Odds & Ends #6

1.  Sesame Street's Oscar the Grouch is singing a new tune that supposedly teaches kids about self-restraint and resisting temptation.  It's kinda cute.  Only, "stop looking at those cookies, Oscar!  Oh, there you did it, couldn't resist for more than a few minutes, could ya?"

2.  I'll admit it--I've started to take a few health supplements, after shunning them for years.  However I'm aware of excerpts such as this, that assert we Americans usually do not benefit from multi-vitamins, and that some vitamins actually increase the risk of cancer and heart disease.  (A small minority of studies showing a contrary result can sometime result in "publication bias" or, more often, reader selection bias.)  Even anti-oxidants have come under a cloud of suspicion.  More is not always better...so it goes.  It's probably more important what we avoid eating, and I'm not sure even that is anywhere nearly as important as either heredity or the mind-body connection.

3.  A recent article states that China is the largest foreign investor in U.S. firms that are critical to national security.  I guess China figures this is more valuable than our worthless government bonds.  Soon, our gigantic, bloated military and security agencies will be protecting assets that mostly belong to China.   ;-)

4.  Watch this underwater wheelchair lady.  Now ask yourself what it was you thought you couldn't do.  (Reminds me I haven't done any scuba diving in quite a while.  :-)

5.  If you're into scientific stuff (or even if you're not) here are some cool videos.

6.  This guy will hopefully make you more open to classical music and inspire you as well.

7.  Here is a Ted talk playlist on some pretty cool animals.

Economic Recovery or Stock Market Crash?

How much higher can the stock market go before it corrects?

Nobody knows. People predicted the bursting of the housing bubble literally years before it happened. I doubt it will take years before the stock market dips...more likely weeks or months.

In any case, consider these facts. As of this writing (Dec 9, 2013):

Margin buying of stocks is at an all-time high.
Stock indices keep setting record highs.
Rich valuations: The Russell 2000 average P/E = 84.5 (!) compared to 29.1 one year ago.
Consumer confidence is at a 7 month low, and retailers had weak Thanksgiving sales weekend.
VIX (volatility index) is extraordinarily low
Looming debt ceiling fight, theatrics and government dysfunction, Act II.
Looming repeat of "taper" talk. (It may never happen, but that's another story.)
A recent survey showed 57.1% of investors are bulls, only 14.4% are bears (a bearish signal)
Profit growth is not sustainable--it has been fueled by cost cutting, inventory increases and stock buybacks using borrowed money.
Gold and silver have been heading into the toilet.
Global stocks have been on the longest winning streak since 2009, with not even a minor correction.
Pundits are saying "relax; stocks will continue to go up, because they always do in December."

Companies are still pulling shenanigans despite all the empty talk about financial regulation...here's just one tiny example:   IWM, the Russell 2000 etf, is sold by Blackrock, the "worlds most respected and prudent fiduciary."  They advertise a 29.59 average p/e ratio (instead of 84.5). Want to know how they do it? If you read the fine print, they calculate it like this: Each holdings' p/e is the latest closing price divided by the latest 12 months' earnings per share. Negative earnings are excluded, extraordinary items are excluded, and p/e ratio's over 60 are set to 60.

Here's an even more bizarre and shady instance of what can only be labelled as pure evil--and yet something that is not even regulated, and thus not illegal!  Blackstone Group conspired with a client to make a late loan payment so that its own credit default swaps that it owned relating to that client company would pay out $15.6 million to Blackstone.  Incredible...this is analogous to taking out multiple fire insurance policies on your neighbor's house and then making a deal with your neighbor to light it on fire so you can collect.  Since the world is awash in $800 trillion in derivatives such as this (or about 10 times world GDP), this sort of corruption has ominous implications...in addition to the very existence of all these derivatives themselves--but that's another story.

In the interest of fairness and objectivity, there ARE some significant signs of a rebounding economy. The U.S. GDP grew by 3.6% in the 3rd quarter. The U.S. just reported the 4th month of solid job gains. It's possible that real increases in gross income (versus gross margin expansion) may yet happen.

The CAPE (Shiller) P/E's on the major indices (other than the Russell 2000) are still "reasonable" by historical standards, if you consider "reasonable" to be 20.8 versus a historical average of 15.8 for the S&P 500. There are some good reasons to be wary of the well-intentioned but overly-simplistic Shiller P/E. For instance, artificially low interest rates and a huge market fluctuation over the last 10 years make its calculation a bit questionable, although it is still better than using the regular P/E ratio.

So the U.S. stock market might not crash.  Perhaps there will only be a modest correction.  But if it does crash, it probably won't be alone. The Federal Reserve, Bank of Japan, European Central Bank, and Bank of England have all been offering super cheap financing (i.e., "printing money like crazy") and keeping interest rates artificially low. This is influencing investors to become more highly leveraged and increase their risk appetite. It is also fueling bubbles in riskier bond markets and in all types of other investments, all over the world. For instance, more money is now shifting to riskier developing countries and previously shunned countries such as Russia and Greece.  (Yes, that's right, most of the QE stimulus may end up outside the U.S.)

If a major correction is in the cards, I don't know how soon it will happen--it could still be many weeks or months away. But I find it a bit concerning. I don't know how this is all going to end up, but I believe it will be a global phenomena that will leave a lot of social and political turmoil in its wake, including in the U.S. this time around. I suspect prices of everything from stocks to bonds to every other type of financial investment all over the world may go down in unison--but again, this is only speculation on my part. This might be accompanied by dollar debasement or even a dollar collapse, especially if the U.S. starts to lose its reserve currency status due to reckless 30% budget deficits each year (papered over by QE). However, that is a far more ominous subject that is better explained by a plethora of doom-and-gloom prepper-type websites...I'd rather not go there.

Again, there's always the possibility that I'm dead wrong about a major stock market correction being in the works. The U.S. economy could continue to improve, stocks continue to advance, QE winds down in a way that avoids crashing the stock market or the housing market, and--perhaps least likely--Congress starts to get its act together and implements sound fiscal policy while avoiding sending the economy into a tailspin.

Perhaps the most likely scenario is also the most boring: A stagnant, sideways stock market for the next several years.  This would mirror what happened in Japan during their "lost decade".  In fact, from a historical standpoint, the analogy is eerily prescient.

Have a nice day. It's only money.

Odds and Ends #5

1. We always suspected that musical tastes are correlated to our character/habits, our culture and even our individual mental capacity.  Some people--such as gangs of troubled youths--really do not like classical music, for instance.  Other people--such as Somali Pirates--do not like listening to Brittney Spears.  (Perhaps this is their only redeeming quality?)  Here are 6 songs that have been used to torture and intimidate, with rather mixed success.

2.  In 2012, the Obama administration finalized regulations requiring new vehicles to average 54.5 miles per gallon by 2025 (in 13 years), up from 28.6 mpg at the end of last year. The requirements will be phased in gradually between now and then.  Many Republicans (notably Mitt Romney) opposed this doubling of the required fuel mileage, saying it was technically too difficult and predicting it would make cars too expensive.  (Meanwhile, Volkswagon recently introduced the XL1, a car that gets up to 270 mpg.)  So how far has the the U.S. come in fuel mileage?  Does it really require great leaps in technology?  Here's a list of high-fuel-mileage (and mostly inexpensive) cars made in the last 30 years:

• 2008 Toyota Prius Hybrid, 48/45 mpg (city/highway), 1 liter gasoline/battery

• 1995 Honda Civic HB VX, 1.5 liter, 47/56 mpg, gasoline

• 1990 Suzuki Swift, 1.0 liter, 46/50 mpg, gasoline

• 1985 Honda Civic CRX HF, 51/54 mpg, gasoline

• 1981 Volkswagen Jetta, 41/57 mpg, diesel

• 1980 Honda CRX, 50/60 mpg, gasoline

In light of this list, the relatively expensive Toyota Prius doesn't seem quite the amazing technological breakthrough it's often touted as.  It's quite possible the U.S. automakers will easily beat the Obama administration's fuel mileage regulations, not because of the regulations themselves, but because of global competition and demand for more fuel-efficient cars.

Rich and Poor: The Divide

What do most Americans think about the distribution of rich and poor?  

Here's a video that summarizes some survey information and compares it to factual information.  It will shock you.  This video as well as Credit Suisse’s new Global Wealth Report set forth some shocking facts, such as "just 1% own 46% of the world, while the bottom 80% of the population has only 7% of the nation's wealth between them"....and "the situation today in the U.S. is...worse than history’s worst. Twice as bad as in ancient Rome, worse than in tsarist Russia, worse than in America’s Gilded Age, worse than in modern Egypt, Tunisia or Yemen, worse than in many banana republics in Latin America. Yes, today’s inequality is even worse than experienced by slaves in 1774 colonial America."  It compares our situation today with the situation just prior to the French Revolution.

Nick Hanauer is a respected entrepreneur and venture capitalist.   His TED talk disputes the idea that the rich are job creators.   His presentation was apparently considered to be so controversial it was removed, as discussed here.  A Forbes article naturally provides a rebuttal to Nick's presentation with predictable "let them eat cake" arguments such as the one that implies poor people can invest in stocks and get the lower 15% capital gains tax rate just like rich people can, so the system "must be fair".  If you like melodrama, here's a debate between Hanauer and Neil Cavuto on Fox News.

Are Hanauer's assertions supported by actual data?  Yes.  For example, here's a graph (copied from Wikipedia) demonstrating that, if anything, lowering taxes on the rich actually hurts--rather than helps--the economy.

A 2012 study by the Tax Justice Network indicates that "wealth of the super-rich does not trickle down to improve the economy, but tends to be amassed and sheltered in tax havens with a negative effect on the tax bases of the home economy," resulting in a greater government deficit and a more sluggish economy.  Some people might attempt to dodge this fact by asserting that taxes in general are too high.  In actuality, the federal tax rates had fallen to the lowest level in 30 years when President Barack Obama took office — and have fallen more since that time.  Top federal tax rates and capital gains rates (on the rich) are indeed very low by historical standards.

"Trickle down theory" is not (and never was) a valid economic theory.  It was a pejorative phrase once used by Will Rogers as part of a joke.  If it actually did work, the Middle Ages and serfdom would not have lasted for hundreds of years.  In fact, this "theory" has been completely refuted throughout history, up to the present day.  Reagan's version of "trickle down theory" was "supply side economics".  It didn't work.

The vast majority of super rich people are not inventors, startup entrepreneurs, angel investors or venture capitalists...they simply hold large investments that compound automatically and effortlessly, often in offshore tax havens.  The poor make their money via toil and sweat.  They do not contribute a huge amount to the tax roll for one reason and one reason alone:  they are too poor to have any money left over after paying for food, clothing and shelter.  If you consider yourself a Christian and are tempted to believe the poor are not paying their fair share, you might want to pick up a Bible and read Mark 12:41-44.

As referenced in a previous blog post, this article suggests that the government's QE program--while well intentioned--has done much to further exacerbate the growing inequality, as well as impeding and delaying--rather than spurring--job growth.  However, lacking any fiscal policy from Congress, it was the only thing that could be done, and it does seem to be helping Japan, at least from the standpoint that it's devaluing their currency and making it easier to export.  Europe has already demonstrated to us that the opposite approach--austerity--doesn't work.

Some people believe our problem with wealth inequality lies with the government--ironically, rather than accusing it of favoring the rich, it's instead believed to be too big, too inefficient, unaccountable to its constituents, pandering to the poor, etc.  This is a vague accusation that is usually accompanied by anecdote but rarely by actual facts or statistics.  In fact, under President Obama's term, the government had shrunk even more than the private sector!  Meanwhile, the divide between rich and poor has only accelerated.

A good education has traditionally at least bought us a ticket to the middle class.  However, the middle class has been shrinking at an alarming rate.  We all should be worried, especially because of its implications regarding the lack of appropriate job skills and declining levels of education and literacy in the U.S.

Eventually there will be a backlash to the growing divide between rich and poor, and--lacking either an economic or political solution--it could potentially turn into a violent class struggle, which would be tragic for all of us.  The good news is that it is not too late to do something about it.

There are already hints of a backlash, even in the business community--such as this observation that capital investment and wages have been falling while at the same time, corporate profits have been rising; or this criticism of Walmart employees' low wages.

Here are the author's suggestions:

1.  Understand and discuss the aforementioned issues with your friends.

2.  Vote for politicians--regardless of party affiliation--who are educated, reasonable and willing to negotiate on tax and spending issues...in other words, pragmatists rather than ideologues. Vote for a politician who strongly believes in educating our future workforce and giving them appropriate skills.  Do not vote for any politician who believes in the myth that "big government" is somehow to blame for all our problems, or that lowering taxes on the rich will spur job creation.

Over-population

Americans spend about $52 billion on their pets each year. Meanwhile, each day 21,000 children die, according to the UN. That $52 billion corresponds to about $6800 per child, perhaps 10 times what it would cost to save a child. The silent killers are poverty, hunger, easily preventable diseases and illnesses, and other related causes. Despite the scale of this daily/ongoing catastrophe, it rarely manages to achieve, much less sustain, prime-time or headline coverage.

It is commendable to take action to save lives, and these actions depend on charitable contributions. I fully support such actions, it is our Christian duty. For that matter, it is our fundamental duty no matter what our religion is. To turn a blind eye to this is simply...evil.

However, it is also good to remember that, behind economic, social and environmental causes of tragedies such as this lies a more fundamental mechanism: overpopulation. This is the elephant in the room that nobody wants to talk about. It is a taboo subject. And yet, attempting to solve a problem without regard to its fundamental, root cause is not likely to result in the desired end.

Here's a chart of world population growth:



The Global Education Project's website states that "Directly or indirectly, the human species already captures nearly 40% of the total biological productivity on land and 70% of the productivity of the marine environment - the "net primary productivity" of the planet - for its exclusive use. The rate of increase in human use is about 2% per year."

The effect of overpopulation and unsustainable practices means that "...over the past 40 years, approximately 30% of the world's cropland has become unproductive...90% of the developing world's waste water is still discharged untreated into local rivers and streams."  We are losing biodiversity at an alarming rate, via extinctions due to industrialization and land development.  Also, freshwater is becoming more and more scarce.

Many experts predict that we are nearing (i.e., this century) a massive human and biological catastrophe of heretofore-unheard-of proportions in the history of the world. Similar to previous human catastrophes, it will most likely start with a string of bad weather years or a natural catastrophe (which upsets an increasingly delicate supply/demand balance), and will spiral into famine, mass migration and war, and affect virtually every country on earth.

The poorest and least educated continue to multiply and are often unwittingly aided in this endeavor by well-meaning government programs, non-profit humanitarian organizations and other types of domestic or foreign aid. These organizations often treat a problem such as poverty, sickness and hunger without regard to its root cause. In addition, cultural and religious attitudes, ignorance, sexual discrimination and the poor treatment of women often exacerbate the best efforts of governments or NGO's to promote birth control measures.

Perhaps it would behoove us to rate the desirability of the three main population control mechanisms. Most of us (including myself) would rate them in this order:

1. Voluntary: Education, economic assistance, empowerment of women, government or NGO initiatives to change social attitudes via media messages
2. Punitive and Draconian: Governmental financial incentives and laws enforced to curb population growth
3. Nature's Backup Plan: Starvation, AIDS and other diseases, and murder/war/genocide

Almost anything is better than option 3, yet this is what we're allowing to happen.

Odds and Ends #4

1.  "BOOK REVIEWS":  "Majestie", by David Teems, is a fascinating look at the life of King James (VI of Scotland and I of England) as well as the monumental effort that went into the King James translation of the Bible.  It deals more fairly and sympathetically with the foibles and defects of King James than some other recent accounts, and it provides a fascinating description of the brilliant scholars who translated the bible, and their methods.  It explains the reasons behind the sonorous, poetic, lyrical and majestic tone of this Bible translation in addition to its reasonably good accuracy (at least for its time).  The side notes regarding earlier Bible translators such as John Wycliffe and William Tyndale are also quite interesting.  A must read if you're curious about any of these subjects, or if you just want to read (or listen to) a historical account that makes for an interesting story.

   An autobiographical work by Frederick Douglass, "Narrative of the Life of Frederick Douglass, an American Slave" is a classic, and an eye-opener to the horrors of slavery.  Douglass recounts his life as a slave and his eventual escape from slavery to become a leading abolitionist, orator and social reformer.  Douglass sadly recounted that the most brutal slave masters he encountered were also the most religious.  Perhaps this was an inevitable effect of their hypocrisy and self-deception; i.e., owning slaves and being  "Christians" at the same time, they apparently were more likely to look upon their slaves as subhuman in order to justify their ownership and poor treatment of them, in their own minds.  There was, of course, a powerful economic incentive that warped their thinking--they saw their non-slave-owning neighbors who were dirt poor by comparison.  Asked what it was like to have escaped from slavery, Douglass said "...There is scarcely anything in my experience about which I could not give a more satisfactory answer. A new world had opened upon me. If life is more than breath, and the 'quick round of blood,' I lived more in one day than in a year of my slave life. It was a time of joyous excitement which words can but tamely describe. In a letter written to a friend soon after reaching New York, I said: 'I felt as one might feel upon escape from a den of hungry lions.' Anguish and grief, like darkness and rain, may be depicted; but gladness and joy, like the rainbow, defy the skill of pen or pencil."

2.  "HERETICS":  What did groups such as the Albigensians/Cathars, Waldenses/Vaudois, Wycliffians/Lollards and Hussites all have in common?  First of all, these were names the Catholics gave them; they did not refer to themselves as such.  More importantly, they were all labelled as "heretics" by the Catholics and severely persecuted for centuries; and sometimes even massacred in great numbers.  They refused to adhere to Catholic doctrines and practices that were not biblical.  Since most surviving accounts of these groups were by their Catholic persecutors who saw them as a threat, they were often viciously maligned and their beliefs described inaccurately, resulting in some confusion as to exactly what their beliefs actually were and how much they varied.  Many would, in hindsight, label these groups as having been true Christians and the Catholics as having been the heretics.  In general, these groups believed in making scripture accessible to the people and using it as their authority rather than the pope.

   Wycliffe, for instance, aimed to do away with the existing hierarchy and replace it with the "poor priests" who lived in poverty, were bound by no vows, had received no formal consecration, and preached the Gospel to the people. These itinerant preachers spread the teachings of Wycliffe. Two by two they went, barefoot, wearing long dark-red robes and carrying a staff in the hand, the latter having symbolic reference to their pastoral calling, and they passed from place to place preaching the sovereignty of God.  Thirty-one years after his death, the "Council of Constance declared Wycliffe a heretic and banned his writings, including his English translation of the New Testament. The Council decreed Wycliffe's works should be burned and his remains exhumed and burnt at the stake.  While they were at it, they burnt Jan Hus and Jerome of Prague alive at the stake also, men who had been influenced by Wycliffe.

3.  "MADE BY MAN":  Some people question whether mankind's activity can possibly have any significant effect on our earth.  Can we--by our 7 billion little old selves--really cause global warming and hasten the "end of the world"--changing our weather and climate patterns?  Our response is either "Pshaw!!"  "Perhaps" or "Definitely", often depending on our political persuasion or level of familiarity with these issues.  So what about other signs of the "end of the world"--like, for instance, more earthquakes?  What about (mud) volcanoes?  Or Floods?  Or desertification?  Or mass extinction?  (And to think that all we used to have to worry about was a man-made nuclear apocalypse.)
    3400 years ago, when the world's population was estimated to be a mere 10 million, a desert tribe was commanded to "cover up your poo-poo" (Deut 23:13) and, even during an all-out war, to spare the trees (Deut 20:13-19).   For what it's worth, leaving your poop on the ground and cutting down a few trees is nothing compared to what we are doing to our environment today...and we could end up being the losers for it if we're not careful.

4.  Of all the thousands of news articles regarding the George Zimmerman case, these three articles about the prosecuter, a court employee and the news media are most instructive.

Odds and Ends #3

1.  The oxymoron "self regulation" is interesting.  It would be deemed ridiculous as applied to chemical companies, big pharma, nuclear energy, or the airline industry.  However, there are still many who decry excessive government regulation and believe that Wall Street is capable of self-regulation, as Bernie Madoff once argued.


2.  The author predicts that thermoset plastics and Thermoplastics--both employing carbon fibers--will become the next big thing in automotive technology, making cars lighter.  I hesitate to say this--I was originally quite skeptical--but I suspect that in another 5-10 years, we will will gradually go to an "ammonia economy" using fuel cells and electric motors.  Liquid ammonia poses fewer technical  and cost challenges than hydrogen in terms of use and storage, and hydrogen is easily converted to ammonia and vice versa.  A better, less expensive battery technology could still thwart this trend, though.

3.  Here is an article that makes a compelling argument that Quantitative Easing (QE) actually costs jobs.  A company enjoying loans at near-zero interest rates is more likely to make big capital expenditures--which impact cash flows only slightly--rather than hiring more people--which make a much bigger negative impact on cash flows.  Therefore, QE ends up spurring capital investments, automation (to replace workers), capital investment in low-wage countries, and merger and acquisition activity.  Also, QE costs jobs that would otherwise be created by higher interest income levels and the resulting consumer spending.  Finally (and this is my own opinion), extremely low interest rates are also fueling stock buybacks that, again, primarily benefit the rich and do nothing to spur hiring.  If our unemployment rate is inching down, it may be in spite of quantitative easing.  The article ends with these conclusions:  

"...it is well-documented that quantitative easing increases inequality.  Quantitative easing doesn't help Main Street or the average American. It only helps big banks, giant corporations, and big investors.  Too much inequality causes economic downturns and decreases aggregate consumer demand ... and companies fire workers when demand decreases.  So quantitative easing also indirectly - but in a very real fashion - destroys jobs by destroying consumer demand."

4.  Here's my quote for the month, by Edward Gibbon (author of "Decline and Fall of the Roman Empire):

“The five marks of the Roman decaying culture:
Concern with displaying affluence instead of building wealth;
Obsession with sex and perversions of sex;
Art becomes freakish and sensationalistic instead of creative and original;
Widening disparity between very rich and very poor;
Increased demand to live off the state.” 

The Quality Guru We Ignored (2012)

Okay, here's yet another blog post that I wrote last year but didn't bother to publish.  Another item in my garage sale of ideas that I couldn't bear to just throw in the trash...   :-)



At Toyota’s headquarters, there is a framed photograph even larger than that of the founder of Toyota, Kiichiro Toyoda.  "Who would that be?" you might ask.  Who?  A man who originally was born and reared on a chicken farm near Sioux City, IA.  This man's business philosophies revolutionized Japan.   His business and quality processes transformed a country once known for producing cheap junk.   In turn, this resulted in a relatively small island nation with almost no natural resources becoming the 2nd (now third) largest economy in the world.  To this day, he is revered in Japan.  His name is W. Edward Deming.

As the worlds first and foremost quality guru, Deming was largely unknown and unrecognized in his own country, even after he moved back to Washington DC and set up shop as a consultant. In 1980, he was featured prominently in an NBC documentary titled If Japan can... Why can't we? about the increasing industrial competition the United States was facing from Japan. As a result of the broadcast, demand for his services increased dramatically, and Deming continued consulting for industry throughout the world until his death at the age of 93.

But how seriously did we really take Deming's advice in the U.S.?  Here are Deming's 7 deadly sins, from which you can judge for yourself:

The "Seven Deadly Diseases" include:

1. Lack of constancy of purpose
2. Emphasis on short-term profits
3. Evaluation by performance, merit rating, or annual review of performance
4. Mobility of management
5. Running a company on visible figures alone
6. Excessive medical costs
7. Excessive costs of warranty, fueled by lawyers who work for contingency fees

The answer is obvious:  not very seriously.  We had our own individual-focused, prima donna management culture, and it was not going to change.  Since Deming, many more management consultants have come and gone, but Deming's work still strikes me as the most controversial and daring broadside to the traditional American way of doing business.  And yet, we know it works.  He proved it.  Today we have lots of additional ideas and concepts in continuous improvement, the most common being 6-sigma, Kaizan, TQM, Lean, etc.  These are great tools, but they stop short of a higher objective--that of challenging the very fundamental culture of the company.  As a result, some companies that use, for instance, 6-sigma, are very successful where others are failing.  It's not 6-sigma, it's the culture.

Perhaps companies have largely ignored Deming because some of his recommendations are "too hard" or just "not practical".  Take merit pay, for instance.  GE had been using merit pay and also firing the bottom 10% of their workforce every year, and they seemed to do very well--at least from the viewpoint of an outsider.  Of course, this practice at Enron produced "ruthlessness, selfishness and greed" and ultimately did the company in. 

Merit pay doesn't sound controversial, it just makes sense, right?  So was Deming crazy?  It stands to reason, for instance, that merit pay ought to improve the quality of our educational system.  Or not?  Here are a some interesting articles that discuss this.  Here are some arguments against merit pay of teachers, and here's another similar argument, and another.  Deming felt that merit pay discouraged teamwork and collaboration and promoted short-term, me-first thinking.  Another article regarding the pitfalls of merit pay cited an insufficient difference between merit pay for high/low performance, and a lack of a clear concept by the employee as to exactly what/when/how he needs to do a task (as an individual) to merit the pay increase.  Not to mention, if this is already in his job description and goals, where does merit pay fit in?  Merit pay is not a substitute for a manager taking responsibility for coaching and guiding his employee.  As Deming would say, it's at least partly the manager's fault if the employee is not performing.

Items 2, 4 and 5 on Deming's list of 7 deadly sins are also especially relevant, and are a problem with many companies who hire "quick turnaround artist" CEO's with business degrees and little technical background.  Item (1) is a problem with many companies that hire new CEOs who desire to make a legacy (or at least a quick profit) by buying another company, rather than "sticking to their knitting" and growing organically.  Some companies are better than others at reigning in healthcare costs (6) through innovative, proactive, incentivised company programs.  And many U.S. companies have finally taken reliability and warranty costs (7) seriously.  We've made slow progress on some of these items.  On others, we've failed, and the corporate culture of greed--especially among top executives--is at least partly to blame.

Drug Abuse (2012)

This is another example of a blog post that I created nearly a year ago but did not bother to publish.  Just in case you are interested in the problem of drug addiction, you might find some of this interesting, if a little dated.


After reading an article about drug addiction, my interest was piqued, so I did a little digging on the subject.  I have never used illicit drugs and do not intend intend to.  However, I found this exercise to be somewhat illuminating, at least from a psychological standpoint.

Here are some conclusions that I came to.  They are not the conclusions of an expert.  Don't mistake this for the advice of a professional.

--The U.S.'s war on drugs--at least in its present form--has been the most disastrous of all our wars.  The Obama administration quietly (and wisely) has begun to change course.
--The pharmaceutical industry is unwittingly a big part of the problem.
--Legalizing drugs will not stop drug abuse, any more than legalizing alcohol stopped alcohol abuse.  But our current approach is not working, and is instead turning our prison system into a training ground for criminals.  It's also ruining lives of people who do not have (or did not have) a serious drug addiction problem beyond cannabis.
--Some rehab programs are far more successful than others.  It's not necessarily a hopeless situation.
--We may be able to learn a lot by examining the different drug policies of other countries.




MOST DANGEROUS ABUSED DRUGS IN THE WORLD

Based on overall societal harm--i.e., lives lost--alcohol and tobacco are the most harmful drugs on the planet.  This is in large part due to the fact that their legality, availability and cultural acceptance makes them widely used.
Based on a weighted average of (a)  impact on society, (b) addictive property and (c) individual harm, someone has compiled this list of the worlds most dangerous drugs, in order of most to least dangerous.    Not surprisingly, alcohol and tobacco are on this list as well.  Of course, there are other drugs not on this list that are very dangerous but not (yet) widespread.

Cannibis is documented to be the least dangerous drug.  Supposedly, no one has ever died purely from overdosing on pot or using pot.  Compare this to the millions who have died from health problems or overdose problems or accidents traced directly to alcohol or tobacco.  On the other hand, due to its illegal status--and thus its social link to more dangerous illegal drugs--it often serves as a "gateway drug".

Here are some examples of some really bad drugs not on this list:

"Bath Salts", a "legal" fake meth, has recently been in the news because of cases where its users became completely psychotic.  Another "legal" drug, fake marijuana, ("K2" or "Spice"), sold as incense, is proving to be much more addicting than marijuana.  While not as dangerous as some other drugs, its availability and the misconceptions around its addictive nature make it far worse than cannabis.

There are medical reasons why Methamphetamine has been labelled one of the world's most dangerous drugs.  However, Krokodil, a home-made form of of fake meth used in Russia by people who can't afford Heroin, may be even worse, as discussed in this documentary,

Fentanyl is a form of "fake" heroin, but it is about 75 times more potent, and as a result, many more drug overdoses are seen in many parts of the U.S.  A combination of heroin and fentanyl such as "cheese" has resulted in many deadly overdoses.

As an aside, some drugs are mis-used for criminal purposes rather than to "get high".  Think GHB (the date rape drug) is bad?  It's nothing compared to Scopolamine or "Devil's Breath", used by criminals in Brazil to "hypnotize" their fully-awake but amnesiatic victims.  Scopolamine is easily obtainable in Brazil and it has a long and dark history.  It was also once used as a truth serum.  Like many abused drugs, scopolamine has some legitimate medical uses, such as minute amounts used to treat sea-sickness and motion sickness, to prevent nausea after anesthesia and surgery, to treat the tremors in Parkinson's disease, and even to treat depression in some patients.




DRUB ABUSE STATISTICS

Drug Use Facts
Main problem drugs, by country
Addiction rates of various drugs
Prescription Drug Overdoses by State
International U.S. Policy Objectives Survey
Age distribution of Treatment Admissions for Various Drugs





THE WAR ON DRUGS:  DIFFERENT COUNTRIES' POLICIES

U.S.
1.  Drug production, possession, sale, transport and use of all drugs--both hard and soft--is illegal and subject to incarceration.
2.  U.S. represents 5% of world population but houses 25% of worlds prison inmates
3.  500,000 incarcerated for marijuana use, out of a total of 2.3 million inmates (22%)
4.  Philosophy:  Illegal drugs are a crime problem, not a public health problem

Netherlands
1.  Production, possession, sale, and transport of drugs is illegal, with the exception that small amounts of soft drugs (i.e., pot) are legal to have in possession, to grow, to sell and to use
2.  Actual use of both soft (i.e., cannabis) and hard drugs is legal
3.  While growing larger amounts of cannabis is illegal, enforcement of this is not a priority
4.  Philosophy:  Help addicts rather than incarcerate them; make a clear distinction between pot and hard drugs; focus on harm reduction more than enforcement.

Other countries with drug policies worth comparing (good and bad):  Portugal, Spain, Russia

A British News Article Detailing the U.S.'s Disastrous War on Drugs (2010)

Obama Administration's New Drug Control Policy Reform (2012)

NEUROBIOLOGY AND PATHOLOGY OF ADDICTION

Alcohol and Drugs
Neurochemistry of Relapse and Recovery
Is Addiction a Disease?
Gambling, also this and this and this
Video Game Addiction, also this
Internet Addiction
Food Addiction, also this and this
Sugar and Obesity
Addiction to money (not neurobiology, though)




WHY DO PEOPLE START TAKING DRUGS?

   1.  A person wants to escape from his troubles (i.e., war, poverty, bad memories, dysfunctional family, personal problems and fears, etc.), and/or may have an addictive personality or even an existing mental disorder that makes him more vulnerable to the use of drugs.
   2.  Or sometimes, the person is a happy, intelligent, upstanding, nice person from a good family who just decides one day to try a drug just once to see what it feels like to "get high", perhaps just out of curiosity or for the sake of a new adventure.  The person has absolutely no intention of continuing to use it or of getting hooked on it.  They just want to find out what the feeling is like.
   3.  The drugs are legal--so the person figures they're safe to try.  (But even drugs like tobacco and alcohol can be more addictive than some illegal drugs; not to mention, being the #1 and #2 killers.)
   4.  The person is prescribed painkillers like vicodin and oxycontin, or perhaps prozac for depression, and they (or someone else) now have them in their possession.  From that point, it's very easy to pop another leftover pill just to duplicate that good feeling they might have experienced, or for another family member or friend to do so.  This is a huge problem.  There are now more deaths by overdose from these drugs than from cocaine and heroin combined.
   5.  They are easy to obtain.  This includes prescribed and over-the-counter pharmaceuticals or "disguised" drugs and many street drugs such as Marijuana.  Combine this with rebellion, boredom, curiosity, or peer pressure.
   6.  Proximity to drug use (i.e., at a party or with friends) combined with peer pressure and curiosity, especially for adolescents, who are more likely to take risks.
   7.  Branching out from alcohol or marijuana with the intention of getting an enhanced buzz.
   8.  Self-medication for pain, stress, depression, etc. with marijuana, alcohol, other drugs.  The likelihood of taking the drug and subsequently getting addicted is even greater if the person has an existing mental illness such as depression or bipolar disorder.
   9.  A common perception is that people try drugs because they are weak, have low morals and are lazy, trashy, angry, rebellious, impulsive, unsociable, unintelligent, non-conformist types who want the reward of  "feeling good" without having to earn it.  This perception may contain a grain of truth in some cases, but in the vast majority of circumstances it is actually a perception of what people inevitably become like after they have already become addicted to drugs.

Nobody ever plans to get addicted to drugs--he or she wants to try a drug "just once".  And even after becoming psychologically addicted, the person still tells himself that he is not in danger of becoming addicted--until it is too late.

The following description of a user's experience with heroin addiction (taken from a discussion board) may be illuminating and in many ways typical of drug addiction:

   "Heroin initially makes you forget all your troubles, it makes you feel content and happy, even if prior to use you were borderline suicidal. It takes the user, wraps him up in this safety blanket, and allows everything to be nice again, no matter what.  Therefore, if you're--say--suffering from depression, and then try heroin, you're going to have a hard time staying away.
   Look at heroin addiction around the world. It's available almost everywhere, but where does it remain? In the first-world middle classes? Rarely.  In working-class neighborhoods where life is tough, quality of life is low? In countries ravaged by war? In countries ravaged by poverty?  Massively.
   Now, although heroin appeals especially to people who have things they want to escape from, either physically or mentally, it is also enjoyable no matter who you are.  It is extremely psychologically and physically addictive.
   Long before a physical addiction has built up, while the user himself still feels 'safe' from addiction, a psychological addiction is already festering.  And it is this which tricks your mind into taking heroin a day before you said you would, or to 'reward' yourself for something -- anything!  Usage spaced by months becomes weeks, by weeks, becomes days, and suddenly, you're using every day.
   Once physical addiction takes hold, which again is relatively rapid, the user is no longer using for that high.  In fact, the high is dramatically lowered, once the 'honeymoon' period with heroin use is over. Instead, the user is using because he is both physically and psychologically unable to function without heroin. It is this need which turns junkies from individuals, into the stereotyped addict, who engages in nearly any activity in order to get his next dose."



IS THERE A PARTICULAR "GATEWAY DRUG"?

Marijuana is often described as a "gateway" drug to eventual use of harder, more dangerous drugs.  Cannibis is supposedly only about as addictive as caffeine, and there's little biological or chemical evidence to directly implicate it as a gateway drug.   However, there are compelling reasons why pot really does serve as a gateway to hard drugs nonetheless, whether for psychological, neurobiological or social reasons.

Are there other "gateway drugs"?  Many experts claim that tobacco and alcohol deserve the title even more than Marijuana.  Compared with lifetime nondrinkers, adults who have consumed alcohol were 26 times more likely to use cocaine, 14 times more likely to use cannabis, and 13 times more likely to use psychedelic drugs.  And those who started smoking tobacco by the age of 12 were 26 times more likely to start using cannabis or other illicit drugs by age 17.  A typical progression is smoking, drinking, cannabis, and finally, harder drugs. Prescription drugs (often very dangerous by themselves) also can become "gateway drugs"--for example, painkillers like Vicodin and Oxycontin as well as inhalents.  And finally,  "legal" disguised drugs like "K2" and "Bath salts" are probably becoming "gateway drugs" as well, due to their easy availability.

Nevertheless, marijuana is the drug still most often cited as a "gateway drug".   This is because it is easy to find, most likely to be first introduced by a friend at a party, and often peddled by the same people who peddle the more dangerous hard drugs--due to its illegal status.  And most people know Marijuana is supposed to be relatively harmless--ironically, this makes it even more likely to become a gateway drug because people are less afraid of it.  Some argue that legalizing pot would mostly eliminate it as a gateway drug since it would then be more socially isolated from peddlers and users of harder illegal drugs--this is a topic of controversy.

People typically first start using drugs when they are 11-20 years old, when peer pressure is a major factor, and when the "wiring" of a person's brain for critical thinking and risk avoidance has not yet been fully developed.  Tragically, continued drug use then prevents this important brain circuitry from being fully developed.  Instead, a strong memory pathway connecting drug use and the feeling of pleasure is established, that supersedes everything else.

One final tidbit:  Some people suggest that sugar is the original gateway drug.  Gateway theory suggests that, all other things being equal, an adolescent who uses any one drug is more likely to use another drug.  Considering the similar neurobiological effects of sugar, some have suggested that sugar is actually the very first gateway drug, leading to food addiction (and obesity) or to drug or alcohol addiction.  A study on lab rats seems to further support a link to later alcohol addiction.  In addition to this, excessive childhood consumption of sugar shows some correlation to violent behavior in later life.  This study does not prove a direct cause-and-effect relationship; in fact, one might find a whole host of things that are correlated and which would prove difficult to sort out.  For instance, there is likely to be a correlation between dozens of different negative factors, i.e., drug abuse, poverty, IQ, violence, child neglect or abuse, alcoholism, crime, etc.

There are most likely many different pathways to drug addiction.  No one substance, behavior or personality trait can carry all the blame for someone starting down this road.  Instead, a certain "balanced" combination of nature and nurture ingredients is likely to be required in order for a person NOT to be prone to addiction--reminiscent of Tolstoy's quote that while "happy families are all alike, every unhappy family is unhappy in its own way."  Finally, there seem to be many cases where a person may be intelligent, may come from a privileged home and good parents etc., and yet still become addicted to drugs.  This supports that idea that--for better or worse--chance circumstances may have a bigger role in shaping people's lives than we might imagine.

THE PHARMACEUTICAL INDUSTRY AND DRUG ADDICTION

The pharmaceutical industry has saved many lives, and is one of the miracles of the modern world.  However, just like some other industries, it has its dark side.  Based on the statistics and facts listed below, you can determine for yourself to what extent this industry has spawned the problem of drug abuse.

Here are some alarming statistics from the CDC regarding addiction to prescription drugs:

--In 2010, about 12 million Americans (age 12 or older) reported non-medical use of prescription painkillers in the previous year.
-- Enough prescription painkillers were prescribed in 2010 to medicate every American adult around-the-clock for a month. Although most of these pills were prescribed for a medical purposes, many ended up in the hands of people who misused or abused them.
--Prescription painkiller overdoses killed nearly 15,000 people in the US in 2008. This is more than 3 times the 4,000 people killed by these drugs in 1999.   There are now more deaths by overdose from prescription painkillers than from cocaine and heroin combined. 
--Nearly half a million emergency department visits in 2009 were due to people misusing or abusing prescription painkillers.
--Nonmedical use of prescription painkillers costs health insurers up to $72.5 billion annually in direct health care costs.
--The quantity of prescription painkillers sold to pharmacies, hospitals, and doctors’ offices was 4 times larger in 2010 than in 1999.
--Many states report problems with "pill mills" where doctors prescribe large quantities of painkillers to people who don’t need them medically. Some people also obtain prescriptions from multiple prescribers by "doctor shopping."

Here are some additional statistics compiled by the woman behind Confessions of an Rx Drug Pusher.  (This link has some fascinating videos with additional information.)

--The U.S. represents 5% of the world's population, yet we take 70% of the worlds pharmaceutical drug prescriptions.
--More U.S. soldiers have returned from Iraq and then died as a result of prescription drugs than died in the war.
--The U.S. and New Zealand are the only two countries in the world who allow direct advertising by the pharmaceutical industry.
--Sloppy handwriting is the cause of 7000 patient deaths each year, while preventable medication mistakes hurt 1.5 million people.
--At least 106,000 people die each year from adverse drug reactions.
--These medical errors and deaths are equivalent to 6 jumbo jets falling out of the sky each and every day...the only difference is the media coverage--there are no public displays of grief for those who die of faulty medicine.
--A mere 6% of all listed adverse drug reactions are actually identified in practice.  Most side effects are instead mistaken for new disease symptoms, leading to further drugging and unnecessary medical procedures, increasing the risk of death even further.
--The mortality rate for people between the ages of 45-64 who took their prescription drugs correctly, rose 90% in just 5 years.
--In 2001, Pfizer was the most profitable Fortune 500 company in the world, with $7.8 billion in profits.
--In 2002, the profits from the top 10 drug companies comprising the Fortune 500 exceeded the profit of the other 490 companies.
--More than half of the U.S. population received unnecessary medical treatment--that's about 50,000 people per day.  Forty-two percent have been directly affected by a medical mistake, from a procedure or drug, and 84% of our population personally know someone who's been a victim of a medical error.
--The American medical system is the #1 killer in the United States.  The deaths, caused by conventional medicine, in just one decade, equate to approximately 8 million.  That's more than all the casualties from all the wars America has fought in its entire history.
--In 2006, healthcare spending reached $2 trillion, far more than most other developed countries per capita.

Here are some issues with the pharmaceutical industry that I personally find troubling:
   For profit reasons, U.S. drug companies have made a concerted effort to prevent drug re-importation, when in fact, it is safe.  (from Confessions of a Healthcare Hitman)
   THC, the active ingredient in Cannabis is known to have many medicinal properties; it is as addictive as caffeine, and no deaths have ever been linked to its use.  In some cases, it can do the job of a half-dozen potent pharmaceutical drugs but with none of the harmful side affects or addiction potential.  The pharmaceutical industry does not like cannibis.  They promote the idea that it has no medicinal value...that is, unless they can patent derivatives of it and make lots of money.  If doctors were able to prescribe marijuana (or its active ingredient, THC) and pharmacists to dispense it, this would supposedly lead to an "epidemic of prescription drug abuse"--but this is already happening with existing prescription drugs, which are far more dangerous and addicting than marijuana.  More likely, what would really happen is that drug company profits from dozens of these existing, more dangerous and less effective drugs would decline.
   A problem with prescription of drugs for depression and a host of other mental illnesses is that there are usually no specific biological tests the psychiatrist can use to diagnose these illnesses.  Rather, diagnosis is based on interpretations of the DSM (psychiatric diagnosis) manual--a manual which is facing increasing criticism and the accusation that it is not based on good science.  This naturally results in inconsistent or even false diagnoses, especially when a psychiatrist is afraid of getting sued later on if he doesn't come up with a specific diagnosis and prescription, and then something bad happens later on with the patient.  Result?  More  psychiatric medications are prescribed, even if the patient is lying about his symptoms in order to get the prescription.
  Most prescribed drugs do not "cure" people of mental disease, but only mask the symptoms.  Once someone gets started on a drug regimen, they may stay on it for life.  Drugs often lose their efficacy over time, and dosages must be gradually increased or changed.  Finally, drug side affects present the doctor with an opportunity to prescribe yet more drugs.  This is profitable (and therefore acceptable) for the drug companies and their researcher scientists, as they naturally "follow the money".
   Another problem is that drug companies pay doctors, who are influenced to prescribed particular medicines, also described here.  Follow the money.
   Drug companies spend a gargantuan amount on marketing and administration...and when they do their clinical trials, they generally do NOT have to compare their new drugs with existing drugs or with the best standard treatment--but only against a placebo.  This means that "recycled" and trivial "me too" drugs dominate the market of new drugs.  Only a small percentage of new drugs introduced represent actual improvements over existing drugs.  This adds to their profits but doesn't benefit anybody else in the process.
   Some companies engage in drug profiteering based on shortages.  Often this is indirectly related to ballooning purchases of drugs used for street purposes, causing the DEA's approved production numbers to be inadequate.  Other reasons include quality issues or lack of profit due to generic drugs.  This seems inexcusable if it is a consequence of sloppy, inefficient production management coupled with a monopoly on the manufacture of certain drugs.
   There are usually alternative treatments for any specific problem, but these are rarely considered by a doctor if he has a drug purported to be specifically for that ailment.  Rather than deal with the complexities and review all the possible sources of and best solutions to a problem, it's easier and quicker (and perhaps less risky for the doctor) to just prescribe a popular drug.  For example, while Ritalin has arguably been a relatively effective "solution" for millions of ADHD sufferers, there nevertheless exist alternative treatments for ADHD that may be more effective or have fewer side effects.  (See Overview, Neurofeedback, Cannabis, TM, Natural medicine, L-theanine, Non-western diet, Omega-3s, PhosphatidylSerine plus Omega-3.)  Ritalin addiction is on the rise, and its use with alcohol can often be deadly.
   An increase in medication given to children accompanies the dramatic increase seen in chronic childhood illnesses and diseases like ADHD, autism, asthma, eczema, obesity, type I and II diabetes, etc.  One may question whether there is a possible connection to environmental toxins and their epigenetic effect, childhood vaccinations, antibiotic usage, processed food diets, or some other underlying factor whose understanding may lead to a better solution than today's prescription drugs.  For the drug companies, though, drugs are the only answer, and the power of money ensures that it stays that way and that no research is done beyond finding a new "blockbuster" drug to mask the symptoms.  Also, little is known about the long-term affects of some widely prescribed drugs given to children and their effect on brain development and overall health.
   Most dangerous and addictive drugs are either a direct or indirect result of the pharmaceutical industry.  Any technology can be used for good or evil.  However, the addictive aspect of many of this industry's products, and its effect on the human brain, has increased the potential for biological and societal harm.
  So who makes money off other people's addiction?  Casinos, stock trading companies, video game developers, producers of porn, illegal drug rings, drug dealers, private companies running prisons and...and...pharmaceutical companies.  The drug companies profit from the drugs whether they are used for legitimate purposes or not, and the necessarily tight control of some drugs guarantees they will be expensive. Even when used for legitimate purposes, a drug used long term and whose dosage may need to be increased over time results in the same kind of profit stream associated with illegal addictive drugs.

IS THERE A RELATIONSHIP BETWEEN DRUG ADDICTION AND MORAL CHARACTER?

Temptation often leads to addiction.  What does the Bible say about temptation?  Some might believe that turning our drug problem into a "moral" issue is inappropriate.  However, some of the most successful drug rehab programs use principles from the Bible--especially the avoidance of temptation.  Susceptibility to temptation is certainly one aspect of the drug problem, so we should understand it.

Here is some ancient wisdom from the Bible regarding temptation, addiction and recovery.

It is important to instill self-discipline in a child:
   "Surely I have behaved and quieted myself, as a child that is weaned of his mother" (Psalm 131:2)
   Don't withhold correction from a child (Proverbs 22:15; 23:13; 29:15; Eccl 10:16)
   "Train up a child in the way he should go..."  (Proverbs 22:6; Gal 4:1-2)

Certain character traits can increase the risk of being tempted and falling prey to an addiction:
   Lack of firm convictions (Luke 8:13)
   Lack of self discipline (2 Timothy 2:21; John 15:2; Psalm 1:15; 119:101; Proverbs 1:15; 1st Peter 3:10; Jer 14:10;
   Laziness and perversity (Proverbs 22:5)
   Criminal tendencies (Psalms 9:16; Proverbs 29:6)
   Susceptibility to others' influences (Proverbs 29:25)
   Tendency to associate with a bad crowd (Proverbs 13:20, Psalms 1:1)
   Rebelliousness (Proverbs 14:16; 15:20)
   Lack of morals or conscience (Proverbs 14:9,12,16; 2nd Peter 2:12-14)
   A tendency toward strife (18:6-7)
   Selfishness (Gal 6:7-9, Eph 2:3)

Certain universal temptations can also lead to addiction, perdition and self-destruction:
   Pursuit of money and power (Proverbs 23:4; 28:22; Eccl 2; 1st Tim 6:10-11)
   Pursuit of pleasure (Eccl. 2:1-2; Proverbs 21:17; Luke 8:14)
   Alcohol (Proverbs 23:20; 23:35)
   Illicit sex (Proverbs 23:27, Eccl 7:25-26, 1st Cor 6:18)

A temptation cannot be overcome.  It can only be avoided.
   Flee from temptation (1st Cor 10:14, 2nd Tim 2:22, 1st Tim 6:11, 1st Cor 6:18)
   A prayer to avoid temptation.  (Matthew 6:13)
   Your good intentions alone are not enough to avoid temptation. (Matthew 26:41; Romans 7:17-26)
   God provides a way to escape temptation. (1st Cor 10:13)
   Temptation occurs when you turn your attention to a particular thought or memory--instead, fill your mind with other, good, healthy thoughts.  (Proverbs 24:9; James 1:13-15; Phillipians 4:8; Proverbs 6:18; Gen 6:4-6; Isaiah 55:7; Phil 3:13)

Information, understanding, wisdom and the fear of God give you power to avoid the temptations that can trap you and cost you your life (Proverbs 1:4,7; 4:5-7; 7:4-27, 13:14; 14:27; 24:4,5)

Additional advice for recovery of an addict:
   If someone is overtaken in a fault, it is your responsibility to help him, in a spirit of meekness.  (Galations 6:1)
   You will greatly increase your chances of succeeding in your battle if you first seek (and heed) wise advice from multiple counselors.  (Proverbs 12:15; 13:13-14; 24:6)
   A good person keeps getting back up when he falls.  (Proverbs 24:16)




MOST SUCCESSFUL DRUG REHAB PROGRAMS IN THE WORLD

It would be great if more effective drugs were developed to aid in the recovery of an addict.  Such efforts are, indeed, being pursued.  In the mean time, one might ask "what are the characteristics of a successful drug rehab program?"

Before discussing this, it's important to understand the neurobiology of addiction:

Neurobiology of Addicton for Dummies -- This is a very helpful, easy-to-understand  presentation
Stanford Marshmallow Study
Self Control, Addiction and Brain Differences
Learning to juggle grows brain networks
Le Mont Michael Expectations
Le Mont Michael Policies
10 Tips for 1st year of Recovery
Drug based "cure" for alcoholism in rats

The San Patrignano treatment center in Italy is one of the most successful drug-free approaches to drug treatment in the world, advertising a 72% success rate for those staying at least 18 months.  The St. Jude Retreats have a relatively high success rate of 62%.  Note that these percentages are based on particular assumptions, so they cannot be compared on an apples-to-apples basis.  These are just two examples of good treatment centers.  (Note that many treatment centers advertise high success rates, but cannot point to any independent studies to confirm it.  Also, some drug treatment centers are a disguised racket; for example, a cursory review of this program might look impressive until you read this. )

These success rates compare to an industry average of between 16-20%, with the majority of drug abusers relapsing.  So is there something that these rehab facilities are doing differently that accounts for this relatively  high success rate?  Here are some clues:

1.  None of these programs use the AA-derived 12-step program, and they do not psychologically "break down" their clients.  The well-intentioned (but poorly performing) 12-step program uses a watered-down "piece" of religion as a "tool" to kick a habit, whose participants often enter the program as an alternative to jail time.  These are often people with limited commitment and who have no real interest in changing their lifestyle, beliefs or their way of thinking, beyond just this one particular habit.  People typically drop out of the 12-step program before a year is up, not really seeing it as something they need or want to do for multiple years, much less seeing it as part of a religion to be practiced all their lives.  The program also tends to scare people away unless/until they're desperate.  (This criticism does not generally apply to Christian drug rehab programs, just to the 12-step program.  And despite theological, psychological and and practical problems, even the 12-step program does have some good points.)

2.  These programs are typically MUCH longer than the typical 30 days--more like 3-18 months or more.  Most drug treatment programs are 30 days in length, because that is what insurance companies will pay for.  In general, the success of a drug treatment program appears to be roughly proportional to the time length of participation.

3.  These programs typically take the client completely out of his former negative environment to a new, sheltered community.  It is important that the former addict give up his old identity and culture--and often, this means giving up his old druggie friends, his old personal appearance, his old thinking patterns, etc.  Then afterwards, the best success is often achieved when the person does NOT go back to the same environment he came from--perhaps moving to a different location, etc., to be away from his old influences, and to start a new career with the new job training and coping skills he has gained.  These programs also typically provide ongoing support and reassurance that help is still available for him if/when he needs it--in other words, an effective relapse prevention program.

4.  These programs do not treat alcohol as a chronic disease, believing that this just allows people to feel like victims.  This bucks the conventional wisdom, at least in terms of how the residents are treated.  For instance, the San Patrignano philosophy is that drug abuse in not a disease of the body, but "a disease of the soul"--and it is not a chronic disease, even if it is a recurring one.  The St. Jude programs call the "disease of addiction" model a sham, and do not believe in labeling "regular problems" as diseases and disorders.  These programs are based on the assumption that it really is possible to stop taking drugs.  Complete sobriety is the goal, regardless of what drugs were taken.  Based on this assumption, the programs do not use drugs (beyond initial detox) as part of their treatment.  (It may seem shocking, but success with drug abuse recovery has been--in general--so dismal that many professionals have developed the defeatist opinion that drug addicts are unrecoverable and the objective is merely to improve the quality of life of those who continue to be drug addicts.)

5.  These programs typically are NOT focused on the drug abuse, and do NOT label their residents as drug abusers.  Instead they address issues that made the person vulnerable to drug abuse in the first place.  The founder of the San Patrignano community described it as follows:  “Among the problems that affect the drug addict, drug use is the least relevant.  The core of the problem is not drugs, nor the abstinence crisis: it is the human being with his fears and the black holes that threaten to suck him in. That is why I do not like to say nor hear that ours is a community for drug addicts. Ours is a community for living, where you can restart after years spent as a social outcast. Ours, if we really need a definition, is a community against social marginalization.”  The San Patrignano community provides continuing studies as well as job training and social re-integration as a key part of their program.  An educational and social approach based on compassion and empowerment that teaches life skills is typical of these programs, rather than a medical or drug-based approach.

6.  These programs seek to provide the client with new interests and new friends, and to give his life new meaning, while keeping him busy with "normal" activities that are nevertheless physically and mentally challenging, that encourage him to try new things and challenge himself, activities that boost his self confidence, self reliance, self-control and his sense of responsibility and accomplishment.  Education and job training are also critically important.  If, upon leaving rehab, the client is still not employable, and/or has not developed new interests and found new purpose and meaning in his life, he is in danger of becoming bored or depressed--and this is the surest way for him to have a relapse.





HOW TO IDENTIFY A DRUG USER--typical characteristics

There are many clues that suggest someone MIGHT be a substance abuser.  These included behavioral clues, psychological/spiritual clues, personal grooming and physical appearance clues, clues based on characteristics of family and friends, and health symptoms.

Here are some URL links that list identifiable characteristics of a substance abuser:
1.  Typical characteristics of a substance abuser
2.  Seven psychologica/spiritual characteristics of functioning alcoholics
3.  Identifying a drug abuser in a waiting room or at a pharmacy counter
4.   Characteristics of drug inhalers

Beside the more obvious clues, sometimes even the most seemingly unrelated characteristics or events can serve as clues for drug use; i.e., someone who mistreats animals or has a pit-bull chained in his yard, or, if your child is on drugs, missing teaspoons from your kitchen drawer, missing money or valuable items from your home.  Multiple tattoos are often an indicator of deviant behavior, including drug abuse.  Body piercings, sagging pants, side-ways worn baseball caps and spiked hair can also be hints that a person is associated with a drug culture.  Even a preference for rave music, techno music or certain types of dance music can be a strong indicator of drug use, as well as pop or punk music whose lyrics have references to pot.  Hip hop / rap, techno, R&B and reggae music is often associated with a whole range of drug and alcohol abuse.  Even country music has some association with alcohol abuse, although it is not a strong link.

Perhaps some of the strongest indirect clues for long term drug addiction--and the most tragic--are poverty, joblessness, homelessness, loss of friends and social support, loss of self respect and morals, anti-social or deviant behavior, and depression.