Is it addiction or dependency?

Addiction vs dependency5Dr. Michael J. O’Connell, Healthcare Consultant, New Hampshire commented that the distinction between addiction and dependency is constantly mangled by the press, lay people and even many professionals.  The difference between dependency and addiction is not withdrawal.  Withdrawal is a phenomenon common to both.

Addiction marks a transition into pathology; the chemical, activity or behavior to which one is dependent (oxycodone, heroin, alcohol, THC, sex, eating, extrovertism/introvertism) becomes harmful…physically, psychologically and/or functionally, to the individual.  Withdrawal or craving is not necessarily a pathology and therefore not necessarily an indication of addiction.

One would be hard pressed to declare a weekly snorter of heroin or cocaine an addict.  If a person dreams much about food, craves certain tastes or dishes, but lives a functional work and social life and is not obese, this can hardly be defined as an addict.  If another has elevated liver enzymes, presence of abdominal fat in an otherwise slender body, is thinking about drinking alcohol much of the day, has a couple DUIs, occasional blood in the stools, and yet persists in drinking alcohol, this is most likely an addict.

If a chronic back pain patient has had a laminectomy and then fusion, still requires pain meds but goes into intense withdrawal with sweating, shakes, diarrhea, and piloerection, when away on a trip forgetting meds at home, this is dependency, but unlikely addiction.

 

Gender inequality and income…

pay inequality 3Dr. Michael J. O’Connell, Healthcare Consultant, Barrington, New Hampshire commented that the media is once again exploding over the issue of gender inequality regarding income.  So no better way of making the case than parading out Jennifer Lawrence, the eminent female star of the Hunger Games series et al, who earns a paltry $14 million per film.  Apparently that’s not as much as what a star leading man commands.  Who knew?  What a damn shame.

Why is it, Liberals are so quick to aim their weapons at CEOs and Wall Street tycoons, and the perceived glass ceilings, and yet ignore the conspicuously wealthy in Hollywood?  Could it be that what really matters to them is the politics of the fat cats?  The horror of a stockbroker earning $200,000 a year…this deserves Liberal protests, chest pounding and screams of outrage.  But the fact that Oprah earns $200,000 a month does not cause them a stir.  Interesting.

Liberals have always given the entertainment industry a pass on its arrogance and innumerable individual misdeeds, and the industry rewards this nod by donating its celebrity (and celebrity dollars) to Liberal politicians.  If Hillary Clinton and Bernie Sanders are truly committed to reversing the earnings’ disparities, as they both claim in their debates, maybe they need to start including those glaring examples that are among their very donors.

 

Kudos to Papplebon!

PapplebonDr. Michael J. O’Connell, Healthcare Consultant, Barrington, New Hampshire commented that last October we witnessed on the professional baseball field something that doesn’t happen but once in a blood moon.  A ballplayer (Jonathon Papplebon) called out a teammate (Harper) for not hustling his run to first base on a routine fly ball.  The two argued briefly in the dugout, then scuffled with a few punches flying briefly, all caught on televised broadcast.

Such laziness and lack of hustle is commonplace in baseball in particular (showing late for practice is commonplace in football).  In decades past this behavior was met with fairly severe measures including counseling by the manager (on and off the field), fines imposed by the team, possible suspension.  This discipline never happens nowadays, partly due to the union influence, partly due to our politically correct society.

The real travesty though is not Harper’s lack of hustle, that’s expected, but the fact that Papplebon was suspended.  Not Harper… Papplebon.  Jonathon should be rewarded for having the balls to do what today’s coaches/managers/owners are scared to death of doing. For what the players are paid, for such incredibly narrow talents/skills, they should run out all fly balls – run like they mean it.

Freedom of speech???

freedom of speech 3Dr. Michael J. O’Connell, New Hampshire commented that a reportedly racist ‘chant’ caught on a privately made video at a large Oklahoma university fraternity has resulted in closure of the offending SAE fraternity on campus and expulsion of two drunken student ‘chanters’ a couple of months ago.  This seemingly extreme action by the University of Oklahoma raises many questions….such as how does freedom of speech enter into this equation?

Speech, regardless of how repugnant, is generally protected by the constitution after all.  Does the fact that alcohol was involved have any relevance?  I am told folks are disinhibited by alcohol, they may even have sex, is sex a crime between two consensual but drunken adults? The fact that the chant occurred in a private setting, is that important?  Geez.  Private.  Can’t folks do most anything in private so long as it hurts no one?

Amazing how every remark about recently hypersensitized blacks, even slightly negative ones, are scrutinized by the racism police.  Where are the rap police?  The lyrics of much rap music condones rape, even incest, and encourages liberal use of the “N” word, yet rap and rap artists somehow escape most any level of scrutiny.  Those who are so bold as to portray the Obamas as characters from the Planet of the Apes are hunted down as criminals, yet no such effort was engaged when millions circulated objectionable (but admittedly kind of amusing) images of George W. Busch evolving from a primitive ape.  Why wasn’t that criminal if a private video is?  Seems speech crime is somewhat arbitrary, to be carted out and punished when it extends a political agenda.  Hmmm.

Opioid addiction…

Opioid addictionDr. Michael J. O’Connell, New Hampshire recently commented that the horn blowing by politicians and law enforcement over “complicity of physicians in the heroin crisis” is an attempt to affix and thereby shift blame for the recent spate of overdose deaths.  The current theory goes that by ‘over-prescribing’ opioids to patients in the ER, post operatively for pain control, and in family practitioner offices for chronic maladies, that the consumers ‘become’ addicts, get ‘hooked’.  This is utter nonsense, and for which there is not one shred of evidence.  While an understandable layman’s intuitive conclusion, but nonsense nonetheless.

Perhaps officials, governors, drug czars and police chiefs alike, are too familiar with the old model of blaming the demon alcohol for the alcoholic.  To blame prescriptions for opioid addiction and Jack Daniels for alcoholism is like blaming a deck of cards for a gambling addiction.  It’s like blaming malls for compulsive shopping, or restaurants for obesity.

Addiction is an extremely complex condition, and reducing it to a simple ‘cause and effect’, while serving the accusers very well, does nothing to solve the problem of addiction.  Addiction requires a susceptible individual (the right combination of social experience and genetic makeup), stress, and yes, availability of agent.  With respect to availability of opioids, they always have been, whether by black market or by prescription or by cultivating poppies. Nothing has changed in overall availability in a century.

Gay rights…

gay 5Dr. Michael J. O’Connell, New Hampshire, noted that the governors of Arkansas and Indiana both caved recently to pressures from gay rights groups and other “piggy back” activists, and quickly amended their recently signed, nearly identical laws which ostensibly reinforced freedom of religious expression as protected by our Constitution.  The laws have been interpreted by many to license discrimination under the guise of religious principles.  Specifically, opponents of the laws fear that a restaurant owner, for example, whose religion does not acknowledge or condone gay marriage, could be justified and legally protected, in refusing to serve a gay couple.

There is no evidence that such discriminatory practices would actually happen, or that they have occurred in the many states that have had similar laws on the books for many years.  While such a practice would be decidedly repulsive and perhaps shocking in today’s progressive society, the legitimate question remains, should folks be forced to deny or at least compromise their religious beliefs?  Can we insist that business owners not discriminate on any grounds?  Does the Civil Rights Act deny entrepreneurs the right to choose their clients based on their own religious criteria and personal beliefs (right or wrong)?  A restaurant is hardly a “public good” that is to be cherished and protected for access by all humanity, isn’t it?

The controversy over these laws appears to be much ado about nothing.  The enactment of the laws in these two states would have gone unnoticed if not for the hypersensitized environment we live in, one that has cried ‘racism’ and ‘discrimination’ at the slightest provocation (usually committed by a white individual), and totally ignores blatantly racist, sexist and discriminatory actions of its minority population.

Gun control…

Gun control Charleston4Dr. Michael J. O’Connell, New Hampshire, commented that it is rare that I agree 100% with any decision or remark President Obama makes.  In the wake of the church shooting in Charleston, South Carolina, he expressed the opinion, as he has many times before, that lack of gun control in this country is directly related to our number one ranking among industrialized nations in murders by firearms.  While there may be a dearth of direct evidence that gun controls are responsible for containment of violent shootings, the fact is that all countries with lower rates of violent crime also have serious gun control measures in place.  I would argue, as does Obama, that his opinion is indeed de facto.

Dr. O’Connell added that to “prove” the causal relationship, a prospective scientific approach would be needed, but absolutely impossible to conduct.  Can you imagine doling our gun permits on a purely random basis, and mandating that all others turn in all their firearms?  Then for the next ten years the pattern of crimes would be followed and data collected.  Could never happen.  Another insoluble problem would be how to account for crime committed with weapons stolen from permit owners, or imported from regions outside of the region under ‘study’.  Clearly such a scientific experiment will not be conducted.

I would argue that such experimentation is not necessary.  The reality is that the closest this country will ever come to ‘proof’ that gun control reduces violent crime is the ongoing worldwide, rather unscientific retrospective study, in which some countries ban firearms and some don’t.  The former enjoy markedly lower rates of crime using firearms.

Dr. O’Connell stressed that he fully understands firearms are featured in sport.  It’s a huge industry.  And in an ideal world one should be free to enjoy these sports.  However, isn’t there a point at which enjoyment by a few must be sacrificed to the interests of many?

Confederate flag…

Confederate flagDr. Michael J. O’Connell, New Hampshire, commented that in the wake of the tragic Charleston shootings a few months ago, Confederate flags that dotted the south have mostly come down.  My first reaction, I assume consistent with that of the majority of Americans, was one of surprise that the flag was still commonplace, and even in public arenas.  As Obama said in his eulogy, the flag, among other things, is a symbol of a failed government, one based on the institution of slavery.  Why retain the symbol, some 150 years after the regime’s demise?  The answer to this must be very complex as to elude the comprehension of most Americans.

Unfortunately, removal of the flag may do little to expunge whatever deep seated sentiments have promoted its endurance.  I suspect these sentiments involve notions that blacks continue to lag behind in experiencing the rewards of our great society, despite affirmative action, equal opportunity, and burgeoning welfare state.  I suspect the fact that violent crime is much more common among the black population than any other groups contributes significantly to these sentiments.

Finally, the south and more than a few entities in the north, have removed a symbol of repression and hatred.  Good riddance.  I hope the Confederate flag is gone for good.  The animosity behind that flag will not so easily retreat, however, and that is apparently an enduring problem.  Until the black race is seen as working hard to better itself without over-dependence on handouts, such sentiments will remain.  As the prominent black figure Thomas Sowell has said “self-respect can seldom be gotten from even a successful playing of a parasitic role in the name of a make believe equality.”

Jon Stewart…

Jon Stewart4Dr. Michael J. O’Connell, New Hampshire, recently commented that the quick witted Daily Show host Jon Stewart has departed.  Praise the Lord, or whichever non-sectarian higher power is responsible for this gift.

There is no more polarizing political figure than this liberal highly Jewish talking head.  I get that – it’s his shtick, right bashing satire attracts a certain audience, and for sure the stodgy conservative religious folks provide much fodder for his biting remarks and pointed jokes.  I have watched his show sporadically for years, and would totally enjoy his product if not for his singular target theme.  Its wears a little thin.  What has always puzzled me though is his unwillingness to admit to the wildly unbalanced nature of his show.  He readily criticizes Fox News for its unbalanced content, and ‘fair and balanced’ message, yet doesn’t see this same incongruity in himself.  There is so much on the left side of life that can provide equal opportunity for shits and giggles.  Oh, every once in a while he castigates a lefty for some wrong-headed action (our VP for example), something so egregious it can’t be ignored even by Stewart, but this always comes off to me as window dressing.  Something to demonstrate that unlike the far right Fox News, his show is not far left.  But he is wrong and I believe he totally knows it.  Jon Stewart is a proud standard bearer for left wing politics.

Stewart’s replacement seems to be hinting at significant change.  We’ll see.  It will take considerably more courage than what Stewart has displayed for the past 16 years.  Again I call for more debate of the issues that emanates from a centrist position.  I’ve had quite enough of Rush Limbaugh, and now Jon Stewart.

Homosexual marriage…

Gay marriage 2Homosexual marriage…

Dr. Michael J. O’Connell, New Hampshire noted that finally a possible end to this extraordinary national debate is in sight.  The whining by both sides of the issue has been a recurrent irritation for decades, and a major distraction of the country’s attention from truly important matters such as terrorism, global warming and preservation of our planet earth. 

The view of many religious folks that marriage is an institution requiring preservation is a rather weak one.  Allowing homosexual marriage does not prevent heterosexual marriage.  And the benefits of marriage are difficult to see, with its sky high divorce rates and even more marriages that are very unhappy though otherwise intact.  Is the institution something to be proud of, to the extent of wanting to relegate it to heteros only?  I might argue that all couples, gay or straight, should participate in the same ugly institution if they so desire.

The view of many gay groups and liberal supporters has been a ‘justice for all’ approach.   This has some merit on the surface.  Why shouldn’t homosexuals be able to avail themselves of an apparent societal benefit?  How is this different from gaining equal access to a restaurant, a college, or an empty seat at the front of a bus?  The benefit is clear in these cases.  The benefit of marriage of course is not.  Also it is entirely arguable that marriage is derived entirely from the private sector, why is it reasonable or necessary to guarantee access to this broken institution for all? 

Anyway, same sex marriage is a tired issue.  In my opinion, the Supreme Court has done us all a favor this week.  After more anticipated grumbling and threatened legislation, we are likely to see the issue finally put to rest.  So as a nation we can spend our capital on more critical concerns.  I wish all the best to gays and hope they will thrive and prosper and feel more secure in marriage.  Now, let’s move on.