The Evolution of Addiction

This week, I focused a majority of my research time to reading a book written by my interviewee, William White. The book, titled Slaying the Dragon: The History of Addiction Treatment and Recovery in America, gives a very detailed account of the societal and political evolution of addiction and alcoholism, all the way from the late 1700s to modern day America.

What I found the most interesting after all of my reading was that as decades passed, social and political action against alcoholism, and more so, addiction, did not improve, but actually worsened. Even as recently as 1978, Dr. Sheldon Zimberg noted that "'physicians, psychiatrists, and other mental health professionals have been ineffective in the treatment of [addicts and alcoholics] and have lost interest in attempting to treat them'" (qtd. White 99). This disinterest in treatment coming from the physicians, accompanied by the government's extreme drug criminalization that was "driven by fear" (White 114), further ostracized alcoholics, and again, more so, addicts.

While this situation was bleak, the 20th century did come up with many different treatment techniques, some of which worked and some of which didn't. One of the most successful treatment methods was called "Aversion Therapy," which after being the strongest method for 60 years, paved the way for new approaches and treatments to be developed later in the 20th century. When in Aversion Therapy, the patient would be placed in a room void of anything except for a couple bottles of alcohol, a glass, and themselves. The patient was then giving a vomit-inducing drug so that when the patient drank the alcohol, the immediate reaction was to vomit. Additionally, administrators took great care to ensure that no positive feelings of intoxication reached the patient. So the patient would be in this room, alone with their thoughts, alcohol, and nausea. After repeating this for a set number of days, and repeated over a set number of months, the patient would naturally associate drinking with nausea and vomiting, which, in theory, cures the alcoholism.

While seemingly painful, this method yielded outstanding results. When followed-up with in the 1940s, aversion therapy patients reported recovery rates from 45% to 60%, substantially above the recovery rates for any other method in history. In his book, White mentions that this is likely because "all of the patients were voluntary and committed to the goal of permanently eliminating alcohol from their lives" (White 107), where in other methods, patients were often forced by family members or law officials.

Even though this is only the tip of the iceberg in the extensive history of addiction and alcoholism in America, it was a very interesting start, and I am intrigued to learn more as I continue to work on my Junior Theme.

"Big Bucks, Big Pharma"

As a part of my Junior Theme research this week, I was advised to watch something called "Big Bucks, Big Pharma: Marketing Disease and Pushing Drugs," an educational film that "examines how direct-to-consumer advertising of medications is a fairly recent innovation that has led to a sharp increase in the sales of prescription drugs." Although some parts of the film veered away from my "why" question, it definitely brought up many pertinent, interesting points that I had previously not seen. 

One of the strongest explanations it offered (for why such a large industry can get away with so much) was the relationship that the pharmaceutical industry, or Big Pharma, has with the FDA and the US Congress. According to the film, approximately 50% of the FDA's budget for approving drugs is funded by the very drug companies it's examining. Clearly, such a large amount of financial assistance would, and does, lead to a bias in the approval process. It also makes the FDA a "partner" of the industry it was formed to monitor, which greatly influences the integrity of the approval process. 

One speaker in the film also mentions how the "federal government has been coopted by the pharmaceutical industry." This makes sense, considering the FDA is a government organization under the US Department of Health and Human Services. But not only is Big Pharma directly involved with the FDA, it also "gives generously" to campaigns, and is the "largest lobby in Washington." All of this gave me a lot of insight into my topic, as it explains why the government would make the decisions they do when dealing with addiction treatment and prevention. Making a decision that would negatively affect Big Pharma (financially) would backfire on them, which is something no government or company wants to deal with. 

Since this film exhaustively analyzes what could be perceived as corruption in one of the largest industries in America, I hope to use this information in the section of my essay that explains/argues the financial impact or benefits of addiction treatment and prevention. 

America and Addiction

Throughout the course of this year, it feels like many of the topics we have studied in our American Studies class have been connected to the War on Drugs in some way or another. Whether the link was clear or vague, I thought it was interesting how significant a role this war played in current and past American society. Looking into it more, I wanted to find out what the government's role was, not just in arrests and incarceration (as we looked at in class), but in the more personal aspect of the Drug War: Addiction.

After a little bit of research, I came across a 2005 study that found this startling information: "Of the $373.9 billion spent by federal and state governments [on substance abuse], some 95.6 percent was spent to 'shovel up the consequences and human wreckage of substance abuse and addiction,' while only 1.9 percent was spent on prevention and treatment, 1.4 percent on taxation and regulation, and less than 1 percent on research and interdiction." 

Chart from the 2005 study, "Shoveling Up II: The Impact of
Substance Abuse on Federal, State, and Local Budgets"

This led me to wonder, why is this happening? Why is such a disproportionate amount of money being spent to "shovel up the consequences" of addiction, rather than actually treating the problem? (Especially considering States spend more on substance abuse and addiction than they spend on Medicaid, higher education, transportation or justice)

It turns out that there are many reasons (as would be expected), but probably the most significant is that addiction is lucrative. Much like how the lottery can profit off of gambling addicts, large pharmaceutical companies and doctors that specialize in addiction treatment profit off of substance abusers. And while there are many examples of this occurring, one of the strongest is the prescription and use of a drug called "buprenorphine" (also known as "bupe"). 

I plan to write a more in-depth blog on the controversy surrounding buprenorphine soon, but the gist of it is that buprenorphine is a "substitute opioid used to treat opioid addiction." Although there have been countless success stories showing how buprenorphine (often sold in a compound called Suboxone) was prescribed correctly and cured addictions (to drugs such as heroin), it still easily finds its way into corrupt, power-abusing hands. And once in those hands, we see doctors and research companies making thousands off of addicts (often by hiking up prices) who are only trying to find help. This benefits the government via the economy, which in the end, in why an insignificant amount of funds are allocated for combatting addiction (more addicts = more buprenorphine purchases = more money in more likely-to-be spender's pockets). This is only one reason for the disproportionality, but clearly, it plays a major role. 

As I continue my research, I hope to be able to really pick apart the government's reasoning for its decision-making. By the end and in the very least, I hope to be able to see a viable solution or improvement to an issue that has plagued America for far too long. 

A New Future for American Higher Education, Part 2

Back in January, I wrote a blog post about Obama's goals of mending America's flawed higher education system, starting with lowering the cost of community colleges. Just recently, Obama has revealed next obstacle he hope to conquer: student loans.

This proposal, which he announced in a speech at Georgia Tech on Tuesday, would "reform and streamline income-driven repayment to ensure that program benefits are targeted to the neediest borrowers and to safeguard the program for the future." In other words, the many income-based student loan systems would converged into a modified form of the previously existing "Pay As You Earn" plan. In the end, this process should turn out to be less costly and less daunting for borrowers with lower household incomes. And, as you can see from the graph below, that's something that this system desperately needs.

 Currently, Pay As You Earn "caps payments at 10 percent of discretionary income and allows forgiveness after just 20 years," which is something that won't change as a result of the proposal. What will change is eligibility: Currently, only newer borrowers are eligible for this plan. However, starting in 2015, borrowers who took out loans before October 2007 or stopped borrowing by October 2011 will now be eligible. This change is expected to affect over 5 million people who are currently on less financially-forgiving plans (i.e. the income-based repayment plan, which caps payments at 15% of disposable income. The 5% increase can make an incredible difference in affordability of one is in the low income bracket). 

While there are other aspects to this proposal (which is expected to be implemented in December 2015), the Pay As You Earn eligibility adjustment seems to be the most crucial. If successful, this plan could make a huge difference both on an individual and a national level. Less debt is obviously preferable to the consumer and to the country's economy as a whole. Hopefully, Obama's proposals will reach their full potential, and the 70% of students who have debt after earning their bachelor's degree will not feel the same burden that they do today.

Steps Towards Equality, and All That Jazz

It seems that just in the past year or two, the amount of transgender representation in mainstream media has grown exponentially. Last year it was Amazon's Transparent and this year it was Glee's second transgender character, Coach Beiste, and now, for the first time, TLC will be producing an 11 part reality series surrounding the life of a transgender teen Jazz Jennings, aptly titled All That Jazz. While more and more transgender-themed reality shows (ABC Family's My Transparent Life, Discovery's New Girls on the Block, etc.) are airing with each passing month, All That Jazz offers a more unique perspective. It shows the transgender journey in first-person while also showing Jennings' traversal the infamously difficult teen years. And with Jennings already having an amazing reputation as a teen author and activist, the possibilities for this show to break boundaries that even others have failed to are unlimited. But as Nancy Daniels, General Manager of TLC, stated, "Jazz may be known as an author and activist, but she’s first and foremost a teenage girl with a big, brave heart, living a remarkable life."

Looking at the bigger picture, this boost in transgender media prevalence points to good things for the television industry as a whole. As we've discussed in class, TV shows for a long time have been fairly homogenous: all white, all straight, with the occasional gay couple. By breaking the norm and increasing the representation of more members of the LGBTQ+ community (although only transgender for now), networks are allowing for "transgender Americans [to become] ever more visible in pop culture, normalizing the way society views them." Similar to the goals of eliminating the racial TV Tokenism, eliminating LGBTQ+-based TV Tokenism could further help America reach the equality it seems to be striving for. Considering television is often a reflection of the society it's coming from (to a certain extent), seeing progress on the screen would mean progress in the real world, which in the end, is what really needs to happen. If trends like this continue in what appears to be a snowball effect, maybe we will see this change sooner rather than later.
          ______________________________________________________________________

Jennings' inspirational ad for Clean & Clear:

50 Years Later, How Much Has Changed?

On March 7th, 1965, an estimated 600 brave Americans walked solemnly across the Edmund Pettus Bridge in a march for voting rights that marked the "political and emotional peak of the American Civil Rights Movement".  Now known as 'Bloody Sunday,' this day was a horrifying example of police brutality - clubs, tear gas, hand-to-hand combat, and more was used to physically beat down the marchers until they were forced to turn around. But mentally, they were undeterred. They came back even stronger two days later, on what is now called 'Turn Around Tuesday,' and again on March 21st, when they were finally able to finish their march to Montgomery. The determination of the marchers gave "courage to millions," and their actions will forever be seen as some of the most remarkable in American history.

Flash forward 50 years, and we wonder, how much has changed? 

Peaceful Protests: Selma 1965 vs Ferguson 2014

On Saturday, President Obama visited Selma to commemorate the sacrifices the marchers made for the Civil Rights movement, and in his speech, he pointed out that "Right now, in 2015, 50 years after Selma, there are laws across this country designed to make it harder for people to vote. As we speak, more of such laws are being proposed." Not only is it true that more voting restrictions have been placed, but we seem to be seeing police brutality to this day that is eerily reminiscent of that in 1965.

Police brutality: Selma 1965 vs Ferguson 2014

It is indescribably unfortunate that despite the sacrifices of those involved in the Civil Rights movement all those years ago, things like this are still going on today. And while strides have been made in the fight for racial equality in America, "This nation's long racial history still casts its long shadow upon us. We know the march is not yet over, the race is not yet won" (Obama in Selma, March 7th). As proven by yet another shooting of an unarmed black teen two days ago and the whitewashed Oscars two weeks ago, Obama is absolutely correct in saying that "the race is not yet won." It seems that right now America is in its own, modern form of 'Bloody Sunday.' But, hopefully soon, justice can be found for Trayvon, Michael, Eric, and the countless others who have died for the crime of being black in America. Hopefully soon, we will be able to overcome years of systemic racism and march all the way to Montgomery, and equality.

Black Lives Matter at the Grammys

In the few days after the Grammys air, it seems that all the buzz is about who wore what, who won what, who lost what, and who interrupted who onstage. But this year, amidst frivolity of it all, some artists strived to take advantage of the 25.3 million-person audience and convey a more serious message.

One artist, Prince, gave a subtle nod to the "Black Lives Matter" movement in his presentation speech for Album of the Year: "Albums, remember those? Albums still matter. Like books and black lives, they still matter.”

In a more visually impactful fashion, artists Pharrell and Beyoncé showed their support by incorporating symbolic gestures into their performances. During a pause is his song, "Happy," both Pharrell and his backup dancers (many wearing hoodies, alluding to the Trayvon Martin case) took a moment to raise their hands in the air, the symbol for the Black Lives Matter movement after the Michael Brown case this last August.

"Hands up, don't shoot"

Then, towards the end of the evening, Beyoncé gave a similarly riveting performance. As she sang the gospel song, "Take My Hand Precious Lord," her background dancers can also be seen exhibiting the "Hands up, don't shoot" gesture. Seeing as Beyoncé doesn't typically give such solemn performances, this was even more impactful.

Beyoncé closing out the 57th annual Grammy Awards
 with a powerful message

To add on to that, Beyoncé's song gave way to a performance of Selma's "Glory," by Common and John Legend. With images from Selma playing in the background, it was clear that the goal was to have the viewers make the connection between past and present and to reflect on it. With the current state our nation is in regarding civil rights, it's crucial that we recognize that something needs to be done. To see that these artists using their influential power to make a change is huge, considering what a crucial part media plays in all of our lives. I hope to continue to see performances such as this that keep the Black Lives Matter movement at the forefront of everyone's minds because no change will ever be made if we let it just fade away.