Behind the opioid crisis: Republicans and Obama cleared the way for corporate murder

By Patrick Martin
16 October 2017

Leading Republican and Democratic members of Congress and top Obama administration officials collaborated to shut down efforts by the Drug Enforcement Administration (DEA) to stem the flow of prescription opioids that have killed 200,000 Americans over the past two decades, according to a devastating exposure published Sunday by the Washington Post and broadcast Sunday night on the CBS news magazine “60 Minutes.”

The joint investigation by the Post and “60 Minutes” made use of extensive whistleblower revelations by former officials of the DEA, which has the main responsibility for halting the flow of illegal narcotics, including prescription drugs like oxycodone and hydrocodone diverted into the black market.

Three major companies, all in the top 20 of the Fortune 500 and hugely profitable, dominate the distribution of these opioids: McKesson, Cardinal Health, and AmerisourceBergen, with combined revenues of more than $450 billion. McKesson chairman and CEO John Hammergren has the largest pension fund of any US corporate boss, a $160 million personal nest egg.

These gigantic revenues and huge personal fortunes were accumulated by means of what can only be termed a massive social crime: the flooding of impoverished working-class neighborhoods with high volumes of opioids, narcotics that were being prescribed in vast quantities by doctors and pharmacists and illegal “pain centers” and “pill mills” that were a constant presence in the affected areas.

The consequences have been felt in a historic reversal in the long-term rise of life expectancy in the United States. For middle-aged whites, particularly those living in rural areas, life expectancy is declining and death rates soaring, in large part because of the impact of opioid abuse and addiction.

Appalachia is a center of the opioid crisis. The figures presented in the Post/”60 Minutes” report are staggering—and damning. To Mingo County, West Virginia, an impoverished former mining area on the state border with Kentucky, population 25,000, the mid-sized Ohio-based drug distributor Miami-Luken shipped 11 million doses of oxycodone and hydrocodone in a five-year period: enough to give two pills a week to every man, woman and child in the county.

In the county seat, Williamson, population 2,938, Miami-Luken shipped 258,000 hydrocodone pills in one month to a single pharmacy. The city of Williamson has filed suit against the company and other drug distributors, charging them with deliberately flooding the city with pain pills to supply the black market. A document filed in the suit charges, “Like sharks circling their prey, multi-billion dollar companies descended upon Appalachia for the sole purpose of profiting off of the prescription drug-fueled feeding frenzy.”

Post reporters Scott Higham and Lenny Bernstein and “Sixty Minutes” reporter Bill Whitaker conducted dozens of interviews for their exposé, but the principal whistleblower is Joseph T. Rannazzisi, who headed the DEA’s Office of Diversion Control for a decade until he was forced out in 2015.

The Office of Diversion Control oversees the flow of prescription drugs produced by the major US pharmaceutical companies and shipped to hospitals and pharmacies and other prescribers by distributors, including the big three. By targeting unusually large and unexplained sales—for example, several Walgreen’s pharmacies in Florida sold more than one million opioid pills in a year, compared to a nationwide average of 74,000—the DEA unit could force companies to pay substantial fines.

These big three and smaller distributors paid more than $400 million in fines over the last decade as the result of the DEA, but this is a pittance compared to their gross revenues during that same period, well over $5 trillion. One former DEA official told the Post this sum simply represented “a cost of doing business.”

A more serious problem for the industry was the issuance of “freeze” orders, in which the DEA could use its authority to order a distributor to halt a shipment if there is “imminent danger” to the community. According to Rannazzisi, there was increasing resistance from top-level DEA officials, from 2011 on, to approving such “freeze” orders against opioid distributors. During this period, the drug distributors hired 46 DEA officials either directly or through law firms or lobbying groups representing them.

In 2014, industry lobbyists produced a bill, written by a former DEA lawyer, and introduced by Republican Representative Tom Marino, that substantially raised the threshold of proof for a DEA order to halt a shipment. Instead of “imminent danger,” such an order required proof of “a substantial likelihood of an immediate threat,” a standard so strict that, once adopted, there were no further DEA orders to halt drug distribution.

Marino’s bill was initially blocked by DEA opposition, but it was reintroduced with Democratic cosponsors and passed the House of Representatives by a voice vote, without opposition, in April 2015. In October 2015, Rannazzisi was pushed into retirement at the DEA, after previously being removed as head of the Office of Diversion Control by means of heavy pressure from congressional Republicans on the Obama Justice Department. In March 2016, the Senate passed a modified version of the Marino bill, and the House accepted the changes the following month. The DEA was now handcuffed, and the drug distributors could proceed without any concern about federal oversight.

As Rannazzisi told “60 Minutes”: “The drug industry—the manufacturers, wholesalers, distributors and chain drugstores—have an influence over Congress that has never been seen before. And these people came in with their influence and their money and got a whole statute changed because they didn’t like it.”

The protection of the giant drug distribution companies—amid a nationwide epidemic of drug overdose deaths caused by the products they were distributing—was a bipartisan affair. Congressional Democrats cosponsored the legislation, and a former top Clinton administration official, Jamie Gorelick, was a lead attorney and lobbyist for the distributors. Attorney General Loretta Lynch approved the legislation, and President Obama signed it into law, with the White House issuing a one-page press release to mark the occasion.

None of those involved, including Lynch and Obama, would comment to the Post or “60 Minutes.” According to the Post, “The DEA and Justice Department have denied or delayed more than a dozen requests filed by The Post and ‘60 Minutes’ under the Freedom of Information Act for public records that might shed additional light on the matter,” indicating that the Trump administration is continuing the stonewalling tactics begun under Obama.

When a “60 Minutes” camera crew came to Marino’s office, his aides called Capitol Hill police to have them removed.

Trump has rewarded the darling of the drug distributors, Representative Marino, by nominating him last month to become the next White House “drug czar,” in charge of coordinating federal efforts against the opioid crisis. Representative Marsha Blackburn of Tennessee, the main cosponsor of the bill, is now favored to be the Republican nominee for US Senate in Tennessee in 2018. Both representatives come from districts ravaged by the opioid crisis. According to the Post account, 106 people have died in Lycoming County, Pennsylvania, the largest in Marino’s district, since he first introduced his anti-enforcement legislation.

The following exchange from the “60 Minutes” program sums up the reality of corporate domination of American life, and the catastrophic impact on working people:

BILL WHITAKER: You know the implication of what you’re saying, that these big companies knew that they were pumping drugs into American communities that were killing people.

JOE RANNAZZISI: That’s not an implication, that’s a fact. That’s exactly what they did.

… These weren’t kids slinging crack on the corner. These were professionals who were doing it. They were just drug dealers in lab coats.

http://www.wsws.org/en/articles/2017/10/16/drug-o16.html

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Following Trump executive orders, Democrats offer Obamacare “fix”

A new stage in the bipartisan health care counterrevolution

14 October 2017

The last 10 days have marked an escalation of the bipartisan conspiracy against the health care rights of working class Americans. After Congressional Republicans’ numerous failed attempts in recent months to “repeal and replace” the Affordable Care Act (ACA), the Trump administration has issued a series of executive orders aimed at undercutting the legislation popularly known as Obamacare.

The president’s first order expanded exemptions for employers who claim moral or religious objections from requirements under the ACA to provide their workers with no-cost birth control.

Next, Trump finalized an executive order to allow “association health plans” an exemption from the ACA’s requirements to provide 10 essential services in their insurance coverage.

Finally, the administration announced that, beginning next Wednesday, it would be scrapping cost-sharing reduction payments (CSRs) to private insurers that help low-income Americans purchase health coverage.

Trump made clear that he is seeking to reach out to congressional Democrats to make a deal on health care “reform,” that is, changes to Obamacare to further reduce health care coverage. In a post on Twitter Friday morning, he said, “The Democrats[’] ObamaCare is imploding. Massive subsidy payments to their pet insurance companies has stopped. Dems should call me to fix!” He went on to call the law “a broken mess.”

All of Trump’s orders will have the effect of raising insurance premiums, particularly for older, poorer and unhealthy people, and denying access to basic medical services for millions. But this is not what concerns the Democrats in Congress.

House Minority Leader Nancy Pelosi and Senate Minority Leader Chuck Schumer issued a demagogic statement Friday night scolding Trump for stopping the CSRs, stating in part: “[I]t seems President Trump will single-handedly hike Americans’ health premiums. It is a spiteful act of vast, pointless sabotage leveled at working families and the middle class in every corner of America.”

But the Democratic leaders concluded with their real point, which was to chastise the president if his actions meant he “is walking away from the good faith, bipartisan Alexander-Murray negotiations and risking the health care of millions of Americans.”

Earlier this month, following the Republicans’ failed repeal and replace attempts, Trump tweeted, “I called Chuck Schumer yesterday to see if the Dems want to do a great HealthCare Bill.” Schumer responded: “If he wants to work together to improve the existing health care system, we Democrats are open to his suggestions. A good place to start might be the Alexander-Murray negotiations that would stabilize the system and lower costs.”

Schumer is referring to the health care talks being led by Senators Lamar Alexander (Republican of Tennessee) and Patty Murray (Democrat of Washington). These bipartisan negotiations have nothing to do with expanding medical coverage to the 28 million Americans who remain uninsured, improving the already hopelessly inadequate benefits of many, or in any way reining in the profiteering and power of the insurance and pharmaceutical monopolies.

Instead, their “fixing” of Obamacare involves shoring up the insurance industry by means of various payouts. The Democrats have also agreed to a “compromise” allowing insurers to skirt the Obamacare regulations requiring insurance companies to offer a set of essential benefits by offering “skinny” plans, as well as to dodge ACA protections for individuals with preexisting conditions.

Any “compromise” between the Democrats and Republicans on health care reform is by its very nature a conspiracy against the working class. It is entirely premised on the subordination of the need for health care to the profits of the corporations and the functioning of the capitalist market.

Ohio Governor John Kasich was more transparent on what a bipartisan deal on health care would look like, stating this summer, “After two failed [Republican] attempts at reform, the next step is clear: Congress should first focus on fixing the Obamacare exchanges before it takes on Medicaid. … Once we see these repairs taking hold, Congress should then take up needed improvements to Medicaid as part of comprehensive entitlement reform.”

All of the failed Republican versions of Obamacare repeal and replace cut hundreds of billions of dollars from Medicaid, the government health insurance program for the poor, elderly, the disabled and pregnant women. They posed the virtual end of the program as a guaranteed entitlement program, by imposing block-granting and per-capita caps to the states, which would force states to deny benefits to people who qualify.

Through these measures, Medicaid would be starved of funds on the road to privatizing and ultimately dismantling the program. There have been no clear statements from leading Democrats opposing in principle the termination of Medicaid, which everyone in the political and media establishment knows is the first step to dismantling and privatizing Medicare, the government insurance program for the elderly, and Social Security, the government pension system.

The bipartisan plans to “fix” Obamacare in the interests of the insurance companies—further slashing benefits and raising premiums for working families, while cutting costs for the government and corporations—are not at odds with the spirit of Obamacare. In fact, they reflect its essence and objective: that workers are living too long into retirement, receiving costly and “unnecessary treatments,” and that something must be done to curb costs in the interest of corporate profit.

As early as 2009, the year before the ACA was signed into law, the World Socialist Web Site wrote:

“[Barack Obama’s] drive for an overhaul of the health care system, far from representing a reform designed to provide universal coverage and increased access to quality care, marks an unprecedented attack on health care for the working population. …

“Obama’s health care counterrevolution is of a piece with his entire domestic agenda. It parallels the multi-trillion-dollar bailout of the banks, the imposition of mass layoffs and wage and benefits cuts in the auto industry, and a stepped-up attack on public education and on teachers.”

The Democrats’ policies on health care reform are no alternative to Trump’s. Both will lead to untold suffering, misery and preventable deaths. The defense of basic social needs such as health care requires a fight against capitalism, which in its advanced stage of crisis is incompatible with basic democratic and social rights.

A fight in defense of health care requires a fight for socialism. The health care industry must be removed from private hands and placed under public ownership and the democratic control of the working class. This is not an unrealistic pipe dream but the only rational solution to a health care system dominated by profit and defended by an outmoded ruling elite.

Kate Randall

http://www.wsws.org/en/articles/2017/10/14/pers-o14.html

Trump administration limits access to birth control under ACA

By Trévon Austin
7 October 2017

The Trump administration has announced plans to revoke the federal requirement for employers to include birth control coverage in health insurance plans. The new policy would expand exemptions under the Affordable Care Act (ACA) for employers who claim moral or religious objections to contraception.

Under the previous mandate, more than 55 million women employees had access to no-cost birth control. According to the Kaiser Family Foundation, the percentage of women employees that pay with their own money for birth control fell from 21 percent to 3 percent after contraception became a covered preventive benefit.

The new exemptions will be available to for-profit companies, nonprofit organizations and colleges and universities that provide health care to students and employees.

Hundreds of thousands of women could potentially lose access to benefits they receive at no cost. The Trump administration itself estimated that some 200 employers who have already voiced opposition to the Obama-era mandate would qualify for exemption, and that 120,000 women would be affected.

In expanding the exemption for employers, the Trump administration claims there are “dozens of programs that subsidize contraception for the low-income women” and various alternative sources for birth control exist.

The administration also cites health risks that it says are correlated with the use of certain types of contraceptives, and claims the previous mandate that required employers to cover birth control could promote “risky sexual behavior” among teenagers and young adults.

In contrast, many obstetricians and gynecologists say contraceptives have been and are generally beneficial for women’s health.

Dr. Haywood L. Brown, the president of the American College of Obstetricians and Gynecologists, expressed concern for consequences on women’s health. “Affordable contraception for women saves lives,” he said. “It prevents pregnancies. It improves maternal mortality. It prevents adolescent pregnancies.”

The Trump administration cites the Religious Freedom Restoration Act, a 1993 law protecting religious liberty, as legal reasoning for the new mandate. The administration admits that moral objections are not protected by the law, but states: “Congress has a consistent history of supporting conscience protections for moral convictions alongside protections for religious beliefs.”

Attorney General Jeff Sessions announced the Department of Justice would take steps to protect the new policy and stated, “President Trump promised that this administration would ‘lead by example on religious liberty,’ and he is delivering on that promise.”

The new policy is expected to face a large number of lawsuits. The National Women’s Law Center, a nonprofit advocacy group, has been preparing a lawsuit since last spring. Brigitte Amiri, a senior attorney for the ACLU, said, “We are preparing to see the government in court.”

In addition, Massachusetts Attorney General Maura Healey and California Attorney General Xavier Becerra announced plans to file a suit against the new mandate.

Trump’s new policy is an obvious attempt to win support from religious groups and conservatives, such as Speaker of the House Paul Ryan, who claimed today is “a landmark day for religious liberty.”

A group supportive of the administration’s action is the Little Sisters of the Poor, an order of Roman Catholic nuns who said that being required to cover contraception would make them “morally complicit in grave sin.” The organization sued the government, despite an already existing exemption for churches and other religious employers to opt out by notifying the government.

During his 2016 presidential bid, Trump promised that he would “make absolutely certain religious orders like the Little Sisters of the Poor are not bullied by the federal government because of their religious beliefs.” At a Rose Garden ceremony in May, he told the religious order, “Your long ordeal will soon be over.”

The Trump administration’s mandate sets a dangerous precedent for working women’s health. In 2014, in the case Burwell v. Hobby Lobby, the Supreme Court ruled that the ACA violated the religious liberty of Hobby Lobby, and stated that corporations could object to the birth control coverage mandate on religious grounds. Under Trump’s mandate, corporations could deny women employees access to no-cost birth control simply based on “moral objections.”

The new policy sets a precedent for corporations to deny other health coverage to employees under conditions in which the state of women’s health in the United States is already dire. The US holds the highest maternal mortality rate among industrialized nations, and a lack of access to birth control will potentially exacerbate the problem.

The new policy goes into effect immediately.

http://www.wsws.org/en/articles/2017/10/07/birt-o07.html

America’s Overlooked Addiction Crisis

Alcohol abuse is a fast-growing problem. Higher taxes on beer, wine and spirits could help.
Cheap hit.

 Photographer: Denver Post via Getty Images

As alarms over the opioid crisis sound ever louder, a larger and more expensive substance problem in the U.S. is quietly growing much worse. One in eight Americans abuses alcohol, a new study finds, a 50 percent increase since the start of the century.

Alcohol abuse is as old as civilization itself, of course, but quantifying its costs is a more recent endeavor. Alcohol is responsible for one in 10 deaths among working-age Americans — from accidents as well as illnesses. There are almost 90,000 alcohol-related deaths in America every year. Excessive drinking, mainly binge drinking, costs some $250 billion a year in lost productivity, health care and other expenses. The toll in personal suffering and ruined lives is incalculable.

Yet there has been a strange reluctance to fight back with the weapons known to work: restrictions on alcohol sales and advertising and, even more effective, higher taxes on alcohol. The federal tax on spirits (about 21 cents per ounce of alcohol; taxes on beer and wine are less than half that) has not changed since 1991, and over the past few decades the inflation-adjusted cost of drinking has fallen considerably. Many states have likewise neglected to index their alcohol taxes to inflation.

That’s too bad, because making drinking more expensive is the single strongest way to reduce harm from alcohol. Yes, higher prices burden the poor more than the well-off, but they can significantly reduce excessive drinking and its harmful effects: crime, violence, car crashes, suicides and sexually transmitted diseases.

If that’s not enough reason for Congress and state legislatures to raise alcohol taxes, consider that the government’s share of alcohol’s economic cost is about $100 billion a year, while state and federal alcohol taxes bring in about $15 billion. The difference amounts to quite a subsidy for excessive drinkers paid by many taxpayers who drink moderately or not at all.

There are other ways besides simply raising taxes — setting a minimum price for every unit of alcohol a drink contains, for example. Unlike taxes, which can be selectively absorbed by wholesalers or retailers, minimum prices must be borne by the drinkers. Five years ago, Scotland passed a law meant to set a 50-pence (65-cent) minimum price for every unit a drink contains, though the Scotch Whisky Association has so far kept it tied up in court.

Lawmakers need to be clear about the problem, however, and ways to control it. Attorney General Jeff Sessions has declared drug overdose deaths, which reached nearly 60,000 in 2016, to be America’s “top lethal issue.” He’s not the only one who needs to be reminded that alcohol abuse is significantly more deadly, and just as deserving of attention.

To contact the senior editor responsible for Bloomberg View’s editorials: David Shipley at davidshipley@bloomberg.net .

https://www.bloomberg.com/view/articles/2017-09-01/america-s-overlooked-addiction-crisis

How Renaissance Painting Smoldered with a Little Known Hallucinogen

Forrest Muelrath

Looking at depictions of St. Anthony in the paintings of Renaissance masters, the influence of the disease of ergotism on the history of art starts to become clear.

Follower of Pieter Bruegel the Elder, “The Temptation of Saint Anthony” (c. 1550/1575), oil on panel, Samuel H. Kress collection

A fungal infection known as ergotism influenced Northern Renaissance painting to an extent that a majority of art institutions have yet to grapple with. During the Renaissance ergotism was colloquially known as St. Anthony’s Fire, named for the third-century desert Father who had hallucinatory bouts with the devil.

In 1938 the Swiss chemist Albert Hoffman accidentally synthesized the psychedelic drug LSD-25 for the first time from ergot fungi — the same fungus that causes the disease ergotism — while researching pharmaceuticals for postpartum bleeding. Some of the symptoms of ergotism closely resemble the effects of LSD, which makes sense given that the same or similar alkaloids are present in both the fungus that causes illness and the drug. Looking at depictions of St. Anthony in the paintings of Renaissance masters, the influence of the disease on the history of art starts to become clear.

During the time of the Renaissance, ergotism was a phantasmagoric event with an onset that was difficult to distinguish from the bubonic plague: it came on first as nausea and insomnia, then developed into sensations of being engulfed in flames while hallucinating over several days, and often ended with the amputation of one or more limbs due to gangrene, or ended in death. In some locations, the symptoms associated with ergotism were considered to be the first step towards hell.

Ergot growing on rye (image courtesy Wikimedia commons)

The illness is contracted by ingesting ergot fungus, which appears on cereal grains when the growing conditions are right — most commonly on rye. The last known severe outbreak occurred in the French village of Pont-Saint-Espirit in 1951. The outbreak was documented in the British Medical Journal, which describes symptoms such as nausea, depression, agitation, insomnia, a delirium that includes feelings of self-accusation or mysticism, and hallucinations that commonly include animals and fire. A non-fiction book about the 1951 outbreak, written by American author John G. Fuller, titled, The Day of Saint Anthony’s Fire, describes specific ergot-related psychotic episodes. For example, there is the afflicted man who thought he was an airplane and jumped out the asylum’s second floor window with outstretched arms expecting to fly, telescoped both his legs upon landing, and then ran 50 meters at full speed on shattered bones before being wrestled to the ground by eight other men.  All in all, the accounts of symptoms from the 1951 outbreak resemble both acid causality tales hyperbolized as anti-drug propaganda, and descriptions from the LSD how-to manual coauthored by Timothy LearyRalph Metzner, and Richard Alpert, titled The Psychedelic Experience.

Some art historians, such as Bosch scholar Laurinda S. Dixon, have proffered for decades that the symptoms of ergotism influenced painters like Jheronimus (aka Hieronymus) Bosch and Matthias Grünewald. In looking further at depictions of Saint Anthony — from medieval folk art, a plethora of Renaissance work, to a series of paintings by surrealist artists, such as Max Ernst’s 1945, “The Temptation of Saint Anthony” — a pattern begins to develop in which a mimesis of visual hallucinations associated with ergotism is clearly presentFor instance, Gustave Flaubert’s novel The Temptation of Saint Anthony, contains not only hallucinatory imagery congruent with the effects of ergot alkaloids, but also contains in the opening passage of the novel a clear symbol of a known cause of ergot poisoning: a description of a loaf of black bread inside the hermit saint’s cabin.

The Isenheim altarpiece closed (image courtesy Wikimedia commons)

So why is St. Anthony associated with ergot? The devout will often look towards the legend of Anthony’s temptations when faced with mental or emotional anguish. This is because the devil is said to have tempted Anthony with mirages of jewels, and dressed up as seductive women to deter the hermit from his asceticism. As the devil was tormenting Anthony, the saint was said to be wandering through the Egyptian wilderness. The events of Anthony’s story as recounted by his original hagiographer, St. Athanasius of Alexandria, also read as hallucinatory, with a blend of imagery, ecstasy and madness. From Life of Saint Anthony by St. Athanasius:

For when they cannot deceive the heart openly with foul pleasures they approach in different guise, and thenceforth shaping displays they attempt to strike fear, changing their shapes, taking the forms of women, wild beasts, creeping things, gigantic bodies, and troops of soldiers. But not even then need ye fear their deceitful displays. For they are nothing and quickly disappear, especially if a man fortify himself beforehand.

The notion that the harmful hallucinations will cease if the subject is fortified beforehand, is a reoccurring theme not only in Life of Saint Anthony, but also in the instructions for tripping on LSD given in The Psychedelic Experience: 

At this time you may see visions of mating couples. You are convinced that an orgy is about to take place. Desire and anticipation seize you, You wonder what sexual performance is expected of you. When these visions occur, Remember to withhold yourself from action or attachment. Humbly exercise your faith. Float with the stream. Trust the process with great fervency. Meditation and trust in the unity of life are the keys.

This simple comparison between the texts of a third-century hermit and the megalomaniacal ‘60s drop-out prototype, Timothy Leary, is not enough to clearly demonstrate a correlation between Anthony and psychedelia. What this investigation does make clear is why the hagiography became important to those in the 17th century suffering from symptoms similar to LSD effects in the time before modern medicine first discovered the cause of ergotism.

Aside from the instructions for how to cope with hallucinations, Athanasius’s text also uses imagery that appeared in Renaissance painting, and finds a kinship with symptoms of ergot as described in the British Medical Journal and The Day of St. Anthony’s Fire. According to John G. Fuller, Zoopsie — from the French word meaning hallucinatory visions of animals — was rampant among the afflicted in Pont-Saint-Espirit, who experienced tormenting visions of serpents, tigers, giant spiders, etc. Anthony was tormented by similar visions over and over again, according to St. Athanasius:

the demons as if breaking the four walls of the dwelling seemed to enter through them, coming in the likeness of beasts and creeping things. And the place was on a sudden filled with the forms of lions, bears, leopards, bulls, serpents, asps, scorpions, and wolves…”

The Isenheim altarpiece outer wings opened (image courtesy Wikimedia commons)

Bosch provides the most fertile ground for art lovers wanting to believe that hallucinogenic fungi may have a significant place in art history. This is partially because the painter has a special connection to Anthony, depicting the saint over twenty times throughout his life — one of his most famous paintings being the Anthony triptych. In the town where Bosch grew up, there was a church dedicated to the saint, which the artist almost certainly attended with his family when he was young. The painter lived at a time when knowledge of ergotism would have been near its peak before the cause of the disease was discovered. By the early 16th century (he died in 1516), there would have been at least forty major outbreaks of St. Anthony’s Fire across Northern Europe since the 9th century, with one 1418 outbreak in Paris killing as many as 50,000 by some estimates.

Laurinda S. Dixon presents some of the most convincing evidence to date that Bosch’s imagery was directly influenced by Saint Anthony’s Fire. In a (1984) essay titled “Bosch’s St. Anthony Triptych — An Apothecary’s Apotheosis,” the author finds a common ingredient in medieval medicine used to treat ergot — mandrake root — and the distillation furnaces used to make that medicine. Examining the Bosch painting with the use of high resolution photos available on boschproject.org, Dixon argues that the bulbous buildings, often depicted with a stream of smoke coming out of the top, are nearly identical to the shapes found in contemporaneous schematics of apothecary furnaces.

Other notable imagery in the Anthony Triptych includes the fire raging in the background — fire is found in many Bosch paintings, and is common in other painters’ depictions of Saint Anthony as well. A pair of magi in the center panel are serving musicians a concoction made from berries and herbs — one of the magi with wide-eyes and perhaps intentionally dilated pupils. Anthony is depicted in all three panels, recognized in Bosch paintings by his blue robe and a tau cross either painted on the robe or dangling as jewelry. It’s amusing that in the center panel, Anthony has the look of a strung-out Dead Head at the end of two-day acid trip, with his raised index and middle finger looking simultaneously like a Christian hand gesture and a hippie peace sign. Just below the Grateful Dead Anthony in the center panel, there is another symbol of ergotism — an amputated foot clearly laid on a rag.

Moving on from Bosch, there are scores of paintings that contain depictions of Anthony with many of the same symbols that imply ergotism. A painting attributed to a follower of Pieter Bruegel the Elder shows Anthony in his hermit cabin, as well as flying through the sky on winged beasts. There is a common rumor that ergot alkaloids cause those under their influence to believe they can fly, both in accounts of the disease and in anti-drug propaganda. Again, as in Bosch’s triptych, we see the apothecary furnace on the left side of the painting, this time with a scared looking face peaking out the top — and of course the two fires raging in the distance.

Flemish Painter Jan Mandijn’s vision of Anthony contains a similar set of ergot indicia:  apothecary tools, fire, the saint flying through the air, gangrene. Add to this an odd grass bursting through the roof of the hermit’s cabin, with dark tips that look similar to images of the fungus growing on rye.

Jan Mandijn, “The Temptation of Saint Anthony” (circa 1550) oil on panel, height: 61.5 cm (24.2 in). Width: 83.5 cm (32.9 in). (image courtesy Wikimedia commons)

Moving from the Flemish region to what was then Western Germany, sculpture and woodworker Nikolaus Hagenauer (aka Nikolaus von Hagenau) is surrounded by perhaps the most solid historical evidence that Anthony was a symbol of ergot poisoning for Northern Renaissance artists. Hagenauer’s sculpture of Anthony, carved with virtuosic dexterity in the round from a walnut log, displays subject matter that is congruent with the earliest legends of Anthony — the saint struggling with a single demon underfoot. However, when the artist’s masterwork is taken into consideration — the Isenheim altarpiece which Hagenauer was commissioned to create with painter Mathias Grünewald — the ergot narrative takes flight.

Around the year 1070 C.E., Saint Anthony’s purported remains were moved to La-Motte-Saint-Didier, a commune in southeastern France. The relics of the saint were said to have healing properties that could cure Saint Anthony’s Fire, and in 1095 the Hospital of the Brothers of Anthony was founded with the primary objective of treating those afflicted with ergot poisoning. Four centuries later, Grünewald and Hagenauer were commissioned to paint an altarpiece in nearby Isenheim for a monastery run by the Brothers of Anthony.

The Isenheim altarpiece is in an unusual position for a work of art, in that it was made with the direct intention of soothing physical ailments, as well as symptoms of psychosis. Each of the altarpiece’s nine paintings and its woodcarvings relate to an element of recovery from the symptoms of ergotism. Art historian Horst Ziermann wrote that “it is conceivable that miraculous cures or the relief of symptoms did, in fact, occur at the alter.” Critic David Levi Strauss labeled the work “therapeutic realism.” According to Ziermann, the afflicted would recite prayers in front of the altarpiece that would have been similar to the following: “Anthony, venerable Shepherd, who renders holy those who undergo horrible torments, who suffer the greatest maladies, who burn with hellfire: oh merciful Father, pray to God for us.”

The Isenheim altarpiece inner wings opened (image courtesy Wikimedia commons)

In its original setting the altarpiece would have been illuminated by candles or sunlight through stained glass windows. Unfolding theatrically in three distinct sets of paintings, the wooden frame connected with hinges, each of the three views like an act in a play — or like the three bardos of Timothy Leary’s manual. The monastery where the altarpiece was kept was a place of concentrated prayer for the suffering. The monks would have had little means to treat patients, aside maybe from offering a place to lie that was more comfortable than the street, some warm food, and ointments to sooth the burning of open wounds. The primary tool for healing from ergot related ailments would have been prayer, and relief from the worries of facing hell in the afterlife was redemption through Christ — all which are reflected in the altarpiece.

The alternating horror and mystical ecstasy found between the second and third views of the altarpiece align with accounts of ergot-related mania and psychic anguish, as they do with descriptions found in The Psychedelic

Nikolaus von Hagenau, “Untitled” (ca. 1500) made in Strasbourg, Alsace, present-day France; walnut; 44 1/4 × 17 1/4 × 10 3/4 in., 66 lb. (112.4 × 43.8 × 27.3 cm) (courtesy the Metropolitan Museum of Art)

Experience. The vivacious colors in the second panel recall descriptions of the most ecstatic of those poisoned in Pont-Saint-Espirit, while also sharing elements of the brighter elements of Bosch. The third view returns to Anthony, who is as tormented as ever in the right wing. Most telling is the gangrenous person looking up at the besieged saint from below — his green skin covered in boils that ooze puss and blood, and his belly bloated due to starvation.

The counterculture use of ergot alkaloids proved to be a threat to the dominant mainstream US culture of the 1950s, causing their prohibition. Could the same have happened during the first half of the second millennium, in respect to Christian culture and ergot? Albert Hofmann contributed to an essay titled “The Road to Eleusis: Unveiling the Secret of the Mysteries,” which proposes that ergot alkaloids may have been present during the ancient Greek religious festival known as the Eleusinian mysteries.

Whether appearing as a drug or disease, the visual language of the Northern Renaissance was clearly influenced by the ergot fungus. Further research into this historical intersection will offer a better understanding of the way artists have responded to forces of temptation and torment with visual representation and might do so in the present day.

Our freedoms—especially the Fourth Amendment—are being choked out.

What Country is This?

Photo by Nathaniel St. Clair

“The Fourth Amendment was designed to stand between us and arbitrary governmental authority. For all practical purposes, that shield has been shattered, leaving our liberty and personal integrity subject to the whim of every cop on the beat, trooper on the highway and jail official.”

—Herman Schwartz, The Nation

Our freedoms—especially the Fourth Amendment—are being choked out by a prevailing view among government bureaucrats that they have the right to search, seize, strip, scan, shoot, spy on, probe, pat down, taser, and arrest any individual at any time and for the slightest provocation.

Forced cavity searches, forced colonoscopies, forced blood draws, forced breath-alcohol tests, forced DNA extractions, forced eye scans, forced inclusion in biometric databases: these are just a few ways in which Americans are being forced to accept that we have no control over our bodies, our lives and our property, especially when it comes to interactions with the government.

Worse, on a daily basis, Americans are being made to relinquish the most intimate details of who we are—our biological makeup, our genetic blueprints, and our biometrics (facial characteristics and structure, fingerprints, iris scans, etc.)—in order to clear the nearly insurmountable hurdle that increasingly defines life in the United States: we are now guilty until proven innocent.

Such is life in America today that individuals are being threatened with arrest and carted off to jail for the least hint of noncompliance, homes are being raided by police under the slightest pretext, property is being seized on the slightest hint of suspicious activity, and roadside police stops have devolved into government-sanctioned exercises in humiliation and degradation with a complete disregard for privacy and human dignity.

Consider, for example, what happened to Utah nurse Alex Wubbels after a police detective demanded to take blood from a badly injured, unconscious patient without a warrant.

Wubbels refused, citing hospital policy that requires police to either have a warrant or permission from the patient in order to draw blood. The detective had neither. Irate, the detective threatened to have Wubbels arrested if she didn’t comply. Backed up by her supervisors, Wubbels respectfully stood her ground only to be roughly grabbed, shoved out of the hospital, handcuffed and forced into an unmarked car while hospital police looked on and failed to intervene (take a look at the police body camera footage, which has gone viral, and see for yourself).

Michael Chorosky didn’t have an advocate like Wubbels to stand guard over his Fourth Amendment rights. Chorosky was surrounded by police, strapped to a gurney and then had his blood forcibly drawn after refusing to submit to a breathalyzer test. “What country is this? What country is this?” cried Chorosky during the forced blood draw.

What country is this indeed?

Unfortunately, forced blood draws are just the tip of the iceberg when it comes to the indignities and abuses being heaped on Americans in the so-called name of “national security.”

Forced cavity searches, forced colonoscopies and forced roadside strip searches are also becoming par for the course in an age in which police are taught to have no respect for the citizenry’s bodily integrity whether or not a person has done anything wrong.

For example, 21-year-old Charnesia Corley was allegedly being pulled over by Texas police in 2015 for “rolling” through a stop sign. Claiming they smelled marijuana, police handcuffed Corley, placed her in the back of the police cruiser, and then searched her car for almost an hour. No drugs were found in the car.

As the Houston Chronicle reported:

Returning to his car where Corley was held, the deputy again said he smelled marijuana and called in a female deputy to conduct a cavity search. When the female deputy arrived, she told Corley to pull her pants down, but Corley protested because she was cuffed and had no underwear on. The deputy ordered Corley to bend over, pulled down her pants and began to search her. Then…Corley stood up and protested, so the deputy threw her to the ground and restrained her while another female was called in to assist. When backup arrived, each deputy held one of Corley’s legs apart to conduct the probe.

The cavity search lasted 11 minutes. This practice is referred to as “rape by cop.”

Although Corley was charged with resisting arrest and with possession of 0.2 grams of marijuana, those charges were subsequently dropped.

David Eckert was forced to undergo an anal cavity search, three enemas, and a colonoscopy after allegedly failing to yield to a stop sign at a Wal-Mart parking lot. Cops justified the searches on the grounds that they suspected Eckert was carrying drugs because his “posture [was] erect” and “he kept his legs together.” No drugs were found.

During a routine traffic stop, Leila Tarantino was subjected to two roadside strip searches in plain view of passing traffic, while her two children—ages 1 and 4—waited inside her car. During the second strip search, presumably in an effort to ferret out drugs, a female officer “forcibly removed” a tampon from Tarantino. No contraband or anything illegal was found.

Thirty-eight-year-old Angel Dobbs and her 24-year-old niece, Ashley, were pulled over by a Texas state trooper on July 13, 2012, allegedly for flicking cigarette butts out of the car window. Insisting that he smelled marijuana, the trooper proceeded to interrogate them and search the car. Despite the fact that both women denied smoking or possessing any marijuana, the police officer then called in a female trooper, who carried out a roadside cavity search, sticking her fingers into the older woman’s anus and vagina, then performing the same procedure on the younger woman, wearing the same pair of gloves. No marijuana was found.

Sixty-nine-year-old Gerald Dickson was handcuffed and taken into custody (although not arrested or charged with any crime) after giving a ride to a neighbor’s son, whom police suspected of being a drug dealer. Despite Dickson’s insistence that the bulge under his shirt was the result of a botched hernia surgery, police ordered Dickson to “strip off his clothes, bend over and expose all of his private parts. No drugs or contraband were found.”

Meanwhile, four Milwaukee police officers were charged with carrying out rectal searches of suspects on the street and in police district stations over the course of several years. One of the officers was accused of conducting searches of men’s anal and scrotal areas, often inserting his fingers into their rectums and leaving some of his victims with bleeding rectums.

It’s gotten so bad that you don’t even have to be suspected of possessing drugs to be subjected to a strip search.

A North Carolina public school allegedly strip-searched a 10-year-old boy in search of a $20 bill lost by another student, despite the fact that the boy, J.C., twice told school officials he did not have the missing money. The assistant principal reportedly ordered the fifth grader to disrobe down to his underwear and subjected him to an aggressive strip-search that included rimming the edge of his underwear. The missing money was later found in the school cafeteria.

Suspecting that Georgia Tech alum Mary Clayton might have been attempting to smuggle a Chick-Fil-A sandwich into the football stadium, a Georgia Tech police officer allegedly subjected the season ticket-holder to a strip search that included a close examination of her underwear and bra. No contraband chicken was found.

What these incidents show is that while forced searches may span a broad spectrum of methods and scenarios, the common denominator remains the same: a complete disregard for the rights of the citizenry.

In fact, in the wake of the U.S. Supreme Court’s ruling in Florence v. Burlison, any person who is arrested and processed at a jail house, regardless of the severity of his or her offense (i.e., they can be guilty of nothing more than a minor traffic offense), can be subjected to a strip search by police or jail officials without reasonable suspicion that the arrestee is carrying a weapon or contraband.

Examples of minor infractions which have resulted in strip searches include: individuals arrested for driving with a noisy muffler, driving with an inoperable headlight, failing to use a turn signal, riding a bicycle without an audible bell, making an improper left turn, and engaging in an antiwar demonstration (the individual searched was a nun, a Sister of Divine Providence for 50 years).

Police have also carried out strip searches for passing a bad check, dog leash violations, filing a false police report, failing to produce a driver’s license after making an illegal left turn, having outstanding parking tickets, and public intoxication. A failure to pay child support can also result in a strip search.

As technology advances, these searches are becoming more invasive on a cellular level, as well.

For instance, close to 600 motorists leaving Penn State University one Friday night were stopped by police and, without their knowledge or consent, subjected to a breathalyzer test using flashlights that can detect the presence of alcohol on a person’s breath. These passive alcohol sensors are being hailed as a new weapon in the fight against DUIs. (Those who refuse to knowingly submit to a breathalyzer test are being subjected to forced blood draws. Thirty states presently allow police to do forced blood draws on drivers as part of a nationwide “No Refusal” initiative funded by the federal government. Not even court rulings declaring such practices to be unconstitutional in the absence of a warrant have slowed down the process. Now police simply keep a magistrate on call to rubber stamp the procedure over the phone.)

The National Highway Safety Administration, the same government agency that funds the “No Refusal” DUI checkpoints and forcible blood draws, is also funding nationwide roadblocks aimed at getting drivers to “voluntarily” provide police with DNA derived from saliva and blood samples, reportedly to study inebriation patterns. In at least 28 states, there’s nothing voluntary about having one’s DNA collected by police in instances where you’ve been arrested, whether or not you’re actually convicted of a crime. All of this DNA data is being fed to the federal government.

Airline passengers, already subjected to virtual strip searches, are now being scrutinized even more closely, with the Customs and Border Protection agency tasking airport officials with monitoring the bowel movements of passengerssuspected of ingesting drugs. They even have a special hi-tech toilet designed to filter through a person’s fecal waste.

Iris scans, an essential part of the U.S. military’s boots-on-the-ground approach to keeping track of civilians in Iraq and Afghanistan, are becoming a de facto method of building the government’s already mammoth biometrics database. Funded by the Dept. of Justice, along with other federal agencies, the iris scan technology is being incorporated into police precincts, jails, immigration checkpoints, airports and even schools. School officials—from elementary to college—have begun using iris scans in place of traditional ID cards. In some parts of the country, parents wanting to pick their kids up from school have to first submit to an iris scan.

As for those endless pictures everyone so cheerfully uploads to Facebook (which has the largest facial recognition database in the world) or anywhere else on the internet, they’re all being accessed by the police, filtered with facial recognition software, uploaded into the government’s mammoth biometrics database and cross-checked against its criminal files. With good reason, civil libertarians fear these databases could “someday be used for monitoring political rallies, sporting events or even busy downtown areas.”

While the Fourth Amendment was created to prevent government officials from searching an individual’s person or property without a warrant and probable cause—evidence that some kind of criminal activity was afoot—the founders could scarcely have imagined a world in which we needed protection against widespread government breaches of our privacy, including on a cellular level.

Yet that’s exactly what we are lacking and what we so desperately need.

Unfortunately, the indignities being heaped upon us by the architects and agents of the American police state—whether or not we’ve done anything wrong—are just a foretaste of what is to come.

As I make clear in my book Battlefield America: the War on the American People, the government doesn’t need to tie you to a gurney and forcibly take your blood or strip you naked by the side of the road in order to render you helpless. It has other methods—less subtle perhaps but equally humiliating, devastating and mind-altering—of stripping you of your independence, robbing you of your dignity, and undermining your rights.

With every court ruling that allows the government to operate above the rule of law, every piece of legislation that limits our freedoms, and every act of government wrongdoing that goes unpunished, we’re slowly being conditioned to a society in which we have little real control over our bodies or our lives.

John W. Whitehead is the president of The Rutherford Institute and author of Battlefield America: The War on the American People.

https://www.counterpunch.org/2017/09/07/what-country-is-this/

Medicaid sees big price hikes for decades-old drugs

By Brad Dixon
28 August 2017

An investigation by Kaiser Health News (KHN) found that numerous decades-old drugs still have high price tags, and some remain branded despite how long the drugs have been available on the market.

Based on an analysis of Medicaid data, KHN found that spending by the program on old and commonly used drugs increased by billions of dollars in 2016 compared to the previous year. In fact, the per-unit costs of dozens of generic medications doubled or even tripled during this period.

The costs of 67 generic and non-branded drugs cost Medicaid an extra $258 million in 2016. Medicaid spending on branded drugs, including nine branded drugs that have been available for decades, increased by as much as $3.2 billion.

The costs per unit do not include drug rebates provided by drug manufacturers, but the exact size of these discounts is a closely held proprietary secret.

The report highlighted a number of drugs whose prices increased dramatically in 2016, despite some being available as far back as half a century:

• The price of fluphenazine hydrochloride, used to treat schizophrenia and approved in 1988, rose an average of 347 percent, increasing Medicaid spending by an extra $8.5 million.

• The price of potassium phosphates, used to treat renal failure and was approved in the 1980s, rose 290 percent, costing Medicaid an extra $1.8 million.

• The price of naproxen sodium, the painkiller branded asfluphenazine hydrochloridee that was approved in 1994, rose an average of 236 percent, costing Medicaid an extra $10 million.

• The price of Depo-Provera, used for birth control and approved in 1960, rose by more than 100 percent, costing Medicaid an extra $4.5 million.

In 2016, Medicaid also spent additional funds on a number of branded drugs, including $223 million extra on the arthritis drug Humira, $137 million on the cancer drug Herceptin, $117 million on the schizophrenia drug Latuda, $106 million on the arthritis drug Enbrel, and $102 million on the diabetes drug Humalog. Medicaid spending on the Epipen, the device used to treat serve allergic reactions whose price hikes sparked outrage last year, increased by $70 million.

While the cost of a drug normally declines when it goes generic, a host of factors can delay or undermine this trend. For example, patients may choose stay with the branded version and some states prevent pharmacists from automatically substituting generic for branded prescriptions.

More importantly, the price of generic drugs is related to the number of competitors producing the drug. Citing an analysis by the Food and Drug Administration, the KHN study notes that when there are five or more competitors, the price will drop to about a third of the original price; with two competitors, the price drops to about half the original cost; but when there is only one generic producer, the price only drops by 6 percent compared to the branded version.

Drugmakers have sought to limit competition by illegally colluding with “competitors” in order to keep drug prices artificially high. Since December of last year, 40 states have filed antitrust claims against six generic drug manufacturers—Citron Pharma, Heritage Pharmaceuticals, Myane Pharma, Teva Pharmaceuticals, Aurobindo Pharma, and Mylan Pharmaceuticals—alleging that the companies conspired to divide the market on an antibiotic and an oral diabetes medication, resulting in substantial price hikes.

Pharmaceutical companies also squelch generic competition by suing drugmakers that challenge their patent, or by entering into pay-for-delay deals in which generic manufacturers are compensated for delaying their entry as a generic competitor.

For example, in 2015, Concordia Pharmaceuticals and Par Pharmaceuticals settled charges with the Federal Trade Commission (FTC), which alleged that Concordia agreed to not sell generic versions of Kapvay, a treatment for Attention Deficit Hyperactivity Disorder (ADHD), in exchange for 35 to 50 percent of the net profits made by Par’s sales of the drug. That same year, Teva Pharmaceuticals settled a $1.2 billion lawsuit with the FTC, which claimed that the company it had acquired in 2012, Cephalon, had blocked generic competition against its narcolepsy drug Provigil.

A November 2014 perspective article in the New England Journal of Medicine(NEJM), also drawing on Medicaid data, found a number of similar sharp price hikes among generic drugs between November 2012 and November 2013, including a 5,330 percent increase in the price of doxycycline hyclate, a broad-based antibiotic available since 1967, a 3,780 percent increase in the price of clomipramine, an antidepressant, and a 2,850 percent increase in the price of captopril, used to treat hypertension and heart failure.

The NEJM article also noted a dramatic hike in the price of albendazole, a broad-spectrum antiparasitic medication used primarily to treat immigrants and refugees suffering from intestinal parasites and other maladies. Its price rose by more than 2,000 percent between 2010 and 2013. While the drug is off patent, no companies have sought to introduce generic versions because there is no profit incentive to do so.

This past May, the health care technology company Truveris issued a reportthat drug prices had increased by 8.8 percent in 2016 compared to the previous year—an increase that was 318 percent greater than the rate of inflation. It found that the previous three years have seen an average 10 percent increase in drug prices annually.

A report released this past February by Raymond James & Associates found that the drug industry raised the list prices of 2,353 prescription drugs at the start of 2017.