Way to miss the point. What does trafficking include? The descriptions seem a tad flexible. If you mean "kidnapping, transporting and selling unwilling victims to be raped" then say so... and give the figures for only that crime. 10,000-20,000 people per year in the USA? No. That's bullshit. The lurid-loving evening news would eat that alive; we'd see 10 stories per night if that were true.
"Human trafficking" sounds suspiciously like a deliberately deceptive umbrella term that groups together nightmare bait stories with other crimes, many of which are heinous enough, but from a sociological and criminological perspective are mostly unrelated.
It is both plausible and probable that not all the participants you see in your porn movies are completely willing participants who made a conscious decision to do that for a living
Ah, so it might include infantilization of women stuff too. Gotcha.
1. Anti-pornography feminism is a thing. Has been for decades.
2. It's not quite as bad, but last year multiple high profile self-identified feminist-progressives signed a petition opposing Amesty International... because Amnesty International is against locking up prostitutes.
You know, I've been wondering whether this human trafficking thing was actually terribly serious problem in the West...
Yes, it is. It's a big problem. Look it up.
If it truly is (please notice I said "in the West"), the people crying wolf about nonsense like this are really making it hard for me to take the stories and figures seriously.
What is human trafficking? What could it *possibly* mean that access to porn (but not social media) actually enables it? Are they are conflating all instances of kidnapping into one giant label "human trafficking"? (Most illegal kidnappings are, if I recall correctly, custody disputes... a parent 'kidnapping' their own child.) Are Mexican coyotes human traffickers, even the more humane ones? Are all sex crimes incidents of human trafficking, or only the ones that involve a car ride?
Can we have a little discrimination between regular crime that's existed forever (and needs fighting, sure) and organized cartels working tirelessly to make the world a horrible place for a profit? If you see absolutely no issue with conflating legal pornography and human trafficking, 1. There is something seriously wrong with you and 2. Even if you do have a point, you're making people not take you seriously. The internet is a big place, there's a finite amount of time in the world, and a finite number of things I can spare a few fucks to give about.
"If we could have manufacturers install filters that would be shipped to South Carolina, then anything that children have access on for pornography would be blocked," Chumley reportedly said. "We felt like that would be another way to fight human trafficking."
You know, I've been wondering whether this human trafficking thing was actually terribly serious problem in the West or if it was just the latest bogeyman from the wings of the socially conservative right and the progressive left being used to clumsily push the same tired agenda of indiscriminate prudery.
Or noting my observations of friends in high school and college who developed problems with cocaine and methamphetamines and either upped dosages over time to "cope" or switched to other equally hard drugs of different families once the high became harder to achieve. But yes, it's anecdotal evidence. YMMV.
Were they taking it for productivity, recreationally, or to cope with specific feelings? You just said "high", which implies a strong recreational (or at least meditative/psychonaut-y) element.
Depends on the substance. E or LSD? Sure. Heroin? Not so much.
Heroin absolutely will provide long term antidepressant (as well as analgesic) effects at a constant dosage. You don't have to inject it, you know. It's just that most people willing to go through the effort to get their hands on a large (or at least regular) supply of H aren't in it to be conservative; they're in it to chase the rush.
But that's a product of heroin's illegality and (relative to other opioids) ease of production. Don't screw up your causation chain here.
I would be interested in details of the trials showing just how spectacularly ineffective they are.
Check out Prozac's wikipedia page for some sourced stuff. Prozac was what launched the SSRI "revolution", was one of the most popularly prescribed medicines of all time, is on WHO's essential drug list and is still widely prescribed by physicians who subjectively believe it to be effective based on their own highly biased experience.
Here are the ballpark numbers for Prozac (adjusted for placebo): 2/3 OCD sufferers were not much improved, 4/5 anxiety disorder sufferers did not see control of their panic attacks, and after a 2008 meta-analysis of all the major studies, it appeared that the efficacy of Prozac for mild or moderate depression was insignificant. As in, the effect was so small they can't be sure it helped anyone. (Its efficacy for major depression is also insignificant. Almost no drug will put a dent in major depression short of powerful euphorics.)
Some other SSRIs fare a bit better, but frankly I don't trust those numbers. It took decades for Prozac's ineffectiveness to come to light, and 8 years after the news broke it's STILL approved to treat depression and it's STILL on WHO's essential medicines list despite not being a good treatment for *anything* except maybe as a third or fourth line Hail Mary option. I haven't had time to go digging through how drug trials work, but the whole thing stinks to high heaven. (At a minimum, I strongly suspect they are suppressing negative studies and basically just rolling the dice until they get lucky.)
But all that aside, even the more effective SSRIs do not adequately resolve depression or anxiety for most of the people taking them. Because of this, psychiatrists are now frequently recommending stuff like atypical antipsychotics (which have significant physiological and psychological side effects) or mood stabilizers as an adjunct.
I am, however, aware of a concerns that began within the last couple of years that seemed to show that unpublished clinical trials showed SSRIs to be no more effective than placebos.
Oh, I didn't see this bit when I wrote the above. Yeah, except it's been over 8 years since they had compelling evidence, and they've done absolutely nothing. Prozac and other SSRIs have been HUGE business; I mean it was completely revolutionary.
And it dovetailed *so* nicely with all of their anti-addiction / anti-abuse rhetoric. The psychiatric industry wanted a placebo desperately, even moreso than their poor suffering patients, and eight years later they're too gutless and self-serving to even admit to their patients that there's a problem.
Contrast this to any other medical disorder you could think of: if the FIRST LINE TREATMENT your doctor told you to take had a 80% ch
That sounds like an issue with how the Tor people are doling out the bridges. (One alternative being that Turkey's intelligence agencies are capable enough to do traffic analysis to deduce the identity of bridges located in other countries, which seems unlikely.)
A more robust system would be penpal-like, with communication between the bridge provider and user to (at least tentatively) verify legitimacy. The bridges wouldn't be rotated; they would be kept secret. But on top of this, on could build a F2F network to allow bridge sharing.
by the last paragraph, I merely mean to imply that's probably why they were willing to give MDMA a chance, not that it will necessarily be ineffective.
Holy shit you are an intellectually bankrupt liar. Either that or just incredibly lazy to bother doing even the tiniest bit of research for your own arguments. I wasn't going to waste my time, but after 45 seconds the top Google results all confirmed my suspicions: MDMA is for therapy enhancement only. No tolerance will develop, it will only be administered a handful of times with days or weeks in-between, and the patient will not be trusted to take the medicine on his or her own time.
This is a massive indictment of the psychiatry community and assorted regulatory bodies. It entirely supports my claims whilst undermining yours.
MDMA will not be given for long term, patient-administered treatment. You're lying when you imply otherwise, and you've yet to even try challenging any one of my assertions. The fact that MDMA isn't going to be used for long term or probably even medium term symptom management strongly supports my case, not yours. *Of course* they're willing to touch euphoric drugs,... if they're going to be so locked down as to make abuse or addiction nigh impossible.
Incidentally, it has a significantly different mode of action than amphetamine and you demonstrate your own profound ignorance when you imply they are closely rated in neurological effects. MDMA has a strong effect on serotonin, which is part and parcel of the pathological serotonin-worshipping cargo cult that developed in the psychiatric community over the past few decades in the aftermath of Prozac's popularity.
Most restricted drugs produce short term intense effects. Not very useful for treating ongoing mental illness. And used recreationally, it is easy to abuse and develop a tolerance, causing the user to seek ever higher and more dangerous dosages.
Congratulations for brainlessly repeating the propaganda they instilled in you in elementary school.
What you describe is how it works for reactional users chasing the rush. It is not at all true that your body completely adjusts to low to moderate doses as "the new normal" and you have to increase the dose to get any effect. An interesting exception to the psychiatric taboo against prescribing euphoric drugs is of course in children with ADHD, who are routinely given Ritalin or Adderall (amphetamine, i.e. something that's very very similar to that stuff Walter White was making.)
These drugs have significant effects that persist even though the dose is held constant. It's also pretty well-established that constant-dose opioids have persistent effects. In both cases, it's primarily those people who want instant gratification, pure recreational euphoria, who are compelled to raise the dose.
But as a means for treating mental illness, I have to disagree with your implied hypothesis that mental illnesses would often be better treated with recreational drugs that are currently illegal.
Even if you were correct that euphoric drugs (Just Say No!) lose all potency once the body develops tolerance, this would still be an incorrect conclusion.
What about illnesses that are episodic, like sporadic panic attacks (these, too, are often treated with spectacularly ineffective SSRIs)? What about regular cases of depression (as opposed to refractory major depressive disorder), which can often resolve over just a couple months?
Can't you run TBB as a relay? It's been a few years since I've looked into it. (My current pipe is way crappy to use as a relay, bridge or otherwise, otherwise I'd have looked into this sooner.)
I'm a bit surprised about Vidalia. Would've thought there would be a stronger push to make it easy for people to run relays, but forcing them to run a full Firefox GUI if they want an easy option seems a bit wasteful.
Also, anything that results in even 20% of people having a notable improvement is a HUGE victory
No it isn't. It particularly isn't given the massive costs involved in getting a script (which people are paying for either directly or indirectly), and the discouragement many people face when their glorified placebo doesn't work.
Prescribing drugs that are unlikely to successfully treat a condition is, in most other contexts, grounds for a malpractice suit. Prozac should be removed from WHO's list of essential medicines and the authority to market it for people suffering depression revoked (they can still prescribe off-label if they really want.) There's no excuse whatsoever for this state of affairs.
Major depressive disorder is not trivial, it's not "feeling sad" or "down", it's not a couple of weeks of grieving over a death, etc.
I've been formally diagnosed with and have been dealing with MDD almost continuously, with a few months of respite here and there, since I was ten years old, fuck you very much. (I suspect my biggest ongoing issue is that I'm not able to engage in constructive self-delusion as effectively as most.)
In the past I've been closely involved with someone who also suffered from lifelong MDD with the added bonus of social anxiety with panic attacks, in addition to multiple friends and family members going through "regular" depression, one of whom essentially killed herself. I've also known several people with chronic pain, so I'm familiar with circus surrounding controlled substances.
I have a very, very long list of interesting anecdotes that I'm not going to be getting into here.
Approving MDMA for phase 3 trials with the goal of bringing it to market in 2021
It's been a while since I looked at the MDMA stuff, but as I recall it was being used at low dose whilst *in the therapist's office*, not for daily use. Given the confirmed neurotoxicity of MDMA, I strongly suspect this is the mode of treatment that is still being tested, but I can't be bothered to check. Not symptom treatment, but an attempt at a cure through a handful of one-off doses that make you open up to your therapists. If you want to prove my suspicions wrong, feel free.
There are a dozen other reasons why this pending (not guaranteed) approval isn't all that interesting or contrary to what I'm saying, but an unwillingness to prescribe MDMA on a long term basis (as I suspect will be the case), let alone administration in a home setting, completely proves my point.
just goes to show how full of shit you are about any conspiracy to prevent such substances from being used to treat people.
There's no conspiracy. The "all regular people are just latent addicts/abusers" mindset is mainstream and out in the open. Pathologization of "addiction" is in their fucking handbook, for crying out loud. It's in the prescribing guidelines. It's shown in the way the DEA busts pain clinics and lone wolf doctors who prescribe "inappropriate" medicines. It's not a conspiracy theory. They scream it from the rooftops.
And "mild to moderate depression" is NOT the same as major depressive disorder,
You already conceded that antidepressants suck for MDD. And I've already explained at length that this isn't about any one disorder. So... what the hell is your point?
Prozac is not suitable to treat any type of depression except maybe as a fourth line off-label Hail Mary treatment. Agree or disagree?
Furthermore, given how long its ineffectiveness took to come to light, all SSRIs and SNRIs should be subjected to increased scrutiny and post-market testing and patients should be clearly informed when they are likely wasting their time and money. Agree or disagree?
I'm not going to respond to the bazillion other threads you're replying to, as I think the essentials are all here.
TFS neglects to mention that anyone with a halfway decent internet connection can help people in countries like Turkey evade censors by running a Tor bridge. It appears to be extremely simple to set up. Note that this is a hidden entry node and not an exit node, so your ISP isn't going to be sending you nasty letters.
Yes, there ss an open moral question there given the significant number of nefarious uses of Tor. However, I suspect most of those users aren't going to bother with a bridge... and I happen to think that free speech is something that's worth fighting for. You know, the real thing. Criticism of politicians. Coverage of news events that are being actively suppressed by government censors. This is about actual free speech by any sane definition.
Says the person who can't read my posts properly and refuses to look up the stats herself. Here, let me get you started:
Prozac, the drug that started this craze, a drug that's still WHO's list of "essential medicines", one of the most prescribed drugs of all time (all numbers adjusted for placebo) and one that is still being actively prescribed and investigated for a variety of off-label usages:
2 out of 3 people "not much improved" for OCD.
4 out of 5 people suffering Panic Disorder did not find their panic attacks controlled.
Mild to Moderate Depression: Clinically Insignificant changes. (According to a Kirsch meta study. I looked at some individual studies around when this first came out and it was pretty damning stuff, but I'm not digging through it all for your benefit right now. You want to remain ignorant, that's your choice.)
Pilot, preliminary type data-gathering studies exist for amphetamines, opioids and the like. They aren't controlled, but they indicate very strong potential for a variety of anxiety and depressive disorders. Given how they function and the prevalence of dysphoria in anxiety and depression, this is to be expected. And no, the DEA and anti-addiction wings of the medical establishment aren't fucking happy about any noises rebel psychiatrists make in this direction.
And moving MDMA from schedule 1 to schedule 2 changes nothing about the addiction culture that is their lifeblood. Cocaine is schedule 2 as well. It's technically legal for your doctor to prescribe cocaine off-label for depression. Go ahead, try it. I dare you. But please try to get it on video if you do.
No, I'm not giving you source links for any of this you lazy, lazy person.
No, you did not specifically refer to bipolar depression, so quit lying. The topic was major depressive disorder. Not bipolar (what used to be called manic-depressive) disorder.
Let me try adding bold this time:
1. They are particularly superior for episodic disorders because they work quickly and (because they aren't being taken regularly) they remain at high potency, without tolerance or withdrawal issues. (Assuming a non-"abusing" patient.) I'm not talking about MDD so much here, but rather stuff like (certain types of) bipolar depression. Many anxiety disorders are also episodic.
Christ almighty. Quibble much? None of my points hang on a single disorder here. Psychiatric disorders that involve the patient experiencing significant dysphoria of one form or another constitute the majority of outpatient prescriptions. (Delusional and hallucinatory disorders being possibly the only major exceptions.)
MDMA for PTSD isn't *quite* the same thing as opioids or amphetamines for depression or anxiety. And do you think it'll be first line? Do you think all psychiatrists will be willing to prescribe it?
This is a cultural thing even more than a legal thing. Technically, there's no law preventing psychiatrists from prescribing oxycodone off-label for depression. It's just that very few people are insane enough to actually try that, as it opens them up to DEA scrutiny and lawsuits.
I clearly gave bipolar depression as the sort of thing I was referring to (though it depends on the typical timing and duration of the swings.) Bipolar depression with a mild or nonexistent manic phase also has a name that temporarily eludes me at the moment. It's basically just a cyclical depression.
Dysphoria is best treated by fixing the problem. For gender dysphoria
I am referring to dysphoria as in the inverse of euphoria, not whatever gimmicky buzzword the DSM has popularized this week. (To be clear, I'm disparaging only the buzzword, not the suffering it refers to.) Dysphoria is present in most mood disorders in one way or another.
Intuition and anecdote is all anyone ever has, scientists included, at the very beginning. Provide me the money, and I'll happy to run the trials for you.
What is easily provable is the lack of efficacy of psychiatry against the most common psychiatric complaints. You can dig up the numbers yourself, if you're so inclined.
And from the way you've discussed this, it's obvious you don't even have anecdotal first-hand experience of being diagnosed (instead of saying "gee, I'm depressed this week") and seeking treatment.
Psssssssssh. I don't even know where to begin. Why do you say that? Because I pointed out that SSRIs don't actually fucking work for most people? Because I point out that schedule 1 and 2 euphoric drugs often do?
What's the number needed to treat to completely resolve the symptoms of X (anxiety, depression, MDD, bipolar depression, whatever) for the favorite SSRI of the month? For Welbutrin? For SSRI + Ability? What is the NNT to even mostly resolve symptoms, such that patients are satisfied?
I'm not going to get into any more of my personal anecdotes right now, but if you think most people are satisfied with their anxiety or depression treatment, you are the one who is sadly misinformed here.
Meh. I've heard tales about MDMA studies in the 80s as well. The situation regarding marijuana is slightly encouraging, but I'm not holding my breath. Pot is a special case anyway.
There are obvious risks of abuse
They're never going to allow widespread use of potent euphoria-producing drugs for disorders like depression and anxiety. They might conceivably allow something like LSD, which is widely acknowledged to not be particularly habit-forming, but the big issue there is bad trips can and do happen, and I wouldn't be surprised if they confirm that it can indeed be a psychosis trigger for some people.
But yeah, back to the less trippy euphorics... it's not going to happen (except among a very small number of rebel psychaitrists and their rich clientele), unless and until the paradigm regarding addiction shifts. We might be slowly shuffling in that direction, but I'm pretty sure it'll never become mainstream in any of our lifetimes. There's way too much momentum behind the "addiction is a disease" mentality permeating not just psychiatry but the cops and the courts and the schools and pop culture.
And there are way too few people saying things like "what if we just gave some of these poor souls an unlimited supply of buprenorphine[1] and see what happens ?"
1. In case you've never heard of it, this is a long-halflife opioid that has a built in ceiling dose (so accidental OD is improbable, though it might occur if you're foolish enough to jump from zero to max dose) *and* it binds more tightly to opioid receptors, mostly preventing other opioids from having any effect.
I was not conflating major depression and episodic depression. "Or" does not mean "equals". The reasons why controlled euphoric drugs would be particularly superior in both cases are distinct.
1. They are particularly superior for episodic disorders because they work quickly and (because they aren't being taken regularly) they remain at high potency, without tolerance or withdrawal issues. (Assuming a non-"abusing" patient.) I'm not talking about MDD so much here, but rather stuff like (certain types of) bipolar depression. Many anxiety disorders are also episodic.
2. They are also particularly superior for severe disorders because many of the most common severe psychaitric disorders involve dysphoria of one form or another, and dysphoria is most easily treated with--drum roll please--euphoria-producting drugs.
They are also superior when used on mild and more continuous disorders, but their margin of superiority isn't quite as wide here because the standard first and second line psychiatric treatments have a greater chance (vs. the severe disorders) of actually making a significant dent in 'em.
One of the reasons to go off drugs slowly is because when you quit suddenly, the body tries to compensate by releasing any of the drug stored in the body tissues.
That's the stupidest thing I've ever heard. Did you misspeak or something? Possibly it releases endogenous opioids or something...
Also, nothing is very effective against refractive cases of major depression. Not therapy. Not drugs. All you can do sometimes is reduce the desire for self-harm to a more controllable level and hope that eventually the ship rights itself, so to speak, until the next time.
Show me the large-scale study where they tried oxycodone + adderall (or something similar, with the half-lives and time release pills calibrated correctly so the effects of both fade equally. ) Offer patients in the trial the option of changing to a different % blend if they feel it's too sedating or too anxiety provoking.
I am quite certain that such a combination would achieve noticeable improvement in over 50% of MDD patients, including a significant decrease in self-harm.
"Quite certain? Your'e just making stuff up!" Well, sorry. My intuition is all I have, given psychiatry sold its soul long ago and refuses to do the studies that would prove it. After all, that's my overarching thesis here.
Withdrawal from high doses of a short halflife SSRIs will cause very noticable and unpleasant side effects on withdrawal.
But I mentioned this only to underline that real, significant biochemical changes are taking place. The presence of withdrawal alone isn't a good argument against any drug; to the extent that it becomes a problem for a certain drug, it's just an argument for better prescribing and and dosing practices; like, maybe include a little separate "weaning off" package of pills (in a numbered bubble sheet: day 1, day 2, etc.) with every prescription so the patient can easily taper down the dose if they wish to stop.
1. Benzos, opiates and other controlled sedatives will greatly outperform SSRIs, mood stabilizers or atypical antipsychotics for the management of anxiety, particularly episodic anxiety (but with proper dosing and a non-"abusing" patient, also long term.) and particularly severe anxiety.
2. Damn near any euphoric controlled drug will work better for depression, particularly episodic or severe depression, better than SSRIs, mood stabilizers, atypical antipsychotics, or other first, second and third line drugs.
With depression, even moreso than with anxiety disorders, a combination of sedating (particularly opioid) and stimulating drugs could be used both for the synergistic euphoria and to help cancel out some of the unpleasant side effects of each drug (drowsiness or jitters.) Recreational "speedballs" are considered dangerous only because of the high doses involved, and because recreational users usually don't (or can't) perfectly match the half-lives of both drugs; this obviously isn't a huge issue given the number of drugs available to manufacturers, in addiction to the time-release pill technologies.
3. Yes, under this scheme a significant people would get addicted to the rush (regardless of any safeguards) and that would cause some problems.
a. That doesn't excuse psychiatry from the pseudo-science it's become steeped in and the legions of scientists and doctors that toe the DEA line for political, legal and financial reasons.
b. Those problems sure as hell aren't as bad as our overreaction to them, and an honest look at the disability-adjusted life year numbers for anxiety disorders and depression, the costs incurred by addiction (...costs which, on average, plummet when the addicts aren't being persecuted) and the projected number of new addicts would, I strongly suspect, show that more good than harm would come about if euphoric-producing drugs were more commonly used for common psychiatric disorders. I don't have hard data here, obviously. Just strong suspicions.
I was specifically talking about people with sporadic symptoms in that second post, and the implication (which I thought was clear but apparently wasn't, since several other people have made comments similar to yours) was that I was comparing continual-dose models of modern first and second line antidepressants/anxiolytics (including SSRIs, SNRIs, atypical antipsychotics, bupropion, perhaps some of the tricyclics, etc.) to episodic dosing of "abusable" drugs like opioids, benzos, amphetamines, etc.
At no time was I arguing that SSRIs should be given episodically. Let's get that straight first.
As far as the half-life goes, obviously if you have an episodic disorder that you want to treat episodically, you're not going to prescribe something with a massive halflife. (Unless that is desirable as a means of reducing rebound symptoms as the drug wears off.) You can "judge the efficacy" based on the result of multiple treated episodes.
Slashdot Mirror
"Human trafficking" sounds suspiciously like a deliberately deceptive umbrella term that groups together nightmare bait stories with other crimes, many of which are heinous enough, but from a sociological and criminological perspective are mostly unrelated.
It is both plausible and probable that not all the participants you see in your porn movies are completely willing participants who made a conscious decision to do that for a living
Ah, so it might include infantilization of women stuff too. Gotcha.
1. Anti-pornography feminism is a thing. Has been for decades.
2. It's not quite as bad, but last year multiple high profile self-identified feminist-progressives signed a petition opposing Amesty International... because Amnesty International is against locking up prostitutes.
You know, I've been wondering whether this human trafficking thing was actually terribly serious problem in the West...
Yes, it is. It's a big problem. Look it up.
If it truly is (please notice I said "in the West"), the people crying wolf about nonsense like this are really making it hard for me to take the stories and figures seriously.
What is human trafficking? What could it *possibly* mean that access to porn (but not social media) actually enables it? Are they are conflating all instances of kidnapping into one giant label "human trafficking"? (Most illegal kidnappings are, if I recall correctly, custody disputes... a parent 'kidnapping' their own child.) Are Mexican coyotes human traffickers, even the more humane ones? Are all sex crimes incidents of human trafficking, or only the ones that involve a car ride?
Can we have a little discrimination between regular crime that's existed forever (and needs fighting, sure) and organized cartels working tirelessly to make the world a horrible place for a profit? If you see absolutely no issue with conflating legal pornography and human trafficking, 1. There is something seriously wrong with you and 2. Even if you do have a point, you're making people not take you seriously. The internet is a big place, there's a finite amount of time in the world, and a finite number of things I can spare a few fucks to give about.
"If we could have manufacturers install filters that would be shipped to South Carolina, then anything that children have access on for pornography would be blocked," Chumley reportedly said. "We felt like that would be another way to fight human trafficking."
You know, I've been wondering whether this human trafficking thing was actually terribly serious problem in the West or if it was just the latest bogeyman from the wings of the socially conservative right and the progressive left being used to clumsily push the same tired agenda of indiscriminate prudery.
Thanks for clearing that up for us.
Or noting my observations of friends in high school and college who developed problems with cocaine and methamphetamines and either upped dosages over time to "cope" or switched to other equally hard drugs of different families once the high became harder to achieve. But yes, it's anecdotal evidence. YMMV.
Were they taking it for productivity, recreationally, or to cope with specific feelings? You just said "high", which implies a strong recreational (or at least meditative/psychonaut-y) element.
Depends on the substance. E or LSD? Sure. Heroin? Not so much.
Heroin absolutely will provide long term antidepressant (as well as analgesic) effects at a constant dosage. You don't have to inject it, you know. It's just that most people willing to go through the effort to get their hands on a large (or at least regular) supply of H aren't in it to be conservative; they're in it to chase the rush.
But that's a product of heroin's illegality and (relative to other opioids) ease of production. Don't screw up your causation chain here.
I would be interested in details of the trials showing just how spectacularly ineffective they are.
Check out Prozac's wikipedia page for some sourced stuff. Prozac was what launched the SSRI "revolution", was one of the most popularly prescribed medicines of all time, is on WHO's essential drug list and is still widely prescribed by physicians who subjectively believe it to be effective based on their own highly biased experience.
Here are the ballpark numbers for Prozac (adjusted for placebo): 2/3 OCD sufferers were not much improved, 4/5 anxiety disorder sufferers did not see control of their panic attacks, and after a 2008 meta-analysis of all the major studies, it appeared that the efficacy of Prozac for mild or moderate depression was insignificant. As in, the effect was so small they can't be sure it helped anyone. (Its efficacy for major depression is also insignificant. Almost no drug will put a dent in major depression short of powerful euphorics.)
Some other SSRIs fare a bit better, but frankly I don't trust those numbers. It took decades for Prozac's ineffectiveness to come to light, and 8 years after the news broke it's STILL approved to treat depression and it's STILL on WHO's essential medicines list despite not being a good treatment for *anything* except maybe as a third or fourth line Hail Mary option. I haven't had time to go digging through how drug trials work, but the whole thing stinks to high heaven. (At a minimum, I strongly suspect they are suppressing negative studies and basically just rolling the dice until they get lucky.)
But all that aside, even the more effective SSRIs do not adequately resolve depression or anxiety for most of the people taking them. Because of this, psychiatrists are now frequently recommending stuff like atypical antipsychotics (which have significant physiological and psychological side effects) or mood stabilizers as an adjunct.
I am, however, aware of a concerns that began within the last couple of years that seemed to show that unpublished clinical trials showed SSRIs to be no more effective than placebos.
Oh, I didn't see this bit when I wrote the above. Yeah, except it's been over 8 years since they had compelling evidence, and they've done absolutely nothing. Prozac and other SSRIs have been HUGE business; I mean it was completely revolutionary.
And it dovetailed *so* nicely with all of their anti-addiction / anti-abuse rhetoric. The psychiatric industry wanted a placebo desperately, even moreso than their poor suffering patients, and eight years later they're too gutless and self-serving to even admit to their patients that there's a problem.
Contrast this to any other medical disorder you could think of: if the FIRST LINE TREATMENT your doctor told you to take had a 80% ch
That sounds like an issue with how the Tor people are doling out the bridges. (One alternative being that Turkey's intelligence agencies are capable enough to do traffic analysis to deduce the identity of bridges located in other countries, which seems unlikely.)
A more robust system would be penpal-like, with communication between the bridge provider and user to (at least tentatively) verify legitimacy. The bridges wouldn't be rotated; they would be kept secret. But on top of this, on could build a F2F network to allow bridge sharing.
by the last paragraph, I merely mean to imply that's probably why they were willing to give MDMA a chance, not that it will necessarily be ineffective.
Holy shit you are an intellectually bankrupt liar. Either that or just incredibly lazy to bother doing even the tiniest bit of research for your own arguments. I wasn't going to waste my time, but after 45 seconds the top Google results all confirmed my suspicions: MDMA is for therapy enhancement only. No tolerance will develop, it will only be administered a handful of times with days or weeks in-between, and the patient will not be trusted to take the medicine on his or her own time.
This is a massive indictment of the psychiatry community and assorted regulatory bodies. It entirely supports my claims whilst undermining yours.
MDMA will not be given for long term, patient-administered treatment. You're lying when you imply otherwise, and you've yet to even try challenging any one of my assertions. The fact that MDMA isn't going to be used for long term or probably even medium term symptom management strongly supports my case, not yours. *Of course* they're willing to touch euphoric drugs,... if they're going to be so locked down as to make abuse or addiction nigh impossible.
Incidentally, it has a significantly different mode of action than amphetamine and you demonstrate your own profound ignorance when you imply they are closely rated in neurological effects. MDMA has a strong effect on serotonin, which is part and parcel of the pathological serotonin-worshipping cargo cult that developed in the psychiatric community over the past few decades in the aftermath of Prozac's popularity.
Most restricted drugs produce short term intense effects. Not very useful for treating ongoing mental illness. And used recreationally, it is easy to abuse and develop a tolerance, causing the user to seek ever higher and more dangerous dosages.
Congratulations for brainlessly repeating the propaganda they instilled in you in elementary school.
What you describe is how it works for reactional users chasing the rush. It is not at all true that your body completely adjusts to low to moderate doses as "the new normal" and you have to increase the dose to get any effect. An interesting exception to the psychiatric taboo against prescribing euphoric drugs is of course in children with ADHD, who are routinely given Ritalin or Adderall (amphetamine, i.e. something that's very very similar to that stuff Walter White was making.)
These drugs have significant effects that persist even though the dose is held constant. It's also pretty well-established that constant-dose opioids have persistent effects. In both cases, it's primarily those people who want instant gratification, pure recreational euphoria, who are compelled to raise the dose.
But as a means for treating mental illness, I have to disagree with your implied hypothesis that mental illnesses would often be better treated with recreational drugs that are currently illegal.
Even if you were correct that euphoric drugs (Just Say No!) lose all potency once the body develops tolerance, this would still be an incorrect conclusion.
What about illnesses that are episodic, like sporadic panic attacks (these, too, are often treated with spectacularly ineffective SSRIs)? What about regular cases of depression (as opposed to refractory major depressive disorder), which can often resolve over just a couple months?
Can't you run TBB as a relay? It's been a few years since I've looked into it. (My current pipe is way crappy to use as a relay, bridge or otherwise, otherwise I'd have looked into this sooner.)
I'm a bit surprised about Vidalia. Would've thought there would be a stronger push to make it easy for people to run relays, but forcing them to run a full Firefox GUI if they want an easy option seems a bit wasteful.
Also, anything that results in even 20% of people having a notable improvement is a HUGE victory
No it isn't. It particularly isn't given the massive costs involved in getting a script (which people are paying for either directly or indirectly), and the discouragement many people face when their glorified placebo doesn't work. Prescribing drugs that are unlikely to successfully treat a condition is, in most other contexts, grounds for a malpractice suit. Prozac should be removed from WHO's list of essential medicines and the authority to market it for people suffering depression revoked (they can still prescribe off-label if they really want.) There's no excuse whatsoever for this state of affairs.
Major depressive disorder is not trivial, it's not "feeling sad" or "down", it's not a couple of weeks of grieving over a death, etc.
I've been formally diagnosed with and have been dealing with MDD almost continuously, with a few months of respite here and there, since I was ten years old, fuck you very much. (I suspect my biggest ongoing issue is that I'm not able to engage in constructive self-delusion as effectively as most.)
In the past I've been closely involved with someone who also suffered from lifelong MDD with the added bonus of social anxiety with panic attacks, in addition to multiple friends and family members going through "regular" depression, one of whom essentially killed herself. I've also known several people with chronic pain, so I'm familiar with circus surrounding controlled substances.
I have a very, very long list of interesting anecdotes that I'm not going to be getting into here.
Approving MDMA for phase 3 trials with the goal of bringing it to market in 2021
It's been a while since I looked at the MDMA stuff, but as I recall it was being used at low dose whilst *in the therapist's office*, not for daily use. Given the confirmed neurotoxicity of MDMA, I strongly suspect this is the mode of treatment that is still being tested, but I can't be bothered to check. Not symptom treatment, but an attempt at a cure through a handful of one-off doses that make you open up to your therapists. If you want to prove my suspicions wrong, feel free.
There are a dozen other reasons why this pending (not guaranteed) approval isn't all that interesting or contrary to what I'm saying, but an unwillingness to prescribe MDMA on a long term basis (as I suspect will be the case), let alone administration in a home setting, completely proves my point.
just goes to show how full of shit you are about any conspiracy to prevent such substances from being used to treat people.
There's no conspiracy. The "all regular people are just latent addicts/abusers" mindset is mainstream and out in the open. Pathologization of "addiction" is in their fucking handbook, for crying out loud. It's in the prescribing guidelines. It's shown in the way the DEA busts pain clinics and lone wolf doctors who prescribe "inappropriate" medicines. It's not a conspiracy theory. They scream it from the rooftops.
And "mild to moderate depression" is NOT the same as major depressive disorder,
You already conceded that antidepressants suck for MDD. And I've already explained at length that this isn't about any one disorder. So... what the hell is your point?
Prozac is not suitable to treat any type of depression except maybe as a fourth line off-label Hail Mary treatment. Agree or disagree?
Furthermore, given how long its ineffectiveness took to come to light, all SSRIs and SNRIs should be subjected to increased scrutiny and post-market testing and patients should be clearly informed when they are likely wasting their time and money. Agree or disagree?
I'm not going to respond to the bazillion other threads you're replying to, as I think the essentials are all here.
TFS neglects to mention that anyone with a halfway decent internet connection can help people in countries like Turkey evade censors by running a Tor bridge. It appears to be extremely simple to set up. Note that this is a hidden entry node and not an exit node, so your ISP isn't going to be sending you nasty letters.
Yes, there ss an open moral question there given the significant number of nefarious uses of Tor. However, I suspect most of those users aren't going to bother with a bridge... and I happen to think that free speech is something that's worth fighting for. You know, the real thing. Criticism of politicians. Coverage of news events that are being actively suppressed by government censors. This is about actual free speech by any sane definition.
Says the person who can't read my posts properly and refuses to look up the stats herself. Here, let me get you started:
Prozac, the drug that started this craze, a drug that's still WHO's list of "essential medicines", one of the most prescribed drugs of all time (all numbers adjusted for placebo) and one that is still being actively prescribed and investigated for a variety of off-label usages:
2 out of 3 people "not much improved" for OCD.
4 out of 5 people suffering Panic Disorder did not find their panic attacks controlled.
Mild to Moderate Depression: Clinically Insignificant changes. (According to a Kirsch meta study. I looked at some individual studies around when this first came out and it was pretty damning stuff, but I'm not digging through it all for your benefit right now. You want to remain ignorant, that's your choice.)
Pilot, preliminary type data-gathering studies exist for amphetamines, opioids and the like. They aren't controlled, but they indicate very strong potential for a variety of anxiety and depressive disorders. Given how they function and the prevalence of dysphoria in anxiety and depression, this is to be expected. And no, the DEA and anti-addiction wings of the medical establishment aren't fucking happy about any noises rebel psychiatrists make in this direction.
And moving MDMA from schedule 1 to schedule 2 changes nothing about the addiction culture that is their lifeblood. Cocaine is schedule 2 as well. It's technically legal for your doctor to prescribe cocaine off-label for depression. Go ahead, try it. I dare you. But please try to get it on video if you do.
No, I'm not giving you source links for any of this you lazy, lazy person.
No, you did not specifically refer to bipolar depression, so quit lying. The topic was major depressive disorder. Not bipolar (what used to be called manic-depressive) disorder.
Let me try adding bold this time:
1. They are particularly superior for episodic disorders because they work quickly and (because they aren't being taken regularly) they remain at high potency, without tolerance or withdrawal issues. (Assuming a non-"abusing" patient.) I'm not talking about MDD so much here, but rather stuff like (certain types of) bipolar depression. Many anxiety disorders are also episodic.
Christ almighty. Quibble much? None of my points hang on a single disorder here. Psychiatric disorders that involve the patient experiencing significant dysphoria of one form or another constitute the majority of outpatient prescriptions. (Delusional and hallucinatory disorders being possibly the only major exceptions.)
MDMA for PTSD isn't *quite* the same thing as opioids or amphetamines for depression or anxiety. And do you think it'll be first line? Do you think all psychiatrists will be willing to prescribe it?
This is a cultural thing even more than a legal thing. Technically, there's no law preventing psychiatrists from prescribing oxycodone off-label for depression. It's just that very few people are insane enough to actually try that, as it opens them up to DEA scrutiny and lawsuits.
This may sound a bit self-absorbed, but never in my life have I been so depressed listening to someone agree with me on the internet.
Dysphoria is best treated by fixing the problem. For gender dysphoria
I am referring to dysphoria as in the inverse of euphoria, not whatever gimmicky buzzword the DSM has popularized this week. (To be clear, I'm disparaging only the buzzword, not the suffering it refers to.) Dysphoria is present in most mood disorders in one way or another.
"Feeling like shit."
What is easily provable is the lack of efficacy of psychiatry against the most common psychiatric complaints. You can dig up the numbers yourself, if you're so inclined.
And from the way you've discussed this, it's obvious you don't even have anecdotal first-hand experience of being diagnosed (instead of saying "gee, I'm depressed this week") and seeking treatment.
Psssssssssh. I don't even know where to begin. Why do you say that? Because I pointed out that SSRIs don't actually fucking work for most people? Because I point out that schedule 1 and 2 euphoric drugs often do?
What's the number needed to treat to completely resolve the symptoms of X (anxiety, depression, MDD, bipolar depression, whatever) for the favorite SSRI of the month? For Welbutrin? For SSRI + Ability? What is the NNT to even mostly resolve symptoms, such that patients are satisfied?
I'm not going to get into any more of my personal anecdotes right now, but if you think most people are satisfied with their anxiety or depression treatment, you are the one who is sadly misinformed here.
There are obvious risks of abuse
They're never going to allow widespread use of potent euphoria-producing drugs for disorders like depression and anxiety. They might conceivably allow something like LSD, which is widely acknowledged to not be particularly habit-forming, but the big issue there is bad trips can and do happen, and I wouldn't be surprised if they confirm that it can indeed be a psychosis trigger for some people.
But yeah, back to the less trippy euphorics... it's not going to happen (except among a very small number of rebel psychaitrists and their rich clientele), unless and until the paradigm regarding addiction shifts. We might be slowly shuffling in that direction, but I'm pretty sure it'll never become mainstream in any of our lifetimes. There's way too much momentum behind the "addiction is a disease" mentality permeating not just psychiatry but the cops and the courts and the schools and pop culture.
And there are way too few people saying things like "what if we just gave some of these poor souls an unlimited supply of buprenorphine[1] and see what happens ?"
1. In case you've never heard of it, this is a long-halflife opioid that has a built in ceiling dose (so accidental OD is improbable, though it might occur if you're foolish enough to jump from zero to max dose) *and* it binds more tightly to opioid receptors, mostly preventing other opioids from having any effect.
1. They are particularly superior for episodic disorders because they work quickly and (because they aren't being taken regularly) they remain at high potency, without tolerance or withdrawal issues. (Assuming a non-"abusing" patient.) I'm not talking about MDD so much here, but rather stuff like (certain types of) bipolar depression. Many anxiety disorders are also episodic.
2. They are also particularly superior for severe disorders because many of the most common severe psychaitric disorders involve dysphoria of one form or another, and dysphoria is most easily treated with--drum roll please--euphoria-producting drugs.
They are also superior when used on mild and more continuous disorders, but their margin of superiority isn't quite as wide here because the standard first and second line psychiatric treatments have a greater chance (vs. the severe disorders) of actually making a significant dent in 'em.
One of the reasons to go off drugs slowly is because when you quit suddenly, the body tries to compensate by releasing any of the drug stored in the body tissues.
That's the stupidest thing I've ever heard. Did you misspeak or something? Possibly it releases endogenous opioids or something...
Also, nothing is very effective against refractive cases of major depression. Not therapy. Not drugs. All you can do sometimes is reduce the desire for self-harm to a more controllable level and hope that eventually the ship rights itself, so to speak, until the next time.
Show me the large-scale study where they tried oxycodone + adderall (or something similar, with the half-lives and time release pills calibrated correctly so the effects of both fade equally. ) Offer patients in the trial the option of changing to a different % blend if they feel it's too sedating or too anxiety provoking.
I am quite certain that such a combination would achieve noticeable improvement in over 50% of MDD patients, including a significant decrease in self-harm.
"Quite certain? Your'e just making stuff up!" Well, sorry. My intuition is all I have, given psychiatry sold its soul long ago and refuses to do the studies that would prove it. After all, that's my overarching thesis here.
Withdrawal from high doses of a short halflife SSRIs will cause very noticable and unpleasant side effects on withdrawal.
But I mentioned this only to underline that real, significant biochemical changes are taking place. The presence of withdrawal alone isn't a good argument against any drug; to the extent that it becomes a problem for a certain drug, it's just an argument for better prescribing and and dosing practices; like, maybe include a little separate "weaning off" package of pills (in a numbered bubble sheet: day 1, day 2, etc.) with every prescription so the patient can easily taper down the dose if they wish to stop.
Are my theses still unclear? Ok, look:
1. Benzos, opiates and other controlled sedatives will greatly outperform SSRIs, mood stabilizers or atypical antipsychotics for the management of anxiety, particularly episodic anxiety (but with proper dosing and a non-"abusing" patient, also long term.) and particularly severe anxiety.
2. Damn near any euphoric controlled drug will work better for depression, particularly episodic or severe depression, better than SSRIs, mood stabilizers, atypical antipsychotics, or other first, second and third line drugs. With depression, even moreso than with anxiety disorders, a combination of sedating (particularly opioid) and stimulating drugs could be used both for the synergistic euphoria and to help cancel out some of the unpleasant side effects of each drug (drowsiness or jitters.) Recreational "speedballs" are considered dangerous only because of the high doses involved, and because recreational users usually don't (or can't) perfectly match the half-lives of both drugs; this obviously isn't a huge issue given the number of drugs available to manufacturers, in addiction to the time-release pill technologies.
3. Yes, under this scheme a significant people would get addicted to the rush (regardless of any safeguards) and that would cause some problems.
a. That doesn't excuse psychiatry from the pseudo-science it's become steeped in and the legions of scientists and doctors that toe the DEA line for political, legal and financial reasons.
b. Those problems sure as hell aren't as bad as our overreaction to them, and an honest look at the disability-adjusted life year numbers for anxiety disorders and depression, the costs incurred by addiction (...costs which, on average, plummet when the addicts aren't being persecuted) and the projected number of new addicts would, I strongly suspect, show that more good than harm would come about if euphoric-producing drugs were more commonly used for common psychiatric disorders. I don't have hard data here, obviously. Just strong suspicions.
I was specifically talking about people with sporadic symptoms in that second post, and the implication (which I thought was clear but apparently wasn't, since several other people have made comments similar to yours) was that I was comparing continual-dose models of modern first and second line antidepressants/anxiolytics (including SSRIs, SNRIs, atypical antipsychotics, bupropion, perhaps some of the tricyclics, etc.) to episodic dosing of "abusable" drugs like opioids, benzos, amphetamines, etc.
At no time was I arguing that SSRIs should be given episodically. Let's get that straight first.
As far as the half-life goes, obviously if you have an episodic disorder that you want to treat episodically, you're not going to prescribe something with a massive halflife. (Unless that is desirable as a means of reducing rebound symptoms as the drug wears off.) You can "judge the efficacy" based on the result of multiple treated episodes.