In an inflammatory statement on social media, Cotton, who is funded by the notorious The American Israel Public Affairs Committee (AIPAC), declared: “The ICC is a kangaroo court and Karim Khan is a deranged fanatic. Woe to him and anyone who tries to enforce these outlaw warrants. Let me give them all a friendly reminder: the American law on the ICC is known as The Hague Invasion Act for a reason. Think about it.”

The ICC is a kangaroo court and Karim Khan is a deranged fanatic. Woe to him and anyone who tries to enforce these outlaw warrants. Let me give them all a friendly reminder: the American law on the ICC is known as The Hague Invasion Act for a reason. Think about it.

— Tom Cotton (@SenTomCotton) November 21, 2024

The American Service-Members’ Protection Act, nicknamed “The Hague Invasion Act”, was passed in 2002 to shield US personnel and allies from ICC prosecution. The law authorises the US President to use “all means necessary and appropriate” – including military force – to free any American or allied personnel detained by the ICC in The Hague.

“Tom Quixote,” Digital, Dream / Dreamland v3, 2024

Cotton’s threat comes after ICC pre-trial judges issued arrest warrants yesterday for Netanyahu and Gallant on charges of using starvation as a method of warfare and crimes against humanity including murder, persecution and other inhumane acts in Gaza. The Court determined there were “reasonable grounds” that Israel’s siege and assault on Gaza “created conditions of life calculated to bring about the destruction of part of the civilian population”.

The Biden administration swiftly rejected the ICC’s decision, with White House spokeswoman, Karine Jean-Pierre, expressing “deep concern”. US politicians from both major parties have condemned the Court’s ruling, with Senator Lindsey Graham, an ally of President-elect Donald Trump, calling for sanctions against ICC officials.

ICC member states including France, UK and Canada have indicated that Netanyahu would be arrested if he entered their country. “If Netanyahu comes to Britain, our obligation under the Rome Convention would be to arrest him under the warrant from the ICC” said Emily Thornberry, Labour Chair of the Foreign Affairs Committee.

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Middle East Monitor

( Middle East Monitor ) – The ongoing conflict in occupied Palestine has had a major effect on the mental well-being of Palestinian children. The trauma of living in a war-ravaged region, enduring displacement and witnessing extreme violence can result in a variety of mental health concerns, such as anxiety, depression, post-traumatic stress disorder (PTSD) and behavioural issues. Furthermore, children who have endured these traumas may grapple with feelings of despair, fear and anger. Childhood innocence is under siege.

It is thus crucial for Palestinian children to obtain the necessary support and resources to assist them in managing the mental health consequences of the conflict. UNICEF has identified the Gaza Strip as the most perilous location for children globally. Women and children make up over 70 per cent of the casualties resulting from Israel’s offensive since 7 October. From birth, Palestinian children have been subjected to an Israeli siege and blockade, enduring conditions of poverty and violence.

The predicament of minors in the Gaza Strip was already critical prior to 7 October due to the siege imposed by Israel since 2006 and additional structural obstacles. The majority of children in the Gaza Strip have endured distressing circumstances since last October. These include bereavement, extensive devastation, forced displacement and a serious lack of food, water and medication. Inadequate playgrounds and secure spaces, as well as school closures, are additional contributors to children developing mental health and psychosocial problems.

The solitary psychiatric hospital in Gaza has been targeted by Israel, and the activities of the other six community mental health clinics that serve thousands of patients throughout the enclave have been interrupted as a result of air strikes. In an effort to detect children who are suffering from mass depression, mutism, bedwetting and suicidal thoughts, some medical professionals have attempted to maintain contact with youngsters via the use of WhatsApp.

The present conflict has had an influence on children’s mental health that cannot be compared to the condition that existed before the crisis. This is due to the fact that the level of intensity of the hostilities and the destruction of infrastructure has been unparalleled. To put this into perspective, prior to 7 October, the Gaza Strip was already experiencing a significant number of mental health concerns. Approximately 54 per cent of Palestinian boys and 46.5 per cent of Palestinian girls between the ages of 6 and 12 were found to have emotional and behavioural issues, according to a survey conducted in 2017.

In 2022, Save the Children revealed that 80 per cent of the youngsters who participated in the research had signs of mental distress.

Two-thirds of the children there were engaging in self-harming, and about half of them admitted to having considered ending their own lives. Before 7 October, the availability of mental health care in Gaza was restricted and often subject to social stigma. As a consequence, families and community members did not give priority to mental health and psychological support (MHPSS).

Dr. Mamoun Mobayed, a consultant psychiatrist, and director of treatment and rehabilitation at Qatar’s Behavioural Healthcare Centre, stated that children suffer from the enduring consequences of wartime conditions during their sleep. Nightmares are experienced frequently, and some individuals may suffer from nocturnal enuresis as a consequence of these nightmares. A year ago, Palestinian-American psychologist Dr Iman Farajallah found in her study on the impacts of war on Palestinian children that children who survive such wars often suffer serious psychological, emotional and behavioural repercussions. Ninety-five per cent of Gaza Strip children, according to her study, showed signs of trauma, sadness and worry. Farajallah believes that the solution to the Palestine issue is not to be found in psychology but rather in a peaceful political resolution.

France 24 English Video: “‘Gaza remains hell on earth for children and their families’, Unicef Spokesperson tells FRANCE24”

The ongoing conflict in Israel and Palestine is having a severe impact on children’s mental and physical well-being, confirms UNICEF. UN officials report many children killed and countless more suffering from anxiety and displacement. “The violence is taking a huge toll on children’s mental health,” said Jonathan Crickx, UNICEF’s chief of communication in Palestine. “We’ve received accounts of children who are deeply worried and anxious.” The UNICEF official urged all parties to ensure that children receive the specific protection that international humanitarian and human rights law guarantees them and to provide them with unequivocal protection. Additionally, the UN body demands an urgent cessation of hostilities.

The conditions necessary to deliver humanitarian aid to children in Gaza are not only unfulfilled, but also deteriorating. The prolonged embargo and continuous shelling in Gaza have severely strained the mental health of children, pushing it to its limits. The victims have endured indescribable psychological trauma resulting from acts of violence, severe bodily suffering such as amputations, and the profound loss of their families, homes and educational institutions. More than one million children in Gaza require mental health assistance.

UNICEF reports that Israel has caused the deaths of more than 13,000 children in Gaza since 7 October. In addition, it should be noted that there are other children who are experiencing acute malnutrition and are so weak that they lack the energy to even produce tears. “Our children have experienced various wars,” explained one of the mothers in Gaza. “They were already struggling with resilience, and now coping has become extremely challenging. The children are frightened, angry and can’t stop crying. Many adults are reacting the same way. This is overwhelming for adults, let alone children.”

According to Save the Children in Gaza, if the war is not stopped, there will be additional long-lasting psychological damage to children, with diminishing chances for recovery. Amal, a mother of four children in Gaza between the ages of 7 and 14, said that, “Some of my kids can no longer focus on simple tasks. They forget what I’ve just told them and can’t recall recent events. I wouldn’t even say their mental health has declined, it has been destroyed.”

This is total psychological devastation. 

Children in Gaza are bearing the brunt of the war’s consequences at a disproportionate rate. Brain development may be altered irrevocably as a result of childhood traumas, although the repercussions might not become evident until much later in life. During childhood, the brain undergoes critical developmental periods. Anacker explained that too much stress from grief, anxiety, or a lack of social and emotional interaction during these times can alter brain function. “There’s no effective way to completely reverse the effects of childhood trauma in adulthood, that’s why it’s essential to protect children from stress during these critical stages of development.”

UN Secretary-General Antonio Guterres has cautioned on numerous occasions that children are affected “disproportionately” by contemporary conflicts. Children residing in regions affected by brutal conflict endure profound psychological anguish.

According to Taha et al., the Education Above All Foundation (EAA), a non-profit organisation based in Qatar, is providing psychosocial assistance to a total of 35,000 children, 15,000 caregivers and 1,000 frontline workers in Gaza. In addition, Save the Children is supplying leisure packs and creating secure educational environments for children who have been relocated or are in precarious situations. Organisations such as UNICEF are creating areas where children may participate in physical activities, group games, sketching and communication with experts who provide care. These endeavours are essential in tackling the mental health emergency among youngsters in Gaza.

There are considerable obstacles in providing mental health services to children, owing to a myriad of circumstances. Insufficient understanding among healthcare practitioners, a scarcity of mental health experts and constraints on foreign aid imposed by Israel sometimes result in untreated mental health illnesses. What’s more, the distribution of resources to tackle pressing emergencies, such as the shortage of essential supplies, increases the intricacy of providing mental health interventions for children in Gaza. The declining healthcare infrastructure and lack of protected zones due to ongoing bombardment exacerbate the challenges of addressing the mental health crisis among young people in Gaza.

In conclusion, the relentless conflict in Gaza has subjected Palestinian children to profound and enduring psychological trauma.

These young lives are marred by experiences of violence, loss and deprivation, which have a severe impact on their mental health and overall development. It is imperative that international efforts are intensified to provide comprehensive mental health support and protection to these vulnerable children. Without a peaceful resolution and substantial humanitarian aid, the psychological scars inflicted by the conflict will likely persist into adulthood, perpetuating a cycle of suffering and instability. Ensuring the mental well-being of Palestinian children is not only a moral obligation, but also a crucial step towards building a future where peace and stability can prevail.

 

 

The views expressed in this article belong to the author and do not necessarily reflect the editorial policy of Middle East Monitor.

Middle East Monitor

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From childhood, we are told that patience is a virtue and that good things will come to those who wait. And, so, many of us work on cultivating patience.

This often starts by learning to wait for a turn with a coveted toy. As adults, it becomes trying to remain patient with long lines at the Department of Motor Vehicles, misbehaving kids or the slow pace of political change. This hard work can have mental health benefits. It is even correlated with per capita income and productivity.

But it is also about trying to become a good person.

It’s clear to me, as a scholar of religious ethics, that patience is a term many of us use, but we all could benefit from understanding its meaning a little better.

In religious traditions, patience is more than waiting, or even more than enduring a hardship. But what is that “more,” and how does being patient make us better people?

The writings of medieval Islamic thinker Abu Hamid al-Ghazali can give us insights or help us understand why we need to practice patience – and also when not to be patient.

Who was al-Ghazali?

Born in Iran in 1058, al-Ghazali was widely respected as a jurist, philosopher and theologian. He traveled to places as far as Baghdad and Jerusalem to defend Islam and argued there was no contradiction between reason and revelation. More specifically, he was well known for reconciling Aristotle’s philosophy, which he likely read in Arabic translation, with Islamic theology.

Al-Ghazali was a prolific writer, and one of his most important works – “Revival of the Religious Sciences,” or the “Iḥyāʾ ʿulūm al-dīn” – provides a practical guide for living an ethical Muslim life.

This work is composed of 40 volumes in total, divided into four parts of 10 books each. Part 1 deals with Islamic rituals; Part 2, local customs; Part 3, vices to be avoided; and Part 4, virtues one should strive for. Al-Ghazali’s discussion of patience comes in Volume 32 of Part 4, “On Patience and Thankfulness,” or the “Kitāb al-sabr waʾl-shukr.”

He describes patience as a fundamental human characteristic that is crucial to achieving value-driven goals, and he provides a caveat for when impatience is called for.

1. What is patience?

Humans, according to al-Ghazali, have competing impulses: the impulse of religion, or “bāʿith al-dīn,” and the impulse of desire, or “bāʿith al-hawā.”

Life is a struggle between these two impulses, which he describes with the metaphor of a battle: “Support for the religious impulse comes from the angels reinforcing the troops of God, while support for the impulse of desire comes from the devils reinforcing the enemies of God.”

The amount of patience we have is what decides who wins the battle. As al-Ghazali puts it, “If a man remains steadfast until the religious impulse conquers … then the troops of God are victorious and he joins the troops of the patient. But if he slackens and weakens until appetite overcomes him … he joins the followers of the devils.” In other words, for al-Ghazali, patience is the deciding factor of whether we are living up to our full human potential to live ethically.

2. Patience, values and goals

Patience is also necessary for being a good Muslim, in al-Ghazali’s view. But his understanding of how patience works rests on a theory of ethics and can be applied outside of his explicitly Islamic worldview.

It all starts with commitments to core values. For a Muslim like al-Ghazali, those values are informed by the Islamic tradition and community, or “umma,” and include things like justice and mercy. These specific values might be universally applicable. Or you might also have another set of values that are important to you. Perhaps a commitment to social justice, or being a good friend, or not lying.

“Nizamiyyah University Nishapur,” Digital imagining, Dall-E, 2024.

Living in a way that is consistent with these core values is what the moral life is all about. And patience, according to al-Ghazali, is how we consistently make sure our actions serve this purpose.

That means patience is not just enduring the pain of a toddler’s temper tantrum. It is enduring that pain with a goal in mind. The successful application of patience is measured not by how much pain we endure but by our progress toward a specific goal, such as raising a healthy and happy child who can eventually regulate their emotions.

In al-Ghazali’s understanding of patience, we all need it in order to remain committed to our core principles and ideas when things aren’t going our way.

3. When impatience is called for

One critique of the idea of patience is that it can lead to inaction or be used to silence justified complaints. For instance, scholar of Africana studies Julius Fleming argues in his book “Black Patience” for the importance of a “radical refusal to wait” under conditions of systemic racism. Certainly, there are forms of injustice and suffering in the world that we should not calmly endure.

Despite his commitment to the importance of patience to a moral life, al-Ghazali makes room for impatience as well. He writes, “One is forbidden to be patient with harm (that is) forbidden; for example, to have one’s hand cut off or to witness the cutting off of the hand of a son and to remain silent.”

These are examples of harms to oneself or to loved ones. But could the necessity for impatience be extended to social harms, such as systemic racism or poverty? And as Quranic studies scholars Ahmad Ismail and Ahmad Solahuddin have argued, true patience sometimes necessitates action.

As al-Ghazali writes, “Just because patience is half of faith, do not imagine that it is all commendable; what is intended are specific kinds of patience.”

To sum up, not all patience is good; only patience that is in service of righteous goals is key to the ethical life. The question of which goals are righteous is one we must all answer for ourselves.

Liz Bucar, Professor of Philosophy and Religion, Northeastern University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

What struck me in their report is how unhappy the Middle East is. The only Middle Eastern country in the top twenty is Kuwait (for the first time in this cycle). Kuwait has oil wealth and is a compact country with lots of social interaction. The high score may reflect Kuwait’s lively labor movement. That sort of movement isn’t allowed in the other Gulf States. The United Arab Emirates came in at 22, and Saudi Arabia at 28.

These countries are all very wealthy and their people are very social and connected to clans and other group identities, including religious congregations.

But everyone else in the Middle East is way down the list.

As usual, Gallup found that the very happiest countries were Scandinavian lands shaped by social democratic policies. It turns out that a government safety net of the sort the Republican Party wants to get rid of actually is key to making people happy.

Finland, Denmark, Iceland, Sweden take the top four spots. Israel, which also has a Labor socialist founding framework, is fifth. The Netherlands, Norway, Switzerland and Luxembourg fill out the top nine.

The Gallup researchers believe that a few major considerations affect well-being or happiness. They note, “Social interactions of all kinds … add to happiness, in addition to their effects flowing through increases in social support and reductions in loneliness.” My brief experience of being in Australia suggests to me that they are indeed very social and likely not very lonely on the whole. Positive emotions also equate to well-being and are much more important in determining it than negative emotions. The positive emotions include joy, gratitude, serenity, hope, pride, amusement, inspiration, awe, and altruism, among others.

Benevolence, doing good to others, also adds to well-being. Interestingly, the Gallup researchers find that benevolence increased in COVID and its aftermath across the board.

They also factor in GDP per capita, that is, how poor or wealthy people are.

Gallup Video: “2024 World Happiness Report; Gallup CEO Jon Clifton”

Bahrain comes in at 62, which shows that oil wealth isn’t everything. It is deeply divided between a Sunni elite and a Shiite majority population, and that sectarian tension likely explains why it isn’t as happy as Kuwait. Kuwait is between a sixth and a third Shiite and also has a Sunni elite, but the Shiites are relatively well treated and the Emir depends on them to offset the power of Sunni fundamentalists. So it isn’t just sectarian difference that affects happiness but the way in which the rulers deal with it.

Libya, which is more or less a failed state after the people rose up to overthrow dictator Moammar Gaddafi, nevertheless comes in at 66. There is some oil wealth when the militias allow its export, and despite the east-west political divide, people are able to live full lives in cities like Benghazi and Tripoli. Maybe the overhang of getting rid of a hated dictator is still a source of happiness for them.

Algeria, a dictatorship and oil state, is 85. The petroleum wealth is not as great as in the Gulf by any means, and is monopolized by the country’s elite.

Iraq, an oil state, is 92. Like Bahrain, it suffers from ethnic and sectarian divides. It is something of a failed state after the American overthrow of its government.

Iran, another oil state, is 100. Its petroleum sales are interfered with by the US except with regard to China, so its income is much more limited than other Gulf oil states. The government is dictatorial and young people seem impatient with its attempt to regiment their lives, as witnessed in the recent anti-veiling protests.

The State of Palestine is 103, which is actually not bad given that they are deeply unhappy with being occupied by Israel. This ranking certainly plummeted after the current Israeli total war on Gaza began.

Morocco is 107. It is relatively poor, in fact poorer than some countries that rank themselves much lower on the happiness scale.

Tunisia is one of the wealthier countries in Africa and much better off than Morocco, but it comes in at 115. In the past few years all the democratic gains made during and after the Arab Spring have been reversed by horrid dictator Qais Saied. People seem to be pretty unhappy at now living in a seedy police state.

Jordan is both poor and undemocratic, and is ranked 125.

Egypt is desperately poor and its government since 2014 has been a military junta in business suits that brooks not the slightest dissent. It is 127. The hopes of the Arab Spring are now ashes.

Yemen is 133. One of the poorest countries in the world, it suffered from being attacked by Saudi Arabia and the United Arab Emirates from 2015 until 2021. So it is war torn and poverty-stricken.

Lebanon ranks almost at the bottom at 142. Its economy is better than Yemen’s but its government is hopelessly corrupt and its negligence caused the country’s major port to be blown up, plunging the country into economic crisis. It is wracked by sectarianism. If hope is a major positive emotion that leads to feelings of happiness, it is in short supply there.

Some countries are too much of a basket case to be included, like Syria, where I expect people are pretty miserable after the civil war. Likewise Sudan, which is now in civil strife and where hundreds of thousands may starve.

Poverty, dictatorship, disappointment in political setbacks, and sectarianism all seem to play a part in making the Middle East miserable. The role of the United States in supporting the dictatorships in Egypt and elsewhere, or in supporting wars, has been sinister and certainly has added significantly to the misery. For no group in the region is this more true than for the Palestinians.

( Tomdispatch.com) – Amid ongoing emergencies, including a would-be autocrat on his way to possibly regaining the American presidency and Israel’s war on Gaza (not to mention the flare-ups of global climate change), the U.S. has slipped quietly toward an assault on civil liberties as an answer to plummeting mental health. From coast to coast, state lawmakers of both parties are reaching for coercive treatment and involuntary commitment to address spiraling substance use and overdose crises — an approach that will only escalate despair and multiply otherwise preventable deaths while helping to choke the life out of America.

In December, we wrote about how loneliness has become a public-health crisis, according to the Surgeon General, and the ways in which it drives widespread substance use. We reach for substances to ease feelings of isolation and anguish — and when the two of us say “we,” we mean not just some hypothetical collective but the authors of this article. One of us, Sean, is a doctor living in long-term recovery from a substance-use disorder and the other, Mattea, is a writer who uses drugs.

And we’re anything but unique. Disconnection and loneliness aren’t just the maladies of a relatively few Americans, but the condition of the majority of us. Vast numbers of people are reaching for some tonic or other to manage difficult feelings, whether it’s weed, wine, work, television, or any mood- or mind-altering substance. These days, there’s scarcely a family in this country that’s been unscathed by problematic drug use.

Not surprisingly, under the circumstances, many elected officials feel increasing pressure to do something about this crisis — even as people who use drugs are widely considered to be social outcasts. In 2021, a survey of thousands of U.S.-based web users found that 7 in 10 Americans believed that most people view individuals who use drugs as non-community members. It matters little that the impulse to use such substances is driven by an urge to ease emotional pain or that the extremes of substance use are seen as a disease. As a society, we generally consider people who use drugs as rejects and look down on them. Curiously enough, however, such social stigma is not static. It waxes and wanes with the political currents of the moment.

“Stigma has risen its ugly head in almost every generation’s attempts to manage better these kinds of issues,” says Nancy Campbell, a historian at Rensselaer Polytechnic Institute and the author of OD: Naloxone and the Politics of Overdose. Campbell reports that she finds herself a target of what she calls “secondary stigma” in which others question why she even bothers to spend her time researching drug use.

Perhaps one reason to study such issues is to ensure that someone is paying attention when lawmakers of virtually every political stripe seek to answer a mental health crisis by forcing people into institutionalized treatment. Notably, such “treatment” can increase the odds of accidental death. Allow us to explain.

“Treatment” Can Be a Death Sentence

Across the country, the involuntary detainment and institutional commitment of people with mental illness — including those with a substance use disorder — is on the rise. Deploying the language of “helping” those in need, policymakers are reaching not for a band-aid but a club, with scant or even contradictory evidence that such an approach will benefit those who are in pain.

“The process can involve being strip-searched, restrained, secluded, having drugs forced on you, losing your credibility,” said UCLA professor of social welfare David Cohen in a 2020 statement about his research on involuntary commitment. He co-authored a study that found its use rose nationwide in the decade before the pandemic hit, even as there was a striking lack of transparency regarding when or how such coercion was used.

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Today, many states are expanding laws that authorize mandatory treatment for people experiencing mental-health crises, including addiction. According to the Action Lab at the Center for Health Policy and Law, 38 states currently authorize involuntary commitment for substance use. None of them require evidence-based treatment in all involuntary commitment settings and 16 of them allow facilities to engage in treatments of their choice without the individual’s consent. Nearly every state that ranked among the highest in overdose rates nationally has an involuntary commitment law in place.

In September, the California legislature passed a bill that grants police, mental healthcare providers, and crisis teams the power to detain people with “severe” substance use disorder. The Los Angeles County Board of Supervisors subsequently voted to postpone implementation of the law, with Board Chair Lindsey Hogarth noting the risk of civil rights violations as a reason for the delay. In October, Pennsylvania state legislators introduced a bill that would permit the involuntary commitment of people who have been revived following an overdose. While many mental health advocates acknowledge the good intentions of legislators, the potential for harm is incalculable.

New research shows that people who attended abstinence-based treatment programs were at least as likely, if not more likely, to die of a fatal overdose than people who had no treatment at all. By contrast, those who had access to medications like methadone or buprenorphine for opioid-use disorder were less likely to die. Those medications, however, are not considered “abstinence” and so are not uniformly provided in treatment settings. Though there is extensive evidence of the effectiveness of medications for opioid use disorder, abstinence still remains widely regarded as the morally upright and best path, even if it makes you more likely to die. The reason for the elevated risk of mortality following abstinence-based treatment is no mystery: abstinence reduces the body’s tolerance. If a person who has been abstinent resumes use, the ingestion of a typical dose is more likely to overwhelm his or her bodily system and so lead to death.

Disturbingly, both The Atlantic and the Wall Street Journal recently ran columns favoring mandatory treatment, with the Journal citing as evidence a 1960s study in which individuals fared well after 18 months of mandated residential treatment that included education and job training — a standard of care that’s virtually nonexistent today. The Atlantic referenced a study of 141 men mandated for treatment in the late 1990s whose outcomes were comparable to individuals who entered treatment voluntarily; the study’s own authors had, however, cautioned against generalizing the findings to other populations due to its limited scope — and since then, the potent opioid fentanyl has entered the drug supply and raised the risk of a fatal overdose following a period of abstinence.

Meanwhile, as policymakers turn to coerced treatment, consider this an irony of the first order: there are far too few treatment options for people who actually want help. “There is no place in this country where there is enough voluntary treatment. So why would you create involuntary commitment, involuntary treatment?” asks Campbell. The reason, she suggests, is the inclination of lawmakers not just to do something about an ongoing deadly crisis, but in no way to appear “soft on drugs.”

Just to put the strange world of drug treatment in context, imagine elected officials wanting to seem tough on constituents who have cancer or heart disease. The idea, of course, is ludicrous. But 7 in 10 Americans think society at large views addiction as “at least somewhat shameful” and people who use drugs as significantly responsible (that is, to blame) for their substance use. No surprise, then, that politicians would find it expedient to punish people who use drugs, even if such punishment only layers on still more shame, with research indicating that shame, in turn, exacerbates the pain and social isolation that drives people to use drugs in the first place. As Dr. Lewis Nelson, who directs programs in emergency medicine and toxicology at Rutgers New Jersey Medical School, pointed out to USA Today, the science of addiction and recovery is frequently overlooked because it’s inconsistent with ingrained social ideas about substance use.

“I Still Don’t Need Saving”

Punishing people for substance use worsens the pain and isolation that make drugs so appealing. So rather than punishment — and in our world today this will undoubtedly sound crazy — what if we treated people who use drugs as full and complete human beings like everyone else? Like, say, people with high blood pressure? What if we acknowledged that those who use drugs need the very same things that all people need, including love, support, and human connection, as well as stable employment and an affordable place to live?

Research on this, it turns out, suggests that human connection is particularly good medicine for the emotional pain that so often underlies substance use and addiction. Stronger social bonds — namely, having people to confide in and rely on — are associated with a positive recovery from a substance use disorder, while the absence of such social ties elevates the risk of further problematic drug use. Put another way, perhaps you won’t be surprised to learn that a powerful means of healing widespread mental distress is to connect with one another.

When people in distress have friends, attendant family, and healthcare providers who are genuinely there for them no matter what, their own self-perception improves. In other words, we help one another simply by being nonjudgmentally available.

Jordan Scott is a peer advocate for Recovery Link, which offers free digital peer support to people in Texas and Pennsylvania. She identifies as a person who uses drugs. “I felt like the message got reinforced that there was something wrong with me, that there was something broken with me,” she told us. “Anything that isn’t abstinence, or anything that doesn’t include total abstinence as a goal, is constantly positioned as less than.”

New research published in the journal Addiction draws a contrast between treatment focused exclusively on abstinence and a broader array of wellness strategies, including reducing drug use rather than eliminating it entirely. The study found that reduced use had clinical benefits and that health can distinctly improve even without total abstinence. Director of the National Institute on Drug Abuse Nora Volkow, for instance, supports a nuanced approach that includes many possible paths of recovery along with a shift away from the criminalization of drug-taking to a focus on overall health and wellbeing. And the Substance Abuse and Mental Health Services Administration, a branch of the U.S. Department of Health and Human Services, has identified four dimensions critical to recovery: health, home, purpose, and community.

Most important of all, a person doesn’t necessarily need to be abstinent in order to make gains in all four areas. This makes good sense when you remember that addiction or other problematic substance use is a symptom of underlying pain. Rather than exclusively treating the symptom — the drug use — addressing the underlying loneliness, trauma, or other distress can be a very effective approach. “Family can be a valid pathway to wellness,” Scott pointed out, while adding that her own path went from 12-step meetings like Alcoholics Anonymous to active civic engagement.

For someone else, quality time with his or her kids or even exercising and eating well might be a linchpin for staying mentally healthy. In other words, healing from the pain that underlies substance use disorder can look a lot like healing from any other health challenge.

Yet policymakers continue to call for intensifying the use of coercive treatment. “I think we’re going to see more [involuntary commitment] before we see less of it,” said Campbell, who studies historical patterns in the social response to drug use. There’s nothing new, she noted, in the move to “help” people by institutionalizing them — even if such a move constitutes an erosion of basic civil rights.

“I think most of the time people are genuine in wanting to help,” said Scott, who has been a target of such “help.” The problem, she explained, is the idea that there is a group of people considered “normal” and therefore superior, who think they’re in a position to save other members of society.

“I didn’t need saving. I am a drug user now. I still don’t need saving,” Scott told us. These days she’s focused on being a part of her community through volunteerism while drawing on a support network of people who respect her path.

As for the two of us writing this article, Sean is spending time with his children, staying connected with friends, practicing meditation and yoga, and has for years facilitated a group of physicians in recovery. Mattea has started a new habit of going to the gym with her uncle to ease her loneliness, while also confiding in close friends for support. And all of that truly does make a difference.

Copyright 2024 Sean Fogler and Mattea Kramer

Via Tomdispatch.com

As I began this piece on trees in forests, woods and parks, a friend asked, why in January in New England?  Why didn’t I wait until the deciduous trees were a palette of new spring green crowning the stark brown trunks and branches of winter?  The next day, January 7, nature provided the answer: a 10” snowstorm.  Trees after a winter snowstorm – their upstretched dark deciduous branches shouldered with snow and their downreaching evergreen branches pillowed with snow – are a feast for the eyes.

  “A forest is a sacred place…The medicines available in the forest are the second most valuable gift that nature offers us; the oxygen available there is the first.”  These are the words of Irish born and educated in the ancient Celtic culture of spiritual and physical respect for trees, Diana Beresford Kroeger.  This brilliant botanist went on to receive advanced degrees, culminating in a doctorate in medical biochemistry.  She affirmed that simply walking in a pine forest is a balm for the body and soul, elevating our mood, thanks to their chemical gift of pinenes aerosols released by pine trees and absorbed by our bodies. 

The healing potential of nature even stretches to those hospitalized. Patients recovering from surgery heal more quickly and need fewer pain killers if they have a hospital room with a window that looks out onto nature.  Similarly, studies of students in classrooms with a view of nature have found that they both enjoyed learning and learned more than students without a view of nature.

Suzanne Simard worked for Canada’s minister of forests doing research on the most efficient ways to re-grow forests that had been clearcut by the logging industry.  Loving forests since a child growing up in rural British Columbia, she grasped immediately that clear-cutting whole areas of a forest and applying herbicide to kill any competitor plant or tree before replanting monoculture tree seedlings was a “war on the forest.” In testing her insight, she found that clearcutting and planting single species seedling trees made no difference to speeding up the growth of the desired tree plantation and in some cases, reduced tree survival in the monoculture wood lots. 

“Healing Forest,” Digital, Dream / Mystical, 2024.

In pursuing a doctorate and subsequent years of research, Simard documented that biodiverse forests are the healthiest of forests, with trees communicating with other trees of their own species and other species by an underground fungal network linking their roots with each other. Through this network, known as the wood wide web, trees provide chemical food and medicine to keep each other as healthy as possible.  Her work has shown that “the fungal networks between roots of diverse trees carry the same chemicals as neurotransmitters in our brain,” strongly suggesting, she says, that trees have intelligence.  She has learned from Aboriginal people that “they view trees as their people, just as they view the wolves and the bears and the salmon as their relations.”  We need that back, she asserts. 

Trees teach us lessons of community and cooperation through all the seasons, writes German forester Peter Wohlleben in The Hidden Life of Trees.  He deems forests as “superorganisms,” sharing food with their own species and even nourishing their competitors.  Together they create an ecosystem that enables them to live much longer as a community than a single living tree alone, a life lesson for us humans.  Moreover, “sick trees are supported by healthy ones nearby…until they recover; and even a dead trunk is indispensable for the cycle of lifesaving as a cradle for its young.”

Trees are essential for life on earth; the older they are, the more essential they are.  They remove carbon dioxide from the air, store carbon in their tissue and soil, give back oxygen into the atmosphere and slow global temperature increases. They offer cooling shade in hardscape urban neighborhoods, buffer cold winter winds, attract birds and wildlife, purify our air, prevent soil erosion during rainstorms and filter rainwater falling through their soil.  

Without trees, we could not survive, whereas they have and could live without us.  Older than we so-called homo sapiens (“wise men”) by a thousand times, they are wiser than many humans: they do not wage war with each other nor destroy their own habitat.  They know not genocide nor ecocide.  They are our ancestral model for cooperative, non-violent and sustainable communities.

I write this to honor and thank the multitude of forest protectors across our country and for those working to restore nature to their towns and cities.

Auburn, Al. (Special to Informed Comment) – Peter Attia, M.D. received his medical degree from Stanford University School of Medicine and trained at John Hopkins Hospital in General Surgery and worked at the NIH as a surgical oncology fellow at the National Cancer Institute focusing on immune-based therapies for melanoma. Bill Gifford, a veteran journalist, authored the N.Y. Times bestseller Spring Chicken: Stay Young Forever (or Die Trying). Each of us will one day die. There are two aspects to longevity: first, your chronological lifespan and two, your “healthspan” or how well you live. Most people die as result or effect of the “Four Horsemen,” or chronic diseases, viz., heart disease, cancer, neurogenerative disease (or type 2 diabetes) and related metabolic dysfunction.

Peter Attia (P.) argues that there are three periods or eras in medical history. Medicine 1.0 lasted two thousand years after the death of Hippocrates and dealt with observation and guesswork. Medicine 2.0 has seen its finest hour with fighting COVID-19 yet has made meager progress against what P. names the four Horsemen (heart disease, cancer, metabolic dysfunction, and metabolic syndrome including diabetes and neurodegenerative diseases like Alzheimer’s). Medicine 3.0 suggests that we have an early screening for various diseases. For example, we need to deal with cancer on three fronts: early prevention, more defective and targeted treatments, and accurate and comprehensive detection. The problem is this: we know very little about how cancer begins and why it spreads. In sum, cancer is not one, simple disease, but a condition with “mind-boggling complexity.”  Yet, despite hundreds of billions of dollars spent on research on cancer, death rates have barely moved. We are intervening at the wrong point in time, i.e., well after the disease has progressed. Most diseases have been in our body for several years before they have been detected.  

The main question in this book is this: how can we reduce our risk for disease and death, plus upgrading the quality of our lives as we age? In evaluating new patients, P. asks these basic questions: do we take in too many or two few calories? Are we adequately muscled or under muscled? Are we metabolically healthy or not? If we want to live a long life, we need a tactical plan. P. suggests these five dimensions: exercise, nutrition or diet, sleep, techniques to improve our emotional health, and various supplements, drugs, and hormones or molecules we take in from outside our body. Limitations of space allow me to speak to only three of these dimensions, viz., exercise, nutrition and sleep.

Exercise has the greatest power to determine how one will live out the rest of one’s life. Why so? Exercise retards the onset of chronic diseases, reverses physical decline, gives one more energy, and reverses cognitive decline. Doctors measure cardio-respiratory fitness in terms of VO2 max which is the maximum rate at which one uses oxygen. The good news is this: VO2 max can be increased by training. It’s especially important to strengthen one’s muscles. As a diabetic, I lift weights at the gym four times a week. I also walk vigorously seven days a week and avoid sugar and avoid eating pasta, rice, and heavy carbs. I take no medicine to control my diabetes. The last time I checked my HbA1C score was 5.9. At age 82, I can do twenty-five pushups and can walk with a forty-pound dumbbell in each hand for five minutes. Exercise acts like a drug in that it tells one’s body to produce its own endogenous drug like chemicals. Having strong muscles delays death because it preserves “healthspan” (or the quality of one’s life), as opposed to one’s life span.

Peter Attia with Bill Gifford, OUTLIVE: THE SCIENCE & ART OF LONGEVITY, (New York: Harmony Books, 2023). Click here.

Nutrition has several easy rules. One must eat essential fats, obtain the vitamins and minerals one needs, avoid fructose heavy foods (that likely cause blood- glucose spikes), eat fish, cut down on calories, and avoid pathogens like E. coli and toxins like lead or mercury. No dose of alcohol is healthy; hence I drink one or two bottles of Budweiser Zero Alcohol daily. One should also eat 50 grams of fiber each day. Foods high in protein like eggs have no effect on blood sugar. There’s no one diet for everyone. It depends on one’s health and one’s individual needs. Excess calories contribute to heart disease, cancer, metabolic disorders like diabetes, and Alzheimer’s disease.

Sleep is undoubtedly the best medicine for one’s brain. Our brain works well when we are unconscious as we process memories, thoughts and emotions, hence dreams. Sleep influences one’s memory, cognitive function, and emotional equilibrium. Sleep also staves off Alzheimer’s disease. P. suggests we sleep between seven and a half to eight- and one-half hours a night. One night of bad sleep has a negative effect on our physical and cognitive performance and wreaks havoc on our metabolism. Sleep deprivation increases insulin resistance by up to a third. Higher stress levels make us sleep poorly and cause glucose to be released from the liver. Less than six hours of sleep is associated with a 20 percent higher risk of a heart attack. Chronic bad sleep causes dementia and Alzheimer’s disease. P. notes that alcohol impairs sleep quality more than any other factor. Trazadone works well to help one sleep. The exact dose depends on the individual. Fifty milligrams or even less improves one’s sleep quality without grogginess the next day.

In sum, I give high marks to this study by P. He gives us forty pages of references and a helpful index. In sum, this book took my breath away. Highly recommended!