Does Donald Trump Have Dementia Or Psychiatric Problems?

I have been wondering for quite a while whether Donald Trump’s primary problem is dementia or psychiatric. He has shown some signs of possible dementia, but they were hardly definitive. Psychiatrists have also been questioning Trump’s mental health. We probably now have an answer to the question of whether Trump’s problem is dementia versus psychiatric. Reportedly Donald Trump scored a 30 out of 30 on the Montreal Cognitive Assessment. The test is a pretty reliable indicator of dementia and with a score of 30 and, assuming the report of Trump’s score is factual, it is now doubtful that he has dementia.

With dementia ruled out, Trump should have thorough psychiatric testing, but it is unlikely that he will ever consent to this. The only way to force him to would by trying to remove him from office under the provisions of the 25th Amendment, and this is unlikely to happen unless there is a very clear deterioration .

Study Shows That Legalizing Medical Marijuana Decreases Violent Crime

The Guardian reports on another study showing a decrease in crime with legalization of marijuana:

The introduction of medical marijuana laws has led to a sharp reduction in violent crime in US states that border Mexico, according to new research.

According to the study, Is Legal Pot Crippling Mexican Drug Trafficking Organizations? The Effect of Medical Marijuana Laws on US Crime, when a state on the Mexican border legalised medical use of the drug, violent crime fell by 13% on average. Most of the marijuana consumed in the US originates in Mexico, where seven major cartels control the illicit drug trade.

“These laws allow local farmers to grow marijuana that can then be sold to dispensaries where it is sold legally,” said the economist Evelina Gavrilova, one of the study’s authors. “These growers are in direct competition with Mexican drug cartels that are smuggling the marijuana into the US. As a result, the cartels get much less business.”

The knock-on effect is a reduction in levels of drug-related violence. “The cartels are in competition with one another,” Gavrilova explained. “They compete for territory, but it’s also easy to steal product from the other cartels and sell it themselves, so they fight for the product. They also have to defend their territory and ensure there are no bystanders, no witnesses to the activities of the cartel.

“Whenever there is a medical marijuana law we observe that crime at the border decreases because suddenly there is a lot less smuggling and a lot less violence associated with that.”

In other words, the experience with marijuana prohibition is similar to what we experienced with alcohol prohibition.

This also shows a failure of our political system. Despite ending prohibition being both the sensible choice, and a choice favored by a large majority of Americans, there has been little pressure to change the system from either major political party. While the two parties find plenty to fight over, there is little difference over what they parties actually do on far too many issues.

Psychiatrists Debate Speaking Out On Donald Trump’s Mental Health

The Goldwater Rule has received considerable attention this year with the election of Donald Trump. The rule was put into place to dissuade psychiatrists from talking about the mental health of politicians without actually doing an exam after some had speculated about Barry Goldwater’s mental health.  As I noted in July, the American Psychoanalytic Association has released an emailed statement freeing its members to give opinions on the mental state of Donald Trump. The controversy has continued with the publication of a book entitled The Dangerous Case of Donald Trump: 27 Psychiatrists and Mental Health Experts Assess a President.

The New England Journal of Medicine has an article by a psychiatrist, Claire Pouncey, resonding to criticism of the book and making an argument for psychiatrists to be able to comment on the mental health of Donald Trump. Here is a portion:

…in October, psychiatrist Bandy Lee published a collection of essays written largely by mental health professionals who believe that their training and expertise compel them to warn the public of the dangers they see in Trump’s psychology. The Dangerous Case of Donald Trump: 27 Psychiatrists and Mental Health Experts Assess a President rejects the position of the American Psychiatric Association (APA) that psychiatrists should never offer diagnostic opinions about persons they have not personally examined.Past APA president Jeffrey Lieberman has written in Psychiatric News that the book is “not a serious, scholarly, civic-minded work, but simply tawdry, indulgent, fatuous tabloid psychiatry.” I believe it shouldn’t be dismissed so quickly…

The relevance of the Goldwater rule has spiked in the past 2 years in the setting of Trump’s candidacy and now presidency. There are good reasons to respect the intention of Section 7.3. Most psychiatrists want to teach the public about the myriad presentations of mental illness and character pathology and not to oversimplify, stigmatize, promote stereotypes, or disparage the persons whose mental health we work to improve. We believe that people with mental illness can flourish and contribute to our communities, and on the flip side, we do not assume that everyone who behaves erratically or earns public disapprobation is mentally ill. Most psychiatrists do not think we have superpowers that let us know the inner thoughts and psychological workings of strangers. Section 7.3 reminds us to remain humble about the claims we can reasonably make and to present ourselves responsibly for the sake of our patients and our profession.

Increasingly, however, some psychiatrists are expressing professional concern about Trump’s public remarks and behaviors and what they mean for public safety. Lee and her coauthors clearly take themselves to be fulfilling the moral obligation of Section 7 by using their specific expertise as mental health professionals.

The Goldwater rule, like the other APA annotations, is meant to clarify a principle of medical ethics, not contradict it. Yet in March 2017, shortly after Trump’s presidential inauguration, the APA broadened the rule to apply to “any opinion on the affect, behavior, speech, or other presentation of an individual that draws on the skills, training, expertise, and/or knowledge inherent in the practice of psychiatry”5 — an expansion that would silence psychiatrists who want to honor the moral obligation of Section 7 by educating the public about the dangers they see in Trump’s psychology. The problem is that psychiatric diagnostic terminology has been colloquialized, so the public and the press use it to describe Trump, but when a psychiatrist does so, use of the same words is considered to be a formal diagnosis (at least in the eyes of the APA). As a result, psychiatrists are the only members of the citizenry who may not express concern about the mental health of the president using psychiatric diagnostic terminology.

The Dangerous Case of Donald Trump challenges the APA position that a psychiatrist cannot know enough about a person she has not interviewed to formulate a diagnostic impression. Contrary to the APA, a physician who has not formally evaluated a patient is not making a diagnosis in the medical sense, but rather using diagnostic speculation and terminology informally, with the benefit of education. That characterization applies to the orthopedist or physical medicine specialist speculating on the knee injury of the football player limping off the field and the dermatologist wincing at a stranger’s melanoma in the grocery line as well as to the psychiatrist interpreting Trump’s public statements. Physicians don’t stop knowing what we know when we leave the clinic. Psychiatric terminology has become part of the common parlance, and the authors in Dangerous Case describe and define that terminology much better than, say, Ralph Northam. The question is whether psychiatrists are the ones we should hear it from.

I expect that the APA will denounce and dismiss this book and its authors, but I encourage others not to do so. Dangerous Case is unapologetically provocative and political, and the authors clearly take themselves to be contributing to the improvement of the community and the betterment of public health, as the AMA (and APA) principles of medical ethics direct. Dangerous Case will have supporters and detractors for good reasons — some political, some social, some psychiatric — that have much more to do with views of Trump’s mental health than with the Goldwater rule. I believe that the APA, in the interest of promoting public health and safety, should encourage rather than silence the debate the book generates. And it should take caution not to enforce an annotation that undermines the overriding public health and safety mandate that applies to all physicians. Standards of professional ethics and professionalism change with time and circumstance, and psychiatry’s reaction to one misstep in 1964 should not entail another in 2017.

American Psychoanalytic Association Gives OK To Call Trump Nuts

It is customary to do an exam on a patient actually in their presence for psychiatrists to make a diagnosis. This led to what has been known as the Goldwater Rule prohibiting psychiatrists from giving their opinion about the psychiatric state of public officials they have not examined. The American Psychoanalytic Association has released an emailed statement freeing its members to give opinions on the mental state of Donald Trump:

The impetus for the email was “belief in the value of psychoanalytic knowledge in explaining human behavior,” said psychoanalytic association past president Dr. Prudence Gourguechon, a psychiatrist in Chicago. “We don’t want to prohibit our members from using their knowledge responsibly.”

That responsibility is especially great today, she told STAT, “since Trump’s behavior is so different from anything we’ve seen before” in a commander in chief.

STAT also reports:

In October, a book titled “The Dangerous Case of Donald Trump: 27 Psychiatrists and Mental Health Experts Assess a President” will be published.

“When the book comes out, there will be renewed furor about the Goldwater rule, since it is precisely about what is wrong with him,” said psychiatrist Dr. Lance Dodes, a retired professor at Harvard Medical School who is now in private practice in Los Angeles.

The Goldwater Rule got its name after some psychiatrists answered a survey on whether Barry Goldwater was fit to serve as president in 1964. His slogan, “In your heart, you know he’s right” was mocked by the Johnson campaign with the alternative, “In your guts, you know he’s nuts.”

There have always been exceptions to this rule. It has been customary for the State Department and other federal agencies to ask psychiatrists about the psychological state of foreign leaders based upon public behavior and speech. The rule also carried no penalties, and enforcement by government officials, including license boards, would likely violate First Amendment rights to freedom of speech.

Fortunately other medical organizations have not had such restrictions, as long as it is made clear when a medical opinion is being made without having examined the person. With that in mind, pointing out that I have never examined Donald Trump and that my opinion is based upon observing his public actions alone, in my professional opinion he should also be tested for early Alzheimer’s.

The opinion that Trump might be nuts is not limited to the psychiatric profession. The Washington Post reports on two Senators, Susan Collins (R-Maine) and Jack Reed (D-R.I.), being caught by an open mike questioning Donald Trump’s sanity:

“Yes,” Reed replies. “I think — I think he’s crazy,” apparently referring to the president. “I mean, I don’t say that lightly and as a kind of a goofy guy.”

“I’m worried,” Collins replies.

Finally something we have bipartisan agreement on.

Members of Presidential Advisory Council On HIV/AIDS Resign In Protest Over Policies Of Trump Administration

Six members of the Presidential Advisory Council on HIV/AIDS (PACHA) have resigned in protest over the lack of concern by the Trump administration for treating HIV. They have publicly announced their decision in an open letter published in Newsweek.  The letter notes that, “It is indisputable that the Affordable Care Act has benefitted people living with HIV and supported efforts to combat the HIV/AIDS epidemic.” It notes that, in contrast, provisions of the American Health Care Act which reduce access to health care “would be particularly devastating for people living with HIV.”

Following is the text of the letter:

Five of my colleagues and I resigned this week from the Presidential Advisory Council on HIV/AIDS (PACHA).

As advocates for people living with HIV, we have dedicated our lives to combating this disease and no longer feel we can do so effectively within the confines of an advisory body to a president who simply does not care.

The Trump Administration has no strategy to address the on-going HIV/AIDS epidemic, seeks zero input from experts to formulate HIV policy, and—most concerning—pushes legislation that will harm people living with HIV and halt or reverse important gains made in the fight against this disease.

Created in 1995, PACHA provides advice, information, and recommendations to the Secretary of Health and Human Services regarding programs, policies, and research to promote effective treatment, prevention, and an eventual cure for HIV.

Members, appointed by the President, currently include public health officials, researchers, health care providers, faith leaders, HIV advocates, and people living with HIV. PACHA also monitors and provides recommendations to effectively implement the National HIV/AIDS Strategy, which was created by the White House Office of National AIDS Policy in 2010 and revised in 2015.

The decision to resign from government service is not one that any of us take lightly. However, we cannot ignore the many signs that the Trump Administration does not take the on-going epidemic or the needs of people living with HIV seriously.

While many members of the public are unaware of the significant impact that HIV/AIDS continues to have in many communities— or that only 40 percent of people living with HIV in the United States are able to access the life-saving medications that have been available for more than 20 years—it is not acceptable for the U.S. President to be unaware of these realities, to set up a government that deprioritizes fighting the epidemic and its causes, or to implement policies and support legislation that will reverse the gains made in recent years.

Signs of President Trump’s lack of understanding and concern regarding this important public health issue were apparent when he was a candidate. While Secretary Clinton and Senator Sanders both met with HIV advocates during the primaries, candidate Trump refused. Whatever the politics of that decision, Mr. Trump missed an opportunity to learn—from the experts—about the contours of today’s epidemic and the most pressing issues currently affecting people living with HIV.

In keeping with candidate Trump’s lack of regard for this community, President Trump took down the Office of National AIDS Policy website the day he took office and there has been no replacement for this website 132 days into his administration.

More important, President Trump has not appointed anyone to lead the White House Office of National AIDS Policy, a post that held a seat on the Domestic Policy Council under President Obama. This means no one is tasked with regularly bringing salient issues regarding this ongoing public health crisis to the attention of the President and his closest advisers.

By comparison, President Obama appointed a director to this office just 36 days into his administration. Within 18 months, that new director and his staff crafted the first comprehensive U.S. HIV/AIDS strategy. By contrast, President Trump appears to have no plan at all…

We believe he should embrace the important work accomplished by the National HIV/AIDS Strategy. Public health is not a partisan issue, and this important document could easily be ratified by the Trump Administration. If the President is not going to engage on the subject of HIV/AIDS, he should at least continue policies that support people living with and at higher risk for HIV and have begun to curtail the epidemic.

While these actions and others are gravely worrisome to us as HIV advocates, the final straw for us—more like a two-by-four than a straw—is President Trump’s handling of health care reform.

It is indisputable that the Affordable Care Act has benefitted people living with HIV and supported efforts to combat the HIV/AIDS epidemic. Gains in the percentage of people with HIV who know their status, the percentage engaged in care, the percentage receiving successful treatment, and a decrease in new cases of HIV were seen in Massachusetts under Romneycare. We are beginning to see similar effects on a national level under Obamacare.

People living with HIV know how broken the pre-ACA system was. Those without employer-based insurance were priced out of the market because of pre-existing condition exclusions. And “high risk pools” simply segregated people living with HIV and other health conditions into expensive plans with inferior coverage and underfunded subsidies—subsidies advocates had to fight for tooth-and-nail in every budgetary session.

Because more than 40 percent of people with HIV receive care through Medicaid, proposed cuts to that program would be extremely harmful. Prior to Medicaid expansion under ACA, a person had to be both very low income and disabled to be eligible for Medicaid.

For people living with HIV, that usually meant an AIDS diagnosis—making the disease more difficult and expensive to bring under control—before becoming eligible.

Between reinstating that paradox by defunding Medicaid expansion, imposing per-person caps on benefits, and/or block granting the program, the changes to Medicaid contemplated by the American Health Care Act would be particularly devastating for people living with HIV.

And we know who the biggest losers will be if states are given the option of eliminating essential health benefits or allowing insurers to charge people with HIV substantially more than others.

It will be people—many of them people of color—across the South and in rural and underserved areas across the country, the regions and communities now at the epicenter of the U.S. HIV/AIDS epidemic.

It will be young gay and bisexual men; it will be women of color; it will be transgender women; it will be low-income people.

It will be people who become newly infected in an uncontrolled epidemic, new cases that could be prevented by appropriate care for those already living with the disease.

While we are in agreement that the ACA needs to be strengthened to lower premiums, improve competition, and increase access to care, it makes no sense to dismiss gains made under the ACA just to score political points.

Experts with real facts, grounded in science, must be in the room when healthcare policy decisions are made. Those decisions affect real people and real lives. If we do not ensure that U.S. leadership at the executive and legislative levels are informed by experience and expertise, real people will be hurt and some will even die.

Because we do not believe the Trump Administration is listening to—or cares—about the communities we serve as members of PACHA, we have decided it is time to step down.

We will be more effective from the outside, advocating for change and protesting policies that will hurt the health of the communities we serve and the country as a whole if this administration continues down the current path.

We hope the members of Congress who have the power to affect healthcare reform will engage with us and other advocates in a way that the Trump Administration apparently will not.

Scott A. Schoettes is Counsel and HIV Project Director at Lambda Legal . He resigned from the Presidential Advisory Council on HIV/AIDS on June 13, along with Lucy Bradley-Springer, Gina Brown, Ulysses W. Burley III, Michelle Ogle, and Grissel Granados.

Trump and Republicans Escalate War Against Planned Parenthood And Women’s Health

Republicans love to use rhetoric such as talking about small government and freedom, but their real goal is to use big government to impose their religious views upon others. Maybe deep down Donald Trump even realizes that these actions by the religious right are morally wrong, as the usually loud mouthed president signed a bill targeting Planned Parenthood in private. CNN reports:

“President Donald Trump privately signed a bill on Thursday that allows states to withhold federal money from organizations that provide abortion services, including Planned Parenthood, a group frequently targeted by Republicans.

“The bill, which the usually camera-friendly President signed without any media present, reverses an Obama-era regulation that prohibited states from withholding money from facilities that perform abortions, arguing that many of these facilities also provide other family planning and medical services.

“The bulk of federal money Planned Parenthood receives, though, goes toward preventive health care, birth control, pregnancy tests and other women’s health services. Federal law prohibits taxpayer dollars from funding abortions and Planned Parenthood says 3% of the services it provides are abortions.

Republican who support such measures cannot claim to be for either liberty or small government. This also contradicts all their rhetoric about keeping government from getting between patients and doctors.

Trump Executive Orders Include Expanding Global Gag Rule On Abortion & Reinstating Black Site Prisons Closed Under Obama

Donald Trump’s use of executive orders have confirmed the worst fears about what we would see from a Trump presidency. Everyone who is aware of the policy assumed Trump would reinstate the global gag rule which, since Reagan, has been in place under all Republicans and reversed when Clinton and Obama were in office. This prohibits American foreign aide to organizations involved in providing abortions. What we did not anticipate, and most did not even realize immediately, was that Trump expanded this policy considerably. Michelle Goldberg did notice this and wrote in Slate:

In the past, the global gag rule meant that foreign NGOs must disavow any involvement with abortion in order to receive U.S. family planning funding. Trump’s version of the global gag rule expands the policy to all global health funding. According to Ehlers, the new rule means that rather than impacting $600 million in U.S. foreign aid, the global gag rule will affect $9.5 billion. Organizations working on AIDS, malaria, or maternal and child health will have to make sure that none of their programs involves so much as an abortion referral. Geeta Rao Gupta, a senior fellow at the United Nations Foundation who previously served as deputy executive director of UNICEF, gives the example of HIV/AIDS clinics that get U.S. funding to provide antiretrovirals: “If they’re giving advice to women on what to do if they’re pregnant and HIV positive, giving them all the options that exist, they cannot now receive money from the U.S.”

This makes Trump significantly worse than George W. Bush regarding the gag rule. Bush at least did specifically exempt support for an AIDS program, the President’s Emergency Plan for AIDS Relief (PEPFAR) from the global gag rule:

Scott Evertz, who served as director of the White House Office of National AIDS Policy under George W. Bush, tells me, “It would have been impossible to treat HIV/AIDS in the developing world as the emergency that PEPFAR said it was if the global gag rule were to be applied to the thousands of organizations with which those of us involved in PEPFAR would be working.” Evertz offers the example of a standalone health clinic in the slums of Nairobi, Kenya. Would the U.S. have to certify that it never referred any of its patients to an abortion provider before enlisting it in the fight against AIDS?  “The notion of applying the global gag rule to them would have made it impossible to implement the program,” he says.

Other executive orders involve building the border wall and curtailing immigration, limiting Obamacare, backing the Keystone XL and Dakota Access oil pipelines, and Trump is now reportedly preparing an executive order which would reopen “black site” prisons closed under Obama. The New York Times reports on the later:

The Trump administration is preparing a sweeping executive order that would clear the way for the C.I.A. to reopen overseas “black site” prisons, like those where it detained and tortured terrorism suspects before former President Barack Obama shut them down.

President Trump’s three-page draft order, titled “Detention and Interrogation of Enemy Combatants” and obtained by The New York Times, would also undo many of the other restrictions on handling detainees that Mr. Obama put in place in response to policies of the George W. Bush administration.

If Mr. Trump signs the draft order, he would also revoke Mr. Obama’s directive to give the International Committee of the Red Cross access to all detainees in American custody. That would be another step toward reopening secret prisons outside of the normal wartime rules established by the Geneva Conventions, although statutory obstacles would remain.

Mr. Obama tried to close the prison at Guantánamo Bay, Cuba, and refused to send new detainees there, but the draft order directs the Pentagon to continue using the site “for the detention and trial of newly captured” detainees — including not just more people suspected of being members of Al Qaeda or the Taliban, like the 41 remaining detainees, but also Islamic State detainees. It does not address legal problems that might raise…

Elisa Massimino, the director of Human Rights First, denounced the draft order as “flirting with a return to the ‘enhanced interrogation program’ and the environment that gave rise to it.” She noted that numerous retired military leaders have rejected torture as “illegal, immoral and damaging to national security,” and she said that many of Mr. Trump’s cabinet nominees had seemed to share that view in their confirmation testimony.

“It would be surprising and extremely troubling if the national security cabinet officials were to acquiesce in an order like that after the assurances that they gave in their confirmation hearings,” she said.

Good News From Supreme Court On Abortion & The Typical News On Trump and Clinton

Abortion Sign

It was a good day with regards to reproductive rights as the Supreme Court struck down a law in Texas designed to restrict abortions by imposing absurd requirements on abortion clinics designed to make it too difficult to operate.  The New York Times reports:

The Supreme Court on Monday struck down parts of a restrictive Texas law that could have reduced the number of abortion clinics in the state to about 10 from what was once a high of roughly 40.

The 5-to-3 decision was the court’s most sweeping statement on abortion rights since Planned Parenthood v. Casey in 1992. It applied a skeptical and exacting version of that decision’s “undue burden” standard to find that the restrictions in Texas went too far.

The decision on Monday means that similar restrictions in other states are most likely also unconstitutional, and it imperils many other kinds of restrictions on abortion…

he Supreme Court on Monday struck down parts of a restrictive Texas law that could have reduced the number of abortion clinics in the state to about 10 from what was once a high of roughly 40.

The 5-to-3 decision was the court’s most sweeping statement on abortion rights since Planned Parenthood v. Casey in 1992. It applied a skeptical and exacting version of that decision’s “undue burden” standard to find that the restrictions in Texas went too far.

The decision on Monday means that similar restrictions in other states are most likely also unconstitutional, and it imperils many other kinds of restrictions on abortion..

One part of the law requires all clinics in the state to meet the standards for ambulatory surgical centers, including regulations concerning buildings, equipment and staffing. The other requires doctors performing abortions to have admitting privileges at a nearby hospital.

This law came from Republicans who claim to both oppose over-regulation of business and government take-overs of health care.

The New York Times also points out that the Court has leaned left with eight members when it avoids a tie.

Otherwise it was a typical day. Donald Trump said more stupid things, this time calling Elizabeth Warren a racist. Plus we have further evidence that Clinton was lying about her email as more examples were found of work-related email which appear to have been destroyed with the email Clinton claimed was personal. These stories come after too many examples of Donald Trump saying stupid things to list, and a similar report on Clinton’s email three days ago.

Utah Declares Porn To Be A Public Health Crisis

Pornography Utah

The authoritarian right loves to legislate what others may or may not do, especially when it comes to sex. Utah is passing a resolution declaring porn to be a public health crisis. USA Today reports:

Utah Gov. Gary Herbert will sign a resolution declaring pornography a “public health crisis” at the Utah state capitol today.

The resolution was introduced by Republican state Senator Todd Weiler in January 2015, to battle the “pornography epidemic harming” the state and the country.

The resolution, which was passed last month, calls for increased “education, prevention, research, and policy change at the community and societal level,” to combat pornography.  Anti-pornography group, the Utah Coalition Against Pornography posted on Facebook that the resolution signing marks a “time to celebrate and recognize this historic moment.”

Weiler maintains that the resolution is not a ban on porn or an attack on masturbation, but the first steps toward creating a plan to protect children and families from it.

“Due to advances in technology and the universal availability of the Internet, young children are exposed to what used to be referred to as hard core, but is now considered mainstream, pornography at an alarming rate,” according to the bill. 

Ian Kerner, a psychotherapist and sex expert, says the anti-pornography movement is rooted in a long history of stigmatizing sex and masturbation.

“So much of the anti-porn movement is based on a sense of alarmism,” Kerner said, adding that the anti-pornography movement has blurred the line between child and adult access to pornography. “In this country, we really bundle together children and teens with consenting adults, and the issues are not the same for children and teens as they are for consenting adults.”

In contrast, the American College of Physicians recently called on doctors to do more regarding a real public health crisis which is ignored by many conservatives–climate change.

Larry Flynt is responding by sending a free issue of Hustler to every member of the Utah state legislature, although I’m not sure why he would want to reward those people (other than for the free publicity).  He also issued this statement:

“[T]he Utah Legislature is obviously confused about what constitutes a public health crisis, so I’ll send them our latest issue and they can see for themselves that we’re no danger to the public, only to the repressed,” Mr. Flynt said in a statement.

“In 1969 President Lyndon Johnson and the President’s Commission on Obscenity and Pornography found that no evidence exists that exposure to explicit sexual materials cause any kind of criminal behavior,” the 73-year-old self-declared smut peddler said. “This report has been gathering dust for over 40 years, and Utah is only dragging out this issue now to satisfy religious zealots.”

The porn website XHamster.com responded in the opposite manner compared to Flynt in protest over the passage of the recent “religious liberties” law in North Carolina. They protested by blocking access to the site from computers located in North Carolina. That probably hurt even more than Bruce Springsteen canceling a concert in North Carolina.

Obama, Clinton, and Sanders & The Drug War (Sanders Has The Best Position)

Commuted Sentences Obama

The drug war is one of several areas where Obama has tried to move in the right direction, but his overall accomplishments over the last seven years have been disappointing. Far too little has changed. The White House has now announced that President Obama is reducing the sentences of sixty-one more individuals imprisoned due to drug laws, bringing the total to 248:

Today, the President announced 61 new grants of commutation to individuals serving years in prison under outdated and unduly harsh sentencing laws. More than one-third of them were serving life sentences. To date, the President has now commuted the sentences of 248 individuals – more than the previous six Presidents combined. And, in total, he has commuted 92 life sentences.

Underscoring his commitment not just to clemency, but to helping those who earn their freedom make the most of their second chance, the President will meet today with commutation recipients from both his Administration and the previous administrations of Presidents George W. Bush and Bill Clinton. During the meeting, the commutation recipients will discuss their firsthand experiences with the reentry process and ways that the process can be strengthened to give every individual the resources he or she needs to transition from prison and lead a fulfilling, productive life…

While this is welcome news, both liberal and libertarian commentators have expressed regrets that Obama hasn’t done more. Vox notes:

…the White House is still falling far short of the expectations it set for itself two years ago, when it encouraged thousands of prisoners to apply for shorter sentences. Then–Attorney General Eric Holder even went so far as to speculate that 10,000 prisoners might get their sentences reduced by the end of the Obama administration.

In that context, the 61 new commutations — and even the 248 total commutations — look different: a very small, incremental change that may signal the White House will do more in future but almost certainly won’t help it live up to its own expectations.

This comes not long after considerable discussion in the medical field regrading the negative impact of handling drug abuse as a criminal as opposed to a health matter, including in an article in The Lancet:

In a report published Thursday in The Lancet medical journal, Beyrer and an international team of researchers assessed the growing body of evidence for the public health impacts of programs such as opioid substitution therapy and needle exchange programs. In addition to criminal justice changes, the researchers made specific recommendations for policy makers to improve access to services that can reduce the spread of HIV and hepatitis C virus, also known as HCV.

“We think there is the first opportunity in a generation to have meaningful drug reform,” said Beyrer, who led the research for the report , which was commissioned by The Lancet and Johns Hopkins University

The report comes weeks before the United Nations General Assembly Special Session convenes on April 19 to discuss drug policy for the first time since 1998.

“There is pressure from a number of countries who feel the war on drugs has failed them, particularly Central and South America, where there is some of the worst drug-related violence,” Beyrer said. “We sought to review all the scientific evidence so it would be available to the U.N. member states when this is being debated.”

According to the report, injection drug use has led to increases in new HIV and HCV infections. Unsafe injection practices, such as sharing needles, are linked to about 30% of HIV transmission outside of sub-Saharan Africa. HCV transmission is also high among people who inject drugs, and a study in the United States found that more than half of people got infected in the first year they were injecting.

Hillary Clinton’s opposition to needle exchange programs, along with her hard line overall on the drug war, was an issue in the 2008 election. This year Bernie Sanders differs from his current opponents in going the furthest to oppose the continuation of the drug war:

Bernie Sanders’ campaign is now officially neck and neck with Hilary. Considered by many of us, to be a voice of progress and a champion for a new America. Much of his platform is forward-looking and based on reimagining what Americans should value in the future. To reinforce this outlook, many of his major policies address the redistribution of wealth and the reevaluation of some of the country’s long-standing campaigns—with the the War on Drugs being at the top of the list. Bango, Bernie!

Now pay close attention here, his mandates related to the War on Drugs are to treat and rehabilitate non-violent drug offenders rather than imprison them, to prevent large companies from further profiteering off of prisons and to legalize cannabis. If he is elected and this reform is passed by Congress, America would look very different—for the better, we like to think.

As much as Big Bernie is an advocate for policy change, he’s also focused on creating a major cultural shift. This is most strongly evidenced by his plan to create treatment facilities for non-violent drug offenders. If implemented correctly, the plan would encourage Americans to be more sympathetic towards those who have fallen victim to drug addiction, regardless of how or why. As Sanders sees it, it takes a community to help someone get back on their feet, and we need to be in the business of creating the infrastructure to make this happen…

There were also recent reports that a top Nixon aide had described the real reasons for the war on drugs:

“The Nixon campaign in 1968, and the Nixon White House after that, had two enemies: the antiwar left and black people,” former Nixon domestic policy chief John Ehrlichman told Harper’s writer Dan Baum for the April cover story published Tuesday.

“You understand what I’m saying? We knew we couldn’t make it illegal to be either against the war or black, but by getting the public to associate the hippies with marijuana and blacks with heroin. And then criminalizing both heavily, we could disrupt those communities,” Ehrlichman said. “We could arrest their leaders. raid their homes, break up their meetings, and vilify them night after night on the evening news. Did we know we were lying about the drugs? Of course we did.”

This also fits into the Clinton model of expanding police power. I fear that if Clinton is elected we will slide backwards on continuing the disastrous drug war.