How ‘Real America’ Became Queer America

From The New York Times:  https://www.nytimes.com/2019/03/13/opinion/lgbt-trump-red-states.html

The Trump administration may be busy waging culture wars. But in the heartland, it’s never been a better time to be L.G.B.T.

By Samantha Allen
March 13, 2019

This may seem like a strange time to feel optimistic about the future of L.G.B.T. rights in America. But as a queer transgender woman who has spent most of her adult life in red states, hopeful is exactly how I feel.

In July 2017 — the same month that President Trump announced on Twitter that he would ban transgender troops — I left on a six-week-long road trip across the red states. I wanted to understand what motivated L.G.B.T. people to stay in the heartland at a time when some progressives were still pondering escaping to Canada.

What I learned on the way from Utah to Georgia only reaffirmed what I have come to believe over the past decade: Attitudes toward L.G.B.T. people are changing rapidly in conservative states, and no one inside the Beltway can stop it. This country’s bright queer future is already here, hiding where too few of us care to travel.

From a bird’s-eye perspective, it may not seem that life has changed for L.G.B.T. Americans in so-called flyover country. State laws prohibiting discrimination against them remain elusive in red states — although Utah notably passed one in 2015. But in their absence, midsize cities have become pockets of L.G.B.T. acceptance.

In the West, cities including Boise, Idaho; Salt Lake City; Bozeman, Mont.; and Laramie, Wyo., have passed L.G.B.T.-inclusive nondiscrimination ordinances in the past decade. Below the Mason-Dixon line, the list of cities with such laws includes Atlanta and New Orleans; Birmingham, Ala.; and Jackson, Miss. L.G.B.T. Texans have had to fend off all manner of horrific state-level bills, but if they live in Austin, Dallas, Plano or Fort Worth, they have solid local laws on their side. And Midwestern hubs like St. Louis and Omaha likewise offer L.G.B.T. protections.

The Human Rights Campaign, a national L.G.B.T. advocacy organization, is downright cheerful about this trend at a time when queer optimism feels in short supply. In the its 2018 Municipal Equality Index, the group’s president, Chad Griffin, wrote that “while cynical politicians in Washington, D.C., attempt to roll back our hard-fought progress, many local leaders are championing equality in big cities and small towns from coast to coast.”

And this progress includes transgender people. According to the group’s data, over 180 cities and counties in states whose electoral votes went to Mr. Trump in 2016 now protect employees not just on the basis of sexual orientation but gender identity as well.

Continue reading at:  https://www.nytimes.com/2019/03/13/opinion/lgbt-trump-red-states.html

 

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Could CDC Guidelines Be Driving Some Opioid Patients to Suicide?

As a senior citizen I am surrounded by people who live with chronic, often debilitating pain.  Is it right that people with pain have to suffer because drug addicts abuse drugs?  Further the Opioid Crisis really isn’t so much about opioids as it is about synthetic black market opioid substitutes such as Fentanyl.  But even there we are talking about drug administered to terminally ill cancer patients.

Years ago Niel Young sang, “The Needle and the Damage Done”.  The lesson I’ve learned over the years is that substance abusers abuse substances.  Eliminate the safer and less harmful and they will abuse ever more dangerous substances.  Prohibition didn’t work in the 1920s and the War on Drugs hasn’t worked since.

From Rolling Stone:  https://www.rollingstone.com/culture/culture-features/cdc-opioid-letter-patient-suicide-805564/

In a letter to the CDC, a group of doctors and advocates said the agency’s opioid prescription guidelines are having alarming consequences. But in the midst of an epidemic, where should doctors draw the line?

By EJ Dickson
March 9, 2019

Overall, we have every reason to believe that the opioid crisis is getting better, not worse. Since the Centers for Disease Control issued its guidelines dictating appropriate opioid prescription rates and dosages in 2016, opioid prescriptions have declined significantly. Overdose deaths have also been on the decline, though some health experts believe that effect might be temporary.

Two groups that have not benefited from increasing public health efforts to stem the opioid crisis, however, is people living with chronic pain and their health care providers. In a letter to the CDC that was published on Wednesday, a coalition of health care providers, doctors and patient representatives, writing on behalf of an organization called Health Professionals for Patients in Pain (HP3), issued a call for the CDC to “address misapplication of its guideline on opioids for chronic pain through public clarification and impact evaluation” — in short, to clarify its guidelines on opioid prescription for doctors, particularly when it comes to weaning patients off the drugs.

“Patients with chronic pain, who are stable and, arguably, benefiting from long-term opioids, face draconian and often rapid involuntary dose reductions,” the letter states. Often, alternative pain care options are not offered, not covered by insurers, or not accessible. Others are pushed to undergo addiction treatment or invasive procedures (such as spinal injections), regardless of whether clinically appropriate. Consequently, patients have endured not only unnecessary suffering, but some have turned to suicide or illicit substance use.”

“There’s no question that doctors have [historically] been too liberal in prescribing opioids,” says Sally Satel, MD, a psychiatrist and a lecturer at the Yale University School of Medicine, who coauthored the letter. “But in this pulling back, the pendulum has overshot in some instances, and it’s especially taken a toll on people who have been maintained on usually high-dose opioids for many years for excruciating chronic conditions.”

Currently, the CDC guidelines on opioid prescription recommend that doctors attempt to get patients to taper off the drugs. They also recommend that doctors avoid prescribing opioids for long-term pain management, and that any daily dosage should be below the equivalent of 90 milligrams of morphine.

Continue reading at:  https://www.rollingstone.com/culture/culture-features/cdc-opioid-letter-patient-suicide-805564/

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