“There is something that kills more Americans every year than drug overdoses, than guns, than car accidents. It’s legal, doesn’t require a background check to buy, is widely advertised, and if you’re 21, you can probably buy it at your corner store. It’s called alcohol.
While cold beers, glasses of wine, and hard liquor cocktails are often treated as end-of-the-workday or weekend indulgences, alcohol is technically a psychoactive, addictive drug, one linked to over 50 fatal conditions, including heart disease; breast, pancreatic, and stomach cancers; liver disease; hypertension; and stroke. It contributes to the death of 140,000 people in the US annually, making it one of the leading causes of preventable death in the country.
More and more research supports the conclusion that even light drinking — that is, less than 15 drinks a week for men or eight drinks a week for women — can contribute to an increased risk for heart disease and cancers. More recent medical recommendations in countries like Canada have increasingly tightened, moving toward the idea that there is no truly safe level of alcohol consumption.
But the dose is the poison, and those who are at the greatest risk are those who consistently binge drink. This group suffers from alcohol use disorder, a condition where someone consumes excessive amounts of alcohol to the point that it impairs their ability to stop or control their use despite negative social, occupational, or health consequences. And that group is larger than you might think: more than one in 12 people in the US have AUD [alcohol use disorder], and it’s likely that figure underestimates the real breadth of the problem.”
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” For those with a concurrent diagnosis of AUD and another mental health diagnosis, some form of therapy is often needed to treat both conditions. Mild AUD can be treated with a short mental health screening and intervention in a primary care doctor’s office. Meanwhile, for those with more severe cases of AUD, further treatment — cognitive behavior or motivational enhancement therapy — could help.”
“The CDC estimates 375,000 Americans died due to Covid-19 infection in 2020, and about 460,000 in 2021 — an almost incomprehensible loss of human potential.
In 2022, there were fewer Covid-19 deaths, but still a lot: 244,000.”
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“In 1980, US life expectancy was among the highest in the developed world; now, it’s one of the lowest. There are many possible reasons for this: Compared with other countries, the US’s health care system is one of the most difficult to afford and navigate, and invests less in preventive care than in high-tech treatment. The nation wildly underfunds public health, has a high prevalence of processed foods, and promotes overwork and underrest. And access to guns and opioids has made high rates of death due to both a uniquely American problem.
The prevalence of many chronic health conditions — along with smoking cigarettes, another important contributor to premature death and Covid-19 mortality — can be changed by policy choices.
“Improving the public health system, rebalancing the health care system more toward prevention, thinking about the social drivers of health more intensely, addressing major social challenges that sometimes are right in front of our eyes and associated with a lot of death,” said Sharfstein, “all of those things are going to be necessary” to improve Americans’ overall health.”
“People who disapprove of drugs want to end their use, but consumers have never demonstrated a willingness to comply. Sellers always arise to meet their demand. Drug innovation to evade prohibitionists, and making cocktails of those drugs, is inherently more dangerous than legal markets.”
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“Singer attributes endless innovation in ever-stronger drugs and the rise in resulting overdoses to the competition between prohibitionists and illicit suppliers to outwit one another.
“The iron law of prohibition — ‘the harder the law enforcement, the harder the drug’—means we can expect more potent and dangerous forms of drugs to continue to arise,” he adds.
If you blend “more potent and dangerous forms of drugs” in “polysubstance use” (or just speedball it) you’re going to add risks on top of risks. The results can be tragic, but they’re less the result of drugs than they are of restrictions and prohibitions that inevitably drive consumers to seek intoxicants from illegal suppliers.”
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“”Like opioids, which originally came from the poppy, meth started out as a plant-based product, derived from the herb ephedra. Now, both drugs can be produced in bulk synthetically and cheaply. They each pack a potentially lethal, addictive wallop far stronger than their precursors,” Hoffman wrote.
Why grow a crop in a field, which can be targeted for destruction by prohibitionists, when you can synthesize the active ingredients in a hidden laboratory that’s difficult to find and can be moved if necessary? And if you’re going to synthesize it, why not find ways to make it more concentrated so that large numbers of doses can be moved in compact shipments? You can always cut it at the distribution end and sell it in lower-concentration doses.
Unfortunately, illicit laboratories aren’t always as reliable as aboveboard ones and underground chemists aren’t necessarily as competent or diligent. When somebody screws up or just doesn’t care, it’s much harder to hold a criminal network to account than it is to go after a corporation that has a mailing address and a reputation to maintain. The end result, for the drug trade, is illness and death from intoxicants of unknown purity and potency, if the formulation was even safe to begin with.”
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“People have always wanted to alter their consciousness in ways great and small. They will continue to want to get high no matter how much disapproval their activities draw from sober scolds. The only question is whether those getting high will acquire their intoxicants of choice from legal, responsible suppliers who have to maintain their brands and explain themselves in court, or from illegal suppliers who meet demand by any means necessary.”
“Texas border enforcement cops killed 74 people and wounded almost 200 more during vehicle chases over a 29-month period, according to a report released yesterday by Human Rights Watch. The chases occurred as part of Operation Lone Star, a controversial program that has spent over $10 billion in taxpayer funds to militarize Texas’ border with Mexico.
Operation Lone Star (OLS), which was launched in March 2021 by Gov. Greg Abbot, has devoted a tremendous amount of taxpayer dollars to increasing Texas’ border security, often using extreme tactics. Recently the program came under fire for using razor wire and blade-topped buoys on the Rio Grande in an attempt to keep out migrants.”
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“According to the report, Texas Department of Public Safety troopers working under Operation Lone Star frequently engage in unnecessary vehicle chases and other dangerous driving maneuvers when attempting to make arrests. As a result, unnecessary police chases have increased by as much as 1,000 percent in some Texas counties.”
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“In all, from March 2021 to July 2023, 74 drivers, passengers, or bystanders were killed in these chases, and 189 more were wounded. Those killed include seven bystanders, including a 7-year-old girl and her 71-year-old grandmother.”
“No other high-income country has suffered such a high death toll from gun violence. Every day, 120 Americans die at the end of a gun, including suicides and homicides, an average of 43,375 per year. According to the latest available analysis of data from 2015 to 2019, the US gun homicide rate was 26 times that of other high-income countries; its gun suicide rate was nearly 12 times higher. Mass shootings, defined as attacks in which at least four people are injured or killed excluding the shooter, have been on the rise since 2015, peaking at 686 incidents in 2021. There have been 565 mass shootings in the US in 2023 as of late October, including the Lewiston shooting, and at the current pace, the US is set to eclipse the 2021 record this year.”
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“According to a database maintained by Advanced Law Enforcement Rapid Response Training Center at Texas State University, there were 520 active attacks — defined as when one or more people are “actively killing or attempting to kill multiple unrelated people in a public space,” including but not limited to shootings — between 2000 and 2022. In many of those cases, police were unable to stop the attacker, either because the attack had already ended by the time they arrived or because the attacker surrendered or committed suicide. Only in 160 cases were police able to successfully intervene by shooting or otherwise subduing the attacker.
nother 2021 study from Hamline University and Metropolitan State University found that the rate of deaths in 133 mass school shootings between 1980 and 2019 was 2.83 times greater in cases where there was an armed guard present. The researchers argue the results suggest the presence of an armed guard increased shooters’ aggression and that because many school shooters have been found to be suicidal, “an armed officer may be an incentive rather than a deterrent.””
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“In 2008, the Supreme Court effectively wrote NRA CEO Wayne LaPierre’s “good guy with a gun” theory into the Constitution. The Court’s 5-4 decision in District of Columbia v. Heller (2008) was the first Supreme Court decision in American history to hold that the Second Amendment protects an individual right to possess a firearm. But it also went much further than that.
Heller held that one of the primary purposes of the Second Amendment is to protect the right of individuals — good guys with a gun, in LaPierre’s framework — to use firearms to stop bad guys with guns. As Justice Antonin Scalia wrote in Heller, an “inherent right of self-defense has been central to the Second Amendment right.”
As a matter of textual interpretation, this holding makes no sense. The Second Amendment provides that “a well regulated Militia, being necessary to the security of a free State, the right of the people to keep and bear Arms, shall not be infringed.”
We don’t need to guess why the Second Amendment protects a right to firearms because it is right there in the Constitution. The Second Amendment’s purpose is to preserve “a well-regulated Militia,” not to allow individuals to use their weapons for personal self-defense.
For many years, the Supreme Court took the first 13 words of the Second Amendment seriously. As the Court said in United States v. Miller (1939), the “obvious purpose” of the Second Amendment was to “render possible the effectiveness” of militias. And thus the amendment must be “interpreted and applied with that end in view.” Heller abandoned that approach.
Heller also reached another important policy conclusion. Handguns, according to Scalia, are “overwhelmingly chosen” by gun owners who wish to carry a firearm for self-defense. For this reason, he wrote, handguns enjoy a kind of super-legal status. Lawmakers are not allowed to ban what Scalia described as “the most preferred firearm in the nation to ‘keep’ and use for protection of one’s home and family.”
This declaration regarding handguns matters because this easily concealed weapon is responsible for far more deaths than any other weapon in the United States — and it isn’t close. In 2021, for example, a total of 14,616 people were murdered in the US, according to the FBI. Of these murder victims, at least 5,992 — just over 40 percent — were killed by handguns.”
“in 2022, the death rate for American infants increased for the first time in 20 years.”
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“rates of congenital syphilis — that is, syphilis infections acquired in the womb — have risen tenfold over the past decade.
Although a lot of different risk factors drive each of these trends, there’s an important one they have in common: bad — and worsening — health care access for mothers and babies.
In the US, the obstacles mothers face in accessing health care are too often insurmountable — and as this latest data shows, the consequences to American children are dire. Things might only get worse, some experts fear, as financial, political, and social pressures drive providers further from many of the places where they’re needed most.
“We only are hearing about more [obstetricians] leaving and more maternity wards closing,” said Tracey Wilkinson, a pediatrician who specializes in reproductive health issues at Indiana University’s medical school. “I am terrified about what the data is going to look like next year.””
“Laura Ann Carleton, 66, a California business owner, was shot and killed last weekend after a gunman tore down an LGBTQ Pride flag hanging outside her store and shouted homophobic slurs. Since then, law enforcement has revealed that the gunman — who was killed in an encounter with police — also posted numerous anti-LGBTQ posts on social media accounts they believe are affiliated with him.”
“In the EU, car fatalities, already far lower than America’s, were down by 22 percent over the last decade. Car crashes are just behind guns as the second greatest killer of US children. Black, Hispanic, and Indigenous Americans are disproportionately likely to be killed by a car. Merely taking a walk outside is becoming particularly dangerous: about 7,508 pedestrians were killed by cars last year, the highest number since 1981 and a massive increase over the last decade”
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“there’s a lot we can learn from the aviation system’s approach to passenger safety.
The most obvious is that we shouldn’t accept carnage just because the activity seems inherently dangerous. If we can figure out how to make it exceptionally safe to hurtle through the sky at over 500 miles per hour, we can definitely figure out how to keep people alive on the ground, especially because other countries have done it already. The Netherlands is a famous example, but others, including Canada, with an urban geography much more similar to ours, have steadily decreased their death rates to levels far lower than ours.
A second lesson from the aviation sector is that safety is a systemic responsibility. “The [air] safety regime, with its built-in redundancies, is known in aviation circles as the Swiss cheese model: If a problem slips through a hole in one layer, it will be caught by another,” the New York Times explained, which has added up to a near-spotless safety record.
Compare that to the situation in car safety, where high death rates are accepted as a baseline part of how the system works rather than an institutional failure. Media coverage treats surges in crash deaths as if they are uncontrollable fluctuations in the weather and blames people driving recklessly for getting themselves killed. In the American traffic engineering bureaucracy, there’s a widely circulated myth that the vast majority of crashes are caused by “human error,” transportation writer David Zipper explained in the Atlantic in 2021.
Of course, individuals making unsafe choices — speeding, say, or driving drunk — matters. But these are distractions from what makes the American system of driving so unsafe in the first place: we have a proliferation of fundamentally unsafe roads, known among traffic safety advocates as “stroads,” that combine wide lanes and speeds higher than 25 miles per hour with frequent turns, stops at traffic lights, and shared traffic with cars, pedestrians, and bikes. With all these conflict points, it’s inevitable that collisions will happen.”
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“A third lesson from aviation is that dangerous technology has to be adequately regulated. Empirical research increasingly shows that the rapid takeover of big cars — SUVs and pickup trucks — is a major factor behind our car safety backslide over the last decade. But US Transportation Secretary Pete Buttigieg has declined to call for policies to discourage the proliferation of these vehicles (like Washington, DC’s tax on oversized cars).”