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Does Attention Deficit Disorder Medication “Work”?

2015 May 14

I’ve been skeptical of the official narrative on many mental illnesses for some time.  The evidence that many psychoactive drugs work is weak, at best. In many cases, there is reason to believe that interventions with less unpleasant side effects work as well. In fact, in many cases, doing nothing at all produces better long term results than medicating.

This lengthy paper on the subject is interesting:

it is quite simply hard to see how drugs such as methylphenidate and atomoxetine can have been licensed to “treat ADHD” in the UK. Once we probe behind the “symptom reduction” claim the alleged “benefits” of the drugs are difficult to ascertain. Claims tend to be somewhat folksy such as “improving the quality of life”. The only certain positive effect of stimulant drugs is a short-term increase in ability to concentrate; an effect which is the same for everyone whether or not they have an ADHD label. But the ADHD narrative concedes that this does not translate into an improvement in long-term outcomes. The actual “beneficiaries” of ADHD drugging may be those parents and schools who are glad to see a reduction in the disruptive behaviours which constitute an ADHD diagnosis. But this is not an advantage to the young person. On the other hand the harms are real and tangible and accrue to the young person. For example, methylphenidate routinely causes insomnia and stomach aches. Imagine the effect of suffering from drug induced insomnia throughout your childhood. Atomoxetine is linked to suicidal thinking and suicidal attempts.

If you’re of a certain age, the whole ADHD concept strikes you as strange; We just called such children hyperactive or troublemakers and teachers and parents just dealt with them. There’s no known “cause” for ADHD, as Wylie points out. It is a checklist driven diagnostic category.

Whenever an article like this is written, someone who suffers from the diagnosis will pop up in comments and say “It works for me!” A great, many things work for a great, many people (and the placebo effect is strong), but that isn’t really the point.  The point is whether the medication is beneficial  enough to outweigh any negative side effects.

When behavioral therapy is almost as effective as drugs with nasty side effects, as is the case with ADHD, it’s hard not to suggest that CBT should be done instead, and first, and drugs should be used, if at all, only after behavioral therapy has failed.

But behavioral therapy is expensive, takes trained practitioners to apply and it is hard to centralize the profit-making from it.  Giving the kid a pill makes the problem (for parents and teachers) go away, and if it isn’t as good for the child as therapy, well, it’s easy.

(And, as usual, exercise also works well for people with ADHD, as it does for depression, and many other mental issues.)

Read Wylie’s full paper.


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The Establishment Is Losing Control: Britain Shows Us Change Is Possible

2015 May 13
by Ian Welsh

The Guardian is widely considered a left-wing newspaper:

Guardian cover says Labor Lost Because Not Right Wing Enough

Guardian Cover Shot

When the election results first became clear, I pointed out that Thatcher’s real victory was not the policies she had put in place or the changes she had made to the UK, it was that the main opposition party had become neo-liberal as well. This meant that her project would continue, no matter who was elected.

Neo-liberalism is successful because it is the only alternative to itself; there is no other option but neo-liberalism. Of course, you can choose between flavors of neo-liberalism (“How fast should we do this project?”, “How cruel should we be to poor people?”, and “How quickly should we divest the public sector and the population of their income and wealth and give it to the rich?”), but all you’re choosing between is how quickly the neo-liberal project (which includes austerity as  its logical late form) will proceed.

Other than the process of how actual material circumstances turn into ideology, which then turns into action, nothing is as important as controlling the acceptable matrix of options.

What the Guardian is doing here is attempting to make sure that in response to its loss, Labor becomes even more right-wing, even more dedicated to neo-liberalism. One can equally and easily make the case that Labor was not left wing enough, and that’s why Scotland went SNP (which was more left-wing than Labor); and that’s why left-wing voters didn’t turn out to vote. But that’s not what The Guardian has chosen to do. The Guardian chose to put, on their front page, the assertion that Labor lost because it was not right-wing enough.

Note that most people read only headlines and that the most important headline is the one on the front page. Yes, The Guardian has published articles suggesting that labor wasn’t right-wing, but most people will never read those articles. In “journalism,” as in real estate, the three most important things are location, location, and location.

Do not think that The Guardian’s editors do not know this, or do not understand the consequences of what they are doing. This is their business, and they are good at their business. The conclusion which should be drawn, absent strong evidence otherwise, is that if they are taking an action likely to push Labor right, they know they are doing it, and they want to do it or they wouldn’t do it.  (Since, again, writing the opposite article would be easy enough.)

Now note that this system is breaking down on the peripheries. The Scots voted for the SNP, which was very left-wing by current standards. Albertans recently voted for the Canadian New Democratic Party, the most left-wing party in Canada, which the establishment never thought stood a chance of winning, and which ran on (among other things) increasing the corporate tax rate.

These are glimmers: sparks and little more. But they and the rise of other third parties, including ones I would argue are failing (like Syriza), indicate that the establishment is losing control of the democratic process; their framing is not sufficient.

Given an opportunity to vote for what appears to be a real alternative to the status quo (as opposed to a fake alternative like Labor under Millibrand), many people are starting to do so. This isn’t limited to the left-wing, mind you. UKIP, the anti-immigrant, essentially-fascist party in the UK got over 10 percent of the vote.

In Scotland’s independence referendum, the young voted for independence–it was the pensioner class that kept Scotland in the union.

The winds are shifting, and opportunities are arising. Many people in the core nations know that their lives are getting worse, and they are looking for political options to change that. Note that many of them aren’t that fussy–as in the 1930s, this doesn’t have to head towards anything good. A man on horseback who promises jobs and security and to stop bailing out bankers could easily take power in many countries.

Nor is the time quite here yet for major change, I think. Give it five to ten years, for simple demographic reasons. The new generations must rise, the old generations must get older, and in many cases, die, in order for change to be possible beyond the margins.

Nothing lasts forever: no regime, no form of government, no ideology. Neo-liberalism has gone from middle-aged to old, but still clings to power with an iron gauntlet. But concealed beneath that gauntlet is a shaky hand.

The time is soon. The young, even most of the middle-aged, will see it. Whether that time leads to a better world, or a worse one, is yet to be determined. Pick your sides.


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Tesla’s Home Battery System Is Not the Best Solution

2015 May 11

Why? Because it’s a lithium battery. The advantage of lithium batteries is that they’re relatively small. The disadvantage is that they’re lithium. Salt water batteries, though larger, are generally a better idea because:

  • At the end of their lifetimes, you just drain them. Lithium batteries have to be disposed of properly.
  • Salt water is in plentiful supply. If lithium batteries really take off, we may see supply and price issues.
  • While smaller is better in some situations, larger is better in others. You can throw a Powerwall into your pickup truck, but a salt water battery is too large for that.

I generally admire Elon Musk; he’s one of the only people to come out of the dotcom boom who is doing good work that needs to be done, but lithium household batteries really aren’t the best solution from an ecological viewpoint. Though, yes, combined with renewable energy they’re certainly better than most of the status quo systems.


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Conservatives Appear to Have Won in the UK: What the Left Should Do

2015 May 7
by Ian Welsh

Or so the exit polls are showing.  A likely bare majority government.

The consequences of this are likely to be severe; I would expect most of the remains of the post-war welfare state to be swept away.

I am torn between two reactions:

  • Although this is only a bare majority government, people did vote for Conservatives enough for them to get in and it’s not like they didn’t know the consequences. They have had years of Tory austerity. As H.L. Mencken once said: “Democracy is the theory that the common people know what they want and deserve to get it, good and hard.”
  • On the other hand, Labour under Miliband ran as Tory Lite; as the lesser evil. Voters tend not to be inspired by the “not quite as bad as the other bloke, but they’ll get in eventually and do what they were going to do anyway.” And that was his platform.

I’m seeing a lot of despair from my British friends on the left. And my British friends on the sane, for that matter. Here’s what to do: Either take over the Labour Party, or, if you think that’s impossible, pile into the Greens. Or, heck, create a new party.

I will point to Alberta, where the left-most party in Canada won on a platform of, among other things, raising taxes.  They came, essentially, from nowhere.

Want to win from the left? Be left-wing. Offer a real alternative to neo-liberalism.

I note, also, that Scots may really be regretting not voting for independence. Most of the wonderful social policies Scots value more than the English will now be taken away from them.

Failure of courage when there is a real alternative will reap the expected results.

This is all very sad, but the post-war welfare state has been under assault in England since Maggie Thatcher’s election in the 1970s. The true magnitude of Thatcher’s victory was not her policies, it was that Labour became Tory Lite; she changed the acceptable policy matrix for not just the Conservatives, but for the main opposition party as well.

Until that “acceptable policy window” changes, the trend will continue right–it cannot do anything else. Each Labour interregnum will be just that, a period in which neo-liberal policies are pursued at a slower rate than during Conservative governments, but in which the trend is not reversed.

This is true in almost every country in the West of which I can think (Iceland and perhaps Finland being the lone exceptions).

Offer a real alternative, with real left wing policies. If you can’t capture an existing major party, pile into a minor party or create a new one.


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Alberta Elects the New Democratic Party (NDP)

2015 May 6

This is fairly extraordinary: For non-Canadians, the NDP is the most left-wing party in Canada and Alberta is the most right-wing province in Canada. It’d be like an Elizabeth Warren-inspired party winning Texas. (As a Canadian let me say that this is amazing and almost unthinkable even a few years ago.)

Following were NDP’s key promises:

  • An increase in the corporate tax rate from ten to twelve percent;
  • A $15/hr minimum wage;
  • A review of the royalties that petrocarbon producers pay (which have plummeted in recent years);
  • A ban on corporate donations for elections;
  • A phase out of coal power.

Alberta is the heart of the modern conservative revolution in Canada and was the fastest growing economy during the last fifteen years, thanks to massive increases in oil prices. Alberta also saw a rise in immigration from other parts of Canada, which I suspect had played a huge part in this surprise vote.

I am more interested in whether this means Alberta might be in play during a federal election, however. Traditionally, Alberta has gone right-wing in super majorities, federally. If it’s willing to vote NDP at the national election (which, so far, polls don’t show), the next election may be far more interesting than this one.

Canadian elections can be volatile; there have been a lot of upsets recently and the polls have gotten it wrong repeatedly. Federally, the Liberal Party seems most likely to win, but it’s leader, Justin Trudeau, has been caught flat-footed a number of times, tending to support the same policies as the Conservative Party.

I’m hoping, and now have slightly more hope, that the NDP wins instead.


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Regular Posting to Resume Soon

2015 May 5
by Ian Welsh

Yesterday was a travel day and one of those cases where a four and a half hour itinerary turned into a 16 hour trip, to be topped off by someone doing some sort of machine work outside the window of my new place during the day. I’m operating on about seven hours sleep for the past three days.

Airbus sure knew what they were doing. Air travel really has become like traveling on a Greyhound, but with the extra joy of intrusive security checks.

Hope y’all are having a better beginning to your weeks!

Noam Chomsky Owns Sam Harris and Indicts Bill Clinton

2015 May 2
Picture of Noam Chomsky

Picture of Noam Chomsky

Noam Chomsky had a private email session with Sam Harris about Clinton’s bombing of a Sudanese pharmaceutical factory which Clinton allegedly believed was also manufacturing a nerve agent. I really recommend reading the entire exchange, which is hilarious and horrifying on multiple levels. First, because Harris just doesn’t get that Chomsky is smashing him flat and asks for permission to publish it. Second, because the sort of ethical reasoning Chomsky uses is so alien to so many people in the world (and, sadly, especially to Americans).

To put it simply, Clinton’s destruction of that factory meant that many people didn’t get the drugs they needed to survive. So they died. The number of people who died was much larger than the number of people who died in 9/11. Harris just doesn’t seem to get it, he thinks “intent” matters more and that Clinton deserves the benefit of the doubt. Chomsky points out that any intelligent person would have predicted the effects of bombing that factory and Clinton did it anyway.

If he did it without malice, well, that means he felt nothing even though he had to know he was killing all those people. Feeling nothing about mass murder–and that’s what it was–is arguably worse than murdering someone you acknowledge as human, as having worth.

(There is also a a brief discussion of the Iraq sanctions of the 1990s, which were a terrible crime, as well.)

The point I want to emphasize is this: If you knowingly do something which a reasonable person knows will lead to large numbers of deaths, you are on the hook for those deaths. It may be the “least worst option” in some cases (though not, I think, in either of these cases), but you are still responsible.

A reasonable man (and Clinton is a brilliant man, famed for staying up all night doing research, right down to reading all the appendices and footnotes, unlike many executives), is responsible for the effects of his actions that a reasonable man forsee.

This is Ethics 101—it is also Democracy 101. If you cannot understand this, you cannot hold your legislators and executives responsible.

Chomsky also dismisses questions of motives as irrelevant; virtually everyone says they have great motives, including the Japanese during their mid-20th century wars. At the end of the day, you can only judge with reasonable expectations and by results. Everything else is BS.

I will finally note something a lot of people don’t seem to understand, because they have been exposed more to propaganda about Chomsky rather than his own writings or his seminal work in Linguistics and Cognitive Science. Like him or hate him, Chomsky is one of the great geniuses of the 20th century. Even at age 86 and slowing down, getting into the intellectual ring with him is like trying to bear hug a grizzly. It is unlikely to end well for you

It sure didn’t for Sam Harris.


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Happiness and Freedom: East German Version

2015 April 30
by Ian Welsh

 

Picture: Fall of the Berlin Wall

Picture: Fall of the Berlin Wall

Many East Germans remember East Germany favorably:

Today, 20 years after the fall of the Berlin Wall, 57 percent, or an absolute majority, of eastern Germans defend the former East Germany. “The GDR had more good sides than bad sides. There were some problems, but life was good there,” say 49 percent of those polled.

The state with the Berlin Wall, which people died to get across, is remembered fondly?

Some of this, as the article points out, is nostalgia.  Some of it is from people who were children or not even alive when East Germany fell.

But I’m not surprised, because the happiness and life satisfaction data for East Germany showed a precipitous fall after unification, as it did in Russia after Communism fell there. (That drop has been made up since, but it was huge.)

I’m further not surprised because there were things that East Germany, in particular, did well. To start, it did community and civic association brilliantly: There were clubs for everything, people joined them, and they enjoyed them.

Happiness is strongly correlated to community: The sort of anomie which capitalist societies encourage, where you know hardly anyone well, destroys happiness.

Second, there wasn’t a great deal of inequality compared to modern capitalism. The research on happiness and equality is robust–the more equal a society, the happier people are.

Third, everyone was more or less taken care of. They may not have been taken care of with the finest consumer goods, but they had enough food, shelter, and so on.

Fourth, they didn’t have to move much. Labor force mobility in Germany today isn’t terrible, but the sure knowledge that you can stay where you were born and grew up can be as much a comfort as anything else, and it means that you don’t leave behind your community–your friends and family.

Capitalist transitions are brutal. The data from China is unambiguous: People moving from their ancestral villages to the city generally are never, personally, as happy as they were in the village.

The people interviewed in Der Spiegel’s article on East Germany tend to acknowledge the East German Stasi police state as bad, then wave it aside.

How badly has your life been affected by the fact that your government spies on you 24/7? East Germany may have had huge numbers of informants, but London has cameras everywhere and “anti-social disorder orders,” which make virtually any behaviour cops want to call illegal, illegal. Nor was East Germany’s incarceration rate nearly as high as America’s is now, and so on.

Sure, “the police state” was bad, but that wasn’t, to people who lived there, necessarily the most important thing about being an East German. Westerners believe this because of relentless cold war propaganda. Then the USSR and the Warsaw Pact fell, and our lords and masters started building their own surveillance and police states.

Still, it’s a bad sign when you aren’t even considered a better place to live than East Germany, with its Stasi. The failures of the post-Soviet era are making that period look better and better. In Russia, there is a surge of nostalgia for the USSR, for reasons which are are remarkably similar. People are discovering that, as wonderful as Levis jeans are, there is a cost to the modern consumer society in terms of anomie, corruption, and economic precarity.

Though I think I like the bitter joke from 1990s Russia best:

Everything they (Communist authorities) told us about Communism was a lie. Unfortunately, everything they told us about Capitalism was the truth.

And so the wheel turns. When capitalism, in a large region in one of the most successful countries in the West, has half the population thinking communism wasn’t so bad, something has gone off the rails. Triumphalism of the “we’ve won, so we don’t have to treat the population well” variety may well yet bite capitalists, and all of us, hard.


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Is Violence Ever Justified? Does Violence Ever Solve Anything?

2015 April 28
by Ian Welsh
Painting: Washington Crossing the Delaware

Painting: Washington Crossing the Delaware

I notice a fair number of sweet, well-meaning people saying “violence is never justified.”

This is a position I have a lot of respect for, though it’s not my position. The hard-core pacifist, who always opposes violence, is a person of great bravery.

But to say NEVER is a strong statement. In the US, if you are saying “violence is never justified” with respect to the Baltimore riots, for example, you must also oppose all the wars and killing the US is involved in.

In practical terms, that must mean that you believe that every politician who voted for war is more unethical than any rioter. You must believe that George W. Bush and Barack Obama are far fouler individuals than any rioter.

Ethical outrage must be proportionate to the violence and the violence in Baltimore is nothing compared to the scale of the Iraq War, or Afghanistan, or drone murders. Nor is it anything compared to the scale of police violence against Americans, especially African-Americans.

NEVER is a big word.

What most people really mean is that they condemn non-state sanctioned violence, except sometimes, like, say, in the American Revolution, or the Maidan protests.

In fact, they approve of some violence and not of other violence. Most such people, were you to dig down hard enough, are hypocrites, but some aren’t, even if one disagrees with them. If you were to allow the USSR the right to crush revolutions along with the US, and condemn the American revolution, you wouldn’t be a hypocrite, just not a very nice person.

Trying to argue about popular will and/or democracy is a slippery road, mind. For example, the numbers on the American revolution with which I’m familiar don’t show the majority of the population being for leaving British rule. Maidan overthrew a democratically elected government in the Ukraine and the French revolution was made by the Paris mob, while most people living in rural areas of France (the vast majority of the population) would have preferred to keep the Ancien Regime.

Relatedly, violence often does solve problems. The Native Americans cleansed from North America were “problems” to the settlers, and violence dealt with that problem just fine. Fascist Germany was a problem to most non-German countries, Jews, Gypsies, Socialists, Gays, and many others and violence solved that problem. Carthage was a problem to Republican Rome and violence solved that problem.

And riots, rather better organized than the Baltimore ones, granted, solved the Parisian problem with the old Regime, while the Terror, terrible as it was, did make sure that there was to be no going back–even if France was to alternate between Republics and Empires for some time.

Violence often solves problems and it often does so rather permanently.

Here is what history actually teaches us about violence: People who are better at violence than those they fight get the spoils and often keep them for a long time. You do know that the Angles and Saxons invaded Britain, yes? Then the Normans? Those people did very well out of killing the locals and wiped them almost entirely from the most fertile parts of what is today England.

Europeans conquered most of the world and Europeans today (and their descendants) are powerful and relatively rich compared to almost everyone they conquered. Many economic historians believe that imperialism and colonialism were required for the industrial revolution to really take off; and definitely for capitalism to find sufficient markets. Violence worked very nicely for Europe and especially for England and the United States.

Of course, history marches on, and eventually everyone will get their turn at the curb, their face stomped on. But history can take a long time, and multiple generations can enjoy the fruits of violence–theirs or their ancestors. Violence only doesn’t solve anything in the sense that nothing solves anything—extend history enough in any direction and all peoples eventually have a really bad day (or really bad hundreds of years or millennia). Heck, eventually, all species will go extinct.

I don’t know if violence is ever justified. But I do know that violence often does “solve” problems and I do know that peoples who insist on being entirely non-violent or bad at violence eventually discover that everything they have they hold at the sufferance of those who are good at violence.


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As Baltimore Riots

2015 April 27
by Ian Welsh

I don’t have a great deal to say about this. I’ll simply note that if you shove peoples faces into the concrete enough, it’s not strange that they will riot. Given the well documented rate at which police have been killing African-Americans (and getting away with it, in most cases), well—Baltimore is a city with a long tradition of poverty and police violence in any case.

I’m not going to wring my hands about this. It’s unfortunate, but those who want peace must work for justice, as Pope Paul VI once noted. Instead of just condemning the rioting, the middle and upper classes might bear in mind that those lower on the totem pole, and especially Blacks, live a very different life than them, one in which the police are a constant oppressive force which appears completely unaccountable.

(I will note, again, that rioters need to get it through their heads to take their rioting to the rich areas of town. Rioting in your own backyard is not particularly productive.)


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