The True Opioid and Alcohol Crisis

Our country has taken to heart the “opioid crisis” as it should. But there is nothing new about this crisis as it has been around for at least 100 years. What they are really saying, but won’t, is that the prescription opioid has gotten out of control. People are prescribed an opioid based medication for pain relief and soon find themselves addicted. According to the U.S. Center for Disease Control there are approximately 11,000 opioid deaths per year. The notion here is that either doctors are over-prescribing opioid-based medications or that the addict is easily finding the same medications on the street.
But the real addiction crisis in America is alcoholism. According to the CDC approximately 88,000 people die annually from alcoholism. That’s an 8:1 ratio making alcoholism something greater than a crisis if we are going to apply that apelet to opioids. But I have heard nothing on the news or elsewhere that this crisis is getting much attention.

The problems with treating either addiction starts with the insurance companies. Most, if not all, insurance carriers provide very little assistance in this area. What they are willing to give is a 2-week in-patient treatment followed by out-patient treatment. There is one very simple problem to this approach. The alcoholic and the addict each need at least a 90-day in-patient program to stabilize them. And even that may not be enough as relapse among even those who have been in a 90-day program is high. Both the alcoholic and the addict tend to need long-term treatment, the length dependent entirely upon the individual.

The underlying issue for most, if not all, alcoholics and addicts, is unresolved serious issues earlier in their lives which leave them feeling “less than,” suffering from depression and/or a myriad of other psychiatric issues. But the way the insurance industry followed by the medical community, is to treat the symptom without even evaluating the patient for the real underlying issues.
I was recently hospitalized for a possible heart issue. I had a heart attack 20-years ago and am always considered an at-risk person. While in one of great Boston’s excellent hospitals, I struck up a conversation with the man in the other bed in my room. As it turned out he was an alcoholic. One of the consequences of untreated alcoholism is liver failure. As the liver fails fluid collects in the abdomen causing it to bulge. I found out that this man had had 3.5 liters of fluid removed but still had at least another 10 liters needing removal. He was given the medication Ativan because he was detoxing and without that medication he was likely to experience the delirium tremens, DTs, of withdrawal.

For reasons I could not be privy to, the hospital was only treating his liver issue, the fluid. Although he had a good insurance plan, the hospital, a fairly large one, did not have a detox facility and no program to treat an alcoholic on an in-patient basis. This brings us back to the money issue, insurance. Hospitals cannot survive giving the addict and alcoholic the treatment they desperately need and not get paid for it by the insurance companies.

The National Institute of Health estimates that there are more than 15 million alcoholics in the U.S. today. That comes to about 5% of the entire U.S. population. Other studies have suggested that upwards to 10% of the population suffers from alcoholism. Most, unfortunately, are untreated. And there is the crisis. What I said about alcoholism equally applies to addiction, be it medical based opioids or street drugs.
Right now the number of facilities that are prepared to properly treat the alcoholic or addict is low. The alcoholic or addict who applies to get into one of these facilities is usually greeted by the statement that there is no bed available. At that point the alcoholic gives up and goes back to drinking.

I suspect that in the era of modern medicine, there has never been a concerted effort to treat alcoholics and addicts. These people who suffer from an identified medical, and frequently a psychiatric, illness fall victim to the insurance industry which simply is not interested in dealing with alcoholics and addicts. The irony in all this is that the insurance companies end up paying for alcohol and drug induced ailments over long periods of time which is always very costly. These costs are easily reduced by proper treatment of alcoholics and addicts. The question is: when are the insurance companies going to come to this realization and when is the medical community going to start pushing back at the insurance companies to compel them to act in a more responsible manner?


It’s Time to Bring the MBTA Into the 21st Century

The Massachusetts Bay Transportation Authority (MBTA) (the T) is broken, but no one at the state house, governor, senate, house, cares to address the real problems the T has. At present, the governor and the T are both hailing the arrival of new Red Line and Orange Line cars. But this is little more than a PR stunt meant to divert the public’s attention away from the MBTA’s more pressing issues. The T did need to replace the Orange and Red Line cars but it also has issues that will leave customers sitting disgruntled on these new cars.
Much of the T’s rapid transit system needs to have its signaling replaced. At present the T is only replacing that equipment after a catastrophic failure which gains the public’s ire. This band-aide approach only puts the entire signaling system into a sort of whack-a-mole status. A properly running signaling system is not just an operational issue, it is a safety issue as well.
A transportation system is only as good as its ability to handle the heaviest of rush hours. At this, the MBTA fails on all fronts, rapid transit, bus, and commuter rail. The MBTA is wont to restructure the bus routes for fear of angering the public. I suggest, however, that a phased restructuring would alleviate most of that concern. The Route 39 bus is an example of one problem. The T’s schedule for this route guarantees 8-minute or less headway. But ask anyone who uses this route and the reality is far different. One of the biggest problems is that the busses cluster along the route with one bus directly behind another which will be followed by a 15-minute wait for the next bus. Such occurrences happen on most of the T’s most heavily used routes.
Many of the T’s bus routes are the remnants of the Eastern Massachusetts Street Railway which it took over in 1968. These routes performed well under the old Eastern Mass but have languished under the T. The route runs through heavily populated portions of Woburn, Winchester and Medford. The schedule, however, shows a less than desirable frequency. This route is also an example of the MBTA’s penchant for being reactive than proactive. Their claim is that as demand climbs so will the level of service. But demand will not climb if the route’s frequency is viewed as less than optimal by the public. This mean, to attract more customers the T needs to increase service first. Ironically, this is the only route assigned to both Woburn and Winchester. It would seem that a second route through these towns which ends at Harvard Square would make a lot of sense.
Another issue with the rapid transit system is portions of it cannot handle rush hour traffic effectively. Anyone who has ever ridden on the Green and Red Lines knows how mind numbingly slow these lines can be. The issue with the Green Line is that of four lines, B, C, D, and E feeding into one tunnel. That singular tunnel is a choke point. It is nearly at capacity during off-peak hours which means it is far over capacity during rush hours. The only reasonable solution here is the building of a second tunnel parallel to the first from Kenmore Square to Government Center. This solution is extremely expensive but is the only reasonable one.  Additionally, many routes needs to be extended.  The 85 route is an excellent example.  At present it runs from Kendall Square Cambridge to Spring Hill in Somerville.  This route would serve the public much better if it started at Lechmere, continued through Kendall Square and Spring Hill to Davis Square Somerville, less than a half mile from Spring Hill.
Finally, the best way to lure commuters out of their cars which now clog the Southeast Expressway, the Mass Pike, Route 93 and Route 1 into Boston is to increase the frequency of the trains, add stations a certain key points and run multiple express trains during rush hour. First, the MBTA would need to construct stations everywhere a commuter rail line passes under either an Interstate Highway or Route 1 and then offering express trains into Boston. Additionally, the T needs to totally rewrite its commuter rail schedules discarding the idea that it must stop at every station on every route during off-peak hours. For example, on the Haverhill line there are four station stops within a 2-mile stretch, Wyoming, Melrose, Melrose Highlands and Greenwood. Two other problems with this route are that it runs too few trains between Boston and Reading, and, that it is still single tracked between Reading and Wilmington Jct. which creates scheduling issues. Additionally, many, if not most, commuter rail stations lack sufficient parking for the potential demand. For example, Andover, a heavily used station, has only 150 parking spaces. Reading, also heavily used, with great potential, has only 71 parking spaces. If the MBTA truly wants to get people out of their cars and onto the T then they must have a place for people to park their car.
As it stands now, the MBTA is a less desirable mode of transportation for the Metropolitan Boston area and beyond than the car. The solutions I have suggested above would cost many billions of dollars but that would be funds well-spent. The MBTA must become a far more attractive system than it is now, which is actually a very unattractive system. Massachusetts politicians must come to grips with the idea that the rapid deterioration of our state’s roadways is in no small part due the almost constant heavy traffic they must contend with. But if the cost of maintaining our roadways at present is compared to the suggested upgrade of the MBTA, it then becomes quite easy to justify the outlay of huge sums of money to modernize the MBTA.

Colleges in Crisis: Who Is Responsible?

I read the Sunday Boston Globe (April 1, 2018) today and there was a front-page article regarding the declining enrollment of many Boston area colleges. Without going into the specifics of the article, it centered around the declining enrollment of these colleges, one had lost 90% of its students over the past decade. How did this happen?
I am part of the baby boomer generation who filled college classrooms everywhere to capacity and beyond. Many colleges were founded during that era. But since the 1980s, college enrollment had been declining. The only colleges immune from this have been the Ivy League colleges and other top tier colleges such as M.I.T., Cal Tech, Carnegie Mellon and some small but very highly regarded colleges such as Amherst, Wellesley, and Bowdoin. And because of this, you see colleges who used to have a full enrollment advertising on television in an attempt to attract students. In my area it has been the Massachusetts state schools.
Certain colleges, smartly, have seen the writing on the wall and have combined with other colleges. The fact is, not only do we have fewer students desiring to go to college, but we also have fewer students who belong in college.
Another problem is students are graduating with degrees for which there are very few openings. I recently ran across a young woman who had a degree in Fine Arts from a very good college but had been unable to find a job in that field. She had resorted to being hired by the Audubon Society and giving yoga lessons. But her cumulative pay is far below what someone with her level of education in another field could expect to get. So where does this problem begin?  It begins with high school students not getting sufficient advice on their future prospects.  It continues with student enrolled in fields which see 5000 graduates a year who are competing for 50 jobs.
I put this on the high schools of the United States. I tell people all the time to chase the passion. My qualification to that is, make sure it is a vocation that both has room for you and from which you can expect an income commensurate with having a college degree.
In my case I got a Bachelor of Science degree in computer science with a minor in business. Eventually I got a Master’s of Art degree which looked great of my resume but which in fact I never used. Both fields were then, and are still now, in high demand. It is my belief that every high school guidance counsellor should have in his possession a chart detailing both the demand for any degree desired and the pay a person can expect to start.
Colleges need to reconsider their viability going forward and the sorts of degree programs they offer. They also need to offer counselling services to advise students on their ability to afford the college. Too many students find themselves living hand-to-mouth each semester as they scramble to find the funds to pay for tuition, housing and basic needs. Many fail.
The United States Federal Government in recent years has seen fit to reduce the amount of funding available to college students. Because of this, students are forced to find funding from private financial institutions who change high interest rates and demand the student start paying on the loan shortly after he receives it. This means a student must find employment to cover that debt. This, of course, impacts the student’s ability to focus on his studies.
The answer to all these questions is quite easy in each case. Than manner in which they are resolved, however, is complex and requires a level of effort from our educators and elected officials to find answers.

Who Will Write Planet Earth’s Obituary?

This morning I told my wife our next car will be a hybrid. Knowing me, you would have thought I would have gone that route much earlier. The trouble is my gender. I’m a guy and you know how we like our cars to have a big engine. Well, two years ago, when I went to buy a new Ford Fusion, I asked for their V-6, previously the most powerful engine they offered for such cars. The salesman informed me that Ford no longer had a V-6 version and sold me on a turbo charged 4-cylinder engine. It got only slightly better gas mileage than my previous car and allow me to believe that I had the best engine available.  I have altered my thinking.  I am an excellent recycler but have not taken other issues to heart as I need.
I am a baby boomer which means I was raised in the era of muscle cars and cars we derisively, even then, called tanks. Most often we were referring to the big Buicks and Cadillacs. You need only go back to the 1960s and 70s to see the truth of such a statement. Then in 1974 OPEC came in to being, the U.S. immediately had a gasoline crisis and suddenly car manufacturers were shedding those tanks for smaller cars. But if you look more closely at such cars they were only marginally more fuel efficient than their predecessors.  The requirement for better fuel efficiency was years away although new strict emission standards were put into effect.
But as the years passed, people forgot their history, and the era of the SUV entered. I named the Japanese versions of the crossover SUVs, the Acura MDX, the Infiniti QX70, and the Lexus RX as “a penis on wheels.” SUVs have exploded in the U.S. and both Japanese and U.S. manufacturers have done well with such vehicles. The problem is simple. Most SUVs are in the truck category which makes them exempt for two federal regulations, emission standards for automobiles and fuel standards. Detroit and Tokyo found the loophole and exploited it. Nothing has been done to close this loophole. And the most baffling product to come out of Detroit was General Motors version of the military HUM-V which the dubbed the Hummer.
This brings me the latest issue to rear its ugly head. The United States has the largest coal reserves on the planet and Pres. Donald Trump wants coal to be king again. In the short term, probably very short term, this would breath economic life back into the coal regions of the United States. But the trade-off is painfully obvious. Coal fired plants push extremely large amounts of carbon dioxide, carbon monoxide and sulfur dioxide into the atmosphere. The former creates a warming blanket in the earth upper atmosphere while the latter creates acid rain.

A very recent University of New Hampshire study of sea levels expects there to be a 1 to 1.5-foot rise in sea levels by 2050 (Boston Globe, March 31, 2018, p. 4). Another study of the polar ice caps, and in particular the North Pole:

“The Arctic climate is changing rapidly, breaking at least a dozen major records in the past three years. Sea ice is disappearing, air temperatures are soaring, permafrost is thawing and glaciers are melting. The swift warming is altering the jet stream and polar vortex, prolonging heat waves, droughts, deep freezes and heavy rains worldwide.” (Francis, Jennifer A.; Scientific American, April 2018, p. 50)

I find it alarming the American conservatives are so caught up in their political ideology that they cannot listen to the well-reasoned and heavily researched conclusions of the highly respected scientist who have sounded the alarm. Many have labeled these findings as pseudo-science and that their findings are questionable. Such a statement is difficult, if not impossible, to defend given the overwhelming majority of scientists around the world agree with these findings.
The hard fact is that we are bequeathing our children and grandchildren a planet in its death throws. We could easily be looking at widespread famine, large new deserts, and a world in which people go to war over food and water.
In 1960 a woman named Rachel Carson published a book named Silent Spring in which she predicted everything that is happening today. Now, scientists everywhere are sounding the alarm. The question is an easy one: Why is the Congress of the United States deaf to these warnings?


Why Has The Catholic Church Deserted Me And Millions of Others?

The Roman Catholic Church has to change, particularly in America. It needs to allow women to become priests and it needs to allow priests to marry. Up until 1139 priests were allowed to marry. The idea behind it was to separate priests from a sinful world. The hypocrisy there was that priests were, and still are, sinful themselves. They are human, they screw up, the have to go to confession. At the time it was meant to insure the morality of the priesthood.
That worked up until the mid-20th Century when those men entering the priesthood declined. And the decline continues. There are places in America where churches have no priest permanently assigned, the duties being taken over by a deacon or by a priest who travels from one parish to another.
The American Catholic Church is so arrogant that when Poland offered to send priests to cover parishes in American they were declined! Maybe they were embarrassed that the word would get out that most Sunday masses in America are only lightly attended.
This brings me to my issue with the Church. I am a divorced Catholic and have been so since 1988. Because I am now remarried I cannot receive communion, central to the Catholic service. Curiously, I have been told by more than one priest that were I to stand in front of him to receive communion, and he knowing I was divorced and remarried, he would not deny me. I mention that because there appears to be a large group of priests who believe the prohibition is ridiculous.
There is a remedy according to Rome. A divorced Catholic must petition the Pope to have his marriage annulled. Now understand, an annulment, according to Catholicism, means no marriage occurred in the first place. I have three beautiful children by my first wife. I refuse to insult them, or my former wife, by getting an annulment. But I want my church back.
I firmly believe that were Jesus to come back just to visit the Pope and his college of cardinals, he would have some very harsh words for them. I think they need to read that part of the Bible which speaks of the shepherd who leaves 99 sheep in search of the mission one.

Have Americans Lost Control of Their Government?

The current state of our government and, in particular, the chasm that exists between Republicans and Democrats, seems like a child’s food fight rather that an ongoing adult conversation. Each side is doing what is called, “right fighting.” That is, each side is so convinced that it is right that the art of compromise seems to have gone out the window. An old cliché says that a fish stinks from its head down. Our government right now is exemplifying that more than ever.

Our government was via the Constitution set up with three branches, none of which was supposed to have more power than the other. But our present Congress is so fearful of doing the next right thing, and its job, has abdicated in favor of the Executive Branch. Article 2 of our Constitutes delineates the powers granted the President. What amazes me the most is that Article 2 section 3 clearly states that the President “. . . from time to time give to the Congress Information of the State of the Union, and recommend to their Consideration such Measures as he shall judge necessary and expedient . . . “ The framers of the Constitution left many parts of it vague as they judged that with the passage of time necessary changes to the Constitution or different interpretations of It would be necessary. But it is my opinion the Article 2 Section 3 is rather clear in its intention; that being that changes to law and policy may be suggested by the President and that Congress would then act upon them. The Constitution is also repeatedly clear that a 2/3rds vote should be the standard for passing any legislation.

Over the years, however, Congress has made changes to what is necessary for certain measures and that being a simple majority favor the law.

Most recently, President Trump made the unilateral decision to scale back some remote (Utah) national monuments at the behest of industry. He has also charged his Interior Secretary to find other locations to which he can to the same. The idea of National Parks and National Monuments was the idea of President Theodore Roosevelt when he created Arcadia National Park and Yosemite National Park. “The Antiquities Act is the first law to establish that archeological sites on public lands are important public resources. It obligates federal agencies that manage the public lands to preserve for present and future generations the historic, scientific, commemorative, and cultural values of the archaeological and historic sites and structures on these lands. It also authorizes the President to protect landmarks, structures, and objects of historic or scientific interest by designating them as National Monuments.” (Public Broadcasting Service, The law is quite specific in saying that the President is obligated to preserve “objects of historic and scientific interest. Pres. Trump has chosen to ignore this law and turn over these precious lands to commercial interests, destroying artifacts that favor the public interest and the scientific community.

The Constitution, and all its framers in their writings, made very clear that the first job of the Federal Government is to act in the best interest of the people. But for decades now our Congresses and Presidents have only too frequently done the bidding of powerful interests and PACs. It would be only too easy to show how the Republicans Party over the past 6 years or so has worked mostly in a self-serving manner. But that would less than truthful. The fact remains that the Democrats are equally responsible in bending to the will of powerful and well-monied interests instead of the people. The Democrats have not had control of Congress for many years now and the Republicans have been able to run rough-shod over them by passing bills that make a simple majority vote the rule of Congress. No Democrat has been able to find the inner fortitude to challenge such bills in front of the US Supreme Judicial court.

Time-and-again the Republican Congress has passed bills which are clearly unpopular with the people of the United States. The most visible action at present has been their persistent attempts to gut and eliminate the Affordable Care Act. Their most recent move has been to tied changes to the ACA to the government funding bill now in Congress. Such actions are referred to “rider bills.” It is the blatant attempt to circumvent the proper way to have a bill passed, a “clean bill.” That refers to a bill which has no riders and is voted up or down on its own merits.

Both parties in Congress are not doing the “right thing” but rather doing the most self-serving thing. That has never more true when Senator Mitch McConnell declared that he would not allow then President Obama to seat a new Supreme Court justice when Justice Scalia unexpectedly died two years ago. Not only was that self-serving but it went entirely against the spirit of our Constitution and the manner in which all justices have been confirmed since 1789. Such actions must stop. This means that U.S. Citizens, regardless of political favor, must make Congress accountable for its actions.

A majority of U.S. citizens of both parties has said they do not trust congress to do the right thing. There is an easy solution to that; stop re-electing your representatives and senators.

There is an old saying, “nothing changes if nothing changes.”

Why Is New Hampshire So Passenger Rail Adverse?

Five of New England’s six states have taken a very proactive approach to public transportation. In particular, they have all embraced the idea of upgrading their existing passenger rail lines with an eye towards expanding them. The lone state to shun such thought is New Hampshire.
When the Northern New England Rail Authority was planning a passenger rail route from Boston to Portland, New Hampshire pointedly stated it want no part of it even though the line would run through their state. But as the planning and funding stage turned into preparing the line for passenger service, New Hampshire, somewhat begrudgingly, opted in for stops in Exeter and Dover. It has since added one more station in Durham. Now, many years into the Portland service, all three of those stations have seen considerable use.
In the early 1980s Massachusetts and the Massachusetts Bay Transportation Authority, convinced New Hampshire leaders to have a trial run of passenger service to Nashua, Manchester and Concord. Even though the trial was successful and showed promise of growth, New Hampshire declined to fund it any further and the state has resisted all efforts, both within the state itself and by Massachusetts, to re-instated commuter rail to Manchester with stops in Nashua and Merrimack.
The MBTA also more recently made overtures to New Hampshire to extend the Boston to Haverhill line to Plaistow New Hampshire only to be shunned once again. It is impossible to find any rational reasoning behind such rebuffs. Anyone who commutes into Massachusetts using Route 3, 93, or 125, is keenly aware of the traffic nightmare that exists on all three routes. Worse, in the case of route 125 there is no reasonable way to widen the route. Both route 93 and 3 could be widened but at great cost, more than New Hampshire is willing to commit to at present.
Southern New Hampshire’s population is booming as people who work in and around the great Boston area move further out in search of affordable housing. The four counties in southern New Hampshire closest to Boston are Stafford with 125,600 residents, Rockingham with 300,600 residents, Merrimack with 147,200 residents, and Hillsborough with 405,200, a combined total of 978,600 or 74% of all New Hampshire residents. The state itself expects, conservatively, that each of these counties will grow by at least 10% over the next 20 years.
Years ago, the Boston to Montreal route, which passes through Manchester NH was declared a future rail corridor. Research showed that there is likely sufficient number of boardings on this route to create a Boston to Montreal Amtrak route. And while New Hampshire would have to make a significant investment into the project, it would ultimately pay for itself by removing automobiles from its highways while adding revenue to the state via people who live outside New Hampshire visiting the cities along the route. The Maine model has been so successful that not only it added stops to the original route, it has extended the route to Brunswick and is now planning on a second extension to Rockland with further plans for service to Augusta.
With the rail line through Nashua, Manchester and Concord being raised to passenger service levels the state could then enjoy commuter rail service in the same way Rhode Island has with the extension of the Boston to Attleboro route to Providence and T.F. Green Airport. If the state would simply show the willingness, it could immediately extend the Haverhill route to Plaistow and bring immediate relief to the route 125 travelers.
Another example of two states cooperating in such efforts is Connecticut and Massachusetts who are now actively pursuing and extension of commuter rail traffic from Hartford to Springfield and Greenfield Massachusetts. And Vermont of actively working to reinstate service to Montreal from Burlington using the existing New York to Burlington Amtrak route.
Five states see the benefit of pro-actively working on extending and expanding passenger rail service within their states. It is difficult, if not impossible, to understand New Hampshire’s continuing abhorrence of passenger rail service. I suspect, and hope, that with the continued pressure for rail service expansion in the Northeast, the near future will see the state finally join what has proven extremely desirable and successful for its neighboring states.