New York Times Panics Over Un-Risky Drug Buprenorphine

The New  York Times on Sunday did one of its

usual bits of fearmongering
over the fact that someone,
somewhere might use a useful drug in a way they and authorities
disapprove of or which might even be dangerous to a few people.

This very, very, very long story was about buprenorphine, a drug
used to treat opioid addiction, and unlike methadone actually
available by prescription in the form of “suboxone,” where it is
mixed with naloxone, an opiate-cancelling drug. (You know, so no
one would enjoy it.)

While occasionally acknowledging its lifesaving properties, the
piece can’t help but make it seem more important that someone
somewhere is using it in unapproved ways, or harming themselves
with it, with its long, long narratives of people unhappy with
their choice to take too much of it, or people committing armed
robbery to get it, or doctors who sell it to people who aren’t
“supposed” to have it, or allowing the drug to slip from the
state’s control when the permitted choose to sell it to the
unpermitted.

But, way, way toward the end of this stunningly long story you
find:

Most buprenorphine advocates interviewed said they believed that
deaths were extremely rare. But Suboxone and Subutex [a version
lacking naloxone] were considered the “primary suspect” in 690
deaths — 420 in the United States — reported to the F.D.A. from
spring 2003 through September…..

The F.D.A. information, which is spare, does show that more than
half the American buprenorphine deaths involved other substances
and that only two of 224 cases specifying “route of administration”
indicated injection — the primary concern of regulators.

Fifty deaths are listed as suicides, and 69 involve
unintentional overdoses, drug abuse or drug misuse. Thirty were
fetal or infant deaths after exposure in the womb….

The F.D.A. cautions against assuming that a “primary suspect”
drug was indeed a cause of death.

What does that mean, comparatively?
According to U.S. DEA data
:

IMS HealthTM National Prescription Audit Plus
indicates that 9.3 million buprenorphine prescriptions were
dispensed in the U.S. in 2012. From January to March 2013, 2.5
million buprenorphine prescriptions were
dispensed. 

And that’s just in the past couple of years, those over 10
million licit uses for people who think (or whose doctors think) it
might be useful for them, compared to those 420 deaths over about
the past decade for which the drug might maybe have been
responsible.

Occasional Reason contributor Maia Szalavitz at the
Huffington Post
took on the

Baltimo
re
Sun
for trying to do the same five years
ago:

Using story after story of street abuse and sales, it presents a
bleak picture of a drug that has actually done exactly what it is
supposed to do when it is provided medically: reduce harm related
to opioid misuse.

The Sun
 seems to see such harm reduction as failure: To
the reporters, the existence of any level of misuse is cause for
concern, and perhaps, increased regulation. It doesn’t much matter
whether buprenorphine saves lives, reduces infections and increases
functioning – all that counts are that some addicts are still
injecting and getting high and some prescriptions are still being
sold.

Former Reason man Mike Riggs at the Atlantic

has some data
on how many opioid-related drug overdose deaths
are happening while the FDA dither over making the lifesaving
anti-opioid drug naloxone (a part of suboxone, recall) available
over the counter:

More than 300,000 people died from drug poisoning in the U.S.
between 1999 and 2009. That first year, opioid analgesics—drugs
like methadone, oxycodone, and hydrocodone—were
responsible for 21 percent of drug poisoning deaths. By 2009, that
number had increased to 42 percent, or 15,597 dead, making
prescription painkillers the leading cause of drug-poisoning
deaths…

…..over the decade-long period covered in the study, the
number of counties that had more than 10 drug-poisoning deaths per
100,000 residents increased from 3 percent to 54 percent, and the
drug-poisoning death rate increased 394 percent in rural
counties and 279 percent for large central metropolitan counties.
The study authors say 90 percent of those deaths were related to
prescription drugs, opioids in particular. 

Reason on
naloxone
.

from Hit & Run http://reason.com/blog/2013/11/18/new-york-times-panics-over-un-risky-drug
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US Planning To Train Libyan Security Forces in Bulgaria

According to Reuters, the U.S.
is planning to train
Libyan security forces
. The news comes as the Libyan government
continues to struggle with Islamists and militias that are impeding
attempts to restore some sort of order in the wake of Gaddafi’s
removal from power in 2011.

The instability in Libya has been highlighted by recent
kidnappings and violent clashes involving militias.

Last month, the
prime minister
was kidnapped and later released, and yesterday
Libya’s
deputy director of intelligence
was kidnapped at Tripoli
Airport.

Although many of the militias fought together to remove Gaddafi
from power, the BBC notes
that many remain in control of the towns where they formed.
Recently, Militia groups from Misrata were ordered to leave Tripoli
following violent clashes with protesters.

According to Army Col.
Steve Warren
,  Libyan security forces will be trained in
Bulgaria. Admiral William McRaven has said that this training will
come with risks.

From
Reuters
:

“Right now as we go forward to try and find a good way to build
up the Libyan security forces so they are not run by militias, we
are going to have to assume some risks,” McRaven told the forum
late on Saturday.

“There is probably some risk that some of the people we will be
training with do not have the most clean records. But at the end of
the day it is the best solution we can find to train them to deal
with their own problems.”

It is understandable that McRaven is wary of the risks involved
in training Libyan security forces. Coalition personnel have been
killed in so-called insider attacks
in Afghanistan.
Sixty-four
coalition troops were killed in such attacks last
year in Afghanistan, and according to reporting
from the AP
at the end of last month “insider attacks by Afghan
troops, or insurgents in their uniforms, have left 15 foreign
soldiers dead this year.”

Although plans still need to be finalized, it looks like Libyan
security forces could be receiving training from Americans for some
time. According to Reuters, Bulgaria’s defense minister said in
September that the U.S. plans to train Libyan forces in Bulgaria
for up to eight years.

from Hit & Run http://reason.com/blog/2013/11/18/us-planning-to-train-libyan-security-for
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The Persistent—But Fading—Appeal of JFK Conspiracy Stories

Speaking
of JFK’s assassination
, I have an
article
on the subject at Time.com today. Here’s how it
opens:

"That umbrella, we employed it."If you could settle the question with a
national vote, there would be no doubt that a conspiracy killed
John F. Kennedy. Two weeks after the shooting, a Gallup poll showed
52% of Americans blaming a force larger than Lee Harvey Oswald for
the President’s death. Half a century later, a new Gallup poll puts
the number at 61%. Earlier this year an Associated Press survey
said the number was 59%, while a Public Policy Polling effort said
it was a more modest but still substantial 51% — not far at all
from those initial results in 1963.

Those numbers may sound surprisingly high, but by other years’
standards they’re actually low. A decade ago, an ABC News poll had
70% of the population believing there was more than one man behind
the slaying. When ABC posed the same question in 1983, the number
was 80%. In 1994, the sociologist Ted Goertzel suggested that
belief in a Kennedy conspiracy has “increased as the event became
more distant.” For a while it did, but then it reached a peak and
started sinking.

So there are two trends that cry out to be explained here. Why are
Kennedy-assassination theories still so popular, and why are they
less popular than before?

For my answers to those questions, you can read the rest of the
piece
here
.

On a related subject: New York magazine has marked the
JFK anniversary by publishing a mini-encyclopedia
of conspiracy theories. I contributed the entry on
Operation Mindfuck
.

from Hit & Run http://reason.com/blog/2013/11/18/the-persistentbut-fadingappeal-of-jfk-co
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Jerry Brito on Turning the Tables on the Surveillance State

Narrative ClipSousveillance is the recording of an activity by
a participant in that activity, and it can be thought of as the
inverse of surveillance. The word “sur” in French means “over” or
“above,” hence surveillance is “watching from above” or
“overseeing.” The word “sous,” by contrast, means “under” or
“below.” To date, “veillance” has only been available to the
powerful–whether through corporate or government CCTV cams perched
atop buildings or utility poles. But, writes Jerry Brito, with the
advent of cheap wearable computers, we will all soon be able to
point a camera back at the powers that be from below.

View this article.

from Hit & Run http://reason.com/blog/2013/11/18/jerry-brito-on-turning-the-tables-on-the
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Updated! Show Suspended for 2 Weeks! Alec Baldwin Condemns "Libertarian Trash" Who Are "Defenders of Gay Rights"

This post has been updated at 10pm ET on November 15.
Scroll down to read the update.


The latest rampage by rageaholic – and ultra-talented, btw –
actor Alec Baldwin is on display at TMZ.com (click above to watch).
After winning a case against a stalker,
Baldwin saw fit to scream at and threaten a shutterbug on the
streets of New York.

During the episode, Baldwin refers to the photographer as a
“cocksucking fag,” an insult that calls to mind a previous incident
in which the 30 Rock alum and current MSNBC host
threatened to foot-fuck
a “toxic little queen” and “a toxic
little bitch” who had libeled his wife.

While giving no quarter to what he sees as invasive
photographers, Baldwin has checked in with advisers and
concludes

This tweet came just hours after Baldwin had tweeted
Anti-gay
slurs are wrong. They not only offend, but threaten hard fought
tolerance of LGBT rights
.”

And not long after Baldwin had tweeted (and duly deleted) this
slag on “libertarian trash” who defend gays:


I can’t speak for the Breitbart crowd (though Andrew Breitbart
was certainly a staunch supporter of gay
equality
) but the “libertarian trash” at Reason has been
defending gay rights since the magazine’s earliest days in the late
1960s. In fact, when mainstream liberal and conservative
publications were still arguing over whether homosexuality should
be decriminalized, we were already talking about marriage equality.
If the state is going to involve itself in marriage (and it
shouldn’t) among consenting adults, it should not draw invidious
distinctions and treat some people as second-class citizens.

I’d like to think that Alec Baldwin can understand that about
“libertarian trash.” But if his now-you-see-it, now-you-don’t
Twitter feed is any indication, he’s already on to more important
topics, such as conflating “single-bullet theorists” with
minimum-wage flat-earthers:

Update (10pm ET, November 15):
According to Variety
, Alec Baldwin’s MSNBC show, Up
Late
, has been suspended for two weeks. The suspension comes
not because of the event described above but due to a threat and
insult Baldwin made to a reporter for a local New York Fox
affiliate earlier this week. Along with other journalists hovering
around Baldwin after his testimony against his stalker, the Fox
reporter asked him questions. To which Baldwin responded

“If you’re still here when my wife and kid come out, you’re
going to have a big problem, you know that?” 

He then insulted the reporter, saying, “You are as dumb as
you look. You are with Fox, right?”


More here.

from Hit & Run http://reason.com/blog/2013/11/15/alec-baldwin-condemns-libertarian-trash
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Updated! Show Suspended for 2 Weeks! Alec Baldwin Condemns “Libertarian Trash” Who Are “Defenders of Gay Rights”

This post has been updated at 10pm ET on November 15.
Scroll down to read the update.


The latest rampage by rageaholic – and ultra-talented, btw –
actor Alec Baldwin is on display at TMZ.com (click above to watch).
After winning a case against a stalker,
Baldwin saw fit to scream at and threaten a shutterbug on the
streets of New York.

During the episode, Baldwin refers to the photographer as a
“cocksucking fag,” an insult that calls to mind a previous incident
in which the 30 Rock alum and current MSNBC host
threatened to foot-fuck
a “toxic little queen” and “a toxic
little bitch” who had libeled his wife.

While giving no quarter to what he sees as invasive
photographers, Baldwin has checked in with advisers and
concludes

This tweet came just hours after Baldwin had tweeted
Anti-gay
slurs are wrong. They not only offend, but threaten hard fought
tolerance of LGBT rights
.”

And not long after Baldwin had tweeted (and duly deleted) this
slag on “libertarian trash” who defend gays:


I can’t speak for the Breitbart crowd (though Andrew Breitbart
was certainly a staunch supporter of gay
equality
) but the “libertarian trash” at Reason has been
defending gay rights since the magazine’s earliest days in the late
1960s. In fact, when mainstream liberal and conservative
publications were still arguing over whether homosexuality should
be decriminalized, we were already talking about marriage equality.
If the state is going to involve itself in marriage (and it
shouldn’t) among consenting adults, it should not draw invidious
distinctions and treat some people as second-class citizens.

I’d like to think that Alec Baldwin can understand that about
“libertarian trash.” But if his now-you-see-it, now-you-don’t
Twitter feed is any indication, he’s already on to more important
topics, such as conflating “single-bullet theorists” with
minimum-wage flat-earthers:

Update (10pm ET, November 15):
According to Variety
, Alec Baldwin’s MSNBC show, Up
Late
, has been suspended for two weeks. The suspension comes
not because of the event described above but due to a threat and
insult Baldwin made to a reporter for a local New York Fox
affiliate earlier this week. Along with other journalists hovering
around Baldwin after his testimony against his stalker, the Fox
reporter asked him questions. To which Baldwin responded

“If you’re still here when my wife and kid come out, you’re
going to have a big problem, you know that?” 

He then insulted the reporter, saying, “You are as dumb as
you look. You are with Fox, right?”


More here.

from Hit & Run http://reason.com/blog/2013/11/15/alec-baldwin-condemns-libertarian-trash
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Obamacare’s Website Gets Its First Performance Metrics. Will They Be Enough?

For
the past few weeks, the Obama administration has been promising
that that the federal health insurance exchange portal run through
HealthCare.gov will work “smoothly” for the “vast majority” of
users by the end of the month. But the administration hasn’t
offered much detail about what that means.

For that, we
turn
to The Washington Post, which explains that the
administration is focused internally on getting 80 percent of users
all the way through the enrollment process. In a detail that is
suggestive of the managerial failures that led to the disastrous
rollout of the exchanges, The Post also reports that the goal is
“the first concrete performance standard in the 31/2 years since
the government began to design the health exchange.” Prior to the
launch of the site, the administration had no internal definition
of what constituted a working site. And the contractors who built
the exchange system apparently did not have clear expectations
regarding their work either:

When HHS in 2011 invited contractors to bid on the chance to
build HealthCare.gov, the department’s “statement of work” did not
include requirements typical of many IT contracts in which
interested companies must spell out how the system would perform,
according to an industry representative close to the project, who
was granted anonymity in order to speak frankly. The agreement
that CGI
Federal
, the company chosen as the main contractor, signed on
Sept. 30, 2011, also did not contain specific performance criteria,
success measures or response times.

Well, the site certainly behaved like one built without any
performance criteria.

The revelation of this metric leaves us with several big
questions. Is it achievable? And if so, how will we know whether it
has been achieved? An 80 percent success rate leaves room for just
enough failures that it will be hard to independently verify. And
given previous reports by the Post and others that the site is not
likely to improve enough to be working by the White House’s
end-of-month deadline, there’s reason to doubt that the goal can
actually be reached.

Even if it is achieved, will it be enough? The 80 percent target
is simply for users of the exchange to be able to get all the way
through the enrollment process. But it doesn’t say anything about
the accuracy of the enrollment or pricing data that is generated in
the process. That could be a big problem, given that the site has
been sending bad enrollment data to insurers and has also had
trouble with the subsidy calculator that determines premium prices
and subsidy levels.

Indeed, if the website becomes generally usable for those who
want to enroll but continues to generate bad enrollment and pricing
data, we could end up with large numbers of people who think they
are enrolled in one plan, at a particular price, but whose
enrollment information is never properly transmitted, resulting in
mass confusion once new coverage kicks in next year. Hitting this
particular goal, in other words, might not really fix anything, and
could make things even worse. 

from Hit & Run http://reason.com/blog/2013/11/18/obamacares-website-gets-its-first-perfor
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You Know What This Hotel Made Out of Ice Needs? Smoke Detectors!

Do smoke detectors pick up frostburn?Visitors to the IceHotel in the village of
Jukkasjärvi, Sweden, should consider themselves lucky. Well,
obviously, the hotel, which is exactly what the name suggests, is a
huge draw around the world and reservations aren’t exactly easy to
come by. Anybody who can afford a room there probably leads a
pretty lucky life. But visitors are also lucky that they all
haven’t perished in a roaring fire! It turns out the IceHotel has
been operating all this time (since 1990) with no smoke
detectors!

Authorities in Sweden have finally
put an end
to this reckless endangerment by the company.
Courtesy of Agence France-Presse:

The Ice Hotel, located in the small Arctic town of Jukkasjarvi,
is following a request by authorities to guarantee the safety of
its guests.

Hotel spokeswoman Beatrice Karlsson said the hotel was a little
surprised at first, but understood as “there are things that can
actually catch fire, like pillows, sleeping bags or reindeer
skins”.

“To us the most important concern is the safety of our clients,
so we will comply,” she said.

Some may point out that fires that break out in pillows and
sleeping bags are unlikely to spread anywhere in a hotel made
entirely out of ice or produce enough smoke to cause serious
inhalation problems, but that’s not the point! The point is that
safety rules must be followed no matter what!

Plus, ice can totally catch on fire. As this little experiment
below shows, all they have to do is accidentally build the IceHotel
on top of a bunch of calcium carbide:

from Hit & Run http://reason.com/blog/2013/11/18/you-know-what-this-hotel-made-out-of-ice
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Bill Clinton Hoping For a “Woman President” in His Lifetime

Bill Clinton
has said that he hopes there is a female president in his lifetime,
but added that he has “no idea” if his wife is planning on
running.

From
Politico
:

Former President Bill Clinton said Monday he would like to see a
female president, but he has “no idea” if his wife, former
Secretary of State Hillary Clinton, will run in 2016.

“I hope we have a woman president in my lifetime, and I think it
would be a good thing for the world as well as for America,”
Clinton said at a conference in China, according to Agence
France-Presse.

Although Bill Clinton claims to have “no idea” about his wife’s
plans for 2016, Democratic strategists and donors
are preparing
for a what is widely considered as an
inevitable Hillary Clinton presidential campaign.

Follow this story and more at Reason
24/7
.

Spice up your blog or Website with Reason 24/7 news and
Reason articles. You can get the
 widgets
here
. If you have a story that would be of
interest to Reason’s readers please let us know by emailing the
24/7 crew at 24_7@reason.com, or tweet us stories
at 
@reason247.

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Bill Clinton Hoping For a "Woman President" in His Lifetime

Bill Clinton
has said that he hopes there is a female president in his lifetime,
but added that he has “no idea” if his wife is planning on
running.

From
Politico
:

Former President Bill Clinton said Monday he would like to see a
female president, but he has “no idea” if his wife, former
Secretary of State Hillary Clinton, will run in 2016.

“I hope we have a woman president in my lifetime, and I think it
would be a good thing for the world as well as for America,”
Clinton said at a conference in China, according to Agence
France-Presse.

Although Bill Clinton claims to have “no idea” about his wife’s
plans for 2016, Democratic strategists and donors
are preparing
for a what is widely considered as an
inevitable Hillary Clinton presidential campaign.

Follow this story and more at Reason
24/7
.

Spice up your blog or Website with Reason 24/7 news and
Reason articles. You can get the
 widgets
here
. If you have a story that would be of
interest to Reason’s readers please let us know by emailing the
24/7 crew at 24_7@reason.com, or tweet us stories
at 
@reason247.

from Hit & Run http://reason.com/blog/2013/11/18/bill-clinton-hoping-for-a-woman-preside
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