Month: <span>April 2022</span>

Eschatologist #16: The Right Amount of Danger

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When I was a kid, I had never heard of someone with a peanut allergy. The first time I encountered the condition I was in college, and it wasn’t someone I knew. It was the friend of a friend of a friend. Enough removed that these days you’d wonder, upon first hearing of it, if the condition was made up. But those were more credulous times, and I never doubted that someone could be so allergic to something that if they ate it they would die. But it did seem fantastic. These days I’m sure you know someone with a peanut allergy. My daughter isn’t allergic to peanuts, she’s allergic to tree nuts, and carries an epipen with her wherever she goes.

The primary theory for this change, how we went from no allergies of this sort to lots of them, is the hygiene hypothesis. The idea is that in the “olden days” children were exposed to enough pathogens, parasites and microorganisms that their immune system had plenty to keep it occupied, but now we live in an environment which is so sterile that the immune system, lacking actual pathogens, overreacts to things like peanuts. (Obviously this is a vast oversimplification.)

As the parent of someone who suffers from a dangerous allergy, I feel guilty. I don’t think we went overboard on cleanliness. Certainly we weren’t constantly spraying down surfaces with disinfectant, or repeatedly washing with antibacterial soap. Nevertheless, it appears that we failed to stress her immune system in the way it needed to be—that somewhere in the course of trying to make her safer we actually made her life more dangerous.

Does this idea—that certain amounts of stress are necessary for healthy development—need to be applied more broadly? Do we need to add a psychological hygiene hypothesis to the physical one? I would argue that we do. That it’s not just children’s immune systems which are designed around certain stressors, but that everything involved in their development needs a certain amount of risk to mature properly. 

We see a dawning acknowledgement of this idea in things like the Free-Range Parenting movement, which, among other things, wants to make sure kids can walk, unaccompanied, to and from school, and the local park, without having child protective services called. The free-range argument is that kids need to get out and experience the world. Which presumably means experiencing some danger. If you want to get more technical, the theory underlying all of these efforts is that kids are antifragile and they get stronger when exposed to stress, up to a point. But is having them walk alone to school enough “stress”? When I was 8 I wasn’t just walking to school alone I was wandering for hours in the foothills, and climbing cliffs. These days I’m not sure that would be labeled “free-range parenting”, I think it might still be labeled neglect. It wasn’t, but where do you draw the line? 

In the past a parent could do everything in their power to protect their kids, and they would still experience an abundance of suffering, danger, and stress, enough that no one ever worried whether they might be getting “enough”. But after centuries of progress we’ve finally reached the point where it’s reasonable to ask if we’ve gone too far. Particularly when we have young adults who, historically, would have been raising families or fighting in wars instead declaring that certain ideas are so harmful that they should not be uttered.

For those parenting in a modern, developed country, this problem is one of the central paradoxes of parenting, perhaps THE central paradox. And it’s not just parents that face this paradox, educators and even employers are facing it as well. Unfortunately I don’t have any easy solutions to offer. 

As I mentioned I was wandering in the foothills of Utah when I was 8, but it’s not as if this experience made me into some kind of superman. I’m still at best only half the man my father is, and he’d probably tell you he’s only half the man his father was. All of which is to say, if this is indeed the trend, I’m unconvinced that a small amount of stress, or a few challenges, or a small course correction is all that’s required to fix the problem. 

This would leave us with a very difficult problem: We’ve demonstrated the power to eliminate suffering, do we have the wisdom to bring it back?


The punchline of me wandering in the foothills when I was 8, is that I was nearly always accompanied by my cousin who would have been 5 or 6. So if stories of brave kindergartners is your thing, consider donating, I might have more of them. 


The Drug Crisis (Part 2): Wrapping Up and Maybe Some Solutions?

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I- Why Don’t Other Western, Developed Countries Have the Same Problem?

I generally don’t like breaking posts up into parts, though I’m frequently glad when I do because it often produces the best comments. If I’m in the middle of saying something then it’s more productive to interject a point or a question because it’s easier to incorporate it into what I’m already working on than it is for me to reopen a subject. 

The most interesting comment was left by Zach who pointed me at a tweet, from Max Roser, the founder of Our World in Data, which claimed that the dramatic increase in overdose deaths I talked about in the last post is strictly a US phenomenon. I confess to being embarrassed that I didn’t come across this assertion before starting my examination of the drug crisis. In particular I’m surprised that it was not mentioned in any of the books I read. I think it’s pretty easy to fall into a US centric view of events and issues, which is probably what happened to the authors of the books I read, and it’s definitely what happened to me. Regardless, now that it’s been brought to my attention it deserves a deeper discussion. 

I went to the Our World in Data page the tweet was referencing, and I can’t seem to find the exact chart Roser was using, the one that allows you to compare total overdose deaths by country. If someone else can, let me know. But I can pull a breakdown of the type of overdose deaths (opioids, meth, cocaine, other) by country, and I think the situation is a little bit more complicated than Roser claims. First off when I compare Canada and the US on this website, the percentage increase is pretty similar. Taking the period from 1999 to 2019 (the last year on the site) Canada’s opioid overdoses increased three-fold as compared to a five-fold increase in the US. The US is still worse but it appears more a matter of degree than of kind. 

Roser does include Australia on his chart, which is something, since Australia, unlike the other countries he included for comparison, had a bulge around the turn of the century, but then overdose deaths went down till around 2010 when they started to climb again. But once you look at the breakdown of deaths, Australia appears to have its own unique story to tell, because it’s the only country (as far as I can see) where overdose deaths from “other” drugs are higher than deaths from opioids. I’m not sure what the unique story is behind this phenomenon, but in five minutes of searching it looks like they might have a particularly bad problem with benzodiazepine and antidepressant overdose deaths. 

There are other countries which have seen the same steady upward trend as the US and Australia, but which do not appear on Roser’s chart, these include Finland, Sweden, and the United Kingdom. Also all the Latin American countries I looked at had a steady upward trend of overdose deaths. I don’t want to accuse him of cherry picking countries, but I think he has definitely left out some elements which complicate his narrative. This is of course the whole problem with Twitter. But, despite all of this, his central point stands, some countries are doing much better than other countries. Though I would say that the US is not quite as unique as he claims. 

The next step in this process is to determine why some countries are doing better than others and why all countries are doing better than the US. Roser offers up a Vox article which claims that the reason the US is uniquely bad is that drug programs in the US eschew medications like methadone, buprenorphine and naltrexone in favor of the 12 step program and other non-pharmaceutical interventions. I’m sure this is part of it, but does this same aversion also exist in Canada and the other countries I mentioned? I don’t have the time to research the various drug treatment regimens in all the different countries, but I’d be surprised if all these countries with their different cultures and medical setups just happened to all have the same aversion to these drugs. That Sweden and Finland have a policy similar to the US, but that Norway, sitting between them, does not. 

One answer a lot of people would give is that it has to do with the US healthcare system, which makes drugs uniquely profitable. While presumably Perdue Pharma could sell Oxycontin everywhere, the incentive to set up pill mills only existed in the United States. But then you still have to explain Canada, which has a single payer system. Certainly proximity to the US was a factor, but part of my point in the last post is that technology and progress have made every every location proximate.

This brings up the possibility that the US is on the leading edge of this trend, Canada is close behind and other countries will soon follow. While we just talked about distribution, “marketing” (for lack of a better term) is also a big factor in this upward trend. We can see it play out within the US, where for a very long time opioids were primarily a problem of white America. But recently black Americans have overtaken white Americans in opioid death rates. With the “white” opioid market effectively being saturated, it was predictable that dealers and distributors would turn to marketing to black Americans. Something similar may be coming for those countries that have thus far escaped the drug epidemic. 

Pulling all of this together, my theory at this point would be that once you’ve lost control of opioids it’s difficult to regain that control. That this is what happened in the US, and in other countries where deaths are rising. Perhaps a related thing happened in Australia, they lost control of benzos and that’s how more people are dying from benzo overdoses than from opioid overdoses. (Of course it could also be an artifact of how they collect statistics.)

I’d like to end this section by talking about China. There are actually two things worth mentioning. The first is their role in the US’s fentanyl problem, which, despite the increase in deaths from all the other drugs, is clearly the drug causing the single biggest problem. And according to the DEA, who’s the primary provider of that drug? China, at least as of January of 2020. This is obviously important for a lot of reasons, but while I was in Vegas hanging out with a friend of mine, he brought up one that I had inexplicably missed. It’s hard to overstate the role the Century of Humiliation plays in Chinese thinking, and of course one of the biggest humiliations during that period was the Opium Wars, when the UK forced China to import opium. For a country that is trying to shake off those humiliations, a reversal of that flow, pushing opioids into the US, is too perfect to resist. I am not claiming that this was a grand conspiracy, more that it was a fortuitous opportunity which was too lucrative to pass up, and is now too symbolic to do anything substantial to stop. And, as we’re seeing, China has significant power to stop things. Which takes us to the next point.

In looking through the charts it does appear that China had their own significant problem with opioid overdose deaths in the late 90’s. Deaths started falling precipitously in 2000 and leveled out at about one-fourth their peak. To get the US death total back to where it was before the epidemic we’d have to decrease the total by an even greater percentage. Do you think the Chinese did it through the use of methadone, buprenorphine and naltrexone If not, which seems likely, do you think the methods they did use would work here? I suspect just like Chinese COVID mitigation policies, that we would also be unable to duplicate their opioid mitigation policies.

Speaking of COVID…

II- The Pandemic Made Things Way Worse

Even if the problem is mostly just a US problem it’s still a problem which needs to be solved, and we’ll get to that, but first I want to look at what happened to the problem during the pandemic, because I think it gives us clues to what kind of problem it is.

If you look at graphs of overdose deaths it’s possible to make the case that by 2017 things were plateauing. Roser’s charts conveniently end in 2017, since those were the most recent numbers available to him when he tweeted in December of 2019, which was also conveniently right before the pandemic. As I mentioned in the last post, 2018 was the first year since 1990 when deaths were down from the previous year. And if you adjust for population, 2019 also had a slightly lower death rate than 2017.

Of course, even if deaths were plateauing in 2018 and 2019, it was still a very high plateau, but even a high plateau would be better than having it continue to go up, year after year, which is what it had been doing. And of course one hopes that after it plateaus that it starts gradually coming down. But then 2020 comes along and deaths jump 30%, presumably because of the pandemic. This is the highest increase on record other than the 71%(!) jump from 1998 to 1999. And preliminary numbers for 2021 indicate that it kept going up, though the rate of increase appears to have dropped all the way to 28.5%… I made this point in a previous post, but at growth rates like that everyone in the country will be dead of a drug overdose by 2057, or 35 years from now.  Obviously this rate of increase can’t continue for long, and it’s amazing that it continued for two years.

I bring all of this up for several reasons. First, to give you a sense of the scale of the problem. Obviously it’s bad, but it’s the rate at which it’s getting worse that’s truly alarming. Second, though this is tangential to my primary subject, it’s an interesting but also stark reminder that pandemic precautions were not cost free. I was in favor of most of the precautions that were taken, particularly at the beginning when uncertainty was at its highest, but no one should be under the impression that there are no trade-offs, and some of those tradeoffs consist of people dying, many from drug overdoses, but not all. Third, and most importantly, studying the manner and timing of overdose deaths, particularly when they’re increasing, might help us isolate the cause of those deaths and give us better tools for mitigation. 

Furthermore, as long as we’re talking about the current state of the crisis, I came across one other point that was worth mentioning. A recent paper suggested that up to a quarter of the drop in labor force participation might be due to “increased substance abuse”. So the great resignation might be 25% due to people being addicted to drugs. I don’t have the time to go down that rabbit hole, but it seems like a very big deal. 

I pointed out a lot of reasons in the last section for believing that the problem was not one that was unique to the US, but this is my biggest reason for being cautious. All the numbers I quoted above were from charts that ended in 2019. As I already pointed out all of Roser’s numbers were from charts that ended in 2017. I don’t think we’ll know the true scale of the problem either here or abroad until we have a full accounting of what happened over the last two years. And probably what happened this year as well. Do the pandemic overdose numbers represent a new plateau? Or are they a temporary peak, and we’ll fall back to the numbers of the late 20-teens. Or is it just going to keep getting worse as it has basically every year since 1990? I’d love to be optimistic, but so far the arc of the epidemic has always been worse than I predicted.  

Of course the pandemic was awful, but why did it make overdose deaths so much worse? As in the worst year over year increase since the epidemic started. I assume that there are various possible theories, but I prefer the simple explanation: it was the loneliness. If one could associate any emotion with the pandemic, more than fear, more than frustration, more than anger at the idiots on the other side, the dominant emotion was loneliness. I’ve seen people call these overdoses “deaths of despair”. I’ve also seen people mock this idea, but when deaths go up by 30% one year, and then almost 30% the next year, and those years happen to coincide with a pandemic, I think calling them deaths of despair is probably pretty accurate. I would also accept deaths of loneliness, but I will not accept any explanation which doesn’t include some connection to the pandemic, and I haven’t seen any better ones on offer.

Pinpointing loneliness as the cause of the increase in deaths gives us our starting point for talking about how best to reduce those deaths. 

III- The Best Way to Deal With the Problem 

As I said, all of the information I collected in preparation for this post is from a US perspective. So to the extent that this is or isn’t a problem elsewhere, it isn’t going to enter much into the discussion, though I’m sure there will be some amount of overlap even so. But even should the problem be completely unique to the United States it would still merit serious discussion. Far more than it’s getting now.

To begin with we should talk about what doesn’t work. And it’s clear that top down governmental action is one of those things. Perhaps there was a time when it might have worked, but at this point I think it’s too late. The problem is too big and the addicts are too numerous. In the course of reading several books on the subject it became clear that the federal government, and specifically the FDA, is just too far easy to hack, and beyond that, because the US is the richest country in the world, not to mention the 3rd most populous, the rewards for doing so are enormous. This is similar to the situation that existed in the early days of the internet when there were numerous viruses for Windows machines, but very few for Macs. It wasn’t that Apple machines were significantly more secure, they weren’t. It was the fact that Windows machines were far more numerous. 

Perhaps here we have stumbled on US uniqueness, not that we are uniquely bad at treating addiction, but that we were just the juiciest target for the three factors mentioned in the last post. Pharmaceutical companies were presented with a unique opportunity when the ideology of pain management changed, but where should they pursue this opportunity? Clearly if you were going to start making something like Oxycontin and begin marketing it, the only logical place was the US, and once you had a bunch of addicts, it was also the obvious target for Mexican heroin smugglers (in addition to being next door) and later for distributors of Chinese fentanyl. To reuse our analogy, the change in the terrain of pain management was the internet, and the US is Windows, the biggest attack surface. And as late as 2018 there were still more threats per Windows machine than there were for an individual Mac, but by 2019 that had flipped and there were twice as many threats for each Mac as opposed to each PC. Perhaps eventually something similar will happen, but for now, the US is still the best market for opioids the world has ever known. 

The futility of expecting the federal government and FDA to do anything was brought home most starkly by the story of Insys, told in the book The Hard Sell. As I mentioned in my review, this was a company that started marketing a fentanyl spray in 2012, and did it for five years in the most egregious fashion imaginable before they were finally stopped. If the FDA wasn’t going to pay special attention to fentanyl in 2012, then it kind of feels like they are never going to be the solution to the crisis, nor do other arms of the federal government seem to be doing much better. I’m largely with people who believe that the War on Drugs has been a pretty massive failure. Of course most of these people conclude from this that we should legalize all drugs. 

I had initially planned to spend a fair amount of time talking about legalization, but that time got taken up by dealing with the subject of differential death rates between the US and other western democracies, and given that this post is already late, I don’t have any additional time I can draw on. I will say that when I was young I was a really big fan of legalization. I remember a particular Bloom County comic strip (for those old enough to remember that strip) where drugs were legalized and all the associated drug violence stopped. The punch line was that a drug dealer was out on the lawn wondering what had happened to government price fixing, or something like that (I was unable to find the actual comic). 

I am no longer so idealistic. The problem is how do we keep bad actors from abusing the system in the fashion of Insys and Perdue? One of the arguments has always been that with a legal market at least the drugs won’t be mislabeled or cut with some other, more dangerous drug, but Insys and Perdue produced completely pure product, and that didn’t prevent it from being a gigantic problem. Also the experience we’ve had with marijuana legalization is not encouraging. To take one example California legalized weed in 2016, but five years later 80-90 percent of the market is still underground. The same thing happened in the transition from Oxycontin to heroin, people were addicted to oxy which was available and legal, but expensive, so as a result they turned to heroin which was illegal, but cheap. I would love to hear a credible framework for legalization, even if it were politically infeasible, but I haven’t come across one. Now of course decriminalization is another matter, and I do think that has some real possibilities, which I’ll touch on in just a second.

Okay I’ve talked about all the things that don’t work, it’s finally time to talk about things which might work. Let’s start at the beginning. 

While in Vietnam a significant percentage of soldiers ended up addicted to heroin, and there was widespread belief that upon their return that society would have to grapple with a massive addiction problem, but as it turned out once the soldiers were home the vast majority transitioned back to civilian life and their normal jobs without much fuss. While this was surprising, on a certain level it makes sense. You could imagine that, when faced by the horrors of war, someone might have no other option than to seek to dull things with an opioid, but that once they were home and away from those horrors that they would no longer be dependent on that stuff. 

Despite this, and it’s not clear from the numbers how much of the problem was returning soldiers and how much of the problem was other things, from 1968 to 1969 overdose deaths went up by 19%, and from 1969 to 1970 they went up by 18%. 1971 is when Nixon started the War on Drugs and whether because of this or because of the ongoing drawdown of troops from Vietnam, or because something else, the number of overdose deaths stabilized and even dropped a little bit for the rest of the decade, until 1979 when deaths suddenly more than halved and stayed at that level for several years. (The per capita death rate didn’t surpass the 1978 level until 1993. I have no idea why this happened, and perhaps it’s an artifact of the reporting methodology being changed, but it is interesting to note that when Nancy Reagen was unveiling her “Just Say No” campaign that drug overdose deaths were about as low as they’ve ever been.

The foregoing history of overdose deaths in the 70’s and 80’s was mostly included because it seemed interesting. I’m not sure there are any morals to be drawn, particularly for the sudden drop in 1979, since I have no idea why it happened. Though one might draw the weak conclusion that the initial War on Drugs was not quite the abject failure people claim. No, what I’m mostly interested in, is the lesson of the soldiers returning from Vietnam and the vast increase in deaths during the pandemic, because both phenomena, though directionally opposite, touch on the only thing that seems to be working: being part of an involved community. Soldiers who were addicts in Vietnam were able to shake that addiction when they returned home (clearly not all, but the vast majority did). When people were deprived of community during the pandemic, overdose deaths which were already stratospheric went up even more.

This is a point Sam Quinones returns to again and again in The Least of Us, that what seems to work is when a town, or occasionally something larger decides to really engage with treating the problem rather than locking people up. When they establish special drug courts, de facto decriminalization through suspending sentencing while the defendant seeks treatment, of helping them with jobs, and giving them places to sleep. It’s when an individual addict can draw on the help of several engaged individuals. When, for lack of a better term they have a tribe to draw on. It was when these things were happening that Quinones saw people successfully recovering from their addictions. As he says in the final paragraph of his introduction:

That is what fueled this book—two stories that I set out to tell here. One is the story of an ominous die-off amid a global economy producing catastrophic supplies of dope cheaper and more potent than ever. The other is of Americans’ quiet attempts to recover community through simple acts, guided by the belief—the message of our addiction crisis to those who would notice—that the least of us lies within us all.”

Now I’m not saying this is easy, or straightforward. In particular, I don’t think I can boil it down to something easily digestible in the closing paragraphs of this post. If you’re curious you should probably read the book. Nor am I saying that this is the only possible way to do it. I’d be very interested in trying methadone, buprenorphine and naltrexone as part of a treatment plan. But if you have a bunch of different communities experimenting with stuff then presumably some community will try these drugs and if they work as well as has been claimed then they’ll keep using them and more communities will follow. 

IV- Miscellaneous Points I Wanted to Cover but Didn’t Have Time For

This discussion of the failures at the lowest and highest levels, i.e. the failure of the federal government and numerous individuals reminded me of the central assertion of Why Liberalism Failed by Patrick Deneen: that we have hollowed out the middle of society. Certainly one could make the argument that that’s exactly what has happened with drugs. The federal government midwifed the problem into existence, individuals operating mostly alone acquire the problem and can’t shake it, and only communities acting in the middle can resolve the problems created by both ends. Problems that would not be nearly so bad if communities had maintained their historic strength.

They screwed up so badly with Oxycontin that, perhaps understandably, the entire medical establishment is now overreacting in the other direction—underprescribing opioids. While I do think that our primary focus needs to be on the harms of these substances, particularly while those harms still appear to be increasing, it’s important not to entirely lose sight of the benefits of opioids. One of my readers pointed me at a presentation made by a libertarian city councilor pointing out how difficult it is even for terminal patients in extreme pain to get Oxycontin and similar drugs now. That now everyone is assumed to be an addict. He also reminded me of Scott Alexander’s piece Against Against Pseudoaddiction which makes some related and very valid points. But, to go back to my argument, you could imagine that this also might be something that a strong middle is better at. It’s much easier to prescribe Oxycontin to someone that has the support of a whole community, a community you might very well belong to, that to prescribe them to someone you just met.

A big part of this whole discussion is the idea of hedonic calculus. You can imagine that people feel much happier when they are pain free, but if that comes at the cost of dying early from an overdose how are we to balance those two things? This is why the question of giving opioids to those who are dying is easy “yes”, and the question of whether we should have given opioids to people who ended up dying prematurely an easy “no”. But what about all the space in between? To illustrate I’ll end with a story.

One of my college friends, actually my roommate, had pretty bad back problems and was put on Lortab, which is ​​hydrocodone and acetaminophen. I don’t know if he was overprescribed Lortab, or if he had problems getting it, but he ended up taking a lot of it. Even today doctor’s are less worried about prescribing it because the acetaminophen is supposed to make it difficult to abuse. Because it will destroy your liver. Well that’s what happened to my friend, he died of what the doctor’s said was alcoholic hepatitis, and while I’m sure alcohol contributed, I think it was mostly the acetaminophen. And as a result he died when he was 40. If he had been taking heroin he might have actually lived longer, and one wonders if, in the final analysis, whether it would have been a better life.

I still think about him, a lot.


That ended on a sad note, and of course the whole subject is sad. But sometimes being sad is good; it spurs you to reflection or even action. I kind of doubt that action will be donating to this blog, but on the off chance that is precisely the action it inspires, here’s a link.


The Drug Crisis (Part 1): The Role of Progress and Technology in Creating the Crisis

If you prefer to listen rather than read, this blog is available as a podcast here. Or if you want to listen to just this post:

Or download the MP3


I- COVID Deaths vs. Overdose Deaths

According to Our World in Data, essentially a million people have died from COVID in the United States. Depending on your political persuasion you may think that this is an undercount or an overcount, but as we don’t have the time to get into all of that, this is the number we’re going to use. Not only is it probably about as accurate as one is likely to get without massive effort, particularly if you just want to compare the US with other western democracies, it also happens to be nearly identical to the number I’m going to use to start my discussion of drugs. As it turns out, about a million people have also died from overdosing on drugs in the US since 1999, which is generally when the current crisis is said to have started. Though again you can quibble about that number as well, but I’m going to assume that all different quibbles basically balance out.

So we’re left with 1 million people who died of COVID and 1 million people who died from overdosing, that’s our similarity, but what are the differences?

  • Our overdose statistics go back to 1999, while COVID has only been around since the beginning of 2020. Obviously on a day to day basis COVID is far more deadly.
  • On the other hand, with the exception of a small dip in 2018, overdose deaths just get higher and higher every year, while with COVID we expect the opposite, fewer and fewer deaths as time goes on. 
  • It’s nice to imagine that the United States could have locked down as hard as China and prevented nearly all deaths—though if you’ve seen the news, even China is having problems with that strategy now. But in reality everyone knew that, regardless of what we did, some COVID deaths could not be prevented. On the other hand, in theory, nearly all overdose deaths should be preventable. It’s extremely difficult to avoid getting Omicron. It seems significantly easier to just take fewer drugs.
  • Obviously the previous point is an oversimplification, but we assume at some point (nowish?) that COVID will just be treated like the flu. What is the analogy for overdosing? What is the minimum number of overdose deaths we should expect if things worked as they should? The 17,000 overdose deaths we had in 1999? The 10,000 we had in 1998? The 2,500 we had in 1980?
  • Finally, the biggest difference. COVID has gotten, and probably will continue to get, vastly more money and attention. This is the case even if we compare money and attention for COVID since 2000 with money and attention for overdoses since 1999. Which is not to say we haven’t spent a lot of money on the War on Drugs, much of it misspent, but even critics of the war only put it around a trillion dollars, and this is the cost going all the way back to 1971. While COVID spending is already closing in on $4 trillion

This post is dedicated to considering the drug crisis, and while we have been dealing with this crisis for several decades, I think the pandemic has definitely thrown many of the key issues into sharper relief. People would be very angry if COVID deaths just got worse despite everything we were doing, and yet that’s exactly what’s happening with overdose deaths. With COVID everyone is currently engaged in the exercise of deciding what level of danger is acceptable, are we trying to get it to the same level of the flu? Or is that too ambitious? Or perhaps not ambitious enough? And yet people don’t seem to be doing this with overdose deaths. No one can even imagine that we should be able to drive these deaths back down to their 1998 level or even their 1980 level. But 2022 does not seem all that different from 1998, and yet 10x as many people are overdosing, where does that order of magnitude increase come from? Is it entirely the fault of Purdue Pharma and Oxycontin? Or are there other factors? 

Most of all I want to consider, where do we go from here?

II- How “Technology” Contributed to the Increase 

When considering how the number of overdose deaths increased ten-fold in less than 25 years, I’d like to start by looking at the role of “progress” and “technology” in that increase. You may have noticed that both words are in scare quotes. This is an acknowledgement that I am using them in a more expansive fashion than most people. I nevertheless think that the designation and the grouping is accurate. As the “technology” case is easier to make, let’s start there.

The smoking gun here is fentanyl. To begin with it was first synthesized in a lab in 1960. Using technology which had only been invented in the 50s. Fentanyl is a product of modern technology, which not only didn’t exist, but was impossible to imagine more than 100 years ago. Of course, I understand why it was synthesized. The article I just linked to raves about its utility. Having a super potent opioid is perfect for all sorts of entirely legitimate ends, like anesthesia, and pain relief for terminal patients. But this potency, combined with its ability to be synthesized in a lab, make it perfect for the illegal drug trade as well. The potency makes it easy to smuggle and its ability to be artificially synthesized makes it hard to target the source. 

I’ve been careful to talk about overdose deaths in general, but when most people think about the drug crisis and overdosing on drugs they’re largely thinking of drugs in the opioid class, like heroin and prescription opioids like Oxycontin, or synthetic opioids, like fentanyl. And it is true that deaths from synthetic opioids (mostly fentanyl but excluding methadone) have increased 50 fold(!!) since 1999, with most of that increase coming since 2013. But deaths from cocaine have increased by 4 fold, while deaths from psychostimulants, which mostly refers to meth, have increased 30 fold in that period with most of that increase also coming since 2013. 

Though these latter two categories are less obviously stories of something created by technology getting out of hand, technology has still played a major role. 

If we start by looking at cocaine, it’s not immediately obvious why it’s gotten so much worse. Of course deaths from overdosing on cocaine have not increased at nearly the rate that deaths from meth and opioids have, but a 4x increase is still very significant. I murders or suicides or something similar had quadrupled recently then that’s all anyone would be talking about. And yet you probably haven’t heard anything about this increase. Even the books I read don’t spend any time on it. In part that’s probably because everything is going up. Even deaths from benzodiazepines are rising (a point we’ll return to) and in part it’s because the cocaine crisis started a long time ago, but as it turns out it also involved technology.

In the early 80s there was a glut of cocaine and in order to get rid of it dealers started turning it into crack. From Wikipedia:

Faced with dropping prices for their illegal product, drug dealers made a decision to convert the powder to “crack”, a solid smokeable form of cocaine, that could be sold in smaller quantities, to more people. It was cheap, simple to produce, ready to use, and highly profitable for dealers to develop.

The farthest back I’ve been able to find numbers is starting in 1968, and from then till now the low point of drug overdose deaths was 1980, just before this glut occured. As I’ve said I haven’t read much about the way that crisis unfolded. But what’s interesting is although there was a lot of attention on the “Crack Epidemic” it eventually dissipated, but the actual deaths from cocaine didn’t really go down, and the 90s were worse than the 80’s. In fact in 1999, when all the graphs start, it’s cocaine that’s the leading cause of death, not any of the various opioid categories. 

The important point is that it does appear to be an example of this same process of dealers discovering a new drug, or a new form of an old drug and coming up with innovative ways to sell and distribute it. A story that’s going to get repeated again and again. Which takes us to meth.

If you’ve been following my blog over the last few months I mentioned that I’ve been reading some books in preparation for this post, and The Least of Us by Sam Quinones makes some very interesting claims about meth and technology. The story goes something like this:

Back in the very beginning meth was made using what’s called the P2P method, and it gave off a “smell so rank” it could only be done far away from civilization by biker gangs like the Hells Angels, but sometime in the 1980’s the ephedrine recipe for meth was rediscovered, which was not only less smelly, but also an easier recipe to follow. At the time ephedrine was unregulated, so meth took off. One DEA agent said that between 2000 and 2004 he didn’t remember a single pot or heroin case, it was all meth. (To be clear he was stationed in California, not Appalachia.)

As you might imagine this only lasted for a while before the government responded and started cracking down on the availability of ephedrine. Initially production just moved to Mexico, but in 2008 Mexico banned it outright as well. In a perfect world this would have stopped the meth problem, but we live in a fallen world, and the War on Drugs, though not quite the unmitigated disaster many claim, has nevertheless proven to be an amazingly effective generator of negative second order effects. In this case rather than stop producing meth Mexican producers moved back to the P2P method. Given, by this point, the industrial scale of production, the smell was less of a concern then it had been back in the day, but it turned out that there was a different problem: P2P meth, unlike ephedrine based meth, basically causes people to go insane, or at least that’s what Quinones claims in his book. 

Here’s how one user described it: 

In 2009, out in Los Angeles, a man named Eric Barrera was a long-time user of crystal meth when one night he felt the dope change.

Eric is a stocky ex-marine who’d grown up in Oxnard, not far from Los Angeles. The meth he had been using for several years by then made him euphoric, made his scalp tingle; he grew talkative, wanting to party. But that night, in 2009, he was gripped with a fierce paranoia. His girlfriend, he was now sure, had a man in her apartment. No one was in the apartment, she insisted. Eric took a kitchen knife and began stabbing a sofa, certain the man was hiding there. Then he stabbed a mattress to tatters, and finally he began stabbing the walls, gripped by manic paranoia and looking for this man he imagined hiding inside. “That had never happened before,” he said, when I met him years later.

Eric was hardly alone. The new meth that had just begun to circulate in 2009 was different. Something had changed. Gang-member friends from his old neighborhood took to calling the new stuff “weirdo dope.” “Every bag of dope that I picked up after that,” he told me, “I hoped it would be euphoric like it was before. But the euphoria never came back. Instead I’d be up for days paranoid, wondering, Are they gonna raid the house?”

Obviously the question of what makes this meth different is a big one. And Quinones didn’t have a definitive answer. There seem to be three potential explanations. The first is that the P2P method is prone to contamination from the industrial chemicals used in the process and this contamination is what causes the paranoia. The second possible explanation is that meth comes in two different forms d-methamphetamine and l-methamphetamine. The P2P method produces both in equal quantities. Separating the two is difficult, but according to Quinones, Mexican producers have figured out how to do it. But what if they’re sloppy? It’s possible that if you’re taking a significant amount of l-meth, at the level of an addict, that it might bring paranoia as a side effect. And the third possibility is just some other difference in the P2P process, something we haven’t figured out yet. 

For my part neither of the first two explanations seems particularly compelling. The old ephedrine based meth was made under all sorts of conditions by all sorts of people and yet it reliably produced euphoria? While the P2P meth, now being made on basically an industrial scale, uniformly produces paranoia? Still this is the explanation Quinones seems to lean towards. The other explanation, that the change comes down to an inclusion of the other isomer, makes somewhat more sense to me, given that it’s specific to the new process, but l-meth has been studied a fair amount, and is used as in a variety of medicine and there’s nothing to indicate that it causes paranoia. Though as I pointed out addicts are probably taking a lot more than what any study has used, and there is that old saying that the dose makes the poison. But if I had to make a prediction I think I would assign the highest probability to it being some third thing we haven’t figured out yet, though it would get just a plurality of the probability, not a majority. 

This whole business of meth going from somewhat manageable to causing insanity is not something I’ve seen mentioned anywhere else. So perhaps Quinones is exaggerating the problem. But then again, as I pointed out in the very beginning, lots of things about the drug crisis don’t get nearly the attention they deserve, so it wouldn’t surprise me at all to discover that this is a thing and Quinones was the only one dedicated enough to document it. If it is a real thing, it seems like a thing we really ought to get to the bottom of. 

As you can see, technology has done a lot to create and sustain the drug crisis. So much of the story of the crisis is a story of improving technology and distribution methods. Both of Quinones’ books, The Least of Us, and before that Dreamland have large sections that are all about logistics, and improving those logistics, sometimes through better personnel management, sometimes through improved distribution, and sometimes through technology. Though of course in a broad sense improved HR, and improved distribution are also technological advances, ones they’ve borrowed from business. At this point, of course. Mexican drug operations are basically big businesses, ones that are built around taking some chemicals as input and using them to create a profitable output. Businesses that are largely agnostic about which chemicals go in, and which drugs come out. Under this model it made perfect sense to switch to the P2P method for meth. And it made even more sense to replace heroin production and distribution with fentanyl production and distribution. If you were in business and you could replace hundreds of farmers and truckers with a few chemists and just a couple of truckers, you would count that as progress. And indeed it is, which takes us to:

III- How “Progress” contributed to the Increase  

In Quinones’ book Dreamland (see my original discussion here) he puts forth three developments which combined, in perfect storm fashion, to create the opioid crisis. The first, and best known was the introduction of Oxycontin by Purdue Pharma, the second was the development of a sophisticated heroin distribution system running from Northwest Mexico into the US. And the third was an ideological shift in the way the medical profession viewed pain.

As you may have noticed from the title I decided to split this post into two parts, and we’ll discuss Oxycontin and Purdue in the second part. I’ve already discussed the Mexican logistical revolution as much as I’m going to (which is not to say that my coverage has been comprehensive or even adequate, more just that I ran out of time and space.) Accordingly the only thing remaining is to discuss the way the treatment of pain changed. But in doing so I don’t want to just discuss changes in the treatment of pain. I want to look at changes in the way we do everything.

While I won’t be discussing Purdue Pharma, just yet, I do want to spend a small amount of time talking about Arthur Sackler. As I mentioned in my review of Empire of Pain Arthur Sackler was not one of the Sacklers who owned Purdue—those were his brothers—but this fact does not absolve him of all guilt for our current situation, because while Arthur didn’t have any part in the creation of Oxycontin he created the playbook his brothers used to market it. Arthur’s own fortune was made through the marketing of Valium, a benzodiazepine. And what do you know, if we look at our chart of overdose deaths benzos have a category all of their own, and somehow, despite not benefiting from Mexican innovations in logistics, or being involved in pain management, deaths in this category have also increased a staggering amount since 1999: 10 fold, so more than cocaine, but less than meth and fentanyl. Now many of these deaths, particularly since 2014 have involved people who combined fentanyl and benzos, but eyeballing the chart, it looks like benzos went from around 1200 to around 6000 in the years from 1999 to 2011 before combining it with an opioid really took off. Why would that be? We think we know why opioid overdoses increased so dramatically but why did all other categories of overdosing also increase at the same time? I would opine that it all goes back to Arthur Sackler and Valium, and then just a little bit farther still, back to an idea.

Early on Arthur and his brothers worked in an asylum, where the insane languished in appalling conditions. Being reform minded they looked for some way to help these unfortunate people. The story of their various experiments is too long to go into here, but eventually they discovered that, to quote from The Empire of Pain: 

When they injected forty patients who had been diagnosed as schizophrenic with histamine, nearly a third of them improved to a degree where they could be sent home. Some patients who had not responded to any other course of treatment did respond to histamine.

“There was a sense, in their press clippings, that this trio of brothers at a mental hospital in Queens might have stumbled upon a solution to a medical riddle that had bedeviled societies for thousands of years. If the problem of mental illness originated in brain chemistry, then perhaps chemistry could provide the solution. What if, in the future, the cure for insanity was as simple as taking a pill?”

The fact that schizophrenics improved when given histamine was obviously wonderful news. On the other hand, the idea that all mental issues, large or small, could be fixed with a pill, was a dangerous overreach. Nevertheless they took this idea and ran with it. While the Sacklers didn’t do much to discover new cures, like the one they’d stumbled on with histamine, their zeal, and in particular Arthur’s, led them to become experts at marketing chemicals. A strategy which relied on this idea that just taking a pill was all it took to cure what ailed you.

You might imagine that the next step in this story was applying the strategy to Oxycontin. But actually the next step was applying the idea to pain management in general. Oxycontin didn’t create a revolution in the ideology of pain management, a revolution in the ideology of pain management created the conditions necessary for Oxycontin. The revolution in the treatment of pain management is a long story, and this post is already long, but I came across this comment over on Marginal Revolution from a doctor which sums up the situation pretty well:

I’m an anesthesiologist, so I do all my narcotic “prescribing” via syringe these days. Before that, I was an internist, writing lots of prescriptions. I was doing this up til the mid-90’s, when we started hearing about the supposed “epidemic” of untreated, severe pain. Lots of actors involved in that little drama: pharma; Big Nursing looking to demonize “uncaring” physicians for their own ends; inter alia. Anyone remember “pain is the 5th vital sign”? I sure do. There was relentless pressure to make sure that no one, ever, faced a quantum of untreated pain. Suddenly, pain surveys and other forms of government coercion became part of the water we swam in. Getting a reputation as an “undertreater” of pain could have serious professional consequences.

Is anyone surprised that the pharmaceutical industry responded to this milieu? And that government piled on through its enforcement arms in HHS? If you tell the public for a couple of decades that everyone is entitled to a pain-free existence (not the actual message sent, but often the message received), then don’t be surprised at the disaster that results.

Presumably the connection between that original assertion of the Sacklers (and to be fair I’m sure it wasn’t just them) and this situation should be obvious: If you can cure something as obviously bad as pain with a single pill why wouldn’t you? But once you start thinking along these lines, why would you limit it to only things which are legal? If you can take some drug and it makes all your problems go away why wouldn’t you?

I understand there are other factors involved. Drugs are addictive. Wicked companies have marketed them with lies and distortions. There are all the advancements in distribution and logistics I mentioned previously. But along side all of that, and perhaps preceding it, is the idea that we can use progress to solve all of the old problems. Anxious? Take a Valium. In pain? Take Oxycontin. Not enjoying life as much as you think you should be? Take meth. 

Because the thing is, that as much as we might want to blame Oxycontin for creating a drug crisis, which came out of nowhere in 1999, deaths from drug overdosing have gone up every year since 1990. In the last 30 years no matter what drug you look at, and no matter when you decide to start looking, everything is going up. My argument is that this phenomenon is yet another unforeseen side effect of progress, one that’s going to keep getting worse. Can anything be done? We’ll answer that question next time.


I didn’t want to split this in two, but things have been extraordinarily crazy, and to add to the craziness, we’ve decided to move. If you want to help with the expense of that consider donating


The 9 Books I Finished in March-2022

If you prefer to listen rather than read, this blog is available as a podcast here. Or if you want to listen to just this post:

Or download the MP3


  1. When Genius Failed: The Rise and Fall of Long-Term Capital Management by: Roger Lowenstein
  2. How to Live on 24 Hours a Day by: Arnold Bennet
  3. Burning Chrome by: William Gibson
  4. Public Choice Theory and the Illusion of Grand Strategy: How Generals, Weapons Manufacturers, and Foreign Governments Shape American Foreign Policy by:  Richard Hanania
  5. Virtue Hoarders: The Case against the Professional Managerial Class by: Catherine Liu
  6. Mythos: The Greek Myths Retold by: Stephen Fry
  7. Heroes: Mortals and Monsters, Quests and Adventures by: Stephen Fry
  8. If You Absolutely Must…: a brief guide to writing and selling short-form argumentative nonfiction from a somewhat reluctant professional writer by: Fredrik deBoer
  9. Expeditionary Force Book 8: Armageddon by: Craig Alanson

Somehow, without really planning to, I’ve ended up traveling a lot. As I write this I’m actually in a car headed to Albuquerque (my wife is currently driving). A week ago I was in Lake Geneva, Wisconsin at Gary Con. And later this month I’m going to Vegas. I’m feeling stressed out and frivolous at the same time. 

I mention the traveling to both prepare the ground for the possibility that I might once again not produce as much writing as I want to this month, and because it leads into a story, a story about masks. As I mentioned I just got back from Gary Con and as the convention approached they made it clear that they wanted a total mask mandate. They were so serious about this that they canceled the option for table-side service, which, as I understand, is a major source of revenue for them, because they didn’t want to give people the excuse that they didn’t have their mask on because they were eating. They didn’t say that you couldn’t eat or drink at the table, but they wanted you to quickly pull down your mask, take a bite or a drink and quickly put it back on.

I was not looking forward to the mandate because I think it makes it super hard to communicate in a noisy gaming hall, and, though it might be psychosomatic prolonged mask wearing always gives me a headache, plus with three shots and a verified positive for Omicron I think I’m about as safe as one can be in this day and age. So imagine my delight when I show up and not only are about half the people in the registration line unmasked, but the guy next to me in line says that the mask mandate was removed at the 11th hour, because the hotel itself doesn’t have a mandate, and indeed 90% of them aren’t wearing masks, so the point seemed kind of moot. And indeed when I get up to the window and get my badge no one mentions that I need to put a mask on. The first room I’m in eventually ends up about 50/50 masked vs. unmasked, and it does seem like it’s being left to personal preference.

But then there’s a pushback. Certain areas seem to get very draconian with the masks, arguments erupt on the facebook page. One of the guys in charge of the con posts something very extreme about the requirement for masks and it gets deleted, even as another guy posts something else reminding people of the mask requirement, but in slightly less extreme language. But it was clear that the number of people who were just sick of masks had reached a critical mass, and it didn’t matter how much people begged and cajoled a universal mask mandate just was no longer in the cards. It really felt like being on the front lines of a front that’s collapsing, with people trying to make an orderly retreat, but on the verge of a route.

As one final point, I’m always amazed that the people loudly proclaiming the need for a mask mandate because they personally can’t attend an event otherwise because of their health, never seem to be wearing an N95. My understanding is that you personally wearing an N95, while everyone else is unmasked, is better than everyone wearing a cloth or a surgical mask. So if you’re that worried, why wouldn’t you take the one step that’s completely under your control?

Anyway I’ve gone on too long about this as it is. On to the reviews!


I- Eschatological Reviews

When Genius Failed: The Rise and Fall of Long-Term Capital Management

by: Roger Lowenstein

Published: 2001

304 Pages

Briefly, what is this book about?

The story of Long Term Capital Management (LTCM), a very exclusive hedge fund full of arrogant people that blew up in spectacular fashion.

Who should read this book?

If you enjoyed The Big Short and have a general fondness for stories of financial blow-ups brought on by hubris this is a book about exactly that.

General Thoughts

I remember hearing about the spectacular blow-up of LTCM when it happened in 1998, and my recollection is that it was pretty big news, at least for a week or so. I’m sure that the appeal of the story was helped along by its obvious moral: the arrogant brought low in spectacular fashion by their hubris. Like so many before the principals of LTCM thought that they had outsmarted the market, they were wrong.

The next time I remember encountering the story was while reading Fooled by Randomness by Taleb where he described LTCM as a hedge fund set up by a couple of Nobel Prize winning economists. He scornfully described their delusional belief that they could precisely measure and therefore manage risk. He went on to say that the hedge fund had blown up after four years in what these economists had called a “ten sigma event”, which is to say an event ten standard deviations from the norm—an event which is so improbable that you’re unlikely to see even one such event in the entire history of the universe.

This “ten sigma” claim fascinated me, I was staggered that a Nobel Prize winner could be so wrong. (And yes I know the Nobel in economics is not an actual Nobel Prize.) Ever since then I’ve wanted to hear the whole story about how someone so smart could be wrong on a scale that beggars the imagination. Finally, after many years, I got around to looking into it. To start with I should probably include the section of the book Taleb referenced in making his claim: 

According to these same models, the odds against the firm’s suffering a sustained run of bad luck—say, losing 40 percent of its capital in a single month—were unthinkably high. (So far, in their worst month, they had lost a mere 2.9 percent.) Indeed, the figures implied that it would take a so-called ten-sigma event—that is, a statistical freak occurring one in every ten to the twenty-fourth power times—for the firm to lose all of its capital within one year.

There it is. Of course with all such claims the truth is a little bit more complicated, though it’s also depressingly similar to other stories of financial collapse. (A point which I’ll take up in the next section.)

The fund collapsed through a combination of the 1997 Asian Financial Crisis and the 1998 Russian Currency Crisis, but I didn’t see any evidence that the LTCM principals described this combination as a “ten sigma event” after those things happened. It’s merely that before the events happened their models said that such events were spectacularly rare. If I’m going to be charitable, I don’t think the LTCM guys assumed their model was a perfect representation of reality. But I do get the impression that they thought it was directionally accurate. That it could be used for a baseline. I imagine them reasoning something like this, “At the tails of the model things are probably not completely accurate, so it might only take an seven sigma event rather than a ten sigma event, but that still should only happen once every 2 million years, which is still basically impossible.” I understand that’s still not being particularly charitable, but after reading the book it’s the best I can do. It’s clear that whatever place the models had in their decision making process that their confidence in those models was delusional to the point of insanity.

Before we entirely leave the charitable portion of this review, I need to defend the Nobel Prize winning economists, they didn’t set up the fund, nor did they have a lot of control over how it was run. They were mostly brought on to bolster its reputation. So accusing them of being arrogant and dumb is to overlook the real cocky idiots at the center of the story.

If you’re looking for the person who possessed the plurality of the fund’s hubris that would be Lawrence Hilibrand. I don’t have time to go into all the instances of Hilibrand’s arrogance. It is far easier to list the things he did that weren’t arrogant, because as near as I can tell (and one presumes that Lowenstein might have an axe to grind) there really aren’t any.

He was punished for his arrogance. All of the principals had just about the entirety of their wealth in LTCM, so when it went bust, they went bust as well. Well, not really, not bust in the way you or I would understand it, but they did go from being half-billionaires to merely multi-millionaires, who live in palatial comfort and went on to found yet another hedge fund, JWM Partners.

Unsurprisingly, their arrogance was unabated. The second fund used basically the same models and managed to last all of 10 years before it was killed by the 2007-2008 financial crisis. (Yet another ten sigma event, what are the odds!) You would think this would be the end of things, but they’re actually on their third hedge fund. Though to be fair rather than the billions invested into LTCM they were only able to get tens of millions on this third go around.

Eschatological Implications

If LTCM were an isolated story, then we wouldn’t need this section, but the hubris and collapse of LTCM appear more to be the rule of modern finance than the exception. Despite the lesson of LTCM, the 2007-2008 financial crisis was basically exactly the same story, only this time played out over the entire world rather than over a single hedge fund.

For LTCM it was the Black-Scholes model and the underlying riskless asset was government bonds. In the leadup to 2007 it was the Gaussian copula function and the underlying “riskless” asset was mortgages. We even have the same language being used to declare how improbable it is. In the middle of the crisis David Viniar, the CFO of Goldman Sachs, declared, “We were seeing things that were 25 standard deviation moves, several days in a row” I’m running out of ways to describe how idiotic this is. A 25 standard deviation move should happen once every 10135 years and he’s claiming he saw this sort of thing several days in a row!?!? Furthermore, consider that this is after LTCM, when someone like the CFO of Goldman should know that they can’t use a normal distribution when considering risk. Accordingly, what they thought was so risk free that it should never happen in the lifetime of trillions of universes, happened several days in a row. “Riskless” was anything but.

We have two examples of breathtaking financial incompetence at the highest levels within 10 years of each other. I strongly suspect that if my knowledge of financial history went even deeper that I could come up with a third example. But even if there isn’t, what do you want to bet that it won’t happen a third time? In fact I strongly suspect that the third example is already in motion, and that in 10 years we’ll be able to point to another financial crisis caused by another complicated financial instrument that is already in existence.

If you disagree, then please tell me what we have done since 2008 to keep that from happening. Honestly, I’d like to know how to solve this problem. The LTCM partners went on to found not one, but two different hedge funds after their spectacular collapse, and Lord knows the mountains of bad behavior that led to 2007-2008 crisis went almost entirely unpunished. (In the US only one guy went to jail, though 25 people did end up in jail in Iceland.)

I’m not necessarily saying that the LTCM guys shouldn’t have been able to set up a new hedge fund—I am amazed that people gave them money—I’m saying that exotic financial strategies and the instruments which empower them appear to inevitably blow up in spectacular fashion. And as things increasingly centralize these financial catastrophes just get worse. On top of all this, because of this centralization only governments are in a position to do anything about the problem, and they appear woefully unequal to that task.

It’s possible that none of this will matter, that the invasion of Ukraine will lead to World War III and the last thing on our minds will be complicated financial instruments. But if we do manage to preserve the liberal order, then we’re still going to have to deal with financial crises, because they’re deeply embedded in markets which are a fundamental feature of that order. And I think people underestimate how much the 2007-2008 crisis led to the populism we’re currently seeing, and the attendant political disorder. There are an awful lot of people who remember that while they were getting kicked in the nuts, bankers were making millions of dollars off a crisis they caused. As you can imagine this might lead to them losing faith in the system that allows that, particularly if that system just keeps allowing it to happen. 


II- Capsule Reviews

How to Live on 24 Hours a Day 

by: Arnold Bennet

Published: 1908

92 Pages

Briefly, what is this book about?

It’s a very short, very early self-help book.

Who should read this book?

If you’re a fan of self-help books I think you should check out this one. As I said it’s super short, and reading the earliest examples of any genre always ends up being particularly illuminating. 

General Thoughts

This book put me in mind of Parkinson’s Law, by C. Northcote Parkinson. It’s one of the first, and for my money still the greatest business book. How to Live on 24 Hours is not the greatest self-help book, but it is surprising how many of the themes that are now common in self-help books existed basically from the genre’s inception. Things like prioritization, using your mornings effectively, the power of habits and ongoing effort, etc. And of course we’re still struggling with all those things, in fact, it might be getting worse. I suppose this is more evidence that some problems will always be with us, but even if that’s the case, it’s still useful to read about one of the first people to identify those problems and attempt to fix them.


Burning Chrome 

by: William Gibson

Published: 1982

223 Pages

Briefly, what is this book about?

A collection of Gibson’s cyberpunk stories, something of a prequel to his famous book, Neuromancer

Who should read this book?

If you like Gibson, or cyberpunk, or science fiction short stories as a genre, you should definitely read this book.

General Thoughts

I read this as part of Freddie deBoer’s book club. In particular he wanted to talk about the story New Rose Hotel. I’ve read quite a bit of Gibson, but I’d never read this collection, so it seemed like a great excuse to do so. New Rose Hotel, was the standout story, but possibly just because deBoer drew extra attention to it. But really all the stories were quite good. Gibson is a very literary author, and his prose is always fantastic. Cyperpunk is a close cousin to noir and as such it’s really all about the atmosphere and a certain understated panache, and Gibson, as the designated father of the genre, is the master of both. 


Public Choice Theory and the Illusion of Grand Strategy: How Generals, Weapons Manufacturers, and Foreign Governments Shape American Foreign Policy

by:  Richard Hanania

Published: December, 2021

224 Pages

Briefly, what is this book about?

A comprehensive debunking of the idea that American foriegn policy is driven by a grand, overarching strategy.

Who should read this book?

I would probably just subscribe to Hanania’s substack. I think you’ll get most of the important bits, plus the book itself, as an academic publication, is horribly expensive ($160 hardback, $40 kindle).

General Thoughts

I may have mentioned that I’m part of a local Slate Star Codex meetup group. In addition to meetups we also do a book club, and this was the book we did in February. As part of that we managed to get Hanania to attend our discussion, virtually. So whatever else you might say about Hanania he’s generous with his time. 

His central point essentially boils down to the idea that American foreign policy is incoherent, that it has no overarching goal. Of course people imagine we have an overarching goal, and are quick to offer up suggestions for what that goal is, but Hanania shoots all of them down. As one example many people assume we are trying to maintain our position as the global hegemon. But the only reason that position is under threat is because we gave both Russia and China the necessary help to be competitive. You have to look pretty far back in time to see the help the US gave Russia, but even while outwardly opposed to Stalin, pre-WWII, the US government still allowed US businesses to jump start their heavy industry. Our assistance to China happened more recently when we let them into the WTO and gave them most favored nation status. In other words, the only reason we’re worried about them today is because of the economic help we gave them decades ago. And it wasn’t if they suddenly became our enemy, we have always had a pretty antagonistic relationship. Obviously we did this because we hoped it would provide a long term benefit to us, but this expected benefit was always at cross-purposes with maintaining hegemony. 

On the other side of things even when we’re clearly not hoping to benefit ourselves, when we’re definitely doing things for the sole reason of harming our enemies, our tactics are still incoherent. The best example of this is our habit of imposing sanctions. Hanania points out that sanctions almost never accomplish their intended goal, and generally end up being humanitarian disasters on top of that. Certainly they haven’t really affected Putin, on the contrary they seem to have made him more popular than ever inside Russia. Strengthening the perception that the West will always be implacable enemies of the Russian people and that Putin is the only one who can stand up to them. 

I could go on and cover other suggestions for potential US grand strategies, like the maintenance of international laws and norms. (If that’s our strategy why do we continually break those laws?) But I’m interested in high level questions. Is true grand strategy more common in a multipolar world? As the lone hyperpower is the US trying to be all things to all people? Are monarchies and autocracies better at grand strategy because decision making power is more centralized? Or is it worse because they end up surrounded by “yes men”? Do liberal values make it harder to engage in grand strategy, because there’s an irreconcilable tension between national interests and humanitarian concerns? Is it possible that nations have always fumbled through history, sometimes doing the right thing, sometimes the wrong thing, mostly by chance, but in the age of nuclear weapons, we’re suddenly in a place where these mistakes, which have always happened, might be catastrophic?

As you can imagine the invasion of Ukraine has the possibility of answering many of these questions, and we might not like what those answers turn out to be.


Virtue Hoarders: The Case against the Professional Managerial Class

by: Catherine Liu

Published: December, 2020

90 Pages

Briefly, what is this book about?

There is a war within the left between those who want to prioritize identity (being black, or gay) and those who want to prioritize class. This is a book in favor of the latter and opposed to the former.

Who should read this book?

The book is short, which is why I picked it up, but it’s pretty dense, still if you’re interested in the conflict I just mentioned it’s probably worth reading. Certainly, as someone who’s never really been on the left, it helped me understand things better.

General Thoughts

One of my friends turned me on to Tara Henley who’s kind of the Canadian version of Bari Weiss. And Henley raved about this book, which is how I came to find out about it. Also I’ve long been fascinated by the subject of the book, what Liu calls the professional managerial class (PMC), what others call woke capital, and what still others have labeled “the cathedral”

I have yet to decide which term is best, it’s a little like the ancient parable of the blind men and the elephant. Each term emerges from a different point of view of what is clearly a massive phenomenon. As far as the PMC, Liu ends up defining it more by its relationship to the working class than by any elements inherent to the PMC itself. The PMC is the academic who can’t imagine why the working class doesn’t just go to college, surely it must be clear to them that such attendance is the answer to all of the problems they might be experiencing. It’s the bureaucrat, who enforces laws for the working class’ “own good”, and feels all the more smug when the working class chaffs against these laws.  And to take a quote directly from the book:

PMC virtue hoarding is the insult added to injury when white-collar managers, having downsized their blue-collar workforce, then disparage them for their bad taste in literature, bad diets, unstable families and deplorable child-rearing habits.

As you might have gathered this is a book about the conflict between the professional managerial class and the working class, and in a larger sense it’s a book about the conflict between those who prioritize identity and those who prioritize class. In order to understand how this conflict emerged you have to go back a few decades. This is a vast oversimplification, but Liu and people like her would probably point to a long standing unity between advocates for minority rights and advocates for economic justice. Certainly Martin Luther King Jr. still embodied both strands, and this was fairly mainstream Marxism as well, but in the years after his death these two strands started to subtly drift apart.

These advocates for broad spectrum justice had clearly seized the moral high ground, and as a consequence of this they were growing more powerful. Those already in power, who had gotten there by way of their wealth and status, needed some way to keep their power—it’s hard for people to take you seriously as an advocate for economic justice and the working class if you’re rich. So partially by design, but mostly just because of the way the incentives were structured, those in power started emphasizing the identity side of things and deemphasizing the economic side of things. It became more about minorities who were poor and less about poor people in general. In other words, identity was easier to subvert than class and so that’s what they did. Given that such subversion was second nature for those who already had power and wealth this was fairly easy to do. Basically they adopted the culture of the 60’s and used it as a proxy for virtue of the 60’s, narrowing the definition of virtue in the process, and hoarding what remained. Thus, the title of the book. Here’s how Liu puts it:

The culture war was always a proxy economic war, but the 1960’s divided the country into the allegedly enlightened and the allegedly benighted, with the PMC able to separate itself from its economic inferiors in a way that seemed morally justifiable.

The post -1968 PMC elite has become ideologically convinced of its own unassailable position as comprising the most advanced people the earth has ever seen. They have, in fact, made a virtue of their vanguardism. Drawing on the legacy of the counterculture and its commitment to technological and spiritual innovations, PMC elites try to tell the rest of us how to live…as the fortunes of the PMC elites rose, the class insisted on it’s ability to do ordinary things in extraordinary, fundamentally superior and more virtuous ways: as a class, it was reading books, raising children, eating food, staying healthy, and having sex as the most culturally and affectively[sic] advanced people in human history.

All of this hopefully gives you enough to understand the outlines of the conflict. You can probably simplify it into the Marxists vs. the Woke. Though that might be too simple. The borders of the conflict can seem a little bit messy when you first encounter them, and this book’s primary utility is to clearly delineate those borders. In any case, I am on neither side of the conflict, and although I never thought I would say this, I clearly prefer the Marxists. In part because of things I’ve read elsewhere, but in part because of this book. Though only in this very narrow sphere, everywhere else I prefer just about anything else to Marxism.

Liu does a good job of making the case that the PMC is on the side of the Woke, and that this alignment isn’t bringing us closer to justice, it’s perverting it. Above all she makes the case that the PMC, which she admits she’s a part of (and for that matter, so am I) are mostly a bunch of sanctimonious assholes. 


Stephen Fry’s Greek Myths Retold Series

By: Stephen Fry

Book 1: Mythos

Published: 2019

352 Pages

Book 2: Heroes

Published: 2020

352 Pages

Briefly, what are these books about?

Stephen Fry retells the stories of Greek Mythology.

Who should read these books?

If you like Stephen Fry or Greek Mythology you should read these books, actually you should listen to Stephen Fry narrating these books.

General Thoughts

I was a big fan of Bulfinch’s Mythology when I was a kid. And it’d been a long time since I had revisited the myths, outside of reading the Iliad and the Odyssey and the Greek Dramas, which is not nothing, but it was nice to engage in a comprehensive review of all the myths. 

Fry’s retelling is different from Bulfinch’s (to the extent I remember it) in three respects. First off Bulfinch’s left out the more salacious details, for example I don’t remember reading that when Kronos overthrew Ouranos it involved cutting off his genitals and hurling them across Greece and out into the ocean.

The second point is closely related to the first, as part of this bowdlerization Bulfinch’s left out all of the homosexuality, Fry, for obvious reasons, not only includes it, but really leans into all the LGBT elements of the mythology. For my money a little too much. Which is not to say I think he exaggerates any of the details but rather he can’t resist using these elements as ammo in the current culture war. For example when telling the story of someone who these days would be identified as transgender he offers one of his very few footnotes. Where he not only says that this is proof of current transgender orthodoxy, but goes on to reference an academic paper in support of this point. 

I’m not opposed to such arguments, but for a moment it’s an entirely different book. Rather than being a playful retelling of myths it’s modern cultural pontification. And it’s possible that this point, out of all the points he could have pontificated on, was worth the digression. But it draws unusual attention to the issue which often has the opposite of (what I presume is) the author’s intended goal. “There is no lack of people telling me how natural it is to be transgender, I was reading a book about classic mythology to get away from the grubbiness of the current culture wars. Instead I’m even more annoyed by such statements!”

I don’t want to exaggerate the issue, mostly the books are quite good. Which takes me to the third difference from Bulfinch’s. Fry frequently takes the opportunity to inject humorous asides. You kind of get the sense that these are the Greek myths as told by Douglas Adams (of Hitchhiker’s Guide to the Galaxy fame) though Fry’s humor is not quite so dense. 

In the end these are classic stories, told in a humorous fashion, by a great narrator. I just wish he could have done a slightly better job of keeping his politics out of things. 


If You Absolutely Must…: a brief guide to writing and selling short-form argumentative nonfiction from a somewhat reluctant professional writer

by: Fredrik deBoer

Published: January, 2022

50 Pages

Briefly, what is this book about?

The title pretty much sums it up.

Who should read this book?

If you are genuinely trying to make a living as a blogger, newsletter writer, or even a podcaster then I would definitely read this book.

General Thoughts

Obviously I write argumentative nonfiction, so I was hoping to get a lot of great pointers from this book. There were several, you need a niche/schtick, you need to be honest and fearless, you need to actually write, etc. Mostly stuff I’ve heard before, and it was good to be reminded of these things, but there was also nothing revelatory or earth-shattering. Where the book really excelled was in an area I’m not looking for advice, at least not yet. This was the area of actually, really and truly making a living as a writer, as in it’s your primary source of income. DeBoer gets into the nuts and bolts there, going so far as to include his actual book pitch. But of course making a living as a writer is very difficult, and thus the title, you should do it only “If You Absolutely Must”. 


Expeditionary Force Book 8: Armageddon

by: Craig Alanson

456 Pages

Briefly, what is this book about?

The continued adventures of the merry band of pirates, keeping the Earth safe from the horrors of the galaxy.

Who should read this book?

I guess if you’ve already read the previous seven books you should read this one. But I think if you were on the fence about continuing I might stop at book seven or maybe even earlier. Or at least, if I were you, I would wait until some blogger you trust finishes the series and reports back to you. Because I probably will end up being just such a blogger.

General Thoughts

Increasingly this series is 80% stuff that was interesting the first time, but has been done to death by book 8 and 20% stuff I’m intensely curious and interested in and I can hardly wait to see how it turns out. As an example I was in the middle of the book, and there was a setback, and it was basically the same kind of setback that had happened in nearly all of the previous books, and I honestly just about stopped listening right there. But then just a few minutes later Alanson did some world building (technically galaxy building) and expanded on one of the big mysteries of the book and I was all the way back in, at least for a bit. 

Another element that hasn’t gone quite the way I expected: When you start a series and discover it’s already been mapped out to be 15 books long, you expect that in the course of those books that the characters are going to level up in some fashion, and mostly this hasn’t happened. Though again just as I was about to reach the point of despair here as well, they did substantially level up in this book. So I will continue reading, but I wouldn’t blame anyone else for stopping.


If you were paying attention to page numbers you may have noticed a theme. There were a lot of short books this month. But short books need love just as much as massive classics. And tiny blogs need love just as much as giant newsletters. If this saying I just barely made up for completely selfish reasons resonates at all with you, consider donating.