Rethinking the War on Drugs in the Age of Opioid Addicted Europeans

I don't see racism everywhere I look. In my view, most issues are far too complex for "race" to serve as a dominant explanatory factor.

That said, it's rather stunning to see the recent tsunami of news articles (like this one recent news piece from NPR) taking the position that as people of European descent become an ever bigger percentage of drug addicts, throwing their asses in jail is no longer trendy as a first-choice paradigm for addressing the problem. Almost overnight, in this age of opioid addiction, compassionate treatment has become "common sense."

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The Illusory Truth Effect

Why do we believe things that aren't true? Sometimes, it's a matter of the Illusory Truth Effect: Repeated Exposure to (even false) information becomes easy to process in our brains and that easy processing makes it seem true.

Shane Parish discusses this in his latest post, "The Illusory Truth Effect: Why We Believe Fake News, Conspiracy Theories and Propaganda." Here's an excerpt:

This is how the illusory truth effect works: we all have a tendency to believe something is true after being exposed to it multiple times. The more times we’ve heard something, the truer it seems. The effect is so powerful that repetition can persuade us to believe information we know is false in the first place. . . . [W]e’re often far outside our circle of competence, reading about topics we don’t have the expertise in to assess accuracy in any meaningful way. This drip-drip of information pollution is not harmless. Like air pollution, it builds up over time and the more we’re exposed to it, the more likely we are to end up picking up false beliefs which are then hard to shift. For instance, a lot of people believe that crime, especially the violent kind, is on an upward trend year by year—in a 2016 study by Pew Research, 57% of Americans believed crime had worsened since 2008. This despite violent crime having actually fallen by nearly a fifth during that time. This false belief may stem from the fact that violent crime receives a disproportional amount of media coverage, giving it wide and repeated exposure. When people are asked to rate the apparent truthfulness of news stories, they score ones they have read multiple times more truthful than those they haven’t.

It seems like the repeated exposure creates a slippery path that runs that information quickly and easily through the brain. William James used this type of metaphor of a "path" in his discussion of memory (this is from "Talks to Teachers, Chapter 12, Memory):

Reflection will show you that there are peculiarities in your memory which would be quite whimsical and unaccountable if we were forced to regard them as the product of a purely spiritual faculty. Were memory such a faculty, granted to us solely for its practical use, we ought to remember easiest whatever we most needed to remember; and frequency of repetition, recency, and the like, would play no part in the matter. That we should best remember frequent things and recent things, and forget things that are ancient or were experienced only once, could only be regarded as an incomprehensible anomaly on such a view. But if we remember because of our associations, and if these are (as the physiological psychologists believe) due to our organized brain-paths, we easily see how the law of recency and repetition should prevail. Paths frequently and recently ploughed are those that lie most open, those which may be expected most easily to lead to results. The laws of our memory, as we find them, therefore are incidents of our associational constitution; and, when we are emancipated from the flesh, it is conceivable that they may no longer continue to obtain.

In his incredible opus, The Principles of Psychology, Williams James elaborates this metaphor, writing about the path along with a marble that rolls down the path. Each time the marble rolls down, it smoothens the path a bit more, making it a more and more fast and direct path.

The psychological law of association of objects thought of through their previous contiguity in thought or experience would thus be an effect, within the mind, of the physical fact that nerve-currents propagate themselves easiest through those tracts of conduction which have been already most in use. Descartes and Locke hit upon this explanation, which modern science has not yet succeeded in improving. "Custom," says Locke, "settles habits of thinking in the understanding, as well as of determining in the will, and of motions in the body; all which seem to be but trains of motion in the animal spirits[Pg 564] [by this Locke meant identically what we understand by neural processes] which, once set agoing, continue in the same steps they have been used to, which by often treading are worn into a smooth path, and the motion in it becomes easy and, as it were, natural."[476]

This is a good metaphor for the process of memory, whether or not the memory is about something real in the world or whether the thing remembered is fake news."

I like this phrase Shane Parrish uses in his quote: "information pollution." I'm going add that to my vocabulary.

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George Conway Believes the President

George Conway has nailed it with this pledge to the President, including gems like these:

I believe the president wants to release his taxes but has not because he’s under audit, which is why he has fought all the way to the Supreme Court not to disclose them.

. . .

I believe former national security adviser John Bolton has no relevant testimony because he didn’t leave the White House on good terms.

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Disrupting the Healthcare System

This morning I attended a conference titled “Disruption and Innovation in Healthcare 2.0“ at Washington University in St. Louis. I was humbled at how well informed and nuanced the speakers were. They included Alex Gorsky (CEO of Johnson and Johnson), I certainly learned a lot. My main concern is that the ability to understand the complexity of the health care system is well beyond the ability of most people. The simplistic positions of our politicians are a great disservice to our country. For example, it is absolutely clear that our health care system is NOT a functional market, meaning that the Ayn Rand/Free-Market conservatives are deceiving us when they claim that all we need to do is “get government off our backs” to fix healthcare. I admire that progressive politicians are calling for universal access (something that almost all developed countries have, but not the U.S.). That said, how do we square that universal access with the need to incentivize future innovations, in addition to ongoing care? Any big changes to the current system could have disasterous ramifications.

The stakes could not be higher. To the extent we are tempted to implement broad new changes, we need to keep in mind (as one of today’s speakers said), “This is not a dress rehearsal. It’s the real deal.”

[On the right] Johnson and Johnson CEO, Alex Gorsky

The speakers somberly delivered the following shocking information: There is currently no payment model for many current (and anticipated) extremely expensive curative therapies. Thus, people who can be CURED of horrific diseases will languish under the status quo because we can’t figure out how to give them more than palliative treatment, even when palliative treatment is sometimes more expensive in the long run. I dare you to read previous sentence a few times and then shrug and try to convince yourself that we, as a country cannot do better.

Here’s another fact was mentioned several times today: 75% of our health care budget is the result of bad choices made in early life by individual Americans. Preaching at people to get their act together shouldn’t offend reasonable people. For instance, urging that children should eat healthier food should be applauded, even though some conservatives ridicule Michelle Obama’s urgings in that direction. But what about more? To what extent should we, must we, put some skin in the game for people who are actively self-destructing their bodies? I think we need to seriously look at some low-hanging fruit and make some people uncomfortable for their own well being and for the greater good of the United States. The overall health of the United States is most definitely a public good. The ill-health of any of us affects all of us.

These issues are ultra-complex, highly nuanced, in addition to being critical important. Anyone pretending otherwise should be promptly yanked off the political stage.

Here’s more information about this event. It was being video-recorded and hope that it will be made available to anyone interested in these issues. “2nd Annual Olin Business School Healthcare Symposium: 'Disruption and Innovation in Healthcare 2.0'

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The Importance of Reaching Out to One’s Perceived Enemies

Everyone out there has good stories and lessons to share. It is my faith that it is one of our highest duties as human beings to reach out to connect with other human beings to identify and share those treasures within each other without exception and without judgment. Sometimes it's not easy and it takes some deep breathing to get past crusty exteriors of ourselves and others.

Over the past year I've reached out to have coffee with several local FB Friends who had bristled at my political views (and vice versa). In each case, over a couple hours of conversation we found common concerns and common dreams along with that willingness to connect. Later this week I'm going to join one of those men for coffee again. Aside from his staunch views that many would consider gun-loving libertarian/conservative, he is also a dog lover, brought almost to tears by the thought of dogs who suffer. He is also a dedicated family man, a cancer survivor and a man who, many years ago, pulled himself up (with unfathomable hard work) from a place that would seem to most of us to be an impossibility.

Over the past couple of months, I also reached out to a woman who (I'm certain) gets indigestion when I speak of things like single payor health care. She is a dedicated nurse who, over several decades, worked her way through a dozen challenges that might have crushed many of us. She generously gave me the gift of hours on the phone, during which she invited me to lean hard on her to help me process a situation that felt like an emotional bludgeoning. [More . . . ]

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