ragebutt

I work in gender affirming care that includes pediatric populations and have my services listed online for referrals. It’s not super common to be fair but every once in a while I get an email or voicemail that’s like “you’re a child abuser and you should die” or some shit. It’s why I specifically say voicemail; I don’t answer calls to my business phone bc of this. Everything gets screened and I call back. Thankfully it’s infrequent and this has been enough to ensure I never have to engage with these people.

You’re absolutely right though. I’ve posted about my work before and people will sometimes be like “thank you for doing what you do”. I appreciate that, and those comments outnumber these threats, which again are not very common, but they stick out. Even the ones that don’t wish me dead. Once I got an email that just said “f*g enabler”. I don’t know why I remember that. It was years ago.

It’s the knowledge that someone out there absolutely hates you and wants you to die without knowing anything (really) about who you are, I think.

The really sad part of this is that this is a core part of the minority stress model; that feeling constant oppression from the world around you is noxious and has measurable consequences on physical and mental health. If he and his dumb racist, sexist, transphobic, homophobic, etc cronies reflected on their experience and practiced empathy for even a moment they would realize that this stress is something experienced almost constantly by someone on their hit list, because of them.

Edit: while I appreciate the positivity I genuinely didn’t mean for this to be a “please give me positive support” thing. I dunno I always feel awkward posting about this because it’s like I’m fishing for compliments at the expense of one of the most marginalized communities out there. You don’t need to thank me, though I do appreciate it quite a bit

Oh I don’t mean to imply that one shouldn’t litigate, to be clear. More that we should push for legislation that cause actual consequences to police who do terrible things, eg they have to pay settlements out of pension funds and/or carry malpractice insurance that they pay for

I work in healthcare. I pay several thousand dollars a year out of my pocket for malpractice insurance so that if I fuck up you can sue me and be paid a settlement that is not covered by taxpayers. I take Medicaid and Medicare so I receive some taxpayer funding like police (not nearly as much) but when I fuck up I have to pay the price. Why shouldn’t they be held to the same standard? We might see some real reforms if their wallets are on the line.

Ending or significantly reforming qualified immunity would also be necessary as that is bullshit

Orrrrrrrrrr burn it all down and start over. Law enforcement in America is rotten

Remember that department liability ultimately just means your tax dollars. The cops don’t pay directly from their salaries, pensions, etc and often their budget is unaffected

On one hand I feel hypocritical because again this is very similar to the advice I give people as a counselor and yet I don’t do it. On the other hand I feel validated in that I apparently am not giving people shitty advice, haha

We did have that. It was also terrible. Prohibition is stupid.

That said as someone who works in a field adjacent to addiction it would probably be a great idea to heavily regulate the industry. Banning substances is foolish. But allowing them to advertise and create billion dollar industries? That’s far far far more foolish

I worked on research many years ago about impulse regulation in addiction. It was basically put someone in an fmri with a little lcd screen and show them images. When we showed addicts images of things that triggered their addiction (eg alcoholics a bottle of gin, crack addicts a pipe) the parts of their brain that processed the craving reacted much faster than the parts that regulated impulse control. The takeaway was that things like alcohol advertising was potentially damaging for people attempting to quit.

This is very relevant because if you look at alcohol consumption in america by sales it’s shocking. Something like 90% of alcohol is consumed by the top 5% of users. These numbers are off, I’m going off of memory from like 2 decades ago, but it’s basically that a very small percentage of users consume the overwhelming majority of alcohol sold. It was impossible to determine but we suspected

this was similar for other drugs too. Contrary to popular belief there are people who do heroin, Percocet, Xanax, cocaine, etc casually. They do it uncommonly, every once and a while. But a percentage of users consume a huge amount. We suspected that the split was different due to a combination of higher likelihood of physical addiction and much stronger stigma against casual use, but they do exist (and probably would in greater numbers if legalization or decriminalization occurred)

This is another example of our complete failure of a regulatory state. We have research that indicates things like this but it doesn’t matter. The alcohol industry simply has too much money, so it doesn’t change. So sorry alcoholics, your chances at recovery are much much much harder. It doesn’t matter that there is research that shows your brain simply cannot ignore the urge when presented with stimuli. Sorry gambling addicts too. Fanduel makes too much money! We will just force these companies to put a 1-800 number in small print at the end. That’s a good compromise, right?

What’s crazy is that at one point this country did overcome this issue. Cigarette advertising used to be everywhere. But then it became clear how addictive and how harmful it was and relatively quickly it disappeared. We know alcohol is addictive. We know drinking is harmful. But we don’t care. Budweiser is an american icon

Interesting note: the research continued after I left and found that baclofen, a non addictive muscle relaxant, can modify that brain response and delay the craving enough that impulse control can intervene. Others have built on this research and it’s occasionally prescribed for alcohol addiction now

That’s why I get paid the medium bucks

I would agree with this advice. Additionally smoking limits the physiological harm substantially. Smoking anything is terrible for you. Vaping is (probably) better, but still harmful.

It is likely that without the extremely long and stupid prohibition on marijuana (that’s still ongoing) we’d have researched proper pharmaceuticals that harnessed the benefits of marijuana while limiting the drawbacks. Medications that limited impairing functionality.

However thanks to our dipshit government and harmful puritanical underpinnings of our society we have almost completely banned marijuana research for the better part of a century. Emotions trump science and people with power unilaterally decided that there was no benefit from this plant and maintained that decision for years.

This has finally started to relax and there have been some medications that work on the endocannabinoid system as a result. Marinol, cannabidiol, sativex, and cesamet. These have interesting and very practical applications such treating chemotherapy induced nausea, inducing appetite in hiv/aids patients, an alternative to opioids for chronic pain, and treating seizures/epilepsy.

These medications often use synthetic cannabinoids which allow for modulation of the endocannabinoid system in ways that naturally derived cannabinoids can’t do. They additionally tend to be absorbed better and are more consistent in purity and dosing. But they were initially developed out of necessity: they bypass legal and regulatory bans on cannabis. Most of the above meds exist because of synthesis of cannabinoids.

Although eventually people figured out they could smoke these too and got them banned in many places (remember k2 and spice?). Except that was much worse because as mentioned actual marijuana is a partial agonist of cb1/cb2 whereas synthetic cannabinoids like the Huffman series that was initially popularized (jwh-018 was the first really big one in spice, iirc) is a full agonist, which is why people would sometimes have seizures and such from it.

Prohibition works!

Just imagine where we would be without this stupid restriction. A host of medications acting on an entire system. THC was isolated in 1964 but the endocannabinoid system wasn’t even discovered until the late 80s because of this moratorium on research funding. And this isn’t just about anxiety. Pain management, neuro degenerative diseases, epilepsy. The opioid epidemic could’ve been significantly reduced. Benzodiazepine abuse could’ve been significantly reduced.

Disgusting.

And then look at this behavior and look at where it’s repeated: after a study showing guns in a home were more likely to cause you to kill a family member than an intruder the NRA strongly lobbied to end federal funding for any research concerning guns at all. They were successful and in 1996 the dickey amendment was passed. In addition to this congress removed 2.6 million from the cdc budget, the exact amount they spent on gun research, a punitive measure designed to send a message.

This was only changed after parkland although the change was to allow some research with no funding provided.

No research on safety, epidemiology, risks, etc. and it’s definitely been totally fine for the pass 30 years right? No gun problems in the us?

And now the USA is essentially moving to cut funding in more severe and drastic ways across broad areas of research. We are doooooomed

Therein lies the issue

Irl - going places? Blergh. And I am very privileged to work from home. Do you make friends at like the grocery store? I am confused about this, genuinely

Online? Seeing people regularly? I don’t understand how people do this. I just kind of browse popular feed and pop in to what looks interesting. But even when I do look into communities more regularly I don’t like notice people. Do you? I’m seriously asking. Is there a platform where this makes more sense? Back when I used reddit I was more engrained to certain communities but there were so many users everyone felt anonymous. Here there are less users but still enough that people feel anonymous.

for the record I do have autism. I’m also a counselor, funny enough. When people ask me how to make friends I tell them things generally along your advice: to go to places where they can meet more people ideally along lines with common interests. If they really want to focus on this though I usually refer out as this clearly isn’t my strength

More likely for people that have a predisposition to certain mental health disorders (eg a family history notable for schizophrenia). Key phrase being more likely, it can occur in people without such a thing. Literature shows that it generally wears off with the intoxication but heavy use increases the likelihood of long term mental health issues. Important note is that literature is limited

Additionally there is literature to suggest that frequently using marijuana for anxiety has similar drawbacks to frequently using medications like benzodiazepines, only not as severe. This is because (simplified) your brain chemistry is modified while using the drug which lowers your anxiety temporarily, but then it wears off. You’re left in a state where the brains neurochemistry is disrupted at this point; it’s expecting an increase in neurotransmitters that was just occurring and abruptly stopped. As a result there is now a deficiency which can heighten anxiety, or “rebound anxiety”.

With mild use this effect is minimal, typically. This is why benzodiazepines are still often prescribed in very small amounts for specific phobias like planes. They will dispense 4-5 tablets and the rebound anxiety is minimal relative to the relief provided from the intense panic some people experience on aircraft. Marijuanas rebound is more mild as most benzodiazepines are fairly powerful sedatives but the method of action is fairly similar though the systems acted on are different (GABA vs endocannabinoid) and benzodiazepine addiction is a serious serious danger with a withdrawal that can be fatal if not detoxed appropriately (seriously if you have a benzo addiction and want to quit please detox with medical assistance)

However, with chronic use neuroadaptation occurs. Your brain gets used to this process and as a result the ability to regulate mood and anxiety nature diminishes. Now when you no longer have access to marijuana you may find that you are much more anxious, irritable, etc than you were when you started. The good news is that this is typically reversible (although with long term heavy use there is evidence of structural changes in the brain for both benzodiazepines and marijuana, but this is poorly understood). The bad news is depending on length of time this can take quite a while.

I don’t get how people make friends online

Or offline

He would be so nice as he endorsed a constitutional amendment to permanently remove gay marriage, start a 20 year war under false pretenses for defense contractors that results in a million people in the Middle East getting murdered (the overwhelming majority of which are civilians) and countless more having ghastly war crimes occur similar to what’s occurring in Gaza (being picked off like dogs by snipers, children shot in front of families, bombing weddings, cia posing as the Red Cross, raping people including children, bombing relentlessly) with no accountability aside from a small handful of soldiers getting court martialed (only to eventually be pardoned by trump anyway).

He also greatly eroded privacy protections through things like the patriot act and the grossly illegal PRISM program that was eventually leaked by Snowden. And don’t forget while Clinton was the president who set the stage for the 2008 recession by allowing bullshit regulatory relaxation with repeal of glass-stegall, bush was the president whose administration sat there for almost a decade watching wall street take increasingly large risks, ignoring massive alarms, and was at the helm when it predictably blew the fuck up ruining millions of lives. The after effects of that are still felt today for many families, 17 years later.

But yeah he wasn’t mean on twitter and now he paints pictures and goes out to lunch with Ellen, who is a class traitor and proof that lgbt status means little in the scope of class divide. Fuck that, fuck her for signing on to his pr image rehab campaign bullshit, and fuck bush apologists. He is a monster and a war criminal. If there were justice in the world and america didn’t push its military onto 60% of the globe he would be hung like saddam, and he would deserve it. But the international courts are weak cowards that cannot and will not ever hold america accountable

やります、ありがとう

Oh this made me think of another one: years ago I worked with kids and teens. sometimes they would fuck with my phone when I wasn’t paying attention to go on youtube but I would leave the keyboard on the kana flick keyboard which would stump them