Monday, April 22, 2019

On influence and insensitivity

Kylie Jenner ... influencer par excellence

By Bob Gaydos
        It’s been awhile since I put my name on something I wrote, mostly because there’s really been only one one thing to write about. But other life goes on, so ...
        Last time out, I wrote about how I had recently come to the realization that, much as I chafed at the designation, given the 21st century dilution of the term and the relaxed admission standards that allow anyone with an attitude and an audience into the club, I was — am — for better or worse, a pundit.
    In my defense, just being able to write that sentence should qualify me.
    But punditry, I have even more recently learned, is small potatoes (chicken feed, chump change, yesterday’s news) compared to the title to which anyone with any interest in the power of persuasion today should aspire.
    I want to be an influencer.
    Really. It’s a job. I just found out. Some pundit.
Influencer is such a legitimate thing that Forbes Magazine has initiated a list of the Top 10 Influencers for 2018 in a variety of  categories. It’s starting with Beauty, Fitness and Home, capitalized I assume for influence.
Apparently one qualifies for this list by telling tens of thousands — even millions — of people who follow you on social media what beauty products you prefer, the type of fitness regimens, supplements, food, clothes you prefer or let them in on the type of furniture or decor you like to surround yourself with when relaxing at “home.” Then a lot of those people go out and buy the stuff. Companies pay you for your creative messaging.
It’s kinda like being a shill. In fact, it’s exactly like being a shill. It just pays a lot better, if you’re, you know, influential.
If you sense me being a bit flippant and sarcastic about this discovery it may at least in part be because I am not just a little bit envious of these people who have discovered a way to earn a good living by sitting home, posting photos and writing blurbs on Instagram, Facebook, YouTube and other social media sites and being paid by companies whose product they promote. You don’t even have to use it. All you really need is a ton of followers who believe you and apparently await your every posting to find out what they should really like, then buy it.
For one thing, this says a lot about buying habits today, when so much shopping is done on the internet, with no opportunity to check out the merchandise firsthand. Well, heck, if Randi Jo Cutie Pie says those are cool candles or neat boots or dynamite hair products, they must be. Look, she’s got a million and a half followers.
The Forbes list was heavily female and mostly millennials, which would suggest that a male in his seventh decade might look for another line of work. It’s also prominently featured on Instagram, which I thought was mostly for sharing cellphone photos. So, on second thought, I’m going to stick to punditry, where I don’t have to worry about competing with Kylie Jenner or Cardi B.
— Maybe it’s just me, but … if I’m going to get the news that I’m about to shake off the coils of my current mortal construct and rejoin the Greater Consciousness in some other form real soon, I want a living, breathing doctor standing next to my bed delivering the diagnosis as compassionately as possible, not a streaming image of someone, presumably a doctor, on a screen on a machine wheeled into my hospital room.
Ernest Quintana didn’t get that personal treatment at Kaiser Permanente Hospital in Fremont, Calif. Instead, with his 33-year-old granddaughter standing by his bedside, the 78-year-old, who had been admitted to the hospital for the third time in 15 days because of difficulty breathing, heard the headset-wearing image on the screen say there was serious lung damage. “Unfortunately, there’s nothing we can treat very effectively,” the image said. He also said giving his “patient” morphine might help with pain, but would make breathing more difficult. He topped off his “On Demand” consultation by responding to a question about hospice care thusly: “I don’t know if he’s going to get home.”
     The grand daughter was mortified, as were Quintana’s wife and daughter, who had briefly left the hospital to go home and shower. They complained to the hospital, which was semi-apologetic. Quintana died two days later.
They call it telemedicine and it presumably has its place, but a spokesperson for the AMA said delivering a death sentence electronically should be a doctor’s “last choice.”
Don’t they teach this stuff in med school?
—  Speaking of insensitivity, maybe it’s just me, but the State of Virginia would appear to have a serious race issue. The governor, Ralph Northam, is desperately trying to repair his image after a racist yearbook photo of him was published and he subsequently admitted to wearing blackface in his youth. The state’s attorney general admitted likewise. Both men are white. But get this, mere days after her husband pledged to devote the rest of his term to racial equity, his wife, Pam, leading a tour of the governor’s mansion, handed raw, prickly cotton to 13-and-14-year-old black pages and asked them, “Can you imagine being an enslaved person and having to pick this all day?”
No, they couldn’t and no, they weren’t happy with the hands-on history lesson. Neither were their parents. A former middle school teacher, Northam said she does the same with all the history tours she leads.
Maybe they need to re-evaluate that lesson in First Lady school.

Wednesday, April 10, 2019

Maybe there‘s a little addiction, disorder in all of us

Addiction and Recovery

By Bob Gaydos
Opioids and alcohol get most of the attention, although marijuana, currently undergoing a reputation rehabilitation, has been grabbing plenty of headlines lately. But if you spend any amount of time studying the issue, it doesn’t take long to wonder if there isn’t an addiction, compulsion, behavioral disorder — call it what you will — for every human on the planet.
    Some conditions are more serious than others, but all
either involve the brain’s reward system or relieve anxiety, stimulate compulsive use and bring with them an opportunity for negative consequences. Consider the following an inventory of sorts, a look at some of the substances people use or behaviors they engage in, perhaps to excess. Maybe someone you know shows some of the signs of trouble.

Medically recognized substance use disorders
    Alcohol Use Disorder: Alcohol is a depressant. Alcohol use disorder is more common among adult men than among women, but the gap is narrowing. It typically develops at a young age. Severe use is commonly referred to as alcoholism.
Caffeine Intoxication: Heavy intake of caffeine resulting in symptoms including restlessness, nervousness, insomnia, gastrointestinal disturbance, rambling thoughts and speech, cardiac rhythm disturbances.
Cannabis Use Disorder: Highest among 18- to29-year-olds. Often the first drug used and often used with other drugs. Prevalence decreases with age.
Hallucinogen Use Disorder: These substances alter perception. Phencyclidine — “angel dust” or PCP — produces feelings of separation of mind from body.
Inhalant Use Disorder: Sniffing glue. Inhalant substances are volatile hydrocarbons, toxic gases that are released from glues, fuels and paints, that can have psychoactive effects. Occurs primarily among ages 12 to 17.
Opioid Use Disorder: Opioid drugs include heroin and prescription pain-relievers such as oxycodone, codeine, morphine, and fentanyl. According to the American Society of Addiction Medicine, opioid-related overdoses are now the leading cause of death in Americans under 50 years of age and prescribed opioids are the “overwhelming initial source” of addiction.
    Sedative, Hypnotic, or Anxiolytic Use Disorder: Addiction to sleeping pills and anti-anxiety medications (Valium, Xanax, Librium). These are brain depressants. Rates are highest among 18- to 29-year-olds.
    Stimulant Use Disorder: This group include amphetamines, Ritalin and cocaine. These drugs are commonly prescribed for the treatment of attention-deficit/hyperactivity disorder (ADHD) and narcolepsy. Cocaine use in the U.S. is highest among those aged 18 to 25.
Tobacco Use Disorder: Nicotine in tobacco acts as a stimulant for the central nervous system. Studies show that 68 percent of adult smokers want to quit and 50 percent of smokers have tried.

Behavioral disorders
Binge-eating disorder (overeating disorder): Uncontrolled eating, often accompanied by purging (bulimia).
Gambling disorder: Because of the quick feedback, it can provide reward symptoms to the brain much like alcohol or cocaine.
        Gaming disorder: It has been recognized officially by the World Health Organization, but is still under study in the United States for classification as an addictive behavior. Other behaviors under study include smartphone use, Internet gambling, pornography, eating and shopping.

Compulsive behaviors
        These can include such things as hoarding, shopping, sex, eating, gambling, exercise, even talking compulsively. While the behaviors may not provide the pleasure reward of an addiction, they serve to relieve anxiety and stress and, if unchecked, can have serious negative consequences in a person’s life.

What else to know
        Simply put, an addiction is a repetitive use of a substance or engagement in a behavior because of the rewards message the substance or behavior transmits to the brain, despite numerous negative consequences the activity produces in the person’s life. Tolerance increases with time. The person may not even be aware of the damage being done by the behavior, or may continue in spite of it. At some point, the substance or behavior may dominate the addicted person’s daily life. It is highly likely that these conditions are accompanied by other mental health conditions, such as anxiety or depression.
    Science has been unable to come up with one cause of addiction, nor can it predict who will become addicted. However, there are numerous risk factors that can be recognized, some of which may be avoidable, some not. Genetics/family history play a significant role in determining vulnerability as do environmental factors, including growing up in a dysfunctional family and early exposure to substances or abuse. The presence of other mental health issues can also contribute to susceptibility to addictive behavior. Even physiology may play a role since men seem to be more susceptible to addiction than women.
That said, there are a number of conditions that can predict the presence of an addiction. The following list is adapted from one used by the Mayo Clinic. Substitute the specific substance or behavior for the word “drug.”
    — Feeling that you have to use the drug regularly — daily or even several times a day.
— Having intense urges for the drug that block out any other thoughts.
— Over time, needing more of the drug to get the same effect.
— Taking larger amounts of the drug over a longer period of time than you intended.
— Making certain that you maintain a supply of the drug.
    — Spending money on the drug, even though you can't afford it.
    — Not meeting obligations and school, family or work responsibilities, or cutting back on social or recreational activities because of drug use.
    — Continuing to use the drug, even though you know it's causing problems in your life or causing you physical or psychological harm.
    — Doing things to get the drug that you normally wouldn't do, such as stealing.
    — Driving or engaging in other risky activities when you're under the influence of the drug.
    — Spending a good deal of time getting the drug, using the drug or recovering from the effects of the drug.
    — Failing in your attempts to stop using the drug.
    — Experiencing withdrawal symptoms when you attempt to stop taking the drug.
Generally, two or three symptoms suggest a mild disorder, four or five a moderate one and anything more, a severe disorder.
The good news is that there is a variety of treatment available for all these conditions. If a problem is suspected, don’t try to deal with it alone. Consult with a health professional (doctor, psychologist, social worker, addiction specialist) and begin the road to recovery.