Yves here. This post gives a window into how the US is turning into two countries: the wealthy enclaves full of people who fret over their lack of personal gratification (see our Silicon Valley post today), perhaps live close to the edge of their financial means and have few buffers, and so also live in fear of the loss of income and status, and if they are parents, are deeply invested in making sure their kids are “competitive” enough to get in the Right School and get a Good Job. Needles to say, the latter are more rarified than they used to be.
The other America, of counties that the elites have written off (Clinton yesterday dismissed the people who didn’t vote for her as backward) is growing so rapidly as to be hard to ignore. And its ailments: addiction, disease, and crime, can’t be tidily walled off from the prosperous parts of America as tidily as the rich would like to believe.
Needless to say, as desperation and addiction rises, more and more people will feel unsafe, and among other things, this will lead to more gun ownership by people who often aren’t able to handle them properly. One experienced hunter in comments said he handled a pistol as if it posed imminent harm to him because its tight rotation made that a reasonable assessment.
This is the future of America. Get used to it.
By Brian Rinkler. Originally published at Kaiser Health News
David Cole Lang — or “Cole,” as his family and friends knew him — was shot to death on April 25, 2017, after he attacked a doctor he once saw for opioid addiction treatment, according to police records. He was 33 years old. The doctor, Edwin Zong, was not charged in the death after authorities determined Zong acted in self-defense. (Brian Rinker for Kaiser Health News)
BAKERSFIELD, Calif. — The police report is all David Cole Lang’s family has to describe his last moments on Earth.
Fifty pages of officer narratives and witness interviews filled with grisly detail, it lacks any explanation for his death. Ten months later, Lang’s widow, Monique, says she still has no clue as to why the 33-year-old combat veteran and father who struggled with opioid addiction ended up fatally shot by a doctor whom — as far as Monique knew — he hadn’t seen in over a year.
“I didn’t understand why he was there,” she said. “I still don’t.”
On that April evening last year, according to interviews in the report, Lang yelled and cussed at the addiction and pain treatment doctor, Edwin Zong, in his office, and leapt across a desk to punch him repeatedly. Hearing the doctor scream for help, the last patient waiting to see Zong that day ran to open the door. He told police he found Lang standing over Zong, curled in a fetal position on the floor, his face covered in blood and “the fear of a child in his eyes.”
“Hey!” the patient yelled.
When Lang turned toward the doorway, Zong told police, the doctor opened a desk drawer and grabbed a handgun. He fired three or four times. One bullet tore through the blood vessels in Lang’s neck. He staggered outside, collapsed in a parking lot and died.
Local authorities concluded that Zong had acted in self-defense, and he faced no charges. In an email to Kaiser Health News, the doctor declined a request for an interview but said he believes he was targeted for robbery. “I was lucky I wasn’t killed,” he wrote. “Treating addiction is a very tough job, many doctors won’t do it.”
The tragedy that played out in Zong’s office speaks to a dangerous trend: In many parts of the United States, the number of people addicted to opioids far exceeds the capacity of doctors willing and authorized to treat them. That is particularly true when it comes to professionals like Zong who dispense Suboxone or Subutex, both formulations of buprenorphine — widely considered the optimal addiction treatment because it all but erases opioid withdrawal symptoms without creating a significant high.
With tens of thousands of Americans dying annually from opioid overdoses, the Food and Drug Administration recently signaled that it is open to expanding the number of drugs available to ease withdrawal and reduce cravings, but access to prescribers remains a problem even for the drugs that already exist.
One reason for the shortage of providers is that doctors must take eight hours of training to prescribe the medication and apply for a waiver from the federal Drug Enforcement Administration, because the medicine is itself an opiate. Few doctors are willing to check all those boxes and take on the sometimes difficult patients who seek the drug.
Patients addicted to heroin or prescription opioids like oxycodone or fentanyl suffer severe withdrawal — sweats, tremors, anxiety — and are often desperate for medication-based treatment to wean them from the drugs or at least quell their symptoms. For the cash-strapped patients, the cheaper the better.
Doctors who accept these patients, whether motivated by profit or compassion, can become overwhelmed, seeing far more than their offices can handle, opening the door to chaos and lawlessness. More problematic is that some clinics, like Zong’s, offer a mix of services — treatment for both opiate addiction and pain. Patients being prescribed potentially dangerous narcotics are mixed in the waiting area with those struggling to kick addiction.
Several years ago in Vermont, which pioneered buprenorphine treatment, some small practices rapidly swelled to 600 or 700 patients each, said Dr. Richard Rawson, an experienced addiction researcher at the University of Vermont. Doctors sometimes prescribed more than their authorized limit, failed to test patients for drug abuse and — wittingly or not — fostered illegal sales, Rawson said.
“We know that when you have those types of practices where you bring large numbers of addicted individuals together it produces a mess,” he said. “People are selling drugs in the parking lot and all kinds of wacky stuff like that.”
Inevitably, some patients relapse. Some become angry if they don’t get what they came for. A solo practitioner like Zong — who by many accounts had few employees, a tendency to work late on his own and a high cash intake — faces security risks.
Zong was concerned enough to stow a gun in his desk drawer. “I keep a gun in my office for self-protection,” he said in his email.
Long Lines, Short Appointments
In California, demand for buprenorphine has only grown with the opioid epidemic and recent changes to Medi-Cal, the state’s Medicaid program, which have made it easier and quicker for low-income people to get the drug. The program was expanded under the Affordable Care Act to cover more adults (3.8 million) and more drug treatment.
In addition, beginning in June 2015, doctors were no longer required to get prior approval from the Medicaid program each time they prescribed buprenorphine.
Within seven months, claims jumped 100 percent, according to the state.
Zong, an osteopathic physician who had trained in internal medicine in New York, opened his Bakersfield practice in 2007. Situated next to a marijuana dispensary, it was a one-stop shop for pain management, addiction treatment and acupuncture. Though Zong’s medical training didn’t focus on those areas, he had the necessary DEA waiver to prescribe buprenorphine by 2010, records show.
Zong had a reputation for writing scripts, cheap and fast, according to numerous interviews with former patients, drug treatment professionals and pharmacy employees in the area. Lines of sometimes-agitated patients stretched from the waiting room into the parking lot, the street and the dirt lot across the road, patients and neighbors said.
If the wait was lengthy, the appointments weren’t, the patients said.
“When I walked in the first time,” said Brian Adams, a former patient, “[Zong] said, ‘What’s going on?’ I said, I’m a heroin addict. I need help. He said ‘OK, I’ll write you a prescription for Suboxone.’”
No intake. No drug testing. No counseling. “I was in and out in five minutes,” Adams said.
The price for the visit ranged from $80 to $100 cash to secure the medicine, patients said — far cheaper than anywhere nearby.
Federal regulators say buprenorphine should be “part of a comprehensive treatment plan that includes counseling and participation in social support programs.”
Dr. Edwin Zong closed his practice after the fatal shooting, leaving a handwritten notice on the door. He remains licensed to practice in good standing but says he won’t return. Neighbors say patients still come by looking for him. (Brian Rinker for Kaiser Health News)
There was an option like that within a few miles of Zong’s office: Aegis Treatment Centers, which runs opioid treatment clinics closely regulated by the government. The clinics required services including intake, urine testing and counseling for opioid treatment.
From a hard-up patient’s perspective, Aegis had another downside: It had not yet been approved to accept Medi-Cal for buprenorphine, which was dispensed on-site as take-home pills. The range of services and medication costs nearly $700 for those without insurance, although a limited number of discounts are available to the poor.
Zong’s Medi-Cal patients had it easier: Their freshly issued scripts were covered at local pharmacies.
Anger And Suspicion
Zong had good reasons to be concerned about security. He’d had a handful of break-ins at the clinic, his vehicle and home — one recently, according to the police report.
At some point, he became licensed to carry and conceal a firearm. Adams said he once saw him pull it out when Adams got confrontational.
Angry that Zong wouldn’t prescribe him an anti-anxiety medication, “I stood up and was like ‘Man, [expletive] you,’” Adams said. Zong pulled out his gun and placed it on the table in front of him, Adams said, and he quickly sat back down.
Patients and pharmacists said Zong sometimes did add addictive anti-anxiety drugs like Xanax to buprenorphine prescriptions for people presumably seeking to escape addiction. Besides creating the potential for further drug abuse, the combination can be deadly, experts say.
Records of Medi-Cal claims obtained by Kaiser Health News show that, in addition to treating patients with buprenorphine, Zong prescribed significant amounts of highly addictive opioids, including oxycodone and hydrocodone, as well as habit-forming anti-anxiety medications. They do not show what combinations of drugs were offered each patient.
Staffers at three pharmacies in the area said they were concerned about peculiarities in Zong’s prescriptions or drug-seeking behavior among his patients.
Myron Chang, a pharmacist at the Walgreens at H Street and Planz Road in Bakersfield, said Zong’s prescriptions “were suspicious.” Staffers noticed odd quantities of pills prescribed — 43, 46, he said. Usually, doctors call for 30 or 60 to match a daily dose for a 30-day month, Chang said.
Chang added that Zong’s scripts sometimes included a potentially dangerous cocktail of sleeping pills, narcotics and anti-anxiety medications. He showed a reporter one of Zong’s 2013 prescriptions for Subutex and Xanax.
“We just stopped taking his scripts,” Chang said.
Not The Same Man
After the killing, police found a ski mask, a black hoodie and a recently used meth pipe in Lang’s car, according to their report. Witnesses reported to police that Lang came into the offices saying “something about money” or that he was “waiting on his money.”
Court records show he had pleaded no contest for misdemeanor burglary in 2014 and served three days in jail.
Lang’s family is skeptical that Lang was trying to rob Zong. They acknowledge, however, that he was not the man he used to be.
When Monique met Cole, as he was called, she was still in high school. He was an outgoing and funny 19-year-old, with beautiful green eyes and a sharp wit. In short order, they married and he shipped out to Iraq. Then came two more tours, in Iraq and Afghanistan. One explosion, then another, nearly killed him.
When he came home to his wife and baby daughter, he “was a lot different, especially around family functions,” said Monique Lang. He wouldn’t want to go, and if he did, he was quiet and remote. “I was like, ‘This isn’t you. What is going on?’ He never would say.”
In 2009, after Monique discovered money missing from the couple’s bank account, her husband came clean: He was hooked on opioids. From then on, it was a roller coaster of pills, heroin and rehab. In the middle of it all, they had a son, now 4.
Lang’s family said the former Marine was in constant pain, physically and mentally. He had a severe back injury. He screamed in his sleep. His daughter, now 10, would sleep on the couch downstairs, to escape the sound.
He secretly wrote suicide notes to his wife and kids.
Monique Lang wears her husband’s wedding ring around her neck. They met when she was still in high school. She said he was an outgoing and funny 19-year-old, with beautiful green eyes and a sharp wit. (Brian Rinker for Kaiser Health News)
Zong told reporters the day after the shooting that he did not remember seeing Lang before. But the family told police he was seen on occasion between 2012 and 2015, according to their report, and that he received Suboxone for opioid addiction.
In an interview, Monique Lang said she once accompanied Cole to an appointment. She didn’t like the atmosphere, she said, and didn’t understand how taking a medication with no other services would help her husband.
But that was history — or so the family thought. By last April, they believed Lang was sober, getting the support he needed at Aegis.
Another Clinic ‘Overwhelmed’
Zong told police he performed one final task on his clinic’s last day, with Cole Lang dying outside on the asphalt and squad cars en route: He wiped the blood from his battered face and agreed to write his remaining patient a prescription.
Although Zong — who also goes by the name Yon Yarn — remains licensed to practice with an unblemished osteopathic board record, he says he will not reopen his practice.
His departure created chaos as desperate people dependent on his prescriptions struggled to get help elsewhere.
“We were overwhelmed,” said Javier Moreno, regional clinic manager at Aegis. “We probably fielded a hundred, 200 calls from patients who were panicking — ‘I’m worried about relapse.’ ‘I don’t know what to do.’ ‘My prescription is expiring.’”
Even months after Cole Lang’s death, neighbors said patients still showed up at Zong’s door, with the scrawled “Closed” sign on it, hoping to find that the doctor was in.
This is straight-up heartbreaking.
Insurance covers the shady doc who dispenses without the needed support, and not the treatment center that can provide life-saving medication to manage cravings AND the services needed to support recovery.
That’s about the stigmatization of addiction instead of treating it.
People in genuine pain are another matter, they need their meds.
This is tragic all around, especially for the families of all those involved, including the doctor. What can be done? Start arming all doctors and nurses against shooters and violent patients? I’m putting this death down as a casualty to the opioid epidemic of course.
You know what get me here? Anybody remember when the AIDS epidemic hit America back in the 80s and 90s? The deaths of tens of thousands of Americans whose body count kept stacking up like a Vietnam body count? Anybody remember the AIDS Memorial quilt that grew so large that it covered the Mall in Washington. The protests. The marches that forced Reagan to pull his finger out and actually do his job.
Have people changed so much since then that they are no longer to protest, to organize. This epidemic is killing more people each year than were being killed in Vietnam each year. At what point will enough be enough and trigger a fightback. To be truthful here, at least with the AIDS epidemic the people were not also trying to fight big pharma at the same time as that epidemic.
https://www.nytimes.com/2018/03/10/us/met-museum-sackler-protest.html
Protests are finally happening, and yes, in this case inspired by those who remember
ACT-UP. I think we’ll be seeing more like this.
When the well off are afflicted, then there will be a quilt/some ribbons/bumper stickers/etc. At this point, I don’t know of anyone off the top of my head who is affected by this scourge and I hope I never do. If this happened to kids like mine there would be a class action lawsuits, slogans, moms organizing, etc.
But I will say that we have found passed out people in the alley behind our house and have cleaned up human waste. Don’t know exactly what they were on, as the police officer handled it and I had to take kids to school. He strongly recommended locking up our yard and was glad that we have dogs. Also have seen people wandering around the ‘hood who are clearly in desperate straits amid the fancy cars and manicured houses.
This morning, driving home from school drop off, there was some poor soul just wandering around in traffic. Didn’t realize what was going on until I saw someone get out of their car and walk this man over to the sidewalk and give him some money. Sad as it is, I was happy someone else cares.
Blame the Sacklers.
I bet they have armed guards protecting their ill gotten wealth everywhere they go.
https://www.newyorker.com/magazine/2017/10/30/the-family-that-built-an-empire-of-pain
I do blame the Sacklers. If I were them, I would have armed guards too.
Why aren’t people in the streets protesting high levels of consumer debt? Similar question, perhaps with a similar answer. Our overlords have weaponized shame and self-loathing.
What I see is what strikes me as a deliberate effort to convince those in chronic pain that (a) the news there’s an opioid epidemic is exaggerated and (b) the exaggeration will result in their not being able to obtain their meds. I know a lot of chronic pain sufferers, and many of them are convinced there’s a movement afoot by “liberals” to take away their medication, which suggests most of the push-back is coming from the right. But these days, who knows?
In fact, new one size fits all regulations ARE preventing chronic pain patients from continuing with protocols that have been working for them in some states.
The new regs will be tweaked and refined in time but not soon enough for the Ohio man who committed suicide when denied the meds that kept his excruciating pain tolerable.
Thought it was linked here a while back, maybe it was the Kaiser newsletter.
How is it tragic for the doctor? He was pretty obviously little more than a drug dealer with a license…and an especially reckless one at that:
That, and the fact that he had people getting opiod pain meds in the same waiting room as people getting addiction treatment, shows how little regard for anyone’s safety he had. I don’t think that a person who has acted in a highly unethical manner getting a few wollops and (maybe) scared out of business fits the definition of tragedy….just sayin’.
When historians write of the French Revolution, they also describe a “Reign of Terror” after the actual revolution in which everyone was caught up indiscriminately in the chaos and the death. That is what many forget. Collectively we get to choose. Some of the princes and princesses of America should think long and hard about Louis and Marie riding the tumbril through the streets of Paris.
The entire opioid addiction treatment paradigm needs an overhaul. It is far cheaper and easier to get the addictive opiates than it is to get Suboxone. Oxycodone and hydrocone are long past their patents and competition has brought the cost of these drugs down to about 25-50 cents per pill, or less. Suboxone, OTOH, is only made by a couple of companies and can cost upwards of $10 per pill without insurance. That works out to $600 per month for 2 doses per day, which is what most addicts need to get past the opiate withdrawal symptoms.
In addition, many health insurance plans require prior approval to receive Suboxone, which requires an application every 6-12 months. Opiates have no such requirement in most cases.
It would also help tremendously if the FDA would approve Suboxone for pain management. (It’s just as effective as regular opiates for all but the most severe pain.) Then, it could be prescribed in the first place instead of oxycodone or hydrcodone and thus reduce the risk of addiction. The DEA could also loosen up a bit on the requirements for licensing physicians.
Getting on Suboxone and off of the other opiates should be easier and cheaper than getting addicted.
I have too much to say and no one to say it to, in that spirit ill try to be brief, I have been on subutex for almost 20 years- its a miracle. I had a botched knee surgery that never should have been done in the first place, but the for profit medical industry needs customers, and then my knee got infected. In my late twenties i was hospitalized for over a month fighting the infection and subsequently introduced to pandoras box of opiates. A nightmare insued, subutex finally reversed my addictive habits and moderately satiated the pain. Obviously freedom from dependence would be the perfect solution, but i chose responsable dependence and an ability to excercise, move, and from my subjective experience be sidetracked from what would otherwise be debilitating discomfort. Yes the buprenorphine is like an opiate, which means there is a euphoric effect, but its much more benign then the others as well as longer lasting. The other phenomenal feature is its ability to curb your neurotransmitors demand for dopeamine. Subutex somehow discourages any urges to get high or higher, anotherwords its as if you never opened pandoras box in the first place, but yes youre now dependent on this chemical, though its far safer and much less debilitating regarding sedation and euphoria. Maybe it doesnt work for everybody, but it does for most. Its insane that its harder to get prescribed than other harder more dangerous options. I just got new insurance, and again had to jump through time and $ exhausting loops getting prior authorizations, as well as document baloney contraindications to far more dangerous substitutes in order to get florida blue accepting subutex for 6 months. I take it for pain, but i have to subject myself to being documented as a drug addict in treatment, absorbing the xtra expense of monthly drug tests, and of course insurance doesnt pay for the prescribing doctor visits. I have plenty of comical sad stories relating to those monthly excursions. Sadly most of the doctors ive seen are quacks, but thats probably because of the stigma.
Ive been taking care of my unemployed sister for many years, tragically she was murdered by a texting driver as she walked on a quiet country road new years eve morn. I tell you this because indirectly the opiate crisis most surely contributed. My sister was in a car crash 6 months prior and broke her back. She already had a history of drug abuse but the surgery and post operative pain again introduced her to drugs. She certainly needed pain relief, we both take care of many horses on our sanctuary, and she didnt want to be permanently reposed. Anyways a contributing factor to her inability to possibly avoid the distracted driver was her withdrawal symptoms. She was in horible discomfort that morning and went out for a walk. i suppose to ease the symptoms. That weekend proved a nightmare for her to fill the prescription, she had lost it earlier during the holiday week and had to go through a whirlwind to get another. Police reports, drug tests, plus more time consuming expensive doctor visits with accompanying stressful accusations of fraud. She finally got the script on friday afternoon, but then couldnt find a pharmacy to fill it. Somehow because she kept trying to find a pharmacy that had the medicine, she was using methadone, their computers labeled her as doctor shopping. Maybe because she lost her first prescriptuion, i dont know. By saturday night she had a valid script but no local pharmacy would fill it. Her last t ext to me was confessing her frustration with being a drug addict. She was at our moms house for the holidays, but even if she was home with me i couldnt have helped her with my subutex because both opiates are contraindicated with each other. Subutex will make withdrawal symptoms even worst for a methadone user. She was intending to wait until new years was over and then go back to the pharmacist that knew her whom was unfortunately closed for the holidays. Everytime i hear about the opiate crisis i have horribly mixed emotions. My sister is dead today because the pendulum has swung too far to one side. Sometimes it feels like our society is so damn stupid. This blog has obviously opened my eyes to the real political economy. You know what , most Americans are unfortunately just too misinformed.
I’m so sorry for your loss. My sincere condolences. And a virtual hug, because community.
The man was a combat vet. Where was the VA in all this?
How does the VA handle addictions today? Given that it specializes in trauma and its’ aftereffects, addiction treatment should be part of its’ core purpose. I met quite a few ex-GIs, mainly Nam Vets, who had or had had a “GI Monkey” on their backs. Something doesn’t sound quite right about this story.
Also, I was on a Federal jury judging a “Pill Mill” case from the Gulf Coast area. The description of Dr. Zongs practice fits almost perfectly with what we heard about the pill mill medical practice we were tasked with judging back then.
Don’t take the blue pill, or the red.
Yep – pill mill written all over it.
Most likely the good doctor bugged out before he got killed or jailed.
That’s my impression. I’ve been under treatment for serious chronic pain for ten years and it doesn’t in any way resemble what is described in the post. I had a battery of diagnostic imaging, multiple consultations to discuss and ultimately opt out of high risk surgery, and my opioid pain med use is strictly monitored and controlled.
Oxycontin is overpriced bull shit. It was initially sold on the basis of a lie that its slow release feature was supposed to make it less addictive. It sidestepped becoming generic by having its patent renewed for no other reason that they added a feature that makes pills crush proof. But I’m told there are methods developed by dedicated addicts to defeat this feature. I’ve looked into it as an alternative for myself and I hope I’m wrong but I suspect Suboxone is itself another scam. It is very expensive, purportedly less addictive, and insurance with which I am familiar doesn’t pay for it.
I use low dose morphine. It’s cheap and it increases my ability to function. But then, I don’t get high from it nor do I care to.
@Lee
March 13, 2018 at 11:43 am
——-
Low dose morphine sounds like an excellent choice for you. Oxy- and hydrocodone were originally developed as improvements on morphine that were supposed to have fewer side effects such as nausea, so they were easier to tolerate. IMNSHO, they are also more addictive. Going back to the “basics” appears to be a useful strategy in so many areas of our lives.
In the process of being undermined in preparation for privatization, the same place it’s been for at least the last decade and a half.
When the Rep from AZ was shot in the head, articles were written how she got really excellent therapy for her traumatic brain injury, whereas the many soldiers from middle east wars (due to short staffing and under funding at the VA) would receive a script for Oxycontin.
Since pain is so subjective people who have no future like this man rely on disability payments to raise their family. Triers of fact use metrics to decide how much disability is reasonable. If a person says they have terrible back pain and they take no medication they are going to get a much lower disability rating from the VA or worker’s comp for that matter. If they are taking a ton of narcotics and live in pain clinics they are going to have a higher rating and have a lot more money coming in. These poor people start on the medications and all of a sudden they are addicted. And then the doctors add the Xanax for PTSD and after a few weeks that does not work as well so then you add a few beers to sleep and then pretty soon hard liquor and more drugs etc. etc. It is the same with surgery. Without surgery a painful body part might be worth X and after surgery the same painful body part might be worth 5X. So in an economy and society that has eliminated middle class jobs for people like this man his only options are the pain route. He was never going to compete with a 18 year old illegal physically so he could get below minimum wage from a labor contractor. If we had national health insurance that covered everything for everyone and no worker’s comp or VA care (since they are based on a fault model…..more treatment means more disability which means more money) some of this problem would go away. If we had decent jobs and did not compete with the lowest wage economies in the world it would be better. If the only jobs we can offer our lower middle class men were something other than the military. If we could cut our defense budget in half. If we had decent income maintenance with child support or kindergeld it would be even better. All of it could easily be financed if we had a reasonable tax code. Right now the legal system is driving a lot of medical care especially for pain. Change the incentives and stop paying for pain and pay to support people and you will have less pain. Given the current tax law and defense budget and intelligence budget the chances of any improvement in the near future are nil. And I say this as a veteran who has lived it first hand.
@ambrit
March 13, 2018 at 10:37 am
——
Were you on the jury for the 2 partners in the Mobile pill mill? Pain Management Specialists, IIRC?
That was a huge case. The nurses in the practice were writing as many prescriptions as the doctors. One of the docs had something like 20 exotic sports and luxury cars, a couple of Ferraris, a couple of Lamborghinis, a Mercedes AMG or two, etc.
Sorry, no. This case was from Biloxi. Same modus operandi, but with an Oriental slant. The doctors office was right next to the pharmacy, all in a strip mall in Biloxi. We ended up hung because of the obvious “cowboy” ethic of the DEA agents.
Read: http://www.sunherald.com/news/local/article36455097.html
Also: http://blog.gulflive.com/mississippi-press-news/2010/04/2_biloxi_doctors_get_prison_time_in_alleged_pill_mill_case.html
We gat a dishonourable mention in this post: http://www.wlox.com/story/13285165/biloxi-pharmacist-tran-sentenced-to-10-years-in-prison
This seems to be a bit of a cottage industry. I remember a doctor and nurse prosecuted on a pill mill charge in Bay St Louis a few years ago.
Whenever there is ‘easy’ money to be made, legal or illegal, someone will try.
I live in the Ground Zero region of opioids (Lawrence, MA/Merrimack Valley), as well as the illegal supply lines of both The Dominican and Sinaloa Drug Cartels. Pay no mind about the mountain of money #BigPharma filters to Beacon Hill campaign coffers for the status quo.
The Merrimac Valley is filled with old mill towns, the once lifeblood of the region. Manufacturing jobs were the jobs of the region. Guess what? Those are gone. Guess what else? The political climate here in MA has driven them out even further, good, middle/working class jobs, gone. Throw in massive H-1B abuse and what’s left? A crater of despair separating the have’s and have nots even further.
This is just the beginning innings. Unless you live in a community of real-life walking zombies with “nodz” or death, you will soon enough.
“It’s rotation was too tight for him” ?, WTF is that supposed to mean?
Experienced hunter or not I have no idea what he is referring to and I got my first .22 at age ten in 1963.
Rifle, shotgun or pistol, if you don’t learn how to manipulate it safely you are going to have a problem…just like an automobile.
If you buy a gun for self defense it’s not a bad idea to get some training, go to the NRA website…they have been in the business of teaching Americans how to handle firearms safely since the 1870’s.
Education works, sometimes, it’s why we have mandatory driver safety training for beginners.
Yours Truly has taken NRA training. Good stuff. Ditto for Arizona’s concealed carry course. My instructors were fabulous.
Only downside of the CCW class was the hot-headed attitude of some of my fellow students. Arizona’s laws about when you can and cannot use your weapon were, shall we say, not to their liking.
Another example of a veteran who was psychologically f**ked up in Iraq, and then comes home and . . . (the recent CA Senior Center killing of 3 women was also done by an Iraq veteran) The “Post-War” wreckage “stateside” from Vietnam/Iraq/Afghanistan is truly amazing.
I see why George Bush Jr. is in hiding now.
Yup. His post-presidency reminds me of LBJ’s.
Recall that LBJ kept a very low profile after he left the White House.
His last official speech shows where he was headed in his final days. America has had better days than these.
Read: http://www.americanrhetoric.com/speeches/lbjfinalspeech.htm
But probably not b/c of psych damage from his war service?
There are some pretty convincing posts on 4chan suggesting that he contracted malaria in the jungles of Georgia during his Air Guard stint.
I wonder how high the true death toll of our adventurism in the Middle East, once you consider all of the casualties stateside?
Meanwhile, 55% of military retirees are rated as disabled veterans. I suspect that the military looks the other way at the easy-to-obtain disability ratings, because it reduces the liability of military retirement on the military budget and places that liability on the VA budget instead.
We should also mention the human devastation overseas.
By some counts, the Iraq war caused 400 thousand of “excess deaths” in Iraq.
see https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3797136/pdf/pmed.1001533.pdf
Not all of these deaths were as a direct consequence of US military actions, but were caused by destruction of infrastructure such as sewage facilities and hospitals.
As the population of Iraq (37.2 million) is about 10% of the USA, on a ratio basis, this would be similar to about 4million Americans dying as a consequence of an invasion by a foreign military power.
I hope the species “Chicken Hawk” goes extinct very soon, but instead it seems to be well cared for at various USA think tanks, the Defense department, media outlets and the NYTimes/Washington Post
Chicken Hawks are “involved” in that they lay the eggs, the poor and/or impressionable class are the bacon, as they are “committed”, and the rest of the MIC* is I guess the farmers. Just set things up and collect the money.
*per your post, maybe we really need to start thinking of the NYT etc as part of the MIC too, even though they don’t get their money directly from the taxpayer.
This was a tough one to read through.
I had an old friend die about 4 years ago when he relapsed after a judge slapped him with a parole violation. Prior to, he was 2 years sober. The judge passed the sentence and that night he went out to get high and killed himself dosing the same amount he did 2 years before.
Anyway, seems to me the judge had no regard for his history of drug abuse. I guess they bought into the theory of tough love. Though I think that may be too generous. I just don’t think they cared. Well, he is another statistic now. He was a smart and funny guy, just troubled and sick. Still haven’t been able to cry about it. Probably because I don’t know how to cry about it.
That’s so sad. I know two ex addicts (one meth, one a serious enough alcoholic that it must have been hard to drop, although that was many years ago). The meth addict relapsed several times, and if he hadn’t been able to use marijuana, I doubt he could have gotten off it in the end. The alcoholic was high functioning (as many can be), and in a busy job, so I think the structure of work helped a lot. But so many people don’t have the resources or the support, and one bad shock is all it takes….