UPDATE: New York State goes after the Sackler family's opioid fortune, claims they funneled their Oxy millions through offshore laundries

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Sometimes, in relatively rare cases on the left, they are the same. But not with the vast majority or liberals and progressives who use the imagery – including @doctorow

Really, right-wingers who support the death penalty are posting cartoons of specific African-Americans and Muslims and Jews with their heads in nooses and you’re worried that an anti-death-penalty/pro-regulation progressive like Cory posting these guillotine cartoons is what’s currently normalising political violence? Yes, we’ll have to agree to disagree about where you’re expending your time and effort on this matter.

[Apologies to all for the derail. I’ll end it there, and perhaps @orenwolf might prune this off on its own topic so we have a central reference thread for people expressing concern over BoingBoing’s use of the guillotine imagery.]

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Your added paragraph is precisely the phenomenon I was pointing to above which I reject. You and I have the ability to walk and chew gum at the same time, and both of us are able to think critically about things in their contexts and recognize differences in degree and kind. I’ll leave it there as well.

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There’s a subtext for the alt-right: we will fight back.

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I’m a big fan of and have worn clothing with this image:

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Do I contradict myself? Very well, then I contradict myself.

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It’s a visual reminder;

History

Don’t start none, and there won’t be none.

Start some shit?

Then expect to get ‘some’ shit back, and then some.

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This made sense to me, since the Sacklers almost single-handedly created this opioid crisis. But I see that the Sacklers’ representative has strongly denied the allegations.

So I guess that’s it, then. If he had just denied them, I’d say he was merely a paid mouthpiece making whatever claims would exonerate his clients, in a cynical take on our adversarial legal system. But he strongly denied them.

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The Oklahoma “fix” was likely cheap. New York, though? I’d guess that $1B would be nothing for the Sacklers to absorb… especially if it kept complicit family members out of jail. Correction: Out of Club Fed

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So if it was only 100,000 or 50,000 or 40,000 attributed to them, you’d be ok with that?

If you’d actually read my post, then you’d know that I’m not OK with that.

What I’m arguing here is that persistent inaccurate and exaggerated reporting is driving political pressure to something about the overdoses, regardless of whether that something is effective and regardless of whether it destroys the lives of others.

To respond correctly to the problem, we need to understand what’s actually going on. Instead the media exaggerates the problem and assigns the blame on Purdue, the Sacklers, Insys, etc. Yes, there have been bad actors here, and they should be punished. But that doesn’t solve the problem. They aren’t the root causes.

Instead, the repeated exaggeration of the problem and the over simplification of its causes are triggering knee-jerk reactions that are doing real actual harm to a whole other group of victims without doing anything to solve the problem.

Here’s another way to look at it. If I (incorrectly) report that, in the last 20 years, roughly 800,000 Americans have died in auto crashes involving Volkswagens, and repeat it over and over again, people are going to start believing it. And then I’d be able to whip up a frenzy. The other automakers that compete with Volkswagen would have incentive to help do that. To save hundreds of thousands of American lives, clearly we need to outlaw Volkswagens. (And, yes, Volkswagen has done some shady things, like cheating on emissions testing, so they should be punished even if they aren’t the only cause of auto accidents.) The actual effect of this is that we haven’t really saved any American lives because it turns out that only a fraction of automotive deaths actually involved Volkswagens (let along being caused by Volkswagens). In the mean time, we’ve hurt people who had been employed by Volkswagen, and by companies the make parts for Volkswagens and the mechanics that repair them. People that owned a Volkswagen lose the vehicle that was helping them live their lives. We’ve created a whole second class of victims, without addressing the problem at all because we focused on the “obvious” root cause and reacted without thinking through the ramifications.

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I think you just won the internet for the week. Take the rest of the day off to celebrate!

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The Opiod Crisis has a multifaceted causality.* The behavior of PurduePharma appears to have been blatantly illegal. The family that owns the business made claims that they were not part of the illegal behavior, but the latest filings make it clear that the AG of NY thinks the Sackler family was part of the illegal dealings. Yes, there were many other people accused of being involved in these lawless activities - if you read the complaint, the entire first page is a list of companies and individuals (including 10 unnamed Doe-s) so charged. But the Sacklers alone made Billions of dollars, and appear to have done so knowing exactly the harm their money making was causing, as well as the illegality of much of it. So they are the name that gets applied to the crisis. As a family, they appear to be the single most focused cause of the crisis, and were clearly (imho) profiteering from the problems. So yes, using their name as a stand-in for the illegal activities of many, and doing so knowing that they profited beyond all reason, makes total sense.

–
*I have lived most of my professional career as an RN during the opiod crisis, and watched it grow and explode. It is astoundingly complicated, because the problems ranged across many levels of health care and society, and there is no clear One cause. I will give a summary, but it will be long.

  • in the late 1990s, Nursing and Medicine decided that ‘Pain’ is a ‘Vital Sign’. Nursing was taught, in schools, to “measure” pain, and include that in Every interaction and assesment with patients - from office visits to q5minute vital signs in the ICU. Every pain related intervention with a patient required that you re-evaluate and re-“measure” the patient’s pain, and record whether the intervention helped. The ethos said that all pain was equivalent and patients had to be treated into a pain free state.
    (this makes a lot of sense about some things (broken femur with bone protruding from skin) and less sense about others, eg “I have had a headache for two years.”)

  • regulatory agencies started asking about how well practitioners treated pain, and making not just the attempts at treating pain, but the outcomes and related paperwork, part of their visits.
    (again, much of this makes sense - you don’t want an orthopedic group failing to treat people’s post-operative pain, but do you score neurologists on how many of their patients report total cessation of headaches?)

  • different agencies (medicare, insurance companies) started requiring health care to perform customer satisfaction surveys, and to report the results of those surveys. Since Pain had become a vital sign, you had to include patient’s reports of pain control in those surveys. Surveys generally said that medicine/nursing did not do a stellar job of treating pain, though sussing out the failures has proven very complex.
    (as an anectdotal story, I remember a patient who called to complain that we had failed to treat her abdominal pain, yet in her chart was a quote “I feel great” at discharge… so retrospective analysis of pain treatment by using after discharge surveys does not always coincide with patient’s perception of pain at the time of treatment - it is Complex)

  • Medicare (and insurance companies, by linking their reimbursement rulese to medicare rules) started requiring certain patient satisfaction outcome levels in order for medical facilities (hospitals, surgery centers, clinics…) to maintain their current levels of remimbursement. Ie, if you don’t score high on Patient Satisfaction scores (called HCAHPS, pronounced H-Caps), your payments go down.

  • Providers and Hospitals noted that there were several frequent, nationwide reasons that patients didn’t rate them well, and one of them was Pain Control. And that’s easy to fix, right? Since we already “measure” their pain, we can just make sure that we give enough pain medication to bring down their pain scores.
    (again, there is a level of sense in this, too - no one wants to be undertreating their patients pain - we dont Want people to suffer in our care).

  • Makers of pain medications developed some new medications for pain. Gone were the days of only morphine and meperidine and codeine. We had fentanyl, and hydromorphone, and oxycontin, and ms-contin, and oxycodone and hydrocodone and cyclooxygenase inhibitors (whoopsy) ! We had pills, and lolly-pops (for real), and patches, and slow release pills, and better dosing schedules.

  • Pharmacology companies assured practitioners that we would NOT be making people into addicts. And besides, no one could get hurt from taking their oxycontin - it was Safe. The studies proved it - even if we weren’t told that the same pharma companies funded All the studies that proved safety. And hid the data from the studies that showed danger.

  • Health Care overlooked our own knowledge. We KNEW that opiods cause addiction. It’s been known since they were invented. But we decided to believe the magic claims. There was pressure to believe this - it seemed to be invisible pressure - get good HCAHPS scores, make your patients happy, give lots of medications, send them home with a prescription for some harmless narcotics, end suffering, treat pain…

  • Some of that pressure was more realistic and solid, especially for Doctors. They were heavily courted by pharma. They were given financial incentives to prescribe drugs. Not all of them, for sure, and not everyone succumbed, but many did. The system made it easy, and the riches the pharma companies were making (and spreading around, to a degree) made it easier.

  • Medicine/Nursing/HealthCare also knew that opiods weren’t (aren’t) the right drug to treat many types of pain. They not only cause addiction, but they cause dependency. Dose related dependency. Worse, dependency that rests partly on an increased tolerance, but the side effects do not get a tolerance. But the drugs were touted and believed to be safe, and were an easy answer to many problems (angry patient? bad HCaps? frequent pain patient coming to visit?..).

That sets the stage for 47,600 people to die of Opiod overdoses in 2017. Think about that number. How about if everyone in Olympia, WA or Carl Gables FL died in one year of the same problem?

The troubles built up. People started to die. We started to restric long term narcotic use - but people couldn’t quit, and the system wasn’t adapting. So people turned away from their “safe” prescription drugs and found narcotics where they could. First by subterfuge, then from the street. And who really knows how to safely dose heroin? Or unmarked fentanyl?

This is probably long enough, and I will stop here. I think I’ve described the complexity of the setup for the current system crash. And when you look through this, Most of the people were acting in good faith. Most. But not the Sackler family’s PurduePharma company (which has alread plead guilty to previous charges of illegal marketing). They are the clear and shining example of the personal bad faith decisions that helped create this disaster.

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Yeah, and in the words of Sarah Huckabee Sanders, “I certainly don’t think that the president, at any point, has done anything but condemn violence”. He was just warning about those second amendment people.

Aside: Count me as a leftist who opposes capital punishment and would seriously, strongly, prefer the guillotine to lethal injection or other current methods. Precisely because it is blatantly barbaric. If our government is going to commit barbaric acts they should be honest about it, not pretending they are just putting someone to sleep.

And if you defend and promulgate images of barbarism, be honest about it.
Posing as an ironic hipster giving an airquoted warning isn’t moving our cause along.

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If you can’t make the distinction between that and Cory using the guillotine image as iconic shorthand for “historically, barbaric political violence is what happens when inequality gets so extreme that poor people die because of actions or inactions of the ultra-wealthy” then there’s no real basis for discussion here.

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to quote one of the kings of the kleptocracy:

- John F. Kennedy

The Sacklers and their robber baron kinfolk have exercised such outsized control as to render representative democracy ineffectual at redressing the deliberate wrongdoings and systemic violencing the Sacklers and kind have inflicted.

Boo friggin’ hoo

Laborers didn’t start this war.

Capital did.

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And if we burn, then they burn with us.

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I’m really not down with the invocation of this symbol of mass murder from the French Revolution. As much as people can justify using it for having multiple meanings that argument cuts both ways, using it still has the implication of “do what we want or we will kill you”.

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Precisely this! And when used more seriously, it’s less about what the left plans to do, and more about what can happen if the elites keeps insisting that the rest of us can eat cake when we’re out of bread. It’s a warning from history that not being attentive to the needs of society across the board leads to social break down that can lead to mass violence like the terror. That’s the whole point - DO something to fix these problems now, or it will lead to the break down of society. No one is actually suggesting that we build us guillotines… But given that some right wing racist literally just posted a video of himself on facebook shooting 50 people in the back, well…

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Fuck that.

The Sacklers and their accomplices have killed thousands and purposefully addicted millions. Bezos’ wondeful little internet souk has systemically crippled and baked workers to death. The police kettle and kill people protesting inequality. Wal*Mart has an army of attorneys and union busters on hand to stymie and silence workers.

The rich want to destroy educating - and they are. They came for healthcare.

And you’re acting as if we need to shut up?

Sorry dude. Just because some people enjoy the status quo does not make the status wuo equitable or just.

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Seriously; fuck all that nonsense ‘concern’ about the left using provocative French Revolution imagery to make a point, when there are bigoted fuckers out there actually killing and hurting people.

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You act like you’re responding to a post other than mine. That’s not what I said. I limited my comment to the invocation of guillotines specifically.

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image

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