer momentum.
It used to be that “you were trained your whole life to date,” said Ms. Bogle. “Now we’ve lost that ability — the ability to just ask someone out and get to know them.”
Now that’s sad.
E-mail [email protected]
Op-Ed Columnist
The Demise of Dating
By CHARLES M. BLOW
The paradigm has shifted. Dating is dated. Hooking up is here to stay.
(For those over 30 years old: hooking up is a casual sexual encounter with no expectation of future emotional commitment. Think of it as a one-night stand with someone you know.)
According to a report released this spring by Child Trends, a Washington research group, there are now more high school seniors saying that they never date than seniors who say that they date frequently. Apparently, it’s all about the hookup.
When I first heard about hooking up years ago, I figured that it was a fad that would soon fizzle. I was wrong. It seems to be becoming the norm.
I should point out that just because more young people seem to be hooking up instead of dating doesn’t mean that they’re having more sex (they’ve been having less, according to the Centers for Disease Control and Prevention) or having sex with strangers (they’re more likely to hook up with a friend, according to a 2006 paper in the Journal of Adolescent Research).
To help me understand this phenomenon, I called Kathleen Bogle, a professor at La Salle University in Philadelphia who has studied hooking up among college students and is the author of the 2008 book, “Hooking Up: Sex, Dating and Relationships on Campus.”
It turns out that everything is the opposite of what I remember. Under the old model, you dated a few times and, if you really liked the person, you might consider having sex. Under the new model, you hook up a few times and, if you really like the person, you might consider going on a date.
I asked her to explain the pros and cons of this strange culture. According to her, the pros are that hooking up emphasizes group friendships over the one-pair model of dating, and, therefore, removes the negative stigma from those who can’t get a date. As she put it, “It used to be that if you couldn’t get a date, you were a loser.” Now, she said, you just hang out with your friends and hope that something happens.
The cons center on the issues of gender inequity. Girls get tired of hooking up because they want it to lead to a relationship (the guys don’t), and, as they get older, they start to realize that it’s not a good way to find a spouse. Also, there’s an increased likelihood of sexual assaults because hooking up is often fueled by alcohol.
That’s not good. So why is there an increase in hooking up? According to Professor Bogle, it’s: the collapse of advanced planning, lopsided gender ratios on campus, delaying marriage, relaxing values and sheer momentum.
It used to be that “you were trained your whole life to date,” said Ms. Bogle. “Now we’ve lost that ability — the ability to just ask someone out and get to know them.”
Now that’s sad.
E-mail [email protected]
December 16, 2008
Teen Smoking Rates Decline
By RONI CARYN RABIN
Teen smoking rates dropped in 2008 and are now lower than they’ve been since the early 1990s, according to an annual survey of adolescent behavior.
Just 12.6 percent of high-school students this year said they’d had a cigarette in the last month, down from 13.6 percent last year, according to researchers at the University of Michigan, who conducted the survey.
Many teenagers have negative attitudes toward cigarette smoking. The vast majority said they’d rather not date someone who smoked and two-thirds said that “becoming a smoker reflects poor judgment,” according to the survey.
“That’s a very important message,” said Lloyd Johnston, a research professor at the Institute for Social Research at the University of Michigan and the study’s principal investigator. “For years and years, the industry pitch was that smoking makes you sexy and attractive to the opposite sex. It turns out the absolute opposite is true. It projects a negative image, for both girls and boys.”
Each year, the institute surveys a nationally representative sample of more than 45,000 students in the eighth, tenth and twelfth grades at 400 schools. The survey assesses smoking prevalence by asking students whether they have smoked a cigarette in the previous 30 days.
This year’s drop in smoking rates continues a sharp decline in teen smoking since 1996, about the time cigarette use peaked in that age group. The researchers found that only 7 percent of eighth-graders are smoking, down from 21 percent in 1996, while 12 percent of tenth-graders are smoking, down from 30.4 percent in 1996.
One in five high school seniors smoke now, down from more than a third in 1996.
These days fewer teens even try cigarettes: only 21 percent of eighth-graders said they had tried smoking, down from 49 percent in 1996, the study found. Many teens are critical of cigarette smoking, with over 80 percent of those surveyed saying they disapprove of smoking more than a pack a day and more than 70 percent saying it was a “dirty habit.” Very few believe the harmful effects of smoking have been exaggerated, the survey found.
But it’s still not difficult for youngsters to buy cigarettes, and some 57 percent of eighth-graders said they could obtain cigarettes easily, down from 77 percent in 1996.
Teen Smoking Rates Decline
By RONI CARYN RABIN
Teen smoking rates dropped in 2008 and are now lower than they’ve been since the early 1990s, according to an annual survey of adolescent behavior.
Just 12.6 percent of high-school students this year said they’d had a cigarette in the last month, down from 13.6 percent last year, according to researchers at the University of Michigan, who conducted the survey.
Many teenagers have negative attitudes toward cigarette smoking. The vast majority said they’d rather not date someone who smoked and two-thirds said that “becoming a smoker reflects poor judgment,” according to the survey.
“That’s a very important message,” said Lloyd Johnston, a research professor at the Institute for Social Research at the University of Michigan and the study’s principal investigator. “For years and years, the industry pitch was that smoking makes you sexy and attractive to the opposite sex. It turns out the absolute opposite is true. It projects a negative image, for both girls and boys.”
Each year, the institute surveys a nationally representative sample of more than 45,000 students in the eighth, tenth and twelfth grades at 400 schools. The survey assesses smoking prevalence by asking students whether they have smoked a cigarette in the previous 30 days.
This year’s drop in smoking rates continues a sharp decline in teen smoking since 1996, about the time cigarette use peaked in that age group. The researchers found that only 7 percent of eighth-graders are smoking, down from 21 percent in 1996, while 12 percent of tenth-graders are smoking, down from 30.4 percent in 1996.
One in five high school seniors smoke now, down from more than a third in 1996.
These days fewer teens even try cigarettes: only 21 percent of eighth-graders said they had tried smoking, down from 49 percent in 1996, the study found. Many teens are critical of cigarette smoking, with over 80 percent of those surveyed saying they disapprove of smoking more than a pack a day and more than 70 percent saying it was a “dirty habit.” Very few believe the harmful effects of smoking have been exaggerated, the survey found.
But it’s still not difficult for youngsters to buy cigarettes, and some 57 percent of eighth-graders said they could obtain cigarettes easily, down from 77 percent in 1996.
There is a related video linked at:
http://www.nytimes.com/2009/01/04/opini ... ?th&emc=th
January 4, 2009
Op-Ed Columnist
If This Isn’t Slavery, What Is?
By NICHOLAS D. KRISTOF
PHNOM PENH, Cambodia
Barack Obama’s presidency marks a triumph over the legacy of slavery, so it would be particularly meaningful if he led a new abolitionist movement against 21st-century slavery — like the trafficking of girls into brothels.
Anyone who thinks it is hyperbole to describe sex trafficking as slavery should look at the maimed face of a teenage girl, Long Pross.
Glance at Pross from her left, and she looks like a normal, fun-loving girl, with a pretty face and a joyous smile. Then move around, and you see where her brothel owner gouged out her right eye.
Yes, I know it’s hard to read this. But it’s infinitely more painful for Pross to recount the humiliations she suffered, yet she summoned the strength to do so — and to appear in a video posted online with this column — because she wants people to understand how brutal sex trafficking can be.
Pross was 13 and hadn’t even had her first period when a young woman kidnapped her and sold her to a brothel in Phnom Penh. The brothel owner, a woman as is typical, beat Pross and tortured her with electric current until finally the girl acquiesced.
She was kept locked deep inside the brothel, her hands tied behind her back at all times except when with customers.
Brothel owners can charge large sums for sex with a virgin, and like many girls, Pross was painfully stitched up so she could be resold as a virgin. In all, the brothel owner sold her virginity four times.
Pross paid savagely each time she let a potential customer slip away after looking her over.
“I was beaten every day, sometimes two or three times a day,” she said, adding that she was sometimes also subjected to electric shocks twice in the same day.
The business model of forced prostitution is remarkably similar from Pakistan to Vietnam — and, sometimes, in the United States as well. Pimps use violence, humiliation and narcotics to shatter girls’ self-esteem and terrorize them into unquestioning, instantaneous obedience.
One girl working with Pross was beaten to death after she tried to escape. The brothels figure that occasional losses to torture are more than made up by the increased productivity of the remaining inventory.
After my last column, I heard from skeptical readers doubting that conditions are truly so abusive. It’s true that prostitutes work voluntarily in many brothels in Cambodia and elsewhere. But there are also many brothels where teenage girls are slave laborers.
Young girls and foreigners without legal papers are particularly vulnerable. In Thailand’s brothels, for example, Thai girls usually work voluntarily, while Burmese and Cambodian girls are regularly imprisoned. The career trajectory is often for a girl in her early teens to be trafficked into prostitution by force, but eventually to resign herself and stay in the brothel even when she is given the freedom to leave. In my blog, www.nytimes.com/ontheground, I respond to the skeptics and offer some ideas for readers who want to help.
Pross herself was never paid, and she had no right to insist on condoms (she has not yet been tested for HIV, because the results might be too much for her fragile emotional state). Twice she became pregnant and was subjected to crude abortions.
The second abortion left Pross in great pain, and she pleaded with her owner for time to recuperate. “I was begging, hanging on to her feet, and asking for rest,” Pross remembered. “She got mad.”
That’s when the woman gouged out Pross’s right eye with a piece of metal. At that point in telling her story, Pross broke down and we had to suspend the interview.
Pross’s eye grew infected and monstrous, spraying blood and pus on customers, she later recounted. The owner discarded her, and she is now recuperating with the help of Sina Vann, the young woman I wrote about in my last column.
Sina was herself rescued by Somaly Mam, a trafficking survivor who started the Somaly Mam Foundation in Cambodia to fight sexual slavery. The foundation is working with Dr. Jim Gollogly of the Children’s Surgical Center in Cambodia to get Pross a glass eye.
“A year from now, she should look pretty good,” said Dr. Gollogly, who is providing her with free medical care.
So Somaly saved Sina, and now Sina is saving Pross. Someday, perhaps Pross will help another survivor, if the rest of us can help sustain them.
The Obama administration will have a new tool to fight traffickers: the Wilberforce Act, just passed by Congress, which strengthens sanctions on countries that wink at sex slavery. Much will depend on whether Mr. Obama and Hillary Clinton see trafficking as a priority.
There would be powerful symbolism in an African-American president reminding the world that the war on slavery isn’t yet over, and helping lead the 21st-century abolitionist movement.
I invite you to comment on this column on my blog, On the Ground. Please also join me on Facebook, watch my YouTube videos and follow me on Twitter.
http://www.nytimes.com/2009/01/04/opini ... ?th&emc=th
January 4, 2009
Op-Ed Columnist
If This Isn’t Slavery, What Is?
By NICHOLAS D. KRISTOF
PHNOM PENH, Cambodia
Barack Obama’s presidency marks a triumph over the legacy of slavery, so it would be particularly meaningful if he led a new abolitionist movement against 21st-century slavery — like the trafficking of girls into brothels.
Anyone who thinks it is hyperbole to describe sex trafficking as slavery should look at the maimed face of a teenage girl, Long Pross.
Glance at Pross from her left, and she looks like a normal, fun-loving girl, with a pretty face and a joyous smile. Then move around, and you see where her brothel owner gouged out her right eye.
Yes, I know it’s hard to read this. But it’s infinitely more painful for Pross to recount the humiliations she suffered, yet she summoned the strength to do so — and to appear in a video posted online with this column — because she wants people to understand how brutal sex trafficking can be.
Pross was 13 and hadn’t even had her first period when a young woman kidnapped her and sold her to a brothel in Phnom Penh. The brothel owner, a woman as is typical, beat Pross and tortured her with electric current until finally the girl acquiesced.
She was kept locked deep inside the brothel, her hands tied behind her back at all times except when with customers.
Brothel owners can charge large sums for sex with a virgin, and like many girls, Pross was painfully stitched up so she could be resold as a virgin. In all, the brothel owner sold her virginity four times.
Pross paid savagely each time she let a potential customer slip away after looking her over.
“I was beaten every day, sometimes two or three times a day,” she said, adding that she was sometimes also subjected to electric shocks twice in the same day.
The business model of forced prostitution is remarkably similar from Pakistan to Vietnam — and, sometimes, in the United States as well. Pimps use violence, humiliation and narcotics to shatter girls’ self-esteem and terrorize them into unquestioning, instantaneous obedience.
One girl working with Pross was beaten to death after she tried to escape. The brothels figure that occasional losses to torture are more than made up by the increased productivity of the remaining inventory.
After my last column, I heard from skeptical readers doubting that conditions are truly so abusive. It’s true that prostitutes work voluntarily in many brothels in Cambodia and elsewhere. But there are also many brothels where teenage girls are slave laborers.
Young girls and foreigners without legal papers are particularly vulnerable. In Thailand’s brothels, for example, Thai girls usually work voluntarily, while Burmese and Cambodian girls are regularly imprisoned. The career trajectory is often for a girl in her early teens to be trafficked into prostitution by force, but eventually to resign herself and stay in the brothel even when she is given the freedom to leave. In my blog, www.nytimes.com/ontheground, I respond to the skeptics and offer some ideas for readers who want to help.
Pross herself was never paid, and she had no right to insist on condoms (she has not yet been tested for HIV, because the results might be too much for her fragile emotional state). Twice she became pregnant and was subjected to crude abortions.
The second abortion left Pross in great pain, and she pleaded with her owner for time to recuperate. “I was begging, hanging on to her feet, and asking for rest,” Pross remembered. “She got mad.”
That’s when the woman gouged out Pross’s right eye with a piece of metal. At that point in telling her story, Pross broke down and we had to suspend the interview.
Pross’s eye grew infected and monstrous, spraying blood and pus on customers, she later recounted. The owner discarded her, and she is now recuperating with the help of Sina Vann, the young woman I wrote about in my last column.
Sina was herself rescued by Somaly Mam, a trafficking survivor who started the Somaly Mam Foundation in Cambodia to fight sexual slavery. The foundation is working with Dr. Jim Gollogly of the Children’s Surgical Center in Cambodia to get Pross a glass eye.
“A year from now, she should look pretty good,” said Dr. Gollogly, who is providing her with free medical care.
So Somaly saved Sina, and now Sina is saving Pross. Someday, perhaps Pross will help another survivor, if the rest of us can help sustain them.
The Obama administration will have a new tool to fight traffickers: the Wilberforce Act, just passed by Congress, which strengthens sanctions on countries that wink at sex slavery. Much will depend on whether Mr. Obama and Hillary Clinton see trafficking as a priority.
There would be powerful symbolism in an African-American president reminding the world that the war on slavery isn’t yet over, and helping lead the 21st-century abolitionist movement.
I invite you to comment on this column on my blog, On the Ground. Please also join me on Facebook, watch my YouTube videos and follow me on Twitter.
There is a related video linked at:
http://www.nytimes.com/2009/01/11/opini ... ?th&emc=th
January 11, 2009
Op-Ed Columnist
Striking the Brothels’ Bottom Line
By NICHOLAS D. KRISTOF
POIPET, Cambodia
In trying to figure out how we can defeat sex trafficking, a starting point is to think like a brothel owner.
My guide to that has been Sok Khorn, an amiable middle-aged woman who is a longtime brothel owner here in the wild Cambodian town of Poipet. I met her five years ago when she sold me a teenager, Srey Mom, for $203 and then blithely wrote me a receipt confirming that the girl was now my property. At another brothel nearby, I purchased another imprisoned teenager for $150.
Astonished that in the 21st century I had bought two human beings, I took them back to their villages and worked with a local aid group to help them start small businesses. I’ve remained close to them over the years, but the results were mixed.
The second girl did wonderfully, learning hairdressing and marrying a terrific man. But Srey Mom, it turned out, was addicted to methamphetamine and fled back to the brothel world to feed her craving.
I just returned again to Ms. Khorn’s brothel to interview her, and found something remarkable. It had gone broke and closed, like many of the brothels in Poipet. One lesson is that the business model is more vulnerable than it looks. There are ways we can make enslaving girls more risky and less profitable, so that traffickers give up in disgust.
For years, Ms. Khorn had been grumbling to me about the brothel — the low margins, the seven-day schedule, difficult customers, grasping policemen and scorn from the community. There was also a personal toll, for her husband had sex with the girls, infuriating her, and the couple eventually divorced bitterly. Ms. Khorn was also troubled that her youngest daughter, now 13, was growing up surrounded by drunken, leering men.
Then in the last year, the brothel business became even more challenging amid rising pressure from aid groups, journalists and the United States State Department’s trafficking office. The office issued reports shaming Cambodian leaders and threatened sanctions if they did nothing.
Many of the brothels are owned by the police, which complicates matters, but eventually authorities in Cambodia were pressured enough that they ordered a partial crackdown.
“They didn’t tell me to close down exactly,” said another Poipet brothel owner whom I’ve also interviewed periodically. “But they said I should keep the front door closed.”
About half the brothels in Poipet seem to have gone out of business in the last couple of years. After Ms. Khorn’s brothel closed, her daughter-in-law took four of the prostitutes to staff a new brothel, but it’s doing poorly and she is thinking of starting a rice shop instead. “A store would be more profitable,” grumbled the daughter-in-law, Sav Channa.
“The police come almost every day, asking for $5,” she said. “Any time a policeman gets drunk, he comes and asks for money. ... Sometimes I just close up and pretend that this isn’t a brothel. I say that we’re all sisters.”
Ms. Channa, who does not seem to be imprisoning anyone against her will, readily acknowledged that some other brothels in Poipet torture girls, enslave them and occasionally beat them to death. She complained that their cruelty gives them a competitive advantage.
But brutality has its own drawbacks as a business model, particularly during a crackdown, pimps say. Brothels that imprison and torture girls have to pay for 24-hour guards, and they lose business because they can’t allow customers to take girls out to hotel rooms. Moreover, the Cambodian government has begun prosecuting the most abusive traffickers.
“One brothel owner here was actually arrested,” complained another owner in Poipet, indignantly. “After that, I was so scared, I closed the brothel for a while.”
To be sure, a new brothel district has opened up on the edge of Poipet — in the guise of “karaoke lounges” employing teenage girls. One of the Mama-sans there offered that while she didn’t have a young virgin girl in stock, she could get me one.
Virgin sales are the profit center for many brothels in Asia (partly because they stitch girls up and resell them as virgins several times over), and thus these sales are their economic vulnerability as well. If we want to undermine sex trafficking, the best way is to pressure governments like Cambodia’s to organize sting operations and arrest both buyers and sellers of virgin girls. Cambodia has shown it is willing to take at least some action, and that is one that would strike at the heart of the business model.
Sexual slavery is like any other business: raise the operating costs, create a risk of jail, and the human traffickers will quite sensibly shift to some other trade. If the Obama administration treats 21st-century slavery as a top priority, we can push many of the traffickers to quit in disgust and switch to stealing motorcycles instead.
I invite you to comment on this column on my blog, On the Ground. Please also join me on Facebook, watch my YouTube videos and follow me on Twitter.
http://www.nytimes.com/2009/01/11/opini ... ?th&emc=th
January 11, 2009
Op-Ed Columnist
Striking the Brothels’ Bottom Line
By NICHOLAS D. KRISTOF
POIPET, Cambodia
In trying to figure out how we can defeat sex trafficking, a starting point is to think like a brothel owner.
My guide to that has been Sok Khorn, an amiable middle-aged woman who is a longtime brothel owner here in the wild Cambodian town of Poipet. I met her five years ago when she sold me a teenager, Srey Mom, for $203 and then blithely wrote me a receipt confirming that the girl was now my property. At another brothel nearby, I purchased another imprisoned teenager for $150.
Astonished that in the 21st century I had bought two human beings, I took them back to their villages and worked with a local aid group to help them start small businesses. I’ve remained close to them over the years, but the results were mixed.
The second girl did wonderfully, learning hairdressing and marrying a terrific man. But Srey Mom, it turned out, was addicted to methamphetamine and fled back to the brothel world to feed her craving.
I just returned again to Ms. Khorn’s brothel to interview her, and found something remarkable. It had gone broke and closed, like many of the brothels in Poipet. One lesson is that the business model is more vulnerable than it looks. There are ways we can make enslaving girls more risky and less profitable, so that traffickers give up in disgust.
For years, Ms. Khorn had been grumbling to me about the brothel — the low margins, the seven-day schedule, difficult customers, grasping policemen and scorn from the community. There was also a personal toll, for her husband had sex with the girls, infuriating her, and the couple eventually divorced bitterly. Ms. Khorn was also troubled that her youngest daughter, now 13, was growing up surrounded by drunken, leering men.
Then in the last year, the brothel business became even more challenging amid rising pressure from aid groups, journalists and the United States State Department’s trafficking office. The office issued reports shaming Cambodian leaders and threatened sanctions if they did nothing.
Many of the brothels are owned by the police, which complicates matters, but eventually authorities in Cambodia were pressured enough that they ordered a partial crackdown.
“They didn’t tell me to close down exactly,” said another Poipet brothel owner whom I’ve also interviewed periodically. “But they said I should keep the front door closed.”
About half the brothels in Poipet seem to have gone out of business in the last couple of years. After Ms. Khorn’s brothel closed, her daughter-in-law took four of the prostitutes to staff a new brothel, but it’s doing poorly and she is thinking of starting a rice shop instead. “A store would be more profitable,” grumbled the daughter-in-law, Sav Channa.
“The police come almost every day, asking for $5,” she said. “Any time a policeman gets drunk, he comes and asks for money. ... Sometimes I just close up and pretend that this isn’t a brothel. I say that we’re all sisters.”
Ms. Channa, who does not seem to be imprisoning anyone against her will, readily acknowledged that some other brothels in Poipet torture girls, enslave them and occasionally beat them to death. She complained that their cruelty gives them a competitive advantage.
But brutality has its own drawbacks as a business model, particularly during a crackdown, pimps say. Brothels that imprison and torture girls have to pay for 24-hour guards, and they lose business because they can’t allow customers to take girls out to hotel rooms. Moreover, the Cambodian government has begun prosecuting the most abusive traffickers.
“One brothel owner here was actually arrested,” complained another owner in Poipet, indignantly. “After that, I was so scared, I closed the brothel for a while.”
To be sure, a new brothel district has opened up on the edge of Poipet — in the guise of “karaoke lounges” employing teenage girls. One of the Mama-sans there offered that while she didn’t have a young virgin girl in stock, she could get me one.
Virgin sales are the profit center for many brothels in Asia (partly because they stitch girls up and resell them as virgins several times over), and thus these sales are their economic vulnerability as well. If we want to undermine sex trafficking, the best way is to pressure governments like Cambodia’s to organize sting operations and arrest both buyers and sellers of virgin girls. Cambodia has shown it is willing to take at least some action, and that is one that would strike at the heart of the business model.
Sexual slavery is like any other business: raise the operating costs, create a risk of jail, and the human traffickers will quite sensibly shift to some other trade. If the Obama administration treats 21st-century slavery as a top priority, we can push many of the traffickers to quit in disgust and switch to stealing motorcycles instead.
I invite you to comment on this column on my blog, On the Ground. Please also join me on Facebook, watch my YouTube videos and follow me on Twitter.
January 26, 2009, 9:30 pm
Act of Faith
By Jim Atkinson
Since I began the road to recovery from alcoholism a decade and a half ago, people have frequently asked me how I have changed. I tell them that the process of recovering from an addiction is a kind of moral de- and reconstruction. You tear yourself apart, examine each individual piece, toss out the useless, rehabilitate the useful and put your moral self back together again.
There remains some degree of controversy about whether this process necessitates a spiritual awakening of some sort. But as was pointed out by a fellow contributor to Proof, the author Susan Cheever, no less an authority than the psychologist Carl Jung certainly believed so. And after a decade and a half of sobriety now so do I.
It seems to me that if Americans could understand any addiction, it would be an addiction to alcohol, which is held in almost as high a regard as food in this culture. We’re talking about a substance that must be present at virtually all of the significant passages of our lives: Your birth was probably celebrated with a drink; your death may be. In between, benchmark birthdays, “firsts” such as jobs, raises, homes; marriage, your own children, getting a promotion. Getting fired. All call for a drink, or two, and it seems almost uncivilized not to. In fact, some theological scholars have speculated that wine became part of religious services because the mood alteration it brought on made it easier for the faithful to pray to an unseen deity. Something can’t get much more important than bringing you closer to God.
But our condition continues to be almost pointedly misunderstood by many in what I call the “social drinking majority.” I have pondered the reasons for this pretty much every day for the 16 years that I have been sober, and am still mystified by it. As a rule, Americans tend to be very indulgent of overindulgence. We give a lot of lip service to “eating right,” but that hasn’t stopped two thirds of us from becoming overweight. We still make a lot of noise about being a sexually responsible and moral people, but we continue to have a 50 percent divorce rate and support a multi-billion dollar pornography industry.
It seems that the social drinking majority saves all its moralizing for alcoholics, about whom it ignores the increasingly irrefutable evidence that we suffer from a condition that is, at least in part, nothing more than a chronic disease like diabetes, and choose to adjudge us as morally inferior instead. Perhaps they’re getting back at us for “spoiling the party” for the rest of them by giving drinking a bad name. Or perhaps by labeling us as morally inferior, they are able to feel themselves morally superior—something that’s hard to do in these morally ambiguous times. While the image of those of us who manage to sober up has improved quite a bit since the temperance movement, we continue to be considered “lesser” for having had the problem in the first place.
All of this is kind of moot, though, since regardless of the source of an addict’s problem, it remains his responsibility to get over it. And so, in that sense, his recovery, if not his disease, is a moral matter.
* * *
My own recovery did not require me to become a born-again Christian or a Bible thumper of any sort. But sobering up—and staying that way—did involve a certain tectonic shift in the psyche that had nothing to do with willpower or common sense. In my experience, there are three reasons for this: First, the process of becoming addicted to alcohol involves a kind of twisted leap of faith in itself—coming to believe that all answers and all happiness lay in one more drink—so it only stands to reason that to escape alcohol’s clutches, one must take a similar size leap in the other direction. Second, for me anyway, trying to “reason” my way out of my addiction didn’t work. Talk to any recovering alcoholic and he will tell you about how many times he tried to stop or “manage” his drinking via the left side of the brain and failed. Indeed, it is the inability to control one’s drinking—even in the face of countless rational reasons to quit—that distinguishes the alcoholic from the merely abusive drinker. Finally, under the circumstances, I decided that I had no choice but to try the spiritual route to recovery.
This involved the deployment of two time-honored spiritual tools: surrender to and faith in a power greater than oneself — the often-invoked higher power. For me, surrender—as intimidating a word as it is—was relatively simple. After all, any drunk who decides to go to rehab has made a surrender of a certain measure; he’s saying, “I can’t lick this myself.”
Placing my faith in a higher power to help me with this endeavor was a bit more complicated. It’s not that I’m an atheist; I’m believer enough. It’s just that I’d never had occasion to apply my faith in this specific a way—that is to say, expecting a favorable resolution (losing the compulsion to drink) just for the asking of a favor from some unseen force.
It all felt quite awkward, and frankly, I wasn’t sure I could summon the requisite faith to fully engage the process. But desperation is the mother of many a good recovery, and desperate I was. So I did what I was told: I put blinders on, invested my faith in a higher power and set about the grunt work of recovery—the self examination and soul searching, the forming of a clean and sober and ethical self—with the hope that sooner or later, my compulsion to drink would disappear.
Ironically, it was the willingness to do anything to sober up—a most pragmatic strategy—that was the linchpin of my spiritual leap of faith. And though there was no single moment when I was “struck sober” in the way one hears some alcoholics claim, slowly but surely the obsession with the stuff slipped out of mind. I wouldn’t call it a miracle, but I would say that, as long as I’ve been sober, I still can’t entirely explain it and honestly, it still kind of surprises me that it worked as well as it did.
But I can double-vouch for its efficacy. Five years after I quit drinking back in 1993, I quit smoking using the same modus operandi. In some ways, tossing away the butts was harder than quitting the sauce. But this time I not only had faith; I had confidence. I not only believed I could quit. I knew I would.
http://proof.blogs.nytimes.com/2009/01/ ... 8ty&emc=ty
Act of Faith
By Jim Atkinson
Since I began the road to recovery from alcoholism a decade and a half ago, people have frequently asked me how I have changed. I tell them that the process of recovering from an addiction is a kind of moral de- and reconstruction. You tear yourself apart, examine each individual piece, toss out the useless, rehabilitate the useful and put your moral self back together again.
There remains some degree of controversy about whether this process necessitates a spiritual awakening of some sort. But as was pointed out by a fellow contributor to Proof, the author Susan Cheever, no less an authority than the psychologist Carl Jung certainly believed so. And after a decade and a half of sobriety now so do I.
It seems to me that if Americans could understand any addiction, it would be an addiction to alcohol, which is held in almost as high a regard as food in this culture. We’re talking about a substance that must be present at virtually all of the significant passages of our lives: Your birth was probably celebrated with a drink; your death may be. In between, benchmark birthdays, “firsts” such as jobs, raises, homes; marriage, your own children, getting a promotion. Getting fired. All call for a drink, or two, and it seems almost uncivilized not to. In fact, some theological scholars have speculated that wine became part of religious services because the mood alteration it brought on made it easier for the faithful to pray to an unseen deity. Something can’t get much more important than bringing you closer to God.
But our condition continues to be almost pointedly misunderstood by many in what I call the “social drinking majority.” I have pondered the reasons for this pretty much every day for the 16 years that I have been sober, and am still mystified by it. As a rule, Americans tend to be very indulgent of overindulgence. We give a lot of lip service to “eating right,” but that hasn’t stopped two thirds of us from becoming overweight. We still make a lot of noise about being a sexually responsible and moral people, but we continue to have a 50 percent divorce rate and support a multi-billion dollar pornography industry.
It seems that the social drinking majority saves all its moralizing for alcoholics, about whom it ignores the increasingly irrefutable evidence that we suffer from a condition that is, at least in part, nothing more than a chronic disease like diabetes, and choose to adjudge us as morally inferior instead. Perhaps they’re getting back at us for “spoiling the party” for the rest of them by giving drinking a bad name. Or perhaps by labeling us as morally inferior, they are able to feel themselves morally superior—something that’s hard to do in these morally ambiguous times. While the image of those of us who manage to sober up has improved quite a bit since the temperance movement, we continue to be considered “lesser” for having had the problem in the first place.
All of this is kind of moot, though, since regardless of the source of an addict’s problem, it remains his responsibility to get over it. And so, in that sense, his recovery, if not his disease, is a moral matter.
* * *
My own recovery did not require me to become a born-again Christian or a Bible thumper of any sort. But sobering up—and staying that way—did involve a certain tectonic shift in the psyche that had nothing to do with willpower or common sense. In my experience, there are three reasons for this: First, the process of becoming addicted to alcohol involves a kind of twisted leap of faith in itself—coming to believe that all answers and all happiness lay in one more drink—so it only stands to reason that to escape alcohol’s clutches, one must take a similar size leap in the other direction. Second, for me anyway, trying to “reason” my way out of my addiction didn’t work. Talk to any recovering alcoholic and he will tell you about how many times he tried to stop or “manage” his drinking via the left side of the brain and failed. Indeed, it is the inability to control one’s drinking—even in the face of countless rational reasons to quit—that distinguishes the alcoholic from the merely abusive drinker. Finally, under the circumstances, I decided that I had no choice but to try the spiritual route to recovery.
This involved the deployment of two time-honored spiritual tools: surrender to and faith in a power greater than oneself — the often-invoked higher power. For me, surrender—as intimidating a word as it is—was relatively simple. After all, any drunk who decides to go to rehab has made a surrender of a certain measure; he’s saying, “I can’t lick this myself.”
Placing my faith in a higher power to help me with this endeavor was a bit more complicated. It’s not that I’m an atheist; I’m believer enough. It’s just that I’d never had occasion to apply my faith in this specific a way—that is to say, expecting a favorable resolution (losing the compulsion to drink) just for the asking of a favor from some unseen force.
It all felt quite awkward, and frankly, I wasn’t sure I could summon the requisite faith to fully engage the process. But desperation is the mother of many a good recovery, and desperate I was. So I did what I was told: I put blinders on, invested my faith in a higher power and set about the grunt work of recovery—the self examination and soul searching, the forming of a clean and sober and ethical self—with the hope that sooner or later, my compulsion to drink would disappear.
Ironically, it was the willingness to do anything to sober up—a most pragmatic strategy—that was the linchpin of my spiritual leap of faith. And though there was no single moment when I was “struck sober” in the way one hears some alcoholics claim, slowly but surely the obsession with the stuff slipped out of mind. I wouldn’t call it a miracle, but I would say that, as long as I’ve been sober, I still can’t entirely explain it and honestly, it still kind of surprises me that it worked as well as it did.
But I can double-vouch for its efficacy. Five years after I quit drinking back in 1993, I quit smoking using the same modus operandi. In some ways, tossing away the butts was harder than quitting the sauce. But this time I not only had faith; I had confidence. I not only believed I could quit. I knew I would.
http://proof.blogs.nytimes.com/2009/01/ ... 8ty&emc=ty
February 11, 2009
Editorial
A-Rod’s Belated Confession
Is there any star player in Major League Baseball who has not taken performance-enhancing drugs?
The latest to admit to using illegal substances is Alex Rodriguez, the Yankee slugger who is arguably the game’s best player and inarguably its highest paid.
Rodriguez got caught, along with 103 other players, by urine tests given in 2003 to determine the extent of steroid usage. The results were supposed to be confidential but were seized by federal investigators before they could be destroyed. The fact that Rodriguez tested positive was recently made public by Sports Illustrated.
Although he had denied using steroids in the past, Rodriguez promptly staged a televised confessional in which he acknowledged using banned substances (but could not say what they were or how he got them) while playing for the Texas Rangers from 2001 to 2003. He attributed it to youthful naïveté, enormous pressure from his $252 million contract and a “loosey-goosey” culture in which drugs were prevalent. The steroids presumably helped him lead the league in home runs all three years and win most valuable player honors in 2003.
Rodriguez assures us that he has not used banned substances since joining the Yankees in 2004, and he appears to have passed several drug tests in recent years, although Sports Illustrated reports that he was given advance notice of at least one upcoming test. The pernicious consequence of being caught cheating after emphatic false denials is the suspicion that his cheating may continue, perhaps with harder-to-detect drugs.
The sad part is that the supposedly clean Rodriguez was the great hope to surpass accused steroid user Barry Bonds as a home run hitter, thus giving baseball a purer image at the peak of performance. Instead, his career statistics will henceforth be under a cloud, and he will serve as an object lesson that, as President Obama expressed, “when you try to take shortcuts, you may end up tarnishing your entire career.”
Major League Baseball has stepped up its drug testing in recent years, but it would be reckless to assume that it has emerged from a steroid-tarnished era.
Editorial
A-Rod’s Belated Confession
Is there any star player in Major League Baseball who has not taken performance-enhancing drugs?
The latest to admit to using illegal substances is Alex Rodriguez, the Yankee slugger who is arguably the game’s best player and inarguably its highest paid.
Rodriguez got caught, along with 103 other players, by urine tests given in 2003 to determine the extent of steroid usage. The results were supposed to be confidential but were seized by federal investigators before they could be destroyed. The fact that Rodriguez tested positive was recently made public by Sports Illustrated.
Although he had denied using steroids in the past, Rodriguez promptly staged a televised confessional in which he acknowledged using banned substances (but could not say what they were or how he got them) while playing for the Texas Rangers from 2001 to 2003. He attributed it to youthful naïveté, enormous pressure from his $252 million contract and a “loosey-goosey” culture in which drugs were prevalent. The steroids presumably helped him lead the league in home runs all three years and win most valuable player honors in 2003.
Rodriguez assures us that he has not used banned substances since joining the Yankees in 2004, and he appears to have passed several drug tests in recent years, although Sports Illustrated reports that he was given advance notice of at least one upcoming test. The pernicious consequence of being caught cheating after emphatic false denials is the suspicion that his cheating may continue, perhaps with harder-to-detect drugs.
The sad part is that the supposedly clean Rodriguez was the great hope to surpass accused steroid user Barry Bonds as a home run hitter, thus giving baseball a purer image at the peak of performance. Instead, his career statistics will henceforth be under a cloud, and he will serve as an object lesson that, as President Obama expressed, “when you try to take shortcuts, you may end up tarnishing your entire career.”
Major League Baseball has stepped up its drug testing in recent years, but it would be reckless to assume that it has emerged from a steroid-tarnished era.
Scientists debunk smoking as stress reliever
Survey finds it does the opposite
By Misty Harris, Canwest News ServiceApril 15, 2009 3:02 AM
Canadians hoping to blow off economic anxiety with cigarettes could get burned, according to new research linking smoking with significantly higher-than-normal stress levels.
Drawing on data from 2,250 adults, Pew Research -- a non-partisan American think-tank -- found half (50 per cent) of all smokers claim to experience frequent stress in their lives, compared with just 35 per cent of ex-smokers and 31 per cent of non-smokers.
Even controlling for basic demographic traits such as sex, age, education, income and parental status, the researchers say current smokers are still significantly more likely than non-smokers and quitters to have self-reported stress.
With a survey showing a quarter of smokers worried about the recession are smoking more, and another 13 per cent are delaying quitting for the same reason, experts say the new report reflects an urgent need to debunk the "mythic relaxation response" of cigarettes.
"Many smokers perceive smoking as a way to calm stress, when, in fact, what they're doing is satisfying nicotine cravings and withdrawal," says Rob Cunningham, senior policy analyst for the Canadian Cancer Society.
"In many respects, smoking -- or the delay in having a cigarette -- is the cause of stress."
Cunningham believes Pew's report supports the need for more educational messages about the link between stress and tobacco use.
According to the Pew report, about a quarter of smokers consider themselves "very happy," compared with more than a third of quitters and nearly four in 10 non-smokers.
When asked about family life, smokers were also less likely to report being "very satisfied:" about six in 10, compared with seven in 10 non-smokers and quitters.
The data, collected by Princeton Survey Research International for Pew Research, is considered accurate within 2.3 percentage points, 19 times out of 20.
© Copyright (c) The Calgary Herald
Survey finds it does the opposite
By Misty Harris, Canwest News ServiceApril 15, 2009 3:02 AM
Canadians hoping to blow off economic anxiety with cigarettes could get burned, according to new research linking smoking with significantly higher-than-normal stress levels.
Drawing on data from 2,250 adults, Pew Research -- a non-partisan American think-tank -- found half (50 per cent) of all smokers claim to experience frequent stress in their lives, compared with just 35 per cent of ex-smokers and 31 per cent of non-smokers.
Even controlling for basic demographic traits such as sex, age, education, income and parental status, the researchers say current smokers are still significantly more likely than non-smokers and quitters to have self-reported stress.
With a survey showing a quarter of smokers worried about the recession are smoking more, and another 13 per cent are delaying quitting for the same reason, experts say the new report reflects an urgent need to debunk the "mythic relaxation response" of cigarettes.
"Many smokers perceive smoking as a way to calm stress, when, in fact, what they're doing is satisfying nicotine cravings and withdrawal," says Rob Cunningham, senior policy analyst for the Canadian Cancer Society.
"In many respects, smoking -- or the delay in having a cigarette -- is the cause of stress."
Cunningham believes Pew's report supports the need for more educational messages about the link between stress and tobacco use.
According to the Pew report, about a quarter of smokers consider themselves "very happy," compared with more than a third of quitters and nearly four in 10 non-smokers.
When asked about family life, smokers were also less likely to report being "very satisfied:" about six in 10, compared with seven in 10 non-smokers and quitters.
The data, collected by Princeton Survey Research International for Pew Research, is considered accurate within 2.3 percentage points, 19 times out of 20.
© Copyright (c) The Calgary Herald
Second-hand smoke linked to breast cancer
Finding based on review of studies
By Sharon Kirkey, Canwest News ServiceApril 24, 2009
Parents who smoke are putting their daughters at increased risk of breast cancer, according to an expert panel that has unanimously agreed strong enough evidence now exists to link second-hand smoke to breast cancer.
"Even moderate exposure to passive smoking, such as living or working with a smoker early in life, increases a woman's risk of breast cancer when she is in her 30s, 40s and 50s,"
panellist and University of Toronto public health expert Dr. Anthony Miller says. "That is very important information people should know."
Studies on the possible relationship between cigarette smoke and breast cancer have been inconsistent.
But after reviewing all available evidence--more than 100 studies -- the panel concluded that all women who smoke, particularly young women, are at increased risk of breast cancer, and that even young women who don't smoke are at increased risk if they're exposed to second-hand smoke.
"An estimated 80 to 90 per cent of women have been exposed to tobacco smoke in adolescence and adulthood," says panel chairman Neil Collishaw, of Physicians for a Smoke-Free Canada. "Those women face an increased risk of breast cancer because of that exposure."
"Everyone needs to know that no girls and no women should be exposed to tobacco smoke,"Miller said.
According to the 11-member Canadian expert panel on tobacco smoke and breast cancer risk: - Smoking increases the risk of breast cancer in all women. "On average, it would be about a 50 to 70 per cent increase in risk, depending on how much women smoke,"says Miller, associate director of research at the University of Toronto's Dalla Lana School of Public Health.
One in seven women in Canada will develop breast cancer in their lifetime.
One study of women who carry the genes associated with breast cancer found those who smoked more than one pack a day for five years had double the risk of breast cancer than non-smokers. - Exposure to second-hand smoke increases the risk of breast cancer in younger, primarily pre-menopausal women by 40 to 50 per cent. - There's not enough evidence to judge whether second-hand smoke increases the risk of breast cancer in older women.But Miller says it doesn't make a lot of biological sense to think passive smoking only increases risk in pre-menopausal women. - More research is needed to know how many cases of breast cancer, and deaths, can be attributed to active and passive smoking.
© Copyright (c) The Calgary Herald
Finding based on review of studies
By Sharon Kirkey, Canwest News ServiceApril 24, 2009
Parents who smoke are putting their daughters at increased risk of breast cancer, according to an expert panel that has unanimously agreed strong enough evidence now exists to link second-hand smoke to breast cancer.
"Even moderate exposure to passive smoking, such as living or working with a smoker early in life, increases a woman's risk of breast cancer when she is in her 30s, 40s and 50s,"
panellist and University of Toronto public health expert Dr. Anthony Miller says. "That is very important information people should know."
Studies on the possible relationship between cigarette smoke and breast cancer have been inconsistent.
But after reviewing all available evidence--more than 100 studies -- the panel concluded that all women who smoke, particularly young women, are at increased risk of breast cancer, and that even young women who don't smoke are at increased risk if they're exposed to second-hand smoke.
"An estimated 80 to 90 per cent of women have been exposed to tobacco smoke in adolescence and adulthood," says panel chairman Neil Collishaw, of Physicians for a Smoke-Free Canada. "Those women face an increased risk of breast cancer because of that exposure."
"Everyone needs to know that no girls and no women should be exposed to tobacco smoke,"Miller said.
According to the 11-member Canadian expert panel on tobacco smoke and breast cancer risk: - Smoking increases the risk of breast cancer in all women. "On average, it would be about a 50 to 70 per cent increase in risk, depending on how much women smoke,"says Miller, associate director of research at the University of Toronto's Dalla Lana School of Public Health.
One in seven women in Canada will develop breast cancer in their lifetime.
One study of women who carry the genes associated with breast cancer found those who smoked more than one pack a day for five years had double the risk of breast cancer than non-smokers. - Exposure to second-hand smoke increases the risk of breast cancer in younger, primarily pre-menopausal women by 40 to 50 per cent. - There's not enough evidence to judge whether second-hand smoke increases the risk of breast cancer in older women.But Miller says it doesn't make a lot of biological sense to think passive smoking only increases risk in pre-menopausal women. - More research is needed to know how many cases of breast cancer, and deaths, can be attributed to active and passive smoking.
© Copyright (c) The Calgary Herald
May 7, 2009
Op-Ed Columnist
Girls on Our Streets
By NICHOLAS D. KRISTOF
ATLANTA
Jasmine Caldwell was 14 and selling sex on the streets when an opportunity arose to escape her pimp: an undercover policeman picked her up.
The cop could have rescued her from the pimp, who ran a string of 13 girls and took every cent they earned. If the cop had taken Jasmine to a shelter, she could have resumed her education and tried to put her life back in order.
Instead, the policeman showed her his handcuffs and threatened to send her to prison. Terrified, she cried and pleaded not to be jailed. Then, she said, he offered to release her in exchange for sex.
Afterward, the policeman returned her to the street. Then her pimp beat her up for failing to collect any money.
“That happens a lot,” said Jasmine, who is now 21. “The cops sometimes just want to blackmail you into having sex.”
I’ve often reported on sex trafficking in other countries, and that has made me curious about the situation here in the United States. Prostitution in America isn’t as brutal as it is in, say, India, Nepal, Pakistan, Cambodia and Malaysia (where young girls are routinely kidnapped, imprisoned and tortured by brothel owners, occasionally even killed). But the scene on American streets is still appalling — and it continues largely because neither the authorities nor society as a whole show much interest in 14-year-old girls pimped on the streets.
Americans tend to think of forced prostitution as the plight of Mexican or Asian women trafficked into the United States and locked up in brothels. Such trafficking is indeed a problem, but the far greater scandal and the worst violence involves American teenage girls.
If a middle-class white girl goes missing, radio stations broadcast amber alerts, and cable TV fills the air with “missing beauty” updates. But 13-year-old black or Latina girls from poor neighborhoods vanish all the time, and the pimps are among the few people who show any interest.
These domestic girls are often runaways or those called “throwaways” by social workers: teenagers who fight with their parents and are then kicked out of the home. These girls tend to be much younger than the women trafficked from abroad and, as best I can tell, are more likely to be controlled by force.
Pimps are not the business partners they purport to be. They typically take every penny the girls earn. They work the girls seven nights a week. They sometimes tattoo their girls the way ranchers brand their cattle, and they back up their business model with fists and threats.
“If you don’t earn enough money, you get beat,” said Jasmine, an African-American who has turned her life around with the help of Covenant House, an organization that works with children on the street. “If you say something you’re not supposed to, you get beat. If you stay too long with a customer, you get beat. And if you try to leave the pimp, you get beat.”
The business model of pimping is remarkably similar whether in Atlanta or Calcutta: take vulnerable, disposable girls whom nobody cares about, use a mix of “friendship,” humiliation, beatings, narcotics and threats to break the girls and induce 100 percent compliance, and then rent out their body parts.
It’s not solely violence that keeps the girls working for their pimps. Jasmine fled an abusive home at age 13, and she said she — like most girls — stayed with the pimp mostly because of his emotional manipulation. “I thought he loved me, so I wanted to be around him,” she said.
That’s common. Girls who are starved of self-esteem finally meet a man who showers them with gifts, drugs and dollops of affection. That, and a lack of alternatives, keeps them working for him — and if that isn’t enough, he shoves a gun in the girl’s mouth and threatens to kill her.
Solutions are complicated and involve broader efforts to overcome urban poverty, including improving schools and attempting to shore up the family structure. But a first step is to stop treating these teenagers as criminals and focusing instead on arresting the pimps and the customers — and the corrupt cops.
“The problem isn’t the girls in the streets; it’s the men in the pews,” notes Stephanie Davis, who has worked with Mayor Shirley Franklin to help coordinate a campaign to get teenage prostitutes off the streets.
Two amiable teenage prostitutes, working without a pimp for the “fast money,” told me that there will always be women and girls selling sex voluntarily. They’re probably right. But we can significantly reduce the number of 14-year-old girls who are terrorized by pimps and raped by many men seven nights a week. That’s doable, if it’s a national priority, if we’re willing to create the equivalent of a nationwide amber alert.
Op-Ed Columnist
Girls on Our Streets
By NICHOLAS D. KRISTOF
ATLANTA
Jasmine Caldwell was 14 and selling sex on the streets when an opportunity arose to escape her pimp: an undercover policeman picked her up.
The cop could have rescued her from the pimp, who ran a string of 13 girls and took every cent they earned. If the cop had taken Jasmine to a shelter, she could have resumed her education and tried to put her life back in order.
Instead, the policeman showed her his handcuffs and threatened to send her to prison. Terrified, she cried and pleaded not to be jailed. Then, she said, he offered to release her in exchange for sex.
Afterward, the policeman returned her to the street. Then her pimp beat her up for failing to collect any money.
“That happens a lot,” said Jasmine, who is now 21. “The cops sometimes just want to blackmail you into having sex.”
I’ve often reported on sex trafficking in other countries, and that has made me curious about the situation here in the United States. Prostitution in America isn’t as brutal as it is in, say, India, Nepal, Pakistan, Cambodia and Malaysia (where young girls are routinely kidnapped, imprisoned and tortured by brothel owners, occasionally even killed). But the scene on American streets is still appalling — and it continues largely because neither the authorities nor society as a whole show much interest in 14-year-old girls pimped on the streets.
Americans tend to think of forced prostitution as the plight of Mexican or Asian women trafficked into the United States and locked up in brothels. Such trafficking is indeed a problem, but the far greater scandal and the worst violence involves American teenage girls.
If a middle-class white girl goes missing, radio stations broadcast amber alerts, and cable TV fills the air with “missing beauty” updates. But 13-year-old black or Latina girls from poor neighborhoods vanish all the time, and the pimps are among the few people who show any interest.
These domestic girls are often runaways or those called “throwaways” by social workers: teenagers who fight with their parents and are then kicked out of the home. These girls tend to be much younger than the women trafficked from abroad and, as best I can tell, are more likely to be controlled by force.
Pimps are not the business partners they purport to be. They typically take every penny the girls earn. They work the girls seven nights a week. They sometimes tattoo their girls the way ranchers brand their cattle, and they back up their business model with fists and threats.
“If you don’t earn enough money, you get beat,” said Jasmine, an African-American who has turned her life around with the help of Covenant House, an organization that works with children on the street. “If you say something you’re not supposed to, you get beat. If you stay too long with a customer, you get beat. And if you try to leave the pimp, you get beat.”
The business model of pimping is remarkably similar whether in Atlanta or Calcutta: take vulnerable, disposable girls whom nobody cares about, use a mix of “friendship,” humiliation, beatings, narcotics and threats to break the girls and induce 100 percent compliance, and then rent out their body parts.
It’s not solely violence that keeps the girls working for their pimps. Jasmine fled an abusive home at age 13, and she said she — like most girls — stayed with the pimp mostly because of his emotional manipulation. “I thought he loved me, so I wanted to be around him,” she said.
That’s common. Girls who are starved of self-esteem finally meet a man who showers them with gifts, drugs and dollops of affection. That, and a lack of alternatives, keeps them working for him — and if that isn’t enough, he shoves a gun in the girl’s mouth and threatens to kill her.
Solutions are complicated and involve broader efforts to overcome urban poverty, including improving schools and attempting to shore up the family structure. But a first step is to stop treating these teenagers as criminals and focusing instead on arresting the pimps and the customers — and the corrupt cops.
“The problem isn’t the girls in the streets; it’s the men in the pews,” notes Stephanie Davis, who has worked with Mayor Shirley Franklin to help coordinate a campaign to get teenage prostitutes off the streets.
Two amiable teenage prostitutes, working without a pimp for the “fast money,” told me that there will always be women and girls selling sex voluntarily. They’re probably right. But we can significantly reduce the number of 14-year-old girls who are terrorized by pimps and raped by many men seven nights a week. That’s doable, if it’s a national priority, if we’re willing to create the equivalent of a nationwide amber alert.
Smoking more damaging to women than men
Light smokers still at great risk: study
ReutersMay 19, 2009
Women may be especially susceptible to the toxic effects of cigarette smoking, U. S. researchers said Monday.
They said women who smoke develop lung damage earlier in life than men, and it takes less cigarette exposure to cause damage in women compared with men.
"Overall, our analysis indicated that women may be more vulnerable to the effects of smoking," said Dr. Inga-Cecilie Soerheim of Brigham and Women's Hospital in Boston and the University of Bergen in Norway.
Soerheim, who presented her findings at the American Thoracic Society meeting in San Diego, said researchers suspected this but until now had lacked proof.
Her team analyzed 954 people with chronic obstructive pulmonary disease, which includes lung problems from chronic bronchitis to emphysema. COPD affects nearly 210 million people worldwide.
In the study, about 60 per cent were men and 40 per cent women. Overall, both groups had similar lung impairments. But when they looked at younger people --under age 60--or those who had been lighter smokers, they found women had more severe disease and worse lung function.
"This means that female smokers in our study experienced reduced lung function at a lower level of smoking exposure and at an earlier age than men," Soerheim said in a statement.
Soerheim suspects the differences may be related to anatomy. Women have smaller airways than men, making each cigarette potentially more dangerous, she said. Hormones may also play a role, she said.
"Many people believe that their own smoking is too limited to be harmful-- that a few cigarettes a day represent a minimal risk," she said in a statement. "However, in the low-exposure group in this study, half of the women actually had severe COPD."
© Copyright (c) The Calgary Herald
Light smokers still at great risk: study
ReutersMay 19, 2009
Women may be especially susceptible to the toxic effects of cigarette smoking, U. S. researchers said Monday.
They said women who smoke develop lung damage earlier in life than men, and it takes less cigarette exposure to cause damage in women compared with men.
"Overall, our analysis indicated that women may be more vulnerable to the effects of smoking," said Dr. Inga-Cecilie Soerheim of Brigham and Women's Hospital in Boston and the University of Bergen in Norway.
Soerheim, who presented her findings at the American Thoracic Society meeting in San Diego, said researchers suspected this but until now had lacked proof.
Her team analyzed 954 people with chronic obstructive pulmonary disease, which includes lung problems from chronic bronchitis to emphysema. COPD affects nearly 210 million people worldwide.
In the study, about 60 per cent were men and 40 per cent women. Overall, both groups had similar lung impairments. But when they looked at younger people --under age 60--or those who had been lighter smokers, they found women had more severe disease and worse lung function.
"This means that female smokers in our study experienced reduced lung function at a lower level of smoking exposure and at an earlier age than men," Soerheim said in a statement.
Soerheim suspects the differences may be related to anatomy. Women have smaller airways than men, making each cigarette potentially more dangerous, she said. Hormones may also play a role, she said.
"Many people believe that their own smoking is too limited to be harmful-- that a few cigarettes a day represent a minimal risk," she said in a statement. "However, in the low-exposure group in this study, half of the women actually had severe COPD."
© Copyright (c) The Calgary Herald
June 16, 2009
Alcohol’s Good for You? Some Scientists Doubt It
By RONI CARYN RABIN
By now, it is a familiar litany. Study after study suggests that alcohol in moderation may promote heart health and even ward off diabetes and dementia. The evidence is so plentiful that some experts consider moderate drinking — about one drink a day for women, about two for men — a central component of a healthy lifestyle.
But what if it’s all a big mistake?
For some scientists, the question will not go away. No study, these critics say, has ever proved a causal relationship between moderate drinking and lower risk of death — only that the two often go together. It may be that moderate drinking is just something healthy people tend to do, not something that makes people healthy.
“The moderate drinkers tend to do everything right — they exercise, they don’t smoke, they eat right and they drink moderately,” said Kaye Middleton Fillmore, a retired sociologist from the University of California, San Francisco, who has criticized the research. “It’s very hard to disentangle all of that, and that’s a real problem.”
Some researchers say they are haunted by the mistakes made in studies about hormone replacement therapy, which was widely prescribed for years on the basis of observational studies similar to the kind done on alcohol. Questions have also been raised about the financial relationships that have sprung up between the alcoholic beverage industry and many academic centers, which have accepted industry money to pay for research, train students and promote their findings.
“The bottom line is there has not been a single study done on moderate alcohol consumption and mortality outcomes that is a ‘gold standard’ kind of study — the kind of randomized controlled clinical trial that we would be required to have in order to approve a new pharmaceutical agent in this country,” said Dr. Tim Naimi, an epidemiologist with the Centers for Disease Control and Prevention.
Even avid supporters of moderate drinking temper their recommendations with warnings about the dangers of alcohol, which has been tied to breast cancer and can lead to accidents even when consumed in small amounts, and is linked with liver disease, cancers, heart damage and strokes when consumed in larger amounts.
“It’s very difficult to form a single-bullet message because one size doesn’t fit all here, and the public health message has to be very conservative,” said Dr. Arthur L. Klatsky, a cardiologist in Oakland, Calif., who wrote a landmark study in the early 1970s finding that members of the Kaiser Permanente health care plan who drank in moderation were less likely to be hospitalized for heart attacks than abstainers. (He has since received research grants financed by an alcohol industry foundation, though he notes that at least one of his studies found that alcohol increased the risk of hypertension.)
“People who would not be able to stop at one to two drinks a day shouldn’t drink, and people with liver disease shouldn’t drink,” Dr. Klatsky said. On the other hand, “the man in his 50s or 60s who has a heart attack and decides to go clean and gives up his glass of wine at night — that person is better off being a moderate drinker.”
Health organizations have phrased their recommendations gingerly. The American Heart Association says people should not start drinking to protect themselves from heart disease. The 2005 United States dietary guidelines say that “alcohol may have beneficial effects when consumed in moderation.”
The association was first made in the early 20th century. In 1924, a Johns Hopkins biologist, Raymond Pearl, published a graph with a U-shaped curve, its tall strands on either side representing the higher death rates of heavy drinkers and nondrinkers; in the middle were moderate drinkers, with the lowest rates. Dozens of other observational studies have replicated the findings, particularly with respect to heart disease.
“With the exception of smoking and lung cancer, this is probably the most established association in the field of nutrition,” said Eric Rimm, an associate professor of epidemiology and nutrition at the Harvard School of Public Health. “There are probably at least 100 studies by now, and the number grows on a monthly basis. That’s what makes it so unique.”
Alcohol is believed to reduce coronary disease because it has been found to increase the “good” HDL cholesterol and have anticlotting effects. Other benefits have been suggested, too. A small study in China found that cognitively impaired elderly patients who drank in moderation did not deteriorate as quickly as abstainers. A report from the Framingham Offspring Study found that moderate drinkers had greater mineral density in their hipbones than nondrinkers. Researchers have reported that light drinkers are less likely than abstainers to develop diabetes, and that those with Type 2 diabetes who drink lightly are less likely to develop coronary heart disease.
But the studies comparing moderate drinkers with abstainers have come under fire in recent years. Critics ask: Who are these abstainers? Why do they avoid alcohol? Is there something that makes them more susceptible to heart disease?
Some researchers suspect the abstainer group may include “sick quitters,” people who stopped drinking because they already had heart disease. People also tend to cut down on drinking as they age, which would make the average abstainer older — and presumably more susceptible to disease — than the average light drinker.
In 2006, shortly after Dr. Fillmore and her colleagues published a critical analysis saying a vast majority of the alcohol studies they reviewed were flawed, Dr. R. Curtis Ellison, a Boston University physician who has championed the benefits of alcohol, hosted a conference on the subject. A summary of the conference, published a year later, said scientists had reached a “consensus” that moderate drinking “has been shown to have predominantly beneficial effects on health.”
The meeting, like much of Dr. Ellison’s work, was partly financed by industry grants. And the summary was written by him and Marjana Martinic, a senior vice president for the International Center for Alcohol Policies, a nonprofit group supported by the industry. The center paid for tens of thousands of copies of the summary, which were included as free inserts in two medical journals, The American Journal of Medicine and The American Journal of Cardiology.
In an interview, Dr. Ellison said his relationship with the industry did not influence his work, adding, “No one would look at our critiques if we didn’t present a balanced view.”
Dr. Fillmore and the co-authors of her analysis posted an online commentary saying the summary had glossed over some of the deep divisions that polarized the debate at the conference. “We also dispute Ellison and Martinic’s conclusions that more frequent drinking is the strongest predictor of health benefits,” they wrote.
(Dr. Fillmore has received support from the Alcohol Education and Rehabilitation Foundation of Australia, a nonprofit group that works to prevent alcohol and substance abuse.)
Dr. Ellison said Dr. Fillmore’s analysis ignored newer studies that corrected the methodological errors of earlier work. “She threw out the baby with the bathwater,” he said.
Meanwhile, two central questions remain unresolved: whether abstainers and moderate drinkers are fundamentally different and, if so, whether it is those differences that make them live longer, rather than their alcohol consumption.
Dr. Naimi of the C.D.C., who did a study looking at the characteristics of moderate drinkers and abstainers, says the two groups are so different that they simply cannot be compared. Moderate drinkers are healthier, wealthier and more educated, and they get better health care, even though they are more likely to smoke. They are even more likely to have all of their teeth, a marker of well-being.
“Moderate drinkers tend to be socially advantaged in ways that have nothing to do with their drinking,” Dr. Naimi said. “These two groups are apples and oranges.” And simply advising the nondrinkers to drink won’t change that, he said.
Some scientists say the time has come to do a large, long-term randomized controlled clinical trial, like the ones for new drugs. One approach might be to recruit a large group of abstainers who would be randomly assigned either to get a daily dose of alcohol or not, and then closely followed for several years; another might be to recruit people who are at risk for coronary disease.
But even the experts who believe in the health benefits of alcohol say this is an implausible idea. Large randomized trials are expensive, and they might lack credibility unless they were financed by the government, which is unlikely to take on the controversy. And there are practical and ethical problems in giving alcohol to abstainers without making them aware of it and without contributing to accidents.
Still, some small clinical trials are already under way to see whether diabetics can reduce their risk of heart disease by consuming alcohol. In Boston, researchers at Beth Israel Deaconess Medical Center are recruiting volunteers 55 and over who are at risk for heart disease and randomly assigning them to either drink plain lemonade or lemonade spiked with tasteless grain alcohol, while scientists track their cholesterol levels and scan their arteries.
In Israel, researchers gave people with Type 2 diabetes either wine or nonalcoholic beer, finding that the wine drinkers had significant drops in blood sugar, though only after fasting; the Israeli scientists are now working with an international team to begin a larger two-year trial.
“The last thing we want to do as researchers and physicians is expose people to something that might harm them, and it’s that fear that has prevented us from doing a trial,” said Dr. Sei Lee of the University of California, San Francisco, who recently proposed a large trial on alcohol and health.
“But this is a really important question,” he continued. “Because here we have a readily available and widely used substance that may actually have a significant health benefit — but we just don’t know enough to make recommendations.”
http://www.nytimes.com/2009/06/16/healt ... nted=print
Alcohol’s Good for You? Some Scientists Doubt It
By RONI CARYN RABIN
By now, it is a familiar litany. Study after study suggests that alcohol in moderation may promote heart health and even ward off diabetes and dementia. The evidence is so plentiful that some experts consider moderate drinking — about one drink a day for women, about two for men — a central component of a healthy lifestyle.
But what if it’s all a big mistake?
For some scientists, the question will not go away. No study, these critics say, has ever proved a causal relationship between moderate drinking and lower risk of death — only that the two often go together. It may be that moderate drinking is just something healthy people tend to do, not something that makes people healthy.
“The moderate drinkers tend to do everything right — they exercise, they don’t smoke, they eat right and they drink moderately,” said Kaye Middleton Fillmore, a retired sociologist from the University of California, San Francisco, who has criticized the research. “It’s very hard to disentangle all of that, and that’s a real problem.”
Some researchers say they are haunted by the mistakes made in studies about hormone replacement therapy, which was widely prescribed for years on the basis of observational studies similar to the kind done on alcohol. Questions have also been raised about the financial relationships that have sprung up between the alcoholic beverage industry and many academic centers, which have accepted industry money to pay for research, train students and promote their findings.
“The bottom line is there has not been a single study done on moderate alcohol consumption and mortality outcomes that is a ‘gold standard’ kind of study — the kind of randomized controlled clinical trial that we would be required to have in order to approve a new pharmaceutical agent in this country,” said Dr. Tim Naimi, an epidemiologist with the Centers for Disease Control and Prevention.
Even avid supporters of moderate drinking temper their recommendations with warnings about the dangers of alcohol, which has been tied to breast cancer and can lead to accidents even when consumed in small amounts, and is linked with liver disease, cancers, heart damage and strokes when consumed in larger amounts.
“It’s very difficult to form a single-bullet message because one size doesn’t fit all here, and the public health message has to be very conservative,” said Dr. Arthur L. Klatsky, a cardiologist in Oakland, Calif., who wrote a landmark study in the early 1970s finding that members of the Kaiser Permanente health care plan who drank in moderation were less likely to be hospitalized for heart attacks than abstainers. (He has since received research grants financed by an alcohol industry foundation, though he notes that at least one of his studies found that alcohol increased the risk of hypertension.)
“People who would not be able to stop at one to two drinks a day shouldn’t drink, and people with liver disease shouldn’t drink,” Dr. Klatsky said. On the other hand, “the man in his 50s or 60s who has a heart attack and decides to go clean and gives up his glass of wine at night — that person is better off being a moderate drinker.”
Health organizations have phrased their recommendations gingerly. The American Heart Association says people should not start drinking to protect themselves from heart disease. The 2005 United States dietary guidelines say that “alcohol may have beneficial effects when consumed in moderation.”
The association was first made in the early 20th century. In 1924, a Johns Hopkins biologist, Raymond Pearl, published a graph with a U-shaped curve, its tall strands on either side representing the higher death rates of heavy drinkers and nondrinkers; in the middle were moderate drinkers, with the lowest rates. Dozens of other observational studies have replicated the findings, particularly with respect to heart disease.
“With the exception of smoking and lung cancer, this is probably the most established association in the field of nutrition,” said Eric Rimm, an associate professor of epidemiology and nutrition at the Harvard School of Public Health. “There are probably at least 100 studies by now, and the number grows on a monthly basis. That’s what makes it so unique.”
Alcohol is believed to reduce coronary disease because it has been found to increase the “good” HDL cholesterol and have anticlotting effects. Other benefits have been suggested, too. A small study in China found that cognitively impaired elderly patients who drank in moderation did not deteriorate as quickly as abstainers. A report from the Framingham Offspring Study found that moderate drinkers had greater mineral density in their hipbones than nondrinkers. Researchers have reported that light drinkers are less likely than abstainers to develop diabetes, and that those with Type 2 diabetes who drink lightly are less likely to develop coronary heart disease.
But the studies comparing moderate drinkers with abstainers have come under fire in recent years. Critics ask: Who are these abstainers? Why do they avoid alcohol? Is there something that makes them more susceptible to heart disease?
Some researchers suspect the abstainer group may include “sick quitters,” people who stopped drinking because they already had heart disease. People also tend to cut down on drinking as they age, which would make the average abstainer older — and presumably more susceptible to disease — than the average light drinker.
In 2006, shortly after Dr. Fillmore and her colleagues published a critical analysis saying a vast majority of the alcohol studies they reviewed were flawed, Dr. R. Curtis Ellison, a Boston University physician who has championed the benefits of alcohol, hosted a conference on the subject. A summary of the conference, published a year later, said scientists had reached a “consensus” that moderate drinking “has been shown to have predominantly beneficial effects on health.”
The meeting, like much of Dr. Ellison’s work, was partly financed by industry grants. And the summary was written by him and Marjana Martinic, a senior vice president for the International Center for Alcohol Policies, a nonprofit group supported by the industry. The center paid for tens of thousands of copies of the summary, which were included as free inserts in two medical journals, The American Journal of Medicine and The American Journal of Cardiology.
In an interview, Dr. Ellison said his relationship with the industry did not influence his work, adding, “No one would look at our critiques if we didn’t present a balanced view.”
Dr. Fillmore and the co-authors of her analysis posted an online commentary saying the summary had glossed over some of the deep divisions that polarized the debate at the conference. “We also dispute Ellison and Martinic’s conclusions that more frequent drinking is the strongest predictor of health benefits,” they wrote.
(Dr. Fillmore has received support from the Alcohol Education and Rehabilitation Foundation of Australia, a nonprofit group that works to prevent alcohol and substance abuse.)
Dr. Ellison said Dr. Fillmore’s analysis ignored newer studies that corrected the methodological errors of earlier work. “She threw out the baby with the bathwater,” he said.
Meanwhile, two central questions remain unresolved: whether abstainers and moderate drinkers are fundamentally different and, if so, whether it is those differences that make them live longer, rather than their alcohol consumption.
Dr. Naimi of the C.D.C., who did a study looking at the characteristics of moderate drinkers and abstainers, says the two groups are so different that they simply cannot be compared. Moderate drinkers are healthier, wealthier and more educated, and they get better health care, even though they are more likely to smoke. They are even more likely to have all of their teeth, a marker of well-being.
“Moderate drinkers tend to be socially advantaged in ways that have nothing to do with their drinking,” Dr. Naimi said. “These two groups are apples and oranges.” And simply advising the nondrinkers to drink won’t change that, he said.
Some scientists say the time has come to do a large, long-term randomized controlled clinical trial, like the ones for new drugs. One approach might be to recruit a large group of abstainers who would be randomly assigned either to get a daily dose of alcohol or not, and then closely followed for several years; another might be to recruit people who are at risk for coronary disease.
But even the experts who believe in the health benefits of alcohol say this is an implausible idea. Large randomized trials are expensive, and they might lack credibility unless they were financed by the government, which is unlikely to take on the controversy. And there are practical and ethical problems in giving alcohol to abstainers without making them aware of it and without contributing to accidents.
Still, some small clinical trials are already under way to see whether diabetics can reduce their risk of heart disease by consuming alcohol. In Boston, researchers at Beth Israel Deaconess Medical Center are recruiting volunteers 55 and over who are at risk for heart disease and randomly assigning them to either drink plain lemonade or lemonade spiked with tasteless grain alcohol, while scientists track their cholesterol levels and scan their arteries.
In Israel, researchers gave people with Type 2 diabetes either wine or nonalcoholic beer, finding that the wine drinkers had significant drops in blood sugar, though only after fasting; the Israeli scientists are now working with an international team to begin a larger two-year trial.
“The last thing we want to do as researchers and physicians is expose people to something that might harm them, and it’s that fear that has prevented us from doing a trial,” said Dr. Sei Lee of the University of California, San Francisco, who recently proposed a large trial on alcohol and health.
“But this is a really important question,” he continued. “Because here we have a readily available and widely used substance that may actually have a significant health benefit — but we just don’t know enough to make recommendations.”
http://www.nytimes.com/2009/06/16/healt ... nted=print
Beer, spirits may raise risk of cancer by 800%: study
By Charlie Fidelman, Canwest News ServiceAugust 4, 2009
Heavy drinkers of beer and spirits have significantly higher risks of developing multiple cancers, a Montreal study by a group of epidemiologists and cancer researchers shows.
Their findings suggest that people who hit the bottle the hardest boost their chances of developing six different cancers: esophageal, stomach, colon, liver, pancreatic and lung. But abstainers, light and moderate drinkers, as well as wine tipplers, were not affected.
Researchers compared the drinking habits of 3,064 Montreal men who developed 13 types of cancer with 507 who were healthy.
The results were astounding, said biostatistician and study lead author Andrea Benedetti of McGill University.
The heavier the drinker, the greater the risk. The strongest risk was for esophageal cancer at sevenfold, or 700 per cent, and liver cancer at eightfold, or 800 per cent, Benedetti said, while prostate and colon cancers increased by 80 per cent and lung cancer by 50 per cent.
What surprised Benedetti and her co-researchers, Marie-Elise Parent of INRS-Institut Armand Frappier and Jack Siemiatycki of the Universite de Montreal, was the association of alcohol with lung cancer.
The link held up, even after controlling for age, ethnicity, socioeconomic background, diets and smoking, Benedetti explained.
"The effect was the same, whether you smoked heavily or lightly. Alcohol seems to have an independent effect on lung cancer."
Study results were published in the current issue of the journal Cancer Detection and Prevention.
"It looks like the risks are driven by beer and spirits, but not by wine," Benedetti said, although it would not be fair to say wine drinkers are spared. But perhaps wine contains antioxidants, or wine drinkers tend to have healthy lifestyles, she suggested.
© Copyright (c) The Calgary Herald
http://www.calgaryherald.com/story_prin ... 4&sponsor=
By Charlie Fidelman, Canwest News ServiceAugust 4, 2009
Heavy drinkers of beer and spirits have significantly higher risks of developing multiple cancers, a Montreal study by a group of epidemiologists and cancer researchers shows.
Their findings suggest that people who hit the bottle the hardest boost their chances of developing six different cancers: esophageal, stomach, colon, liver, pancreatic and lung. But abstainers, light and moderate drinkers, as well as wine tipplers, were not affected.
Researchers compared the drinking habits of 3,064 Montreal men who developed 13 types of cancer with 507 who were healthy.
The results were astounding, said biostatistician and study lead author Andrea Benedetti of McGill University.
The heavier the drinker, the greater the risk. The strongest risk was for esophageal cancer at sevenfold, or 700 per cent, and liver cancer at eightfold, or 800 per cent, Benedetti said, while prostate and colon cancers increased by 80 per cent and lung cancer by 50 per cent.
What surprised Benedetti and her co-researchers, Marie-Elise Parent of INRS-Institut Armand Frappier and Jack Siemiatycki of the Universite de Montreal, was the association of alcohol with lung cancer.
The link held up, even after controlling for age, ethnicity, socioeconomic background, diets and smoking, Benedetti explained.
"The effect was the same, whether you smoked heavily or lightly. Alcohol seems to have an independent effect on lung cancer."
Study results were published in the current issue of the journal Cancer Detection and Prevention.
"It looks like the risks are driven by beer and spirits, but not by wine," Benedetti said, although it would not be fair to say wine drinkers are spared. But perhaps wine contains antioxidants, or wine drinkers tend to have healthy lifestyles, she suggested.
© Copyright (c) The Calgary Herald
http://www.calgaryherald.com/story_prin ... 4&sponsor=
This is from 1964, London
The other social habit to abandon for those who have indulged in already, is drinking. There is no doubt that this is one of the most ugly habits which my spiritual children can pick up. This is something which you should stop your family or your children from indulging in. There is no end for this habit, it will not give you any increased worldly happiness and certainly can give you nothing but spiritual sorrow. This is a very unpleasant habit and I condemn it as I condemn smoking, most strongly indeed.
The other social habit to abandon for those who have indulged in already, is drinking. There is no doubt that this is one of the most ugly habits which my spiritual children can pick up. This is something which you should stop your family or your children from indulging in. There is no end for this habit, it will not give you any increased worldly happiness and certainly can give you nothing but spiritual sorrow. This is a very unpleasant habit and I condemn it as I condemn smoking, most strongly indeed.
Jackson was responsible for own death
By Susan Martinuk, Calgary Herald
August 28, 2009 9:18 AM
Michael Jackson's death has apparently been ruled a homicide. But if the latest information about his death is true, there's no mystery about who dunnit. The culprit is Michael Jackson himself.
He may not have administered the final, fatal dose of anesthetic; but he slowly killed himself over a period of years and through a host of decisions he made regarding his health, his doctors and his medications.
Court documents reveal the coroner's preliminary assessment that Jackson died from a lethal dose of Propofol. This powerful anesthetic should only be administered in a hospital, yet it was repeatedly given to Jackson. On the day he died, Jackson received Propofol in addition to a cocktail of sedatives. All drugs were administered by his personal physician, Dr. Conrad Murray, in a rather unconventional effort to treat Jackson's insomnia. Consequently, Dr. Murray is being investigated and may face legal, or even criminal, charges related to Jackson's death. But is the doctor really the one at fault?
Previous reports have stated that Jackson was heavily addicted to pain killers, and a former employee claimed Jackson routinely took 10 Xanax (an anti-anxiety drug) pills per night. Once, he purportedly took as many as 40. His autopsy showed scarred track marks on his arms and legs.
The picture is clear: Jackson was a junkie. He obtained drugs from multiple doctors, using multiple names and pharmacies.
The public seems horrified at Dr. Murray's irresponsible actions, yet none of this is new in the land of celebrity and cultural icons.
2008: Actor Heath Ledger died of an accidental overdose of prescription drugs. A toxicology report revealed he had ingested two different sleep medications, two potent narcotics and two kinds of tranquillizers. I realize it's not politically correct to blame the junkie, but most thinking adults understand that a good sleep isn't the only consequence of ingesting so many pills.
1977: No one knows for sure how Elvis Presley died, but his death is assumed to be related to prescription drug abuse. In eight months preceding his death, he was prescribed more than 10,000 doses of sedatives, amphetamines and narcotics. In 1981, his doctor went on trial for over-prescribing medications to Presley. He was acquitted--only to lose it in 1995 for over-prescribing to other celebrities.
2007: Anna Nicole Smith died of an accidental prescription drug overdose. The autopsy found nine prescription drugs in her body; eight of which were sedatives. Two doctors and her partner/lawyer were later charged with devising a plan to prescribe drugs for Smith using various pseudonyms.
1976: The death and mental/physical decline of billionaire Howard Hughes was widely attributed to his addiction to painkillers. An autopsy found five glass syringes embedded in his arm for injecting codeine. His doctor was put on trial, but then acquitted without losing his medical license.
These deaths and others put the spotlight on celebrity doctors -- those who cater to celebrities or choose to be exclusively employed by celebrity patients. Obviously, these relationships aren't always in the best interests of the patient or the physician. In too many cases the only difference between the doctor and a drug dealer is the medical license.
Ironically, the biggest hindrance to good medical care for celebrities is money. When in the unaccountable and unsupervised employ of a patient, doctors can easily toss aside their ethics and medical judgment to cater to their employer's will. After all, if they refuse, they could lose their jobs.
Jackson paid Dr. Murray $150,000/month to cater to his medical wishes. Dr. Murray obviously violated his professional obligations to act in Jackson's best interests. He should lose his medical license forever, but there's no need for criminal charges.
If Jackson was calling the shots, he is culpable for his own death. He made the choice to hire an employee to maintain him in a permanent state of pharmaceutical oblivion--and he got exactly that.
Susan Martinuk's Column Appears Every Friday
© Copyright (c) The Calgary Herald
http://www.calgaryherald.com/story_prin ... 0&sponsor=
By Susan Martinuk, Calgary Herald
August 28, 2009 9:18 AM
Michael Jackson's death has apparently been ruled a homicide. But if the latest information about his death is true, there's no mystery about who dunnit. The culprit is Michael Jackson himself.
He may not have administered the final, fatal dose of anesthetic; but he slowly killed himself over a period of years and through a host of decisions he made regarding his health, his doctors and his medications.
Court documents reveal the coroner's preliminary assessment that Jackson died from a lethal dose of Propofol. This powerful anesthetic should only be administered in a hospital, yet it was repeatedly given to Jackson. On the day he died, Jackson received Propofol in addition to a cocktail of sedatives. All drugs were administered by his personal physician, Dr. Conrad Murray, in a rather unconventional effort to treat Jackson's insomnia. Consequently, Dr. Murray is being investigated and may face legal, or even criminal, charges related to Jackson's death. But is the doctor really the one at fault?
Previous reports have stated that Jackson was heavily addicted to pain killers, and a former employee claimed Jackson routinely took 10 Xanax (an anti-anxiety drug) pills per night. Once, he purportedly took as many as 40. His autopsy showed scarred track marks on his arms and legs.
The picture is clear: Jackson was a junkie. He obtained drugs from multiple doctors, using multiple names and pharmacies.
The public seems horrified at Dr. Murray's irresponsible actions, yet none of this is new in the land of celebrity and cultural icons.
2008: Actor Heath Ledger died of an accidental overdose of prescription drugs. A toxicology report revealed he had ingested two different sleep medications, two potent narcotics and two kinds of tranquillizers. I realize it's not politically correct to blame the junkie, but most thinking adults understand that a good sleep isn't the only consequence of ingesting so many pills.
1977: No one knows for sure how Elvis Presley died, but his death is assumed to be related to prescription drug abuse. In eight months preceding his death, he was prescribed more than 10,000 doses of sedatives, amphetamines and narcotics. In 1981, his doctor went on trial for over-prescribing medications to Presley. He was acquitted--only to lose it in 1995 for over-prescribing to other celebrities.
2007: Anna Nicole Smith died of an accidental prescription drug overdose. The autopsy found nine prescription drugs in her body; eight of which were sedatives. Two doctors and her partner/lawyer were later charged with devising a plan to prescribe drugs for Smith using various pseudonyms.
1976: The death and mental/physical decline of billionaire Howard Hughes was widely attributed to his addiction to painkillers. An autopsy found five glass syringes embedded in his arm for injecting codeine. His doctor was put on trial, but then acquitted without losing his medical license.
These deaths and others put the spotlight on celebrity doctors -- those who cater to celebrities or choose to be exclusively employed by celebrity patients. Obviously, these relationships aren't always in the best interests of the patient or the physician. In too many cases the only difference between the doctor and a drug dealer is the medical license.
Ironically, the biggest hindrance to good medical care for celebrities is money. When in the unaccountable and unsupervised employ of a patient, doctors can easily toss aside their ethics and medical judgment to cater to their employer's will. After all, if they refuse, they could lose their jobs.
Jackson paid Dr. Murray $150,000/month to cater to his medical wishes. Dr. Murray obviously violated his professional obligations to act in Jackson's best interests. He should lose his medical license forever, but there's no need for criminal charges.
If Jackson was calling the shots, he is culpable for his own death. He made the choice to hire an employee to maintain him in a permanent state of pharmaceutical oblivion--and he got exactly that.
Susan Martinuk's Column Appears Every Friday
© Copyright (c) The Calgary Herald
http://www.calgaryherald.com/story_prin ... 0&sponsor=
Legalized prostitution doesn't work
By Susan Martinuk, Calgary Herald
October 9, 2009 9:13 AM
Prostitution is a risky business.
That's why our society discourages girls from making it a career choice, and encourages prostitutes to pursue an alternate line of work.
But rather than working to get women out of this dangerous business, an idealistic law professor and his students from Osgoode Hall have decided to help prostitutes by joining forces with three women (a dominatrix, a former sex trade worker and a working prostitute) and pushing for the full legalization of prostitution in Canada.
Under our current laws, it's illegal to run a bawdy house, communicate for the purposes of prostitution and live off the avails of prostitution. The Osgoode Hall elites believe this amounts to a legal failure to uphold a prostitute's right to liberty and security.
They reason that if we get ladies off the street and onto soft mattresses, they won't be exposed to the "horrors of predatory killers." By legalizing communication so they can sell their services, prostitutes can have meaningful conversations with prospective clients and accurately ascertain if they're upstanding citizens who aren't given to hitting women or violent sex. By legitimizing transactions using money made from "the avails" of prostitution, women can use their earnings to hire security guards.
Right. That's the first place the money will go. Right after the pimp and the drug dealer.
These women are being horribly misled if they believe that creating laws to sanction the buying and selling of human beings will give them more liberty or security. It's like men on the Titanic protecting women by throwing them into the water and telling them to hang onto the side of the ship. In either case, it's not hard to figure out the final result.
Evidence from countries that have already taken this step make it abundantly clear that legalizing prostitution won't enhance anyone's liberty and security-- it will only enhance sexual exploitation and human trafficking.
In 2000, The Netherlands fully legalized prostitution. It wanted to bring the profession out of the shadows of criminal activity and protect the sex workers. Sounds like our noble, altruistic Osgoode Hall plan but, as they should note, it didn't work and is now being reversed.
Seven years later, Amsterdam's infamous red light district had spread decline throughout the city. No longer a hot tourist destination, it degenerated into the stomping grounds for organized crime, money laundering and drug abuse. It became a prime destination for human trafficking for sexual exploitation (for about 7,000 women per year).
The dream was that legalization would eliminate pimps and turn prostitutes and brothel owners into honourable, taxpaying citizens. But officials say the industry remains dominated by organized crime and sex slaves. About 96 per cent of prostitutes are working illegally, 80-85 per cent of prostituted women are of non-Dutch origin, and 70-75 per cent have no legal papers to live or work in The Netherlands.
Australia didn't fare much better. It legalized prostitution in 1999 for the same reasons as the Netherlands, yet a just-released report by the University of Queensland Working Group on Human Trafficking shows legalization has been an abject failure in reducing organized crime and bettering the lives and conditions of sex workers.
A decade later, only 10 per cent of the industry operates in legal brothels; the other 90 per cent is still mired in underground sex markets that use human trafficking victims and forced prostitution. Even women in licensed brothels say they experience exploitation and coercion. Organized crime and human trafficking have both increased significantly. In short, conditions for prostitutes have never been worse.
Oops. That didn't work.
According to Dr. Michael Horowitz of the Hudson Institute, an American think-tank, resolving the problem of prostitution is more complicated than establishing, "ergonomic standards for mattresses and minimum wages."
It's true that approximately 300 sex workers have gone missing from Canada's streets over the past two decades, and that's why the Osgoode lawyers were quick to play the highly emotional Robert-Picktonserial-killer card.
But before we let fear determine our course of action, we should remember that this violence doesn't stem from the laws governing the occupation--it's inherent to the occupation itself. As long as we allow people to sell their bodies for money, buyers will always be under the impression that they own that body and can do whatever they want to it.
The only way to really protect women is to stop the evil of that transaction.
susan martinuk's column appears every Friday.
© Copyright (c) The Calgary Herald
http://www.calgaryherald.com/story_prin ... 2&sponsor=
By Susan Martinuk, Calgary Herald
October 9, 2009 9:13 AM
Prostitution is a risky business.
That's why our society discourages girls from making it a career choice, and encourages prostitutes to pursue an alternate line of work.
But rather than working to get women out of this dangerous business, an idealistic law professor and his students from Osgoode Hall have decided to help prostitutes by joining forces with three women (a dominatrix, a former sex trade worker and a working prostitute) and pushing for the full legalization of prostitution in Canada.
Under our current laws, it's illegal to run a bawdy house, communicate for the purposes of prostitution and live off the avails of prostitution. The Osgoode Hall elites believe this amounts to a legal failure to uphold a prostitute's right to liberty and security.
They reason that if we get ladies off the street and onto soft mattresses, they won't be exposed to the "horrors of predatory killers." By legalizing communication so they can sell their services, prostitutes can have meaningful conversations with prospective clients and accurately ascertain if they're upstanding citizens who aren't given to hitting women or violent sex. By legitimizing transactions using money made from "the avails" of prostitution, women can use their earnings to hire security guards.
Right. That's the first place the money will go. Right after the pimp and the drug dealer.
These women are being horribly misled if they believe that creating laws to sanction the buying and selling of human beings will give them more liberty or security. It's like men on the Titanic protecting women by throwing them into the water and telling them to hang onto the side of the ship. In either case, it's not hard to figure out the final result.
Evidence from countries that have already taken this step make it abundantly clear that legalizing prostitution won't enhance anyone's liberty and security-- it will only enhance sexual exploitation and human trafficking.
In 2000, The Netherlands fully legalized prostitution. It wanted to bring the profession out of the shadows of criminal activity and protect the sex workers. Sounds like our noble, altruistic Osgoode Hall plan but, as they should note, it didn't work and is now being reversed.
Seven years later, Amsterdam's infamous red light district had spread decline throughout the city. No longer a hot tourist destination, it degenerated into the stomping grounds for organized crime, money laundering and drug abuse. It became a prime destination for human trafficking for sexual exploitation (for about 7,000 women per year).
The dream was that legalization would eliminate pimps and turn prostitutes and brothel owners into honourable, taxpaying citizens. But officials say the industry remains dominated by organized crime and sex slaves. About 96 per cent of prostitutes are working illegally, 80-85 per cent of prostituted women are of non-Dutch origin, and 70-75 per cent have no legal papers to live or work in The Netherlands.
Australia didn't fare much better. It legalized prostitution in 1999 for the same reasons as the Netherlands, yet a just-released report by the University of Queensland Working Group on Human Trafficking shows legalization has been an abject failure in reducing organized crime and bettering the lives and conditions of sex workers.
A decade later, only 10 per cent of the industry operates in legal brothels; the other 90 per cent is still mired in underground sex markets that use human trafficking victims and forced prostitution. Even women in licensed brothels say they experience exploitation and coercion. Organized crime and human trafficking have both increased significantly. In short, conditions for prostitutes have never been worse.
Oops. That didn't work.
According to Dr. Michael Horowitz of the Hudson Institute, an American think-tank, resolving the problem of prostitution is more complicated than establishing, "ergonomic standards for mattresses and minimum wages."
It's true that approximately 300 sex workers have gone missing from Canada's streets over the past two decades, and that's why the Osgoode lawyers were quick to play the highly emotional Robert-Picktonserial-killer card.
But before we let fear determine our course of action, we should remember that this violence doesn't stem from the laws governing the occupation--it's inherent to the occupation itself. As long as we allow people to sell their bodies for money, buyers will always be under the impression that they own that body and can do whatever they want to it.
The only way to really protect women is to stop the evil of that transaction.
susan martinuk's column appears every Friday.
© Copyright (c) The Calgary Herald
http://www.calgaryherald.com/story_prin ... 2&sponsor=
June 28, 2010
Bill Wilson’s Gospel
By DAVID BROOKS
On Dec. 14, 1934, a failed stockbroker named Bill Wilson was struggling with alcoholism at a New York City detox center. It was his fourth stay at the center and nothing had worked. This time, he tried a remedy called the belladonna cure — infusions of a hallucinogenic drug made from a poisonous plant — and he consulted a friend named Ebby Thacher, who told him to give up drinking and give his life over to the service of God.
Wilson was not a believer, but, later that night, at the end of his rope, he called out in his hospital room: “If there is a God, let Him show Himself! I am ready to do anything. Anything!”
As Wilson described it, a white light suffused his room and the presence of God appeared. “It seemed to me, in the mind’s eye, that I was on a mountain and that a wind not of air but of spirit was blowing,” he testified later. “And then it burst upon me that I was a free man.”
Wilson never touched alcohol again. He went on to help found Alcoholics Anonymous, which, 75 years later, has some 1.2 million members in 55,000 meeting groups, while 11,000 professional treatment centers employ the steps.
The movement is the subject of a smart and comprehensive essay by Brendan I. Koerner in the July 2010 issue of Wired magazine. The article is noteworthy not only because of the light it sheds on what we’ve learned about addiction, but for what it says about changing behavior more generally. Much of what we do in public policy is to try to get people to behave in their own long-term interests — to finish school, get married, avoid gangs, lose weight, save money. Because the soul is so complicated, much of what we do fails.
The first implication of Koerner’s essay is that we should get used to the idea that we will fail most of the time. Alcoholics Anonymous has stood the test of time. There are millions of people who fervently believed that its 12-step process saved their lives. Yet the majority, even a vast majority, of the people who enroll in the program do not succeed in it. People are idiosyncratic. There is no single program that successfully transforms most people most of the time.
The second implication is that we should get over the notion that we will someday crack the behavior code — that we will someday find a scientific method that will allow us to predict behavior and design reliable social programs. As Koerner notes, A.A. has been the subject of thousands of studies. Yet “no one has yet satisfactorily explained why some succeed in A.A. while others don’t, or even what percentage of alcoholics who try the steps will eventually become sober as a result.”
Each member of an A.A. group is distinct. Each group is distinct. Each moment is distinct. There is simply no way for social scientists to reduce this kind of complexity into equations and formula that can be replicated one place after another.
Nonetheless, we don’t have to be fatalistic about things. It is possible to design programs that will help some people some of the time. A.A. embodies some shrewd insights into human psychology.
In a culture that generally celebrates empowerment and self-esteem, A.A. begins with disempowerment. The goal is to get people to gain control over their lives, but it all begins with an act of surrender and an admission of weakness.
In a culture that thinks of itself as individualistic, A.A. relies on fellowship. The general idea is that people aren’t really captains of their own ship. Successful members become deeply intertwined with one another — learning, sharing, suffering and mentoring one another. Individual repair is a social effort.
In a world in which gurus try to carefully design and impose their ideas, Wilson surrendered control. He wrote down the famous steps and foundations, but A.A. allows each local group to form, adapt and innovate. There is less quality control. Some groups and leaders are great; some are terrible. But it also means that A.A. is decentralized, innovative and dynamic.
Alcoholics have a specific problem: they drink too much. But instead of addressing that problem with the psychic equivalent of a precision-guidance missile, Wilson set out to change people’s whole identities. He studied William James’s “The Varieties of Religious Experience.” He sought to arouse people’s spiritual aspirations rather than just appealing to rational cost-benefit analysis. His group would help people achieve broad spiritual awakenings, and abstinence from alcohol would be a byproduct of that larger salvation.
In the business of changing lives, the straight path is rarely the best one. A.A. illustrates that even in an age of scientific advance, it is still ancient insights into human nature that work best. Wilson built a remarkable organization on a nighttime spiritual epiphany.
This article has been revised to reflect the following correction:
Correction: June 29, 2010
An earlier version of this column stated that Alcoholics Anonymous has professional treatment centers, but the centers only employ the organization's program without being run by it.
http://www.nytimes.com/2010/06/29/opini ... ?th&emc=th
Bill Wilson’s Gospel
By DAVID BROOKS
On Dec. 14, 1934, a failed stockbroker named Bill Wilson was struggling with alcoholism at a New York City detox center. It was his fourth stay at the center and nothing had worked. This time, he tried a remedy called the belladonna cure — infusions of a hallucinogenic drug made from a poisonous plant — and he consulted a friend named Ebby Thacher, who told him to give up drinking and give his life over to the service of God.
Wilson was not a believer, but, later that night, at the end of his rope, he called out in his hospital room: “If there is a God, let Him show Himself! I am ready to do anything. Anything!”
As Wilson described it, a white light suffused his room and the presence of God appeared. “It seemed to me, in the mind’s eye, that I was on a mountain and that a wind not of air but of spirit was blowing,” he testified later. “And then it burst upon me that I was a free man.”
Wilson never touched alcohol again. He went on to help found Alcoholics Anonymous, which, 75 years later, has some 1.2 million members in 55,000 meeting groups, while 11,000 professional treatment centers employ the steps.
The movement is the subject of a smart and comprehensive essay by Brendan I. Koerner in the July 2010 issue of Wired magazine. The article is noteworthy not only because of the light it sheds on what we’ve learned about addiction, but for what it says about changing behavior more generally. Much of what we do in public policy is to try to get people to behave in their own long-term interests — to finish school, get married, avoid gangs, lose weight, save money. Because the soul is so complicated, much of what we do fails.
The first implication of Koerner’s essay is that we should get used to the idea that we will fail most of the time. Alcoholics Anonymous has stood the test of time. There are millions of people who fervently believed that its 12-step process saved their lives. Yet the majority, even a vast majority, of the people who enroll in the program do not succeed in it. People are idiosyncratic. There is no single program that successfully transforms most people most of the time.
The second implication is that we should get over the notion that we will someday crack the behavior code — that we will someday find a scientific method that will allow us to predict behavior and design reliable social programs. As Koerner notes, A.A. has been the subject of thousands of studies. Yet “no one has yet satisfactorily explained why some succeed in A.A. while others don’t, or even what percentage of alcoholics who try the steps will eventually become sober as a result.”
Each member of an A.A. group is distinct. Each group is distinct. Each moment is distinct. There is simply no way for social scientists to reduce this kind of complexity into equations and formula that can be replicated one place after another.
Nonetheless, we don’t have to be fatalistic about things. It is possible to design programs that will help some people some of the time. A.A. embodies some shrewd insights into human psychology.
In a culture that generally celebrates empowerment and self-esteem, A.A. begins with disempowerment. The goal is to get people to gain control over their lives, but it all begins with an act of surrender and an admission of weakness.
In a culture that thinks of itself as individualistic, A.A. relies on fellowship. The general idea is that people aren’t really captains of their own ship. Successful members become deeply intertwined with one another — learning, sharing, suffering and mentoring one another. Individual repair is a social effort.
In a world in which gurus try to carefully design and impose their ideas, Wilson surrendered control. He wrote down the famous steps and foundations, but A.A. allows each local group to form, adapt and innovate. There is less quality control. Some groups and leaders are great; some are terrible. But it also means that A.A. is decentralized, innovative and dynamic.
Alcoholics have a specific problem: they drink too much. But instead of addressing that problem with the psychic equivalent of a precision-guidance missile, Wilson set out to change people’s whole identities. He studied William James’s “The Varieties of Religious Experience.” He sought to arouse people’s spiritual aspirations rather than just appealing to rational cost-benefit analysis. His group would help people achieve broad spiritual awakenings, and abstinence from alcohol would be a byproduct of that larger salvation.
In the business of changing lives, the straight path is rarely the best one. A.A. illustrates that even in an age of scientific advance, it is still ancient insights into human nature that work best. Wilson built a remarkable organization on a nighttime spiritual epiphany.
This article has been revised to reflect the following correction:
Correction: June 29, 2010
An earlier version of this column stated that Alcoholics Anonymous has professional treatment centers, but the centers only employ the organization's program without being run by it.
http://www.nytimes.com/2010/06/29/opini ... ?th&emc=th
July 14, 2010
Seduction, Slavery and Sex
By NICHOLAS D. KRISTOF
Against all odds, this year’s publishing sensation is a trio of thrillers by a dead Swede relating tangentially to human trafficking and sexual abuse.
“The Girl With the Dragon Tattoo” series tops the best-seller lists. More than 150 years ago, “Uncle Tom’s Cabin” helped lay the groundwork for the end of slavery. Let’s hope that these novels help build pressure on trafficking as a modern echo of slavery.
Human trafficking tends to get ignored because it is an indelicate, sordid topic, with troubled victims who don’t make great poster children for family values. Indeed, many of the victims are rebellious teenage girls — often runaways — who have been in trouble with their parents and the law, and at times they think they love their pimps.
Because trafficking gets ignored, it rarely is a top priority for law enforcement officials — so it seems to be growing. Various reports and studies, none of them particularly reliable, suggest that between 100,000 and 600,000 children may be involved in prostitution in the United States, with the numbers increasing.
Just last month, police freed a 12-year-old girl who they said had been imprisoned in a Knights Inn hotel in Laurel, Md. The police charged a 42-year-old man, Derwin Smith, with human trafficking and false imprisonment in connection with the case.
The Anne Arundel County Police Department said that Mr. Smith met the girl in a seedy area, had sex with her and then transported her back and forth from Washington, D.C., to Atlantic City, N.J., while prostituting her.
“The juvenile advised that all of the money made was collected and kept by the suspect,” the police department said in a statement. “At one point, the victim conveyed to the suspect that she wanted to return home, but he held her against her will.”
Just two days later, the same police force freed three other young women from a Garden Inn about a block away. They were 16, 19 and 23, and police officials accused a 23-year-old man, Gabriel Dreke-Hernandez, of pimping them.
Police said that Mr. Dreke-Hernandez had kidnapped the 19-year-old from a party and had taken her to a hotel room. “Once at the hotel,” the police statement said, Mr. Dreke-Hernandez allegedly “grabbed her around the throat and began to choke her. Hernandez then pushed her head against the wall several times before placing a knife to her throat and demanding that she follow his commands.
“The female further advised that all of the money made was collected and kept by the suspect. At one point, she indicated that she would not prostitute any longer and the suspect subsequently pulled her into the bathroom and threatened her again with a knife.”
Police officials did not release details about the 16-year-old and 23-year-old, though they said customers for the teenager had been sought on the Internet.
There’s a misperception in America that “sex trafficking” is mostly about foreigners smuggled into the U.S. That exists. But I’ve concluded that the biggest problem and worst abuses involve not foreign women but home-grown runaway kids.
In a typical case, a rebellious 13-year-old girl runs away from a home where her mother’s boyfriend is hitting on her. She is angry and doesn’t trust the police. She goes to the bus station in hopes of getting out of town — and the only person on the lookout for girls like her is a pimp, who buys her a meal, offers her a place to stay and tells her he loves her.
The next thing she knows, she’s having sex with four men a night and all the money is going to her “boyfriend.” If she voices reservations, he puts a gun in her mouth and threatens to blow her head off.
Her customers, often recruited on the Internet, may have no inkling that her actions are not completely voluntary. Some mix of fear, love, hopelessness and shattered self-esteem keep her from trying to run away.
No strategy has worked particularly well against human trafficking, and commercial sex may well exist 1,000 years from now. But a starting point is for law enforcement to go after pimps rather than the girls. That’s the only way to break the business model of forced prostitution.
Sweden offers us not only the summer’s top beach paperbacks, but also a useful strategy for dealing with trafficking. The Swedish model, adopted in 1999, is to prosecute the men who purchase sex, while treating the women who sell it as victims who merit social services.
Prosecution of johns has reduced demand for prostitution in Sweden, which in turn reduces market prices. That reduces the incentives for trafficking into Sweden, and the number of prostitutes seems to have declined there. A growing number of countries are concluding that the Swedish model works better than any other, and it would be wise for American states to experiment with it as well. It’s not a panacea, but cracking down on demand seems a useful way to chip away at 21st-century slavery.
•
I invite you to visit my blog, On the Ground. Please also join me on Facebook, watch my YouTube videos and follow me on Twitter.
http://www.nytimes.com/2010/07/15/opini ... &th&emc=th
Seduction, Slavery and Sex
By NICHOLAS D. KRISTOF
Against all odds, this year’s publishing sensation is a trio of thrillers by a dead Swede relating tangentially to human trafficking and sexual abuse.
“The Girl With the Dragon Tattoo” series tops the best-seller lists. More than 150 years ago, “Uncle Tom’s Cabin” helped lay the groundwork for the end of slavery. Let’s hope that these novels help build pressure on trafficking as a modern echo of slavery.
Human trafficking tends to get ignored because it is an indelicate, sordid topic, with troubled victims who don’t make great poster children for family values. Indeed, many of the victims are rebellious teenage girls — often runaways — who have been in trouble with their parents and the law, and at times they think they love their pimps.
Because trafficking gets ignored, it rarely is a top priority for law enforcement officials — so it seems to be growing. Various reports and studies, none of them particularly reliable, suggest that between 100,000 and 600,000 children may be involved in prostitution in the United States, with the numbers increasing.
Just last month, police freed a 12-year-old girl who they said had been imprisoned in a Knights Inn hotel in Laurel, Md. The police charged a 42-year-old man, Derwin Smith, with human trafficking and false imprisonment in connection with the case.
The Anne Arundel County Police Department said that Mr. Smith met the girl in a seedy area, had sex with her and then transported her back and forth from Washington, D.C., to Atlantic City, N.J., while prostituting her.
“The juvenile advised that all of the money made was collected and kept by the suspect,” the police department said in a statement. “At one point, the victim conveyed to the suspect that she wanted to return home, but he held her against her will.”
Just two days later, the same police force freed three other young women from a Garden Inn about a block away. They were 16, 19 and 23, and police officials accused a 23-year-old man, Gabriel Dreke-Hernandez, of pimping them.
Police said that Mr. Dreke-Hernandez had kidnapped the 19-year-old from a party and had taken her to a hotel room. “Once at the hotel,” the police statement said, Mr. Dreke-Hernandez allegedly “grabbed her around the throat and began to choke her. Hernandez then pushed her head against the wall several times before placing a knife to her throat and demanding that she follow his commands.
“The female further advised that all of the money made was collected and kept by the suspect. At one point, she indicated that she would not prostitute any longer and the suspect subsequently pulled her into the bathroom and threatened her again with a knife.”
Police officials did not release details about the 16-year-old and 23-year-old, though they said customers for the teenager had been sought on the Internet.
There’s a misperception in America that “sex trafficking” is mostly about foreigners smuggled into the U.S. That exists. But I’ve concluded that the biggest problem and worst abuses involve not foreign women but home-grown runaway kids.
In a typical case, a rebellious 13-year-old girl runs away from a home where her mother’s boyfriend is hitting on her. She is angry and doesn’t trust the police. She goes to the bus station in hopes of getting out of town — and the only person on the lookout for girls like her is a pimp, who buys her a meal, offers her a place to stay and tells her he loves her.
The next thing she knows, she’s having sex with four men a night and all the money is going to her “boyfriend.” If she voices reservations, he puts a gun in her mouth and threatens to blow her head off.
Her customers, often recruited on the Internet, may have no inkling that her actions are not completely voluntary. Some mix of fear, love, hopelessness and shattered self-esteem keep her from trying to run away.
No strategy has worked particularly well against human trafficking, and commercial sex may well exist 1,000 years from now. But a starting point is for law enforcement to go after pimps rather than the girls. That’s the only way to break the business model of forced prostitution.
Sweden offers us not only the summer’s top beach paperbacks, but also a useful strategy for dealing with trafficking. The Swedish model, adopted in 1999, is to prosecute the men who purchase sex, while treating the women who sell it as victims who merit social services.
Prosecution of johns has reduced demand for prostitution in Sweden, which in turn reduces market prices. That reduces the incentives for trafficking into Sweden, and the number of prostitutes seems to have declined there. A growing number of countries are concluding that the Swedish model works better than any other, and it would be wise for American states to experiment with it as well. It’s not a panacea, but cracking down on demand seems a useful way to chip away at 21st-century slavery.
•
I invite you to visit my blog, On the Ground. Please also join me on Facebook, watch my YouTube videos and follow me on Twitter.
http://www.nytimes.com/2010/07/15/opini ... &th&emc=th