#you can buy alcohol with an alcohol percentage of up to 16

[s1xseasonsandamov1e]

ok so you can get a license at 16 but you can’t have a fucking beer in the privacy of your own home until 21? yea america isn’t real

[stahl-tier]

shock images on cigarettes are not new unless you’re speaking on a specific country that recently adopted them and didn’t specify that. canada’s had them for 20+ years.

Didn't know Canada has them. Honestly most of the time I forget Canada exists, since it's very far away and you barely ever hear about it in the news or in any context really. I assumed OP was referring to the EU countries (honestly an automatic assumption whenever someone talks about the United States as Elsewhere and especially when I reblog from my European mutuals), and specifically where I live the images weren't a thing until literally a couple years ago.

As a rule of thumb, whenever I don't specify what area of the world I'm talking about, especially when in contrast to the US, feel free to assume by default that I am talking about the EU countries, Central Europe, or at least DACH. Since I don't talk with authority about the experience of living in places that I don't have any personal experience living in or directly next to.

My memory on the exact year was a bit foggy so I looked it up, and for reference the EU ruled that its members have to put a large warning text on cigarette packaging in October 2003 (20 years ago), at this point I was only 10 years old so I did not smoke myself yet, but my family has a large percentage of habitual smokers so I do have memories of a time before the written warnings were a thing. Then in April 2014, the EU ruled that the giant shock images have to be added as well. At that point I had already been smoking for around 5 years so I distinctly remember that change. People were annoyed by it but not at all discouraged from continuing their habit, and a popular method to not have to look at the images all day was to buy what we sarcastically called "condoms" (little sleeves for the packs). I don't see these sleeves much anymore nowadays so it's safe to assume that people became indifferent to seeing pictures that used to be disturbing to look at. So really, all that was achieved was to dull people's feelings towards the meaning of the warnings as they became background noise.

What did make people try to reduce the amount of cigarettes they consume a little bit was the fact that the prices have risen very sharply in the past years (but the same is true for most consumer goods) and bringing them over from neighbor countries is no longer a viable way to get them cheaply in bulk, either, after it started being treated as smuggling with harsh fines.

Not very long ago, there were some specific laws introduced in my country that set the minimum age of buying tobacco of any kind to 18 years. And when I say not very long ago, I really mean it in this case since this law took effect in January 2019. Before 2019, you were allowed to buy tobacco at age 16 (back then this meant cigarettes, mainly, but e-cigarettes and shishas are also specifically included in the new version of the law). This was the same as the age at which you were allowed to buy and consume alcoholic drinks (with some "harder" drinks being restricted to 18 years, but the youth protection laws are specific to each state and only have been somewhat unified in 2019, but with some differences remaining... for example one of the states lets you buy tobacco and booze under the age of 18 if your coworkers send you to do it, and another lets you not buy tobacco under 18 or booze under 16 but you can consume it in non-public places).

In a country where according to statistics at least 20% of the (adult) population are active, regular smokers and the age where people start is way below even the previously allowed 16 years, you can probably imagine that it's not something that will simply stop even with rising prices and slightly tightened restrictions on buying the stuff.

In another effort to reduce the smoking there were also laws introduced in the recent years that restrict smoking inside establishements/buildings like restaurants, government buildings, public transportation (trains, trams, etc.) or workplaces to designated smoking areas (usually seperate rooms or zones outside the building, or in the case of the vehicles, only at the stations), something that was received negatively by many and especially the people who ran such places. Because in the luckiest case it meant expensive modifications to the buildings, but in the worst cases having to completely ban smoking from their establishment (which, in the case of the small taverns/cafes/pubs that dominate my country's food service industry, meant a large part of their patrons are smokers and were not thrilled about having to go outside every couple minutes, so they'd go hang out in other establishments with more space and dedicated smoker rooms). This was amended due to all the fierce protest and - as is typical for my country - an exception ruling was added that allows establishments of less than 50m² floor space to ignore the new rules. (And those "less than 50m² floor space" did indeed apply to a vast number of those previously mentioned small establishments.)

As you can see, our relationship with The Vices is a complicated and delicate one. And that's just one country I'm talking about. One of the smallest European countries. I'm sure our neighbors all around have even more thrilling tales of their own to tell.

[underaswift-sunrise]

Thank you so much @ashenwren for tagging me!!! This was sooo fun! 😍 I loved reading your answers as well!! It's going to be a bit long so it’s continuing under the cut! :D I won't be tagging anyone this time around :)

Go on reading if you want to know random things about me ;D

1. What is the color of your hairbrush? Black!

2. Name a food you never eat. I can eat almost everything but some types of read meat are just a no-no for me, I don’t like the taste brrrrr

3. Are you typically too warm or too cold? Usually very warm, but highly depends on how much I’m moving in that moment xD If I start walking a bit fast, I can feel too warm very quickly!

4. What were you doing 45 minutes ago? Watching Nirvana in Fire :D

5. What’s your favorite candy bar? I’m not sure if it’s a candy bar, probably not, but it’s from Ferrero so... It’s called Kinder Fetta al Latte in Italian (something like “milk slice”?) and it’s my absolute favorite sweet snack to eat! Strictly speaking of candy bars, I love Kinder Maxi King!

6. Have you ever been to a professional sports game? Yes,several times! I used to go see games of the fotball team I’m fan of, that is AC Milan.I love going to the stadium if I have a nice place to seat in, I’ve been to the hardcore fans sector more than once but it takes 3 days for me to recover afterwards ahah 

7. What is the last thing you said out loud? “Are they really going to show this movie tonight?” I was speaking about Alvin Superstar 4...

8. What is your favourite ice cream? Such a hard question!!! Probably hazelnut, but honorable mentions go to pistachio, melon, coffee, cassata and tiramisù 😍

9. What was the last thing you had to drink? Water ahah

10. Do you like your wallet? I stopped using a wallet years ago because I’m scared it will get stolen on public transport so I only have a small, rainbow colored card holder and I love it :D

11. What is the last thing you ate? A biscuit eheh

12. Did you buy any new clothes last weekend? No

13. What’s the last sporting event you watched? I have been feeling very disconnected from watching football games lately, probably because seeing the stadium completely empty makes me sad... And I was feeling so down during the first lockdown that I couldn’t bring myself to watch football games :( But the last event I watched was certainly an AC Milan game! 

14. What is your favorite flavor of popcorn? The plain one! 

15. Who is the last person you sent a text message to? I sent to a friend of mine a video of my cat sitting under the tv while the New Year’s concert in Vienna was playing 😂

16. Ever been camping? I haven’t! :( My family has never been into it, but I’d love to do it some day!!

17. Do you take vitamins? I used to take vitamin D but now stopped.

18. Do you regularly attend a place of worship? I don’t

19. Do you have a tan? I don’t really like being in the sun for a long time and this year I’ve been staying home most of the time so no tan for me xD

20. Do you prefer chinese or pizza? Don’t make me choose between good foods, my brain just can’t do this 🥺💔

21. Do you drink your soda through a straw? I rarely drink sodas but I love drinking through a straw!

22. What color socks do you usually wear? Usually plain black! 

23. Do you ever drive above the speed limit? No because I can’t drive! I really should get a license but it’s expensive and I don’t really need a car right now!

24. What terrifies you? Getting stuck in a narrow tunnel and never get out... Seriously, this is one of my recurrent nightmares when I get anxious or I’m in a bad place mentally. It’s just... terrifying 😰

25. Look to your left, what do you see? The door 🚪

26. What chore do you hate most? I actually enjoy cleaning if I have time to do it and I don’t mind most chores because I A) transform them into some sort of game (hanging and folding the laundry it’s my fave and also doing the dusting) or B) sing while I do them 😂 but if I have to pick one I’ll say making the bed because I have a bunk bed and I sleep in the top bed so it’s a struggle 😆

27. What do you think of when you hear an Australian accent? I like it! I’m not super familiar with it but I like it!

28. What’s your favorite soda? not a fan of sodas but I like Fanta!

29. Do you go in a fast food place or just hit the drive thru? I never eat fast food but since I don’t drive I’d go in xD

30. What’s your favorite number? 13!

31. Who’s the last person you talked to? My dad

32. Favorite meat? Meat is my least favorite food category but I like chicken 🤔

33. Last song you listened to? In Quest For by Avantasia ❤️

34. Last book you read? Oh dear... I haven’t read many books this year, mostly because I've read so much fanfiction and also... 2ha happened 😂 But the last one I’ve read is Una Donna by Sibilla Aleramo!

35. Favorite day of the week? Saturday, hands down! I think because I associate it with when I was in high school and uni and Saturday afternoon was “sacred”: no homework and no studying (unless I had an exam the week after), Saturday afternoon was made for meeting friends, enjoying my hobbies or just relaxing! And it still retains that atmosphere for me!

36. Can you say the alphabet backwards? Probably? Oh my goodness, I think I could but very slowly??

37. How do you like your coffee? I used to only drink it with milk but lately I like to have a good espresso in the morining! But my favorite always remains my dear cappuccino 💕

38. Favorite pair of shoes? My black combat boots 🥺

39. Time you normally get up? When I was working at the theatre I usually got up at 7,30 am, now I usually get up at 9am!

40. What do you prefer, sunrise or sunsets? Ahhhh some sunsets make me sad, but it depends on the situation, so I'm gonna say sunrise!

41. How many blankets on your bed? one

42. Describe your kitchen plates. If I could decide I would always have colored/patterned plates because I hate white, empty things (empty walls 😭), they give me a sense of unease! Unfortunately my parents bought white plates xD

43. Describe your kitchen at the moment. Not so tidy ahah

44. Do you have a favorite alcoholic drink? I don’t drink alcohol because I get sooo sleepy and lightheaded after half a glass of wine 😂 I can relate to lwj so much... But I love sweet wine!! Just in very small doses and preferably with a very low alcohol percentage 😂

45. Do you play cards? I used to play cards a lot!! My favorite games where scala quaranta, burraco and scopa, they're Italian games and I don't know if they have an equivalent in English 😱 My problem is I forget about the rules of the game if I don't play for some time xD

46. What color is your car? Don’t have one xD

47. Can you change a tire? I have no idea!!! 😱

48. Your favorite state or province? I suppose this is about the US but I'll talk about Italy and while my region is beautiful my favorite one is Tuscany! :D But there are some regions I've never been to!

49. Favorite job you’ve had? The one I was doing before this pandemic so ballet dancer! I tried different things to survive but honestly nothing beats the feeling of waking up, leaving the house and knowing your workplace is the theatre... Climbing the stairs to the ballet studio, walking through the corridors and hearing opera singers and musicians rehearsing, going to the stage or in the seats just to have a look at the empty theatre 🥺 Ahhh I'm making myself cry here, Gloria out!!! 😂

[itsyourchoicedevotionals]

Fear Breeds Insanity

“‘Ah Lord God! Behold, You have made the heavens and the earth by Your great power and by Your outstretched arm! Nothing is too difficult for You,” Jeremiah 32:17NASB

Nothing is too difficult for the Lord God. In my youth, the doctor told us our son would be crippled and 85% mentally retarded. During birth, our son developed a pneumothorax condition, plus an enlarged heart. He couldn’t suck a bottle, and had an underdeveloped epiglottis. I prepared for the worst, and didn’t know how to hope for better. Through extraordinary events, Lou dedicated our son to God in prayer. BOOM, God turned our boy’s life totally around in one night. He’s now the father of four grown children, and a machinist.

Scared witless, sinner Debbie knelt in a hospital waiting area praying begging God to heal our daughter. Dehydrated, our daughter lay just down the hall in ICU, convulsing multiple times during the night. She’d suffered pneumonia several times with salmonella hidden underneath for over two years. Every time the diarrhea and vomiting would start, here came pneumonia. Doctors treated her for pneumonia, putting salmonella back to sleep, not killing it. God in His mercy brought us to the hospital through a literal time warp to save her life. Why? Because nothing is too difficult to God.

Feat after feat, miracle after miracle God has performed in our family and in my life. He’s bigger than huge and way above and beyond anything great or wonderful you can imagine.

In our text reference— Nebuchadnezzar was besieging Jerusalem, ready to overthrow the government. Judah’s King Zedekiah locked Jeremiah up in prison, for telling him ‘Jerusalem will be overthrown, when Nebuchadnezzar comes.’

God speaks to Jeremiah 32:6-16, ‘I’m sending your cousin to you. Buy the property he’s selling. Get the sale witnessed. Put the deed into a jar for protection. Have Baruch go bury them for you, until after I bring Judah out of captivity— back into Jerusalem again.

Most of our nation has felt like we’re in captivity for over a year. Several states are literally treating the citizens like criminals, removing all their freedoms, scaring them into accepting the imprisonment. Releasing prisoners to spread fear and prevent prison Coronavirus. (Insane) They’re saying ‘we’re protecting you.’ Then, why does it feel like they removed all citizens rights and jailed everyone. How did we lose the sovereignty to make choices over our lives?

Alex Azar Secretary of Health for the US said, ‘65000 suicides during 2020; alcohol consumption up hundreds of percentages; spousal abuses rose with alcohol consumption; eighty percent less cancers detected, ninety percent less child abuse reported.’ He also said ‘Coronavirus fear had consumed all other health and mental concerns. The pandemic would end up killing more people not connected with the virus than from the virus itself.’ Fear breeds insanity.

God speaks loud and clear— “Behold, I am the Lord, the God of all flesh; is anything too difficult for Me?” Jeremiah 32:27NASB. STOP FEAR —DON’T BE AFRAID. We’ll once again buy properties. We’ll once again hug each other. We’ll once again laugh together. We’ll once again have money and restaurants to go enjoy a meal together. Yes, the world is coming to an end— it’s been coming to an end since the moment Jesus was crucified. Yes, end time scriptures will be fulfilled, just not yet. Yes, God will yet rise up and reveal His power and might, see Isaiah 33:10.

We have two choices. Have faith believing in God’s love for us. Or surrender to fear. Remember, fear breeds insanity. This old gal is going to pray, believe, rejoice, buy and sell, trust and obey, enjoy life, dispatch angels to accomplish answers to major prayers, and on and on. And you— what will you do? It’s your choice. You choose.

PRAYER: Holy God is anything too hard for You. Help us conquer fear and develop faith, in Jesus’ name I pray.

by Debbie Veilleux Copyright 2021 You have my permission to reblog this devotional for others. Please keep my name with this devotional as author. Thank you.

[oforamuse]

told you that i missed you

'you and mickey are getting married!?'

or, the one where fiona had to find about ian's engagement through lip.

a missing phone call set somewhere between 10x11 and 10x12

ao3

Ian’s mid-limp towards the fridge when his phone rings in his pocket, and without bothering to check the caller ID, Mickey said he’d call him later when he’d left earlier, he answers and brings the device up to his ear.

‘You and Mickey are getting married!? ’

Ah fuck.  

He should’ve expected this.

‘Hey Fiona…’ Ian trails off, knowing where this conversation is most likely headed. He makes a mental checklist to prepare himself for the showdown that’s about to take place with his older sister, she’s never taken to being left out of things very lightly - which in her defense, didn’t happen very often given her being the head of the household for all of his life.

‘Don’t hey Fiona me, Ian Gallagher’ She practically spits out, dragging the emphasis on their second name with a clear underlying message of are you fucking kidding me, ‘Were you planning on telling me this anytime soon or was I supposed to find out you two were husbands at Thanksgiving or some shit?’

He pictures her fondly, hand on hip and the other one waving about, failing wildly to get her frustrated point across. It’s an image he saw so often throughout his childhood it’s almost comforting, warming.  

‘You planning on being home for Thanksgiving?’ Ian chimes back, hoping to buy himself some time to gather his thoughts, though he immediately knows she won’t take the bait as soon it falls out of his mouth.

‘Don’t change the subject, Ian’ It’s the same tone of voice she used throughout their childhood, the go brush your teeth it’s gone midnight or carl put that hammer down right now before you hurt someone, and for a moment he feels 12 years old and scolded.

The words hang there and he can feel her glare down the phone, like a laser beam marking his pale skin, it’s always felt that way. The classic 100% Fiona Gallagher certified ‘I’m unimpressed’ look, a look he’s definitely been on the receiving end of far too many times to count growing up.

‘I was- listen, it’s been a little crazy here recently, I was going to tell you. It just...slipped my mind I guess’ Ian defends himself quickly, juggling the phone between his ear and shoulder as he attempts to clear the kitchen table from this morning’s wedding planning session with Mick and Sandy. They left after a long conversation about the perfect table cloths, table cloths, to go to the tux shop downtown. He didn’t know there were so many different kinds of things to be thrown, music to be played, or chairs to choose from. It’s been overwhelming to say the least, and deep down still pretty scary, there’s a small nagging part of him worried that this might be a mistake but it’s rightfully overruled by the much bigger and louder part of him saying it will be worth it. Seeing Mickey happy, being happy himself, knowing they can finally just be happy together, will be worth it. Worth any amount of meetings over chairs, or flowers or whatever, he doesn’t really understand it, but he’ll do it.

It isn’t the marriage part, really, that freaks him out - he doesn’t think so at least. He knows he wants to marry Mickey, he knows he wants to spend the rest of his life with him. That’s never been the question, even when they were countries apart or failing to see other people, it was always there in the back of his mind for his future, the ideal. He’s nervous to take that final big leap, to solidify their relationship in front of the world and the law, like actual adults do. He’s seen so many marriages go wrong and it aches to think that they could end up like a statistic, after everything they’ve been through, they could end up just being part of a percentage of divorcees.

But, also, after everything they’ve been through, they may just be strong enough to beat the odds. He doesn’t really know the statistics for gay marriages anyway, specifically for guys, he assumes they must be slightly better, happier or some shit.

If they can make it through homophobic murderous dads, prison sentences and annoying twinks, they can make it through this.

His mind falls back to Fiona on the other end, her constant stream of failed relationships, marriages and almost marriages that littered his adolescent years. A lump forms heavily in his throat and he tries to swallow it back down, he never thought he’d be the first Gallagher kid to get properly hitched, and hitched successfully, because Fiona and Gus do not count.

‘Really Fiona, it’s been crazy here’ He tries again,

He’s not making some dumb excuse, with the last month of being broken up (but so not broken up) then going to engaged to wedding planning all within a few days, calling his older sister wasn’t top of his list.

Perhaps it should’ve been, he thinks, and Ian can’t help it but his stomach rocks with a wave of guilt, crashing onto his mental beach. It sits there, sickeningly. Fiona used to know everything, be part of everything that was happening with the family, now she’s hundreds of miles away and worlds apart.

He knows it was a big deal for Fiona to move away from Chicago, away from them and everything she’s ever known, but that was her choice, he reasons, her choice to be a phone call away rather than just a bedroom. He doesn’t blame her though.

‘So I had to find out from Lip? And only, might I add, because he mentioned how you and Mickey were looking at flowers downtown so obviously I asked him why on earth you would need ‘em and turns out you guys are getting fucking hitched!’

He dumps their coffee mugs in the sink and watches the brown liquid swirl away before he resigns and moves his phone up to his ear.

‘I know I should’ve told you.’ He whispers, turning to lean against the counter top, wishing he didn’t feel so weird about talking about marriage with his older sister, ‘I just, I-I didn’t know how. It’s a really fucking long story, Fiona, and you’re not here…’

The guilt comes rushing back, like a wave crashing onto Ian’s shore. He grips the phone tightly.

Fiona sighs down the phone, and she goes silent, he pictures her running her hands through her hair like she often does when she’s exasperated or worried. His chest warms at the thought, he misses her, he really does.

There’s another beat.

‘I guess I should say congratulations?’ She says breaking the silence, almost posing it as a question. He can hear the hint of humour in her voice, playing it off as both a joke and a genuinely sincere statement.

‘Thanks’ Ian laughs lightly, quietly feeling relieved that she isn’t more upset.

The wave of guilt pulls back into the ocean.

His eyes flicker over to the fridge door opposite, where there’s still an old post-it note of Fiona’s reading ‘Liam. Dentist 12:20’ stuck above the handle. Her presence is everywhere in the house, it’s in the foundations, the walls and the floorboards. It’s her house more so than anyone else’s, a hell of a lot more than it ever was Frank’s, or Monica’s for that matter. Still, it stings to know that she isn’t here, physically.

That she wasn’t here when he got out.

‘How did it happen?’ She asks, her habit for gossip overriding her need to hang onto the sentimentalities.

‘How did what happen?’

‘You know, the engagement, who asked who and all that crap. Not sure how it works when it’s just two guys.’ She snorts, and Ian rolls his eyes fondly, taking comfort in knowing it was meant harmlessly.

‘Pretty much the same way as everything goes with Mick, fighting and making up. Except this time with added engagement’ The bad joke hangs for a moment before he hears Fiona bark out a laugh down the other end, he breathes out, relieved.

He knows his and Mickey’s relationship can be volatile, especially physically. They’re tough, their hearts are tough. How can they not be when they’ve grown up in this shithole, surrounded by violence and poverty all their lives, only to top it off with a light dusting of homophobic and or, alcoholic, parents. They’re a product of their environment, that’s for sure, and it works for them.

‘Not that I’m surprised or nothing, but you guys really got into a fight and then engaged? Sounds like you two’

He winces knowing that Fiona hasn’t always had the best opinion of Mickey or their relationship, but he can’t really blame her given that he kept her out of the most of it in the past. It’s always been easier keeping her, and Lip to be frank, at arm’s length when it comes to Mickey, especially in the last few years. Especially after almost dropping everything and running off with him to Mexico. He was close, he was so close.

He’s quietly hoping the distance between his two worlds will finally change once they officially become family.

‘Nah, I beat down Mick’s date and then, I asked him to marry me.’ He smirks at the memory, sure it was childish to have gone after Byron the way he did but the guy had been pissing Ian the fuck off and he was so fucking bored of playing games with Mick. Plus, no one gets to talk shit about his guy.

‘Mickey’s date?’ She asks, her voice distorted with confusion and rightfully so. She’s missed a lot in the last few weeks, heck, Ian’s been having trouble keeping up with it all and he’s here. He can’t even remember the last time he spoke to Fiona longer than a few minutes except down the tinny prison phone - they must’ve talked when he got out of prison, right?

It dawns on him quickly that he doesn’t think they’ve had a proper conversation since he got out of prison, weeks ago. It sits in his stomach, distastefully. That’s the longest they’ve gone without proper communication since he ran away when he was 16.

‘It’s a long story Fiona’ He sighs, throwing a glance over to the stairs, wishing she’d walk down them this moment, ruffle his hair like she used to then crack open a beer with him.

‘When’s the ceremony?’

‘We’re thinking the next few weeks maybe, Mickey’s really getting into the wedding planning.’

‘Mickey Milkovich is enjoying planning a wedding? That I would like to see!’ She laughs, ‘but jeeze, a few weeks? That’s pretty soon, why rush?’

‘Terry Milkovich paid us a visit cause he’s mad as shit. Shoutin’ the street down and pulling out his gun. It upset Mick so he’s taken to use the wedding as a chance to torture him, I guess he’s hoping he drops dead from his gay son being happy or some shit.’ Ian explains, his hands gesturing in ways that Fiona can’t obviously see. God, Ian should’ve killed the bastard back when they were kids because they deserve a break. Realistically, he knows he couldn’t do it, but fuck, he wishes Terry had gotten stabbed or something in prison the first few times round, it would’ve saved everyone a lot of grief. Himself included.

‘No chance i’ll be able to make it then, I guess…’ Fiona says sadly, though Ian can tell there’s a small attempt to hide the tinge in her voice. She sniffles and the guilt threatens to crash back.

‘I guess not’

Ian thumbs at his engagement ring whilst the two of them hang onto the silence, unsure of where to move forward from here.

‘You happy?’

‘Yeah, yeah I am’ Ian affirms, and he is, he’s really fucking happy. He didn’t think he’d ever get to have this, especially not with Mickey.

‘You gonna be Mr Milkovich?’

‘Fuck off’

‘You guys talked about it?’ She asks, and he can tell this one is a genuine question, whether or not Ian is going to shed the Gallagher name once and for all.

‘Nah, I figured we’ll get round to it after the gold chiavari chairs or something’

‘The gold what?’

‘Don’t ask’ he begs, he’s heard enough about chairs and all that for a lifetime.

‘I’m happy for you’ She says after a few moments, and his heart warms. He imagines her throwing her arms around his shoulders and bringing him in for a tight hug, locked and safe.

‘I wish you could come.’ He whispers, his eyes stinging, his thumb rubbing at his band. He does, he really wishes his big sister could be there to see him and Mickey beat all the odds.

‘I know’ Her voice cracks ever so slightly and Ian aches at the thought of being the one who caused it, ‘I’m sorry I’m not gonna be there’.

‘Not your fault’ Ian sighs, and it isn’t. She needed to get out.

‘Yeah’ She sniffs and Ian has to bring his free hand up to wipe his damp eyes, ‘I want pictures’

‘I’ll have Debs send you some’ Ian says wetly, he’s pretty certain Mickey has even organised a photographer. There’s some rustling on the other end and he can hear someone call out Fiona’s name in the background, it’s muffled but distinct.

‘Ah shit, I’ve got to go.’ She groans, and Ian figures it’s probably for the best. Someone’s bound to be home soon and he knows there will be a lot of questions if he’s found all teary eyed in the kitchen.

‘Okay’ It’s all he can manage.

‘I love you, and I’m happy for you.’ She says, ‘Tell Mickey I’m happy for him too’

‘I will.’ He replies, ‘I love you’

There’s a shuffle, then the line clicks and goes dead.

He hangs against the counter, cradling the phone in both hands, cradling the connection with his sister. He realises she didn’t even ask him anything about prison, or the fact Mickey’s out too. He wonders how much his other siblings talk to her, does Lip keep up with her regularly? It’s hard to imagine with him having to balance everything with Fred.

His phone chimes, he glances down.

3:39pm: MICKEY

‘picked out the tuxes. gonna look so fuckin good.’

God, if fifteen year old Ian Gallagher could see him now. He shoots off a reply.

3:40pm:

‘can’t wait’

And he can’t.

[writingbiologi]

Man, reading about the Swedish alcohol laws on @norsesuggestions is giving me flashbacks. When I first heard off the Swedish alcohol laws I was on a field trip to Aneboda with my limnology course and one evening some of us stayed at the dinner table talking. One of the Swedes told how he was almost caught by the police at age 16 for having a few cans of beer in his backpack after they searched it (don’t think they found it). At first I thought no this can’t possibly be true, but then he proceeded to say that it was not uncommon for 16 year olds to hide in the ditch, pour out their beer, or chuck it when they saw the police drive by—at 16 they were afraid of being caught by the police for having a few cans of beer on them? Being from Denmark where we have a very relaxed attitude towards alcohol, I was so confused. Then he said you had to be 20/21 to by alcohol and you could only by from systembolaget and my brain broke, I could not compute what I was hearing—you have to be 20/21 to buy alcohol in Sweden? Even if I don’t drink myself it was by far the wildest thing I had heard since moving to Sweden and I was in disbelief. I later found out it wasn’t uncommon for 16 y/o to drink in public on 1st of May, but hide it when they saw the police walk by.

To contrast this to Denmark. In Denmark we don’t have a legal drinking age, you could literally start drinking from the moment you exit the womb—hell, the first time my brother got drunk was on Christmas when he was two because he had tasted a little too much of my uncles beer. When my grandfather used to make pancakes he often added three table spoons of beer (it’s was part of the recipe to use either water or beer) and me, my brother, and cousin would often sit on the counter and have a few sips of the beer, we were 3-8 y/o.

We do have a legal age for purchasing alcohol up to a certain percentage which is 16. The first time I bought alcohol I was 16 and that was for my 13 y/o brother. To buy hard liquor such as whisky or vodka you have to be 18 and it can only be bought from behind the counter, but all other types of alcohol (beer, wine, smirnoff) are freely available in every store.

Yeah, I don’t know how to conclude this—I’m still trying to process it all.

[phroyd]

America, can we talk? Let’s just cut the shit for once and actually talk about what’s going on without blustering and pretending we’re actually doing a good job at adulting as a country right now. We’re not. We’re really screwing this whole society thing up, and we have to do better. We don’t have a choice. People are dying. At this rate, it’s not if your kids, or mine, are involved in a school shooting, it’s when. One of these happens every 60 hours on average in the US. If you think it can’t affect you, you’re wrong. Dead wrong. So let’s talk.

I’ll start. I’m an Army veteran. I like M-4’s, which are, for all practical purposes, an AR-15, just with a few extra features that people almost never use anyway. I’d say at least 70% of my formal weapons training is on that exact rifle, with the other 30% being split between various and sundry machineguns and grenade launchers. My experience is pretty representative of soldiers of my era. Most of us are really good with an M-4, and most of us like it at least reasonably well, because it is an objectively good rifle. I was good with an M-4, really good. I earned the Expert badge every time I went to the range, starting in Basic Training. This isn’t uncommon. I can name dozens of other soldiers/veterans I know personally who can say the exact same thing. This rifle is surprisingly easy to use, completely idiot-proof really, has next to no recoil, comes apart and cleans up like a dream, and is light to carry around. I’m probably more accurate with it than I would be with pretty much any other weapon in existence. I like this rifle a lot. I like marksmanship as a sport. When I was in the military, I enjoyed combining these two things as often as they’d let me.

With all that said, enough is enough. My knee jerk reaction is to consider weapons like the AR-15 no big deal because it is my default setting. It’s where my training lies. It is my normal, because I learned how to fire a rifle IN THE ARMY. You know, while I may only have shot plastic targets on the ranges of Texas, Georgia, and Missouri, that’s not what those weapons were designed for, and those targets weren’t shaped like deer. They were shaped like people. Sometimes we even put little hats on them. You learn to take a gut shot, “center mass”, because it’s a bigger target than the head, and also because if you maim the enemy soldier rather than killing him cleanly, more of his buddies will come out and get him, and you can shoot them, too. He’ll die of those injuries, but it’ll take him a while, giving you the chance to pick off as many of his compadres as you can. That’s how my Drill Sergeant explained it anyway. I’m sure there are many schools of thought on it. The fact is, though, when I went through my marksmanship training in the US Army, I was not learning how to be a competition shooter in the Olympics, or a good hunter. I was being taught how to kill people as efficiently as possible, and that was never a secret.

As an avowed pacifist now, it turns my stomach to even type the above words, but can you refute them? I can’t. Every weapon that a US Army soldier uses has the express purpose of killing human beings. That is what they are made for. The choice rifle for years has been some variant of what civilians are sold as an AR-15. Whether it was an M-4 or an M-16 matters little. The function is the same, and so is the purpose. These are not deer rifles. They are not target rifles. They are people killing rifles. Let’s stop pretending they’re not.

With this in mind, is anybody surprised that nearly every mass shooter in recent US history has used an AR-15 to commit their crime? And why wouldn’t they? High capacity magazine, ease of loading and unloading, almost no recoil, really accurate even without a scope, but numerous scopes available for high precision, great from a distance or up close, easy to carry, and readily available. You can buy one at Wal-Mart, or just about any sports store, and since they’re long guns, I don’t believe you have to be any more than 18 years old with a valid ID. This rifle was made for the modern mass shooter, especially the young one. If he could custom design a weapon to suit his sinister purposes, he couldn’t do a better job than Armalite did with this one already.

This rifle is so deadly and so easy to use that no civilian should be able to get their hands on one. We simply don’t need these things in society at large. I always find it interesting that when I was in the Army, and part of my job was to be incredibly proficient with this exact weapon, I never carried one at any point in garrison other than at the range. Our rifles lived in the arms room, cleaned and oiled, ready for the next range day or deployment. We didn’t carry them around just because we liked them. We didn’t bluster on about barracks defense and our second amendment rights. We tucked our rifles away in the arms room until the next time we needed them, just as it had been done since the Army’s inception. The military police protected us from threats in garrison. They had 9 mm Berettas to carry. They were the only soldiers who carry weapons in garrison. We trusted them to protect us, and they delivered. With notably rare exceptions, this system has worked well. There are fewer shootings on Army posts than in society in general, probably because soldiers are actively discouraged from walking around with rifles, despite being impeccably well trained with them. Perchance, we could have the largely untrained civilian population take a page from that book?

I understand that people want to be able to own guns. That’s ok. We just need to really think about how we’re managing this. Yes, we have to manage it, just as we manage car ownership. People have to get a license to operate a car, and if you operate a car without a license, you’re going to get in trouble for that. We manage all things in society that can pose a danger to other people by their misuse. In addition to cars, we manage drugs, alcohol, exotic animals (there are certain zip codes where you can’t own Serval cats, for example), and fireworks, among other things. We restrict what types of businesses can operate in which zones of the city or county. We have a whole system of permitting for just about any activity a person wants to conduct since those activities could affect others, and we realize, as a society, that we need to try to minimize the risk to other people that comes from the chosen activities of those around them in which they have no say. Gun ownership is the one thing our country collectively refuses to manage, and the result is a lot of dead people.

I can’t drive a Formula One car to work. It would be really cool to be able to do that, and I could probably cut my commute time by a lot. Hey, I’m a good driver, a responsible Formula One owner. You shouldn’t be scared to be on the freeway next to me as I zip around you at 140 MPH, leaving your Mazda in a cloud of dust! Why are you scared? Cars don’t kill people. People kill people. Doesn’t this sound like bullshit? It is bullshit, and everybody knows. Not one person I know would argue non-ironically that Formula One cars on the freeway are a good idea. Yet, these same people will say it’s totally ok to own the firearm equivalent because, in the words of comedian Jim Jeffries, “fuck you, I like guns”.

Yes, yes, I hear you now. We have a second amendment to the constitution, which must be held sacrosanct over all other amendments. Dude. No. The constitution was made to be a malleable document. It’s intentionally vague. We can enact gun control without infringing on the right to bear arms. You can have your deer rifle. You can have your shotgun that you love to shoot clay pigeons with. You can have your target pistol. Get a license. Get a training course. Recertify at a predetermined interval. You do not need a military grade rifle. You don’t. There’s no excuse.

“But we’re supposed to protect against tyranny! I need the same weapons the military would come at me with!” Dude. You know where I can get an Apache helicopter and a Paladin?! Hook a girl up! Seriously, though, do you really think you’d be able to hold off the government with an individual level weapon? Because you wouldn’t. One grenade, and you’re toast. Don’t have these illusions of standing up to the government, and needing military style rifles for that purpose. You’re not going to stand up to the government with this thing. They’d take you out in about half a second.

Let’s be honest. You just want a cool toy, and for the vast majority of people, that’s all an AR-15 is. It’s something fun to take to the range and put some really wicked holes in a piece of paper. Good for you. I know how enjoyable that is. I’m sure for a certain percentage of people, they might not kill anyone driving a Formula One car down the freeway, or owning a Cheetah as a pet, or setting off professional grade fireworks without a permit. Some people are good with this stuff, and some people are lucky, but those cases don’t negate the overall rule. Military style rifles have been the choice du jour in the incidents that have made our country the mass shootings capitol of the world. Formula One cars aren’t good for commuting. Cheetahs are bitey. Professional grade fireworks will probably take your hand off. All but one of these are common sense to the average American. Let’s fix that. Be honest, you don’t need that AR-15. Nobody does. Society needs them gone, no matter how good you may be with yours. Kids are dying, and it’s time to stop fucking around.

Written by a very smart man!

Phroyd

[zavalamegan96]

How Would You Get Taller Astonishing Cool Ideas

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Can Microfractures Increase Height

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[vangenius]

Lockdown thoughts

“Why do you have so many friends that are girls?”. Those are the words I used to hear a lot growing up from my mother. She felt that having friends that were girls would negatively impact relationships I would have in the future, maybe she had a point, in the end it was still being in contact with some old friend which doomed my marriage because of unnecessary jealousy throughout it which caused a lot of unneeded arguments and aggression from which was my better half.

The truth is my whole life I have always wanted a close-knit group of male friends. I’ve never found it very easy to get along with guys, whereas girls I seemed to be able to click easier with. This has plagued my mind for a long time. I see old friends in groups like that or I go to friends weddings who have a heap of groomsmen. I have always felt a sense of envy towards that.

Most my life I have always felt like an outsider, like I never really fit in well where ever I was. My first male best friend was in Primary school, his name was Charles. Eventually he went on to a Catholic intermediate/college and my parents thought it would be good for me to go to the same school because of that and discussions with his parents. So I ended up being forced to go to a school I didn’t know anything about or wasn’t interested in. I was Christian at the time and didn’t know anything about being Catholic nor did it interest me. The school as a percentage of people they would let in who were non-Catholic, however after I joined they began pestering my mum to get me baptized so I got put through the lessons and ceremony to appease them. My best friend however left in the second year, he moved to Australia and I was trapped in a place I felt out of touch with.

I went to school there for the next five years, I never felt like I belonged there, the school was obsessed with things like sport and that has never been me. I gained a small group of friends, Joseph, Diego, Richard, Anthony. Hanging out with them on lunch times was sort of a release from it all when I was going through my depression and anxiety for being there, I hated it. There were two things that made me leave the school. The first was that I went through a breakup with one of their friends who then pursued Anthonys friend group and started dating them which made me feel shit, I started getting invited out much less and having that linger in my head was terrible. The second was that being in another place I didn’t feel like I belonged in while I was in these dark periods was doing my head in. One day I tried to give myself alcohol poisoning to end it all but it didn’t work. I was probably acting out a lot at home as well and doing my parents heads in because I was so unhappy. Going to my computer after school every day was my way to escape reality.

An old friend from primary school, Elliot somehow ended up in touch with me, he invited me to a teen social group around this point and I really enjoyed the change of environment, I made some new friends, Thomas, Doyle and Martin at these weekly sessions as well as one of my favourite people in the world, Julia. They told me I should consider changing schools and going to Edgewater to try it out. It was much closer so I think that made it easier for my parents to say yes. I moved schools for 6th form. What I didn’t realise was how fragile the friendships I had with Joseph, Diego, Richard and Anthony actually were because as soon as I moved, I lost all contact with them which tore me up, I was not expecting that at all.

I spent the next two years in Edgewater with my new group of friends. Before I started there, Doyle introduced me to someone at his work called Rudy. When I got into the school I ended up taking a lot of classes with Rudy and Martin and I felt like we just clicked as people and the stuff we were into. I used to love hanging out with Doyle and Elliot a lot, they got me doing things like going to a 3-day concert camp thing that I thought I would never do, Elliot eventually moved to Australia however.

I ended up in a 3 ½ year relationship after college and moved to the North Shore when I was 17 as I didn’t take the news of my parents’ divorce very well, in hindsight this was a terrible idea. The problem with this was that being so far away in peoples’ minds, no one ever came to visit me. However I did try my best to visit all my friends whenever I was back in east Auckland. I would always end up at Doyle’s house for BBQ’s and hangouts with my ex or try and shoot some pool with Rudy and Martin. My ex eventually left me for one of Doyle’s friends and that entire group including Doyle stopped talking to me, inviting me anywhere, no one ever checked on me, etc.

I moved into my mum’s house after this breakup and always tried to stay in touch with the last male friends I had left from Edgewater, Rudy, Martin and Thomas. Martin and Thomas played in a band and we would always go to their gigs or the house parties they threw in Parnell. These were pretty amazing, there was always a bunch of people around. I think eventually as we got a bit older myself and Rudy felt like we were getting a little old for the parties, there was a party we showed up to where the kitchen was covered in shaving cream and there were 16 and 17 year olds around the place (by now we were in our 20’s) and we decided we have had enough. After that Martin ended up getting married to someone pretty awesome and we somehow lost contact, didn’t hang out anymore, etc.

I always considered Rudy one of my closest friends since college, he pushed me to do things like others couldn’t do when I was having anxiety about doing things, going to town, going to gigs, invite me to poker games with his friends, etc. He would go to IRC parties with me since we were 15 and I was too nervous to go alone, I always appreciated his drive and always considered him my closest male friend, it was easy to make him my best man. I sort of subconsciously used him and Julia as benchmarks for my own life (an internal rivalry is good to push you ahead sometimes). I know this was never probably healthy but I looked up to them both so much with how successful they were with things they did, study, work, etc. I felt I was on par with them for a good while but they eventually crept ahead of me in the last 10 years so now I just work on myself where I can.

Throughout the years, in between while I was in my longest relationship, I gained a few male friends through workplaces I was in, however in the end they only ever ended up being acquaintances because they never stayed in contact after they left the workplace.

After my separation a lot of people stopped talking to me. I felt disconnected from the world, stuck down a dark black hole. My hopes and dreams had been crushed, I had felt like I had wasted 11 years of my life. Rudy being the straightforward person he is, attempted to yank me out of my depression by implanting me into another country for two weeks. It was without a doubt one of the most amazing experiences of my life, I never would have dreamed I would get the guts to get back on a plane or go to Mexico and Belize of all places. I felt like I let him down however, I was still super depressed as usual, I didn’t know how to get out of my funk. At one point he threatened he would leave me in the next city if I didn’t cheer up. However after that I got extremely sick, I was throwing up violently, extremely dehydrated, had stomach problems. I think he felt sorry for me so he didn’t say anything like that again after that. I felt like I ruined his trip though. I did try my best to push myself to still do everything in my sick state but now I also just felt bad that I was holding him back from doing more.

The last time I saw Rudy he told me about how he had a friend who he had outgrown. He said he didn’t have anything in common with him anymore like he did with his other friends (he told me how him and his friends were buying property together to sell off). I believe he was talking about me as that friend he had outgrown. After seeing him for that beer I’ve felt super awkward and anxious about meeting up with him again as much as I want to so I just don’t message him anymore. I don’t want to be some sort of friendship burden on anyone.

I don’t really know where this leaves me, part of me maybe has to accept that I’ll never have a group of male friends I can feel close to. I’ll probably never be able to have those “bro out” sort of moments or get invited to things I would love to do. Part of me wonders if I tried so hard to hold onto male friends because my mum would say that line to me all the time but maybe I’m just not destined to be one of those people with close male relationships. I feel the people I meet going forward are probably going to be more like acquaintances and I should keep weary and a distance with them so I don’t continue to go through the hurt of losing friends like that anymore. I don’t really feel like I have much in common with people, I’m a bit of a strange person with the things I’m into. Maybe I just have to accept that’s who I am.

[vmoon6]

QUICK GUIDE TO INTERMITTENT FASTING

What  it is  and why  you should do it

Intermittent fasting  may be a way people schedule meal times. Kris Gunnars, BSc, describes it as an eating pattern that cycles between periods of fasting and eating. People  roll in the hay   for varied reasons. People might participate in intermittent fasting to  reduce , eat better, or improve their health and overall quality of life.

Gunnars says fasting affects your body’s hormone levels, insulin levels, cellular repair processes, and  organic phenomenon .  a number of  intermittent fasting’s benefits include:

   Weight loss

   Improved metabolic health

   Reduced insulin resistance

   Less risk of inflammation

   Reduced cholesterol and  blood glucose

   May prevent cancer

   Improved brain health

   May extend lifespan

   Can counteract disease processes

All these things can  cause  improvements in other health aspects  also .  for instance ,  a discount  in cholesterol and  blood glucose  can cause overall better heart health.     We can  reduce  through intermittent fasting because,  once you  don’t eat, insulin levels can go down and fat cells can release stored sugar to be used as energy.     In addition, intermittent fasting  are often  more convenient than other eating methods or diets.  consistent with  Dr. Jason Fung, MD, it can prevent  time and money. Fasting doesn’t cost anything.  it's going to even  have you ever  buying less at the  grocery  and  you would possibly  also spend less time preparing meals.

Fasting versus calorie counting

    Intermittent fasting is different from calorie counting because it focuses on limiting  the quantity   of your time  you spend eating. Calorie counting doesn’t restrict  the days   you'll  eat, just  what percentage  calories you eat.     People often change what they eat when calorie counting,  choosing healthier foods that are less in calories  in order that they  can eat more of it.  as an example , a carrot  may need  41.35 calories while a hamburger  may need  around 250 calories. You’d be  ready to  eat around six carrots before reaching 250 calories as  against  one single-patty burger.     In one study,  people that  practiced intermittent fasting lost  an equivalent  amount of weight as  those that  restricted caloric intake. However, the study did suggest that fasting  might not  be as effective for ladies . Therefore,  it's going to  not be best  for everybody . The important thing is  you discover  what works for you and your lifestyle in any case .     Moreover, intermittent fasting  is taken into account  to be more successful than calorie counting by some because it allows for beneficial hormonal changes  quite  calorie reduction. Constant intake of food prevents these beneficial changes from occurring,  consistent with  Fung.  to not  mention the failure rate of calorie deficit diets  may be a  whopping 98 percent!     Calorie counting does hold many benefits, like prolonging the nervous systems’ life-span  and sort  2 diabetes prevention.  it's going to  also could also be   a far better  option  surely  individuals, but isn’t as flexible as intermittent fasting.     Usually managing what you eat when participating in intermittent fasting isn’t required but there are different intermittent fasting methods  and kinds  where it  might be  beneficial.     Though it isn’t required, there are better ways  to interrupt   a quick than others. Your first meal after a fasting period can either amplify or hinder your results,  consistent with  Stephanie Eckelkamp.     Megan Ramos, director at the Intensive Dietary Management Program, says  it's  not  an honest  idea to “binge on highly-processed, sugary, or high-carb foods” when breaking your fast because it can undo  the consequences  of the previous fasting period. She suggests breaking a quick  with a wholesome, low-carb, high-fat meal.     She also says that ending longer fasts are  a touch  different  and will  tend more thought than  you would possibly  give breaking a shorter fast. Short-term fasts (fasts under 24 hours) don’t make  an equivalent   quite  changes in digestive functions that long-term fasts (fasts longer than 36 hours) achieve.     With long-term fasts,  there's  more possibility to experience symptoms of gastrointestinal distress  like  diarrhea, gas, and bloating. this will occur thanks to  decreased production of digestive enzymes. Eating better food once you  break  a quick  can reduce such symptoms. attempt to  avoid eating any potentially problematic foods like nuts, seeds, raw vegetables, eggs, dairy, and alcohol.

Ways to fast

    Wikipedia claims there are three methods of intermittent fasting. These include alternate-day fasting, periodic fasting, and daily time-restricted feeding.  i'm  currently participating in daily time-restricted feeding myself. There are various versions  of every .     Some popular ways are 16:8, 20:4, 24-hour fasts, 5:2 fast, 36-hour fasts, and extended fasting.     The 16:8 regiment  may be a  plan where you fast for 16 hours  each day  and eat during the remaining 8 hours.  it's   a kind  of time-restricted feeding.  it's  relatively easy to follow if  you begin abstaining within the  evening before you sleep for the night. Possible times you'll then eat  might be  between 9 a.m. and 5 p.m. or noon  to eight  p.m. it's going to  take some experimenting  to seek out  out  which era   is that the  best  fit   you.     The 5:2 method involves eating regularly for five days and fasting for 2 days. On  the 2  fasting days,  you're  allowed to eat up to 500 calories though.     Alternate-day fasting  has  fasting days with a calorie intake of 500 calories every other day.     Thirty-six-hour fasts are where you’d fast  a whole  day, starting after dinner of the previous day and ending the fast at breakfast subsequent .      There  also are  variations  to those   like  the OMAD diet, a 23-hour fast with an hour to eat one meal.     In general,  it's going to  be  an honest  idea  to undertake  and eat a diet   which will  keep you feeling fuller longer. Medical News Today advises eating fruits, vegetables, and whole grains because  they're rich in fiber, which contributes to satiety. Also,  confine  mind that water and plain tea are usually allowed to consume during fasting periods, too.

Succeeding

    Any diet  are often  hard but  like all  goal, there are  belongings you can do  to extend  your chances of success.  make certain   to line realistic goals. If  you're  a newcomer to intermittent fasting, don’t try a 20-hour fast  to start out  — 12 hours would be more manageable.     Having a buddy  also can   assist you  achieve your fasting goals. Tell someone  you're  trying it  bent  stay accountable. And take it one step at a time. What are some smaller markers  you'll  accomplish while practicing intermittent fasting?  you'll  drink more water,  attend  sleep earlier, or avoid media and exposure to food.     All  this will  help your chances of success. Just remember  to remain committed and remain consistent. Every worthwhile thing takes work to realize  so  persist with  it .

[cobalt-razor-wire]

10 Thanks Giving Fat Burning Tricks

We all like to delight on Thanksgiving, yet have you ever before given any sort of believed to how many fats you need to have to shed for that additional aiding of chicken or that part of pumpkin cake?

However, Thanksgiving doesn't have to be always a while when the scale isn't tipping in your favor. By producing decisions contributing around Thanksgiving day and on Thanksgiving you are able to ward off weight gain. By accepting keto supplement with physical exercise will let you achieve your slimming down goal.

Thanksgiving Weight Reduction Recommendations

Develop New Traditions

Encourage your loved ones to start a brand new Thanksgiving tradition such as exercising until the major meal. Some excellent group tasks include softball backyard football, Frisbee or many cities possess an yearly Turkey Trot on Thanksgiving morning.

Kids might enjoy opting for a family bike experience, rollerblading, or playing tag. Prior to meeting with your family members if your family doesn't share your enthusiasm you can still put apart time for the workout. Perhaps not only will your brand new heritage burn off some calories, however nevertheless, it will help remind one to consume moderation.

Exercise could be included by other traditions instead of lounging around the couch or swapping out alcohol and unhealthy food to get fitter alternatives.

Eat a Protein-Packed Break-Fast

Protein acts as a organic appetite suppressor. Instead of skipping breakfast make some tee break fast. Hard boiled eggs, omelets, cottage cheese with fruit, and nourishment beverages all can be excellent choices.

Avoid Alcoholic Beverages

We know that averting alcoholic beverages is just one of the things you want to listen when it has to do with the holidays. It's the crutch it's a portion of our tradition for example meditating in alcohol consumption on certain vacations and that the will help us live family gatherings.

Nonetheless, it is famous among dieters who alcohol can add at least one's daily intake and tens of thousands of empty calories. If it truly is habitual on your family to consume booze consider buying a club pop or lime instead.

Bake Single Serving Desserts or Healthy Dessert Possibilities

The turkey may take centre stage on the Thanksgiving table, but the desserts are too much. Rather than lining up full cakes and sandwiches onto the buffet dining table this holiday, consider baking an variety of single-serving choices. Every diner could choose tort or her or his own dish. You may utilize Alpha Femme Keto Genix for successful weight loss.

Swap Out Traditional Foods to Get Healthiest Options

The normal Thanksgiving dinner range from 3,000 to 4,500 energy. As an example, 4,500 calories are the same as 14 slices of pumpkin pie.

Get a Handle on Your Portions

Know your Thanksgiving meal is eaten by the percentage dimensions of various food choices and should possible . Predicated in a Rosen Report study from 20-16, it performs for aiding to control portion sizes when some body is very hungry.

Eat Slow & Listen to Your Physique

Until meals gets to the gut and in to the intestine the human body will not discharge hormones which responses in to the mind we are total. Huffington publish did research to establish how much time it takes to feel total. According to their research, it can take between 5 and 20 minutes to feel full after eating.

Drink a Lot of Water

Approximately 60% of their body is drinking water therefore it's vital that you moisturize using a sufficient amount of drinking water. But a lot of that time period on holiday takes a backpack to alcoholic beverages java, and also food. It truly is more important for everybody trying to shed weight to maximize their drinking water consumption on holiday season. Drinking a great deal of water makes it possible to truly feel full so you do stuff your self whole.

Bringyourown Food

If you are attending Thanksgiving at another house at which you should not have a control over the meals served, make your own Thanksgiving meal that is nutritious. Let your host know beforehand of time you're working to lose excess weight and are attracting a meal that may help continue to eliminate weight.

Embrace-Fasting

We aren't proposing that you fast but try performing a 24 hour fast the day. Fasting is one of those world's oldest traditions. Since there are so many advantages to fasting, as probably one of the most essential beings that it will really jump start your approach, it makes a great deal of sense.

[newstfionline]

In Cashless Sweden, Even Panhandlers Accept Credit Cards

Frédéric Faux, Le Figaro, Dec. 5, 2017

STOCKHOLM--When Victor goes out to lunch with friends in Stockholm, he no longer needs to worry about carrying enough cash. “If someone else pays the bill, I pay him back with the Swish app on my phone.”

Same kind of calculation goes for Victor, a 23-year-old wine salesman. “I use my card for everything, regardless of the amount. This is my sixth year without any cash in my pocket,” he says.

In Sweden, the rate of cash payments in stores fell from 40% in 2010 to a stunning 15% in 2016. In terms of total value of purchases, the percentage has tumbled to 1.4%. According to a study by the country’s central bank, two-thirds of Swedes now feel they could live without cash. “It’s a unique development internationally,” according to the bank.

Here in the Swedish capital, a city of some one million inhabitants, it is impossible to pay for public transportation with cash, and forget about checks, an ancient relic abandoned 20 years ago. In church, rather than passing a basket around, congregants donate money using Swish or iZettle, a mini-card reader that connects to a mobile phone. These payment systems have also been adopted in markets, by middle-school students selling raffle tickets and even by homeless people panhandling on the streets.

Many businesses in Stockholm simple no longer accept cash. One of the first to take this step, legal in Sweden, was ABBA singer Björn Ulvaeus, after his son had been repeatedly robbed. Since 2013, the ABBA museum in Stockholm has been completely “cashless.”

David Zetterström, the owner of a bakery chain with 16 shops in the city, took the same step a year ago. “The main reason was the safety of our employees,” he explained at his shop in the trendy Södermalm district. “When they would close up for the night, they’d have to count the money, pack it, move it, and that’s dangerous. Older people or tourists are often surprised, but 99% of our clients understand the reason for this change. Plus, they all have credit cards.”

The trend marks a historical full-circle for Sweden, which in 1661 became the first European country to print banknotes. For Niklas Arvidsson, a professor at the Royal Institute of Technology in Stockholm, this change can be explained through the Swedish penchant for new technology. The country, which is the birthplace of the first cell phone (Ericsson), the music-sharing site Spotify and the game “Candy Crush,” has naturally moved more easily to cashless payment methods. Another important factor is confidence: “The Swedish don’t have to see or touch their money to know it’s safe. They’re confident in the banks and the government,” he said.

This is a sentiment shared at Get Swish, one of the most impressive Swedish success stories. Last August, 25 million payments were made via Swish, for a total of 1.5 billion euros (about $1.7 billion). During peak usage, at lunchtime or on payday, the frequency of payments goes up to 30 per second. “All you need is a smartphone--download the Swish app, connect your mobile number to your account, and you can send money to any of the six million users,” explained Edvin Nygaard, a developer at Swish. “No more need for cash to pay your babysitter or pay back a friend. You take out your phone and transfer the money immediately.”

Today, Swedish banks are the first to praise this method. In the Kungsträdgården branch of SEB, clients are received in small cozy boxes, the bank tellers swirl around with their laptops in hand and a DJ grooves in front of his turntables, ensuring a good ambiance. The bank no longer looks anything like a bank--and indeed, you cannot deposit or withdraw money there.

“It’s like this at most of our branches now,” says Leif Trogen, of the Swedish Bankers’ Association, with satisfaction. “All transactions can be carried out online, for a long while now, and we no longer need to move tons of bills across all of Sweden. Last year, there were only two bank robberies, compared to 110 in 2008. It’s good for security and good for the environment.” And excellent for the banks, who control the main network of ATMs and hold shares in Swish.

Yet this ideal world leaves some stuck on the outside: the many refugees, for instance, who do not have bank accounts; people living in rural or remote areas, where there is little Internet access; or people with handicaps and senior citizens. In a nearby bank branch in Karlaplan, some half a dozen elderly customers, some holding walkers, wait in front of one of the few tellers where cash is still available. “I want to send money to my daughter, but I don’t have a computer,” explains Birgitt, 79. “So I have to come here.”

Bo Johansson, who heads an association for the retired in the county of Stockholm, deplores the situation. “People who haven’t mastered the Internet or who don’t have credit cards have to travel far with their money just to find a bank. They can’t buy public transportation tickets, they can’t pay in certain shops. You even need a card just to go to the toilet at the train station!” The situation is all the more absurd, he says, because just this year Sweden replaced its old bills with new ones bearing Swedish cultural icons, such as Greta Garbo or the director Ingmar Bergman.

Björn Eriksson, who heads Cash Uprising, a group fighting for the continued use of cash, says one million people, or 10% of the Swedish population, will be forced off the digital highway “because they’re not profitable.”

“If I open my wallet,” he said, “you’ll see a lot of cards. I use them, but I want to have the option of using cash, too.” As a former chief of police, he also quickly dismisses the banks’ arguments about security. “Robberies have gone down, it’s true, but now thieves attack small stores that are open overnight. Less cash is circulating, that’s true, but that just increases the risk of loss of privacy, and people know this. Even those who use a card to shop admit that they use cash when they buy alcohol in government stores, because you never know.”

Objections are not reserved for the nostalgics. A report published by the central bank in September warned that “in the eventuality of a systemic shock, an alternative form of payment, such as cash, might not be as easily available as it is today.” In other words, in case of a Russian cyber-attack, or a giant IT breach, Sweden could rapidly descend into chaos.

Per Bolund, the minister for financial markets, tries to reassure: “If you want to use cash, you should be able to. The government funds ‘service points’ in certain stores, places where you can withdraw and deposit money. Cash is always useful, even if it plays a smaller role in our economy.”

Will Sweden continue on this path? If you walk around the premises of Epicenter, a start-up colony in the center of Stockholm where some 2,000 people work to shape our future lifestyles, between two yoga classes and a cup of protein coffee, the answer is a resounding yes.

Timo Keihag, a former Ericsson employee, moved here to develop Rezeet, an app that sends your receipts directly to your phone. “When we buy something with our phone or watch, we don’t want to then stuff our pockets with receipts. The entire transaction should be digital,” he said.

While he waits for his product to be launched, he recently implanted a small chip, the size of a grain of rice, in his right hand, which already allows him to take the train and the metro, open doors and pay for drinks in the Epicenter cafeteria, he says.

“The Swedish government said that cash could disappear completely by 2030,” he adds. “But I’m sure it’ll happen much sooner.”

[elizabethcariasa]

16 states holding back-to-school tax holidays this summer

It's summer, so that means several states once again are holding their annual back-to-school sales tax holidays. There are 16 tax-free events this year, three in July and 13 in August. 

We Americans just can't seem to slow down, even during the traditional summer vacation season. We always are looking ahead.

School's just been out a few weeks in most places and already ads for back-to-school sales are showing up in our television shows, print publications (yeah, a few are still around and read by some of us) and on our electronic devices.

Look for the commercial come-ons to increase, especially in the 16 states that are holding sales tax holidays this year.

These annual events, usually billed as ways to stock up on back-to-school tax holidays, offer shoppers a chance to purchase many items their children will need, from clothing to books to supplies to computers.

16 tax-free events still planned: Sixteen states are holding sales tax holidays during this summer of 2019.

Three states kick off the tax-free shopping season this month.

The mid- to late-July tax holidays are in Alabama, Mississippi and Tennessee.

Alabama kicks off the 2019 summer tax holidays with its event on July 19-21 in Alabama. Yep that's this coming weekend.

Mississippi's tax holiday runs July 26-27. Tennessee shoppers can find tax-free bargains on July 26-29.

Now all y'all can rethink your jokes about Southerners being slow.

The rest of the states hold their no-tax shopping days in August.

The table below lists alphabetically the states that will hold sales tax holidays in 2019. The links within the table provide additional details about the tax-saving events.

2019 State Sales Taxes Holidays

State and sales tax rate (Local taxes also may be waived) Holiday Days and Dates Tax-free products and per-item price limits Alabama 4%

Friday, July 19 through Sunday, July 21

Clothing priced at $100 or less Books priced at $30 or less  School supplies at $50 or less Computers & software priced at $750 or less Arkansas 6.5% Saturday, Aug. 3 through Sunday, Aug. 4 Clothing $100 or less Apparel accessories $50 or less No dollar limit on instructional materials or school & art supplies Connecticut 6.35% Sunday, Aug. 18 through Saturday, Aug. 24 Clothing & footwear priced at $100 or less Florida 6% Friday, Aug. 2 through Tuesday, Aug. 6 Clothing at $60 or less School supplies $15 or less Computers, certain accessories selling for $1,000 or less Iowa 6% Friday, Aug. 2 through Saturday, Aug. 3  Clothing & footwear priced at less than $100 Maryland 6% Sunday, Aug. 11 through Saturday, Aug. 17 Clothing & footwear priced at $100 or less Massachusetts 6.25% Saturday, Aug. 17 through Sunday, Aug. 18 Almost every personal item priced at $2,500 or less New this year, meals are eligible for the sales tax holiday exemption, but alcoholic beverages remain taxable Mississippi 7% Friday, July 26 through Saturday, July 27   Clothing, footwear $100 or less Missouri 4.225% Friday, Aug. 2 through Sunday, Aug. 4  Clothing at $100 or less School supplies $50 or less Computer software $350 or less Personal computers & peripheral devices costing $1,500 or less New Mexico 5.125% Friday, Aug. 2 through Sunday, Aug. 4 Clothing or shoes $100 or less Computers $1,000 or less Computer hardware $500 or less School supplies $30 or less Ohio 5.75% Friday, Aug. 2 through Sunday, Aug. 4 Clothing priced at $75 or less School instructional materials & school supplies at $20 or less Oklahoma 4.5% Friday, Aug. 2 through Sunday, Aug. 4 Clothing, footwear $100 or less South Carolina 6% Friday, Aug. 2 through Sunday, Aug. 4 No purchase price limit on clothing accessories & footwear; school supplies; computers, printers & printer supplies, computer software; & bed linens & bath furnishings Tennessee 7% Friday, July 26  through Sunday, July 28   Clothing $100 or less  School supplies $100 or less Computers $1,500 or less Texas 6.25% Friday, Aug. 9 through Sunday, Aug. 11 Clothing, footwear, backpacks priced at less than $100 School supplies at less than $100 Virginia 4.3%

Friday, Aug. 2 through Sunday, Aug. 4

Clothing & footwear $100 or less School supplies $20 or less Energy Star & WaterSense products $2,500 or less Hurricane preparedness items priced from $60 to $1,000 or less

  Local taxes, too: Note that the percentages by the state names in the table represent the state's sales tax amount.

In some places, cities and/or counties also waive (or are required by law to do so) their additional sales tax collection during the tax holiday period.

In others, the local taxing jurisdictions have the choice to continue collecting their taxes.  

Bad, but popular, tax policy: If your state didn't make this list, congrats on having lawmakers who realize the tax-free events are just that, events.

Tax holidays are gimmicks — and bad tax policy — that don't really produce new sales as much as shift when people will buy the affected items.

Students (and parents) must buy school supplies, tax or no-tax. Back-to-school and similar tax holidays simply prompt shoppers to shift when they buy required classroom items.

I know, I know. Shoppers love them. You, personally, love them and you don't even have any kids!

I get it. Saving money is a good thing, even when it's a few dollars of sales tax.

It's also fun, especially when it's the tax collector's hands you're keeping off your hard-earned money.

And since shoppers also are potential voters, lawmakers like to give them when they want. So every summer, more than two dozen states trot out the tax-free days.

Ready, set, shop: If you plan to shop during the tax holiday where you live, check out my post with 6 tips on how to maximize your savings, tax and in general, and minimize the hassle.

If your state doesn't have a tax holiday but you live near one that does, remember that you still could owe your home state's use tax.

Finally, remember to read the fine print about the tax holiday in your area. You'll find it in the links in the above table.

Most states have some specific and variously humorous or confusing (or both!) rules about what is or is exempt from sales tax.

You'll also find info on whether your local sales taxes are lifted for a few days. 

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[fitnesshealthyoga-blog]

New Post has been published on https://fitnesshealthyoga.com/its-a-fentanyl-crisis-stupid-national-pain-report/

It’s a Fentanyl Crisis, Stupid! – National Pain Report

By Kaatje “Gotcha” van der Gaarden, PA-C, MPAS. 

Editor’s Note: This story was originally published on Dec 17, 2018 on Medium Health.

Featured Image: TEDxABQ 2018 “A Working Parachute: spinal cord injuries, ketamine & comedy” which turned into a 9 min stand-up set! Photo credit Allen Winston Photography

In 2012, life was great: I proudly wore a white coat with a stethoscope around my neck and finally felt useful to humanity. Two decades earlier, as a stuntwoman, my parachute did not quite open, and I landed on my sacrum (tailbone) at 70 mph, crushing the sacral nerves. I had lost two inches of my spine, fractured several vertabrae, and would spend a year in ICU, hospitals, and a spinal cord clinic. I was left with traumatic cauda equina syndrome,¹ suffered from residual pain, and was left with a “sitting disability.” For my atrophied lower leg and foot muscles, I used leg braces, a cane or scooter and I sat on a padded office chair. I’ve schlepped pillows and camping mats with me ever since my skydiving accident. Frequently, lying down for a few minutes was the only way to deal with my disability.

Kaatje “Gotcha” van der Gaarden

As a Physician Assistant in primary care, I loved my job and providing a true provider-patient collaboration. I had ample opportunity to prescribe opioid medications. Responsibly, of course. In my toolbox, I had excellent interview skills, the State’s Prescription Monitoring Program (PMP), and a urine test. The PMP would let me know me if patients were doctor or pharmacy shopping, although it couldn’t take into account other states. A urinalysis would tell me if the patient was taking the opioids as prescribed, or diverting, or using other, illegal drugs, or medications that were not prescribed. Heck yeah, I even had my patients sign an Opioid Use Contract.

One patient’s husband worked for the Drug Enforcement Agency (DEA), and he told me one that opioids went for about 70 cents per milligram on the street, in 2012. However, I never assumed someone was gaming the system and tried to keep an open mind. Some patients did want me to refill their emergency room (ER) hydrocodone prescription, for complaints like a mildly strained knee. At that point, I would print out knee exercises instead. I always tried to understand my patients’ emotional and physical health and encouraged exercise and healthy habits (even if most days, I couldn’t prepare food so I ate LAY’S® Limón Potato Chips and gummi worms).

Another patient had just moved from Arizona, with a history of using 30 mg of MS-Contin, a long-acting morphine tablet, three times a day, plus another opioid, Percocet 10 mg instant relief (IR), one tablet every four to six hours for breakthrough pain. The patient was full-time employed, doing fairly intense labor, and was incensed when I wanted evidence of his “bad back.” The patient did not bring any records during his first visit, but he later returned with a lengthy health record — his pain deriving from five back surgeries, three of them revisions for the original surgeries.

I had never heard of “ultra-rapid” or “slow” opioid metabolizers² which affect adequate treatment, and still believed the Center for Disease Control (CDC) had society’s best interest at heart. The opioid crisis seemed far away, and I believed that did not affect my patients, or myself. Mistakenly, I thought there hardly would have been an “opioid epidemic” had medical providers only accompanied any opioid prescription with this warning: “Use your IR (instand relief) opioid medication when you truly have breakthrough pain, a 7–8 or higher, or it will no longer be as effective.”

Perhaps. But complicating matters was that opioid medications did seem to be prescribed for relatively mild to moderate pain, or in situations where acute pain would soon resolve. For example, to my patient with that strained knee, seen in a Colorado ER. In 1991, I’d fractured my lower leg above the ankle, after a car stunt gone awry, and wasn’t prescribed any opioid medication. The ER doc in Florida who applied the hot pink cast, from my toes to my knee, pointed me to a Walgreens to buy Tylenol (acetaminophen) for the simple, uncomplicated fracture.

Although I was in tremendous pain myself from the sky diving accident and crushed sacral nerves, I denied suffering from intractable pain. Yet I was battling worsening neuropathic (nerve) pain, as well as residual musculoskeletal pain from the sacral and vertebral fractures, on a daily basis. I made it through each workday by lying down on the exam table during lunch. Work gave me great happiness, but physically I had no energy left to cook, maintain friendships or even have a hobby.

That year I recall having to do five mandatory continuing medical education credits by the State on “responsible opioid prescribing.” This seemed ludicrous since I always looked at the PMP before going into the exam room. Especially with a patient that was on medications that fell under the Controlled Substances Act.³ As a non-contract employee, I also paid my own DEA license at $780 every three years for the privilege of writing controlled substance prescriptions. I was ticked off with the cost, but also with what I perceived as government encroachment on my medical decision making.

Sure enough, over the years, after the CDC Opioid Guidelines came out (which are voluntary, and not legally binding), I began to realize that there is no true opioid epidemic. There’s an epidemic alright, of people taking opioids with multiple medications and then adding alcohol and other illegal drugs on top. What we most certainly have is an alcohol epidemic, with 88,000 deaths⁴ annually, and this epidemic is starting to effect millennials. I blame those hipster beers with ridiculously high alcohol percentages, as millennials are dying of liver cirrhosis in record-breaking numbers.

Despite the ongoing alcohol epidemic, from 2012 to 2016, using opioid medication became synonymous with being a “drug seeker.” The “opioid crisis” narrative was perpetuated and fueled by mainstream media, whose culpability lies in using labels like “opioid overdose deaths” instead of the more appropriate “mixed drug intoxication.” True opioid deaths (opioid medications alone) range around five thousand deaths annually, according to Josh Bloom, writing for the American Council on Science and Health.⁵ New York City’s medical examiner’s office is unsurpassed when it comes to accurately determining cause of death: in 2016, 71 percent of all drug-related deaths involved heroin and/or fentanyl.⁶

Looking at the numbers, most of the so-called “opioid deaths” seemed to be people who did not take their medication as instructed, if opioids were legally prescribed in the first place. Seriously, because who cooks their Fentanyl patch and injects it? Not chronic pain patients, who need slowly titrated medication to bathe, cook, work, take care of kids, or go to school. Patients were indeed dying from respiratory depression, caused by taking legal or illegal opiates. But how many of those deaths are suicides? If patients with severe pain, on a stable regimen, are denied access, they may turn to suicide, or illegal opioids like heroin, now tainted by illegal fentanyl. That is not an opioid crisis, but another iatrogenic consequence of the “guidelines.” The Law of Unintended Consequences never fails.

How was it that the CDC took advice from an anti-opioid advocacy group, Physicians for Responsible Opioid Prescribing (PROP)⁸ in constructing the Opioid Guidelines? PROP had lobbied Federal officials and the FDA for years, to change opioid labels. When they were (mostly) rebutted, PROP got involved with the CDC, behind closed doors. The Washington Legal Foundation⁷ notified the CDC in 2015, as in their opinion, the CDC broke the 1972 Federal Advisory Committee Act (FACA) law. Washington Legal Foundation states that a Core Expert Group, advising the CDC, conducted their “research” and “Draft for Opioid Guidelines” in secret, without input from pain experts, pharmocologists, or patient groups.

Dr. Jane Ballantyne (current PROP President) was part of that Core Expert Group and is notorious for her anti-opioid stance. Another Core Expert Group member is PROP executive director, and founder, Dr. Andrew Kolodny, who refers to opiate medication as “heroin” pills and proclaimed that “oxycodone and heroin have indistinguishable effects.”⁹ Yet you oughtn’t compare a 5 mg tablet of oxycodone to IV heroin, without qualifiers on potency. Dr. Kolodny, an addiction expert, doesn’t even distinguish between “plain” heroin, and heroin cut with fentanyl, which is 100 times stronger than morphine. About 80 percent of fatal overdoses are now due to illegal fentanyl. By muddying the issues of opioid dependence, opioid addiction, and heroin use with either false or incomplete statements, PROP also does a disservice to people who are addicted to heroin or illegal fentanyl.

Research has found that 75% of heroin addicts have a mental health illness, and 50% have trauma from (sexual) abuse before age 16, something that gets drowned in Dr. Ballantyne’s simplified narrative of “continuous or increasing doses of opioids [… ] can worsen a person’s ability to function and his or her quality of life. It may also lead to opioid abuse, addiction, or even death.”¹⁰ Like many others, I argue that (illegal) fentanyl, and indirectly, profound loss of hope, is the main driver behind the current “mixed use overdose” deaths.

Dr. Kolodny was Chief Medical Officer of The Phoenix House, an addiction center, at the time he helped draft the CDC Guidelines. PROP also avoids mentioning the Millennium saliva,¹¹ or other DNA tests, to identify how individual patients metabolize opiate medication and that some are “ultrafast” metabolizers. PROP fails to mention opioid blood concentration measurements, no matter how imperfect.¹² However, no one doubts the conflict of interest: PROP Board members are involved with grants from the CDC, addiction centers, medical device companies to develop an opioid tapering mechanism, and even consulted with law firms investigating lawsuits against opiate pharmaceutical companies.

PROP was originally funded by Phoenix House, one of many addiction centers that prescribes buprenorphine. PROP is currently funded by the Steve Rummler HOPE Network,¹³ another anti-opioid group that lists Dr. Ballantyne and Dr. Kolodny on the medical advisory committee. Dr. Kolodny admitted in a 2013 New York Times article titled “Addiction Treatment with a Dark Side” that as a New York City Health official, he lobbied on behalf of the buprenorphine pharmaceutical industry. He was quoted as saying, “We had New York City staff out there acting like drug reps [with $10,000 incentives -KG].”¹⁴

Buprenorphine was the supposed miracle drug after methadone, but its known side effects include serious diversion, addiction, and possibly, lifelong treatment. Dr. Kolodny publicly promoted buprenorphine in various media outlets, despite evidence of buprenorphine overprescribing, pill mills, and overdoses. The true scale is not known, as most ERs and medical examiners do not test for the presence of buprenorphine. The CDC does not track buprenorphine deaths, despite a 2013 study¹⁵ that found a tenfold increase in buprenorphine-related ED visits, according to the Federally funded Substance Abuse and Mental Health Services Administration (SAMHSA). As “bupe” availability increased, so did diversion and overdose deaths.

Interestingly, that Dr. Kolodny promotes the idea that heroin and opioid medications are the same molecular compound. Actually, buprenorphine has a molecular profile¹⁶ that more closely resembles heroin, than hydrocodone. Dr. Kolodny indirectly claims that CDC “Guidelines” are effective, when the truth is that by the time PROP advised the CDC, prescriptions had already tapered off. This is evidenced in his statement as chief medical officer from a Phoenix House Q&A,¹⁷ dated December 2015: “It will take some time, but we’re already beginning to see a plateau in opioid prescribing.” Dr. Kolodny appears to take credit for a trend that had nothing to do with PROP, and he omits the fact that prescriptions are down since 2011, and yet overdoses are up.

Mainstream media occasionally, and accidentally, reveals the truth. CNN¹⁸ in 2018: “Fentanyl-related deaths double in six months; US government takes some action.” Then again, the echo of Dr. Kolodny’s statements, as reported by CNN: “The recent rise in popularity of these synthetics has been called the third wave of the opioid epidemic; the first wave was attributed to the overprescribing of painkillers like oxycodone and hydrocodone and the second to heroin. The drugs are all chemically similar and act on the same receptors in the brain.” Again, not one word about potency.

Few realize that when the CDC issued the Opioid Guidelines in 2016, there was inadequate research done ahead of time to determine the true cause of the rise in opioid-related deaths. There are no long-term studies on the effects of chronic opiate therapy. Very few, if any, pain management experts or pharmacologists were consulted to determine potential impacts on their practice. Neither veterans nor chronic pain patients were given a true opportunity to issue public comments to the CDC or any other Federal authority prior to the implementation of these new prescribing mandates. The CDC ended up targeting one of the most vulnerable groups, patients with intractable pain.

The CDC’s Guidelines also affect patients with cancer and patients who no longer receive cancer treatment because, unfortunately, both groups report similar pain levels. The guidelines allow the use of opioids during cancer treatment, but they are confusing when it comes to equally severe, post-cancer treatment pain. I fear this “opioid” crisis is far from over, and yet, trust me, this will go down as “reefer madness” in another hundred years. It is a manufactured tragedy that does real harm to patients with intractable pain. The “opioid” crisis also hurts human beings who suffer from heroin, opioids or other addictions by siphoning money, goodwill, and energy.

Few people realize that the CDC hired a PR agency to help sell the American people myths on the “opioid epidemic.” The agency, PRR, designed graphics to “educate” primary care providers that “one in four patients on opioids will develop addiction.” Even the National Institute of Health,¹⁹ another federal entity, estimates this to be 5 percent, not 25 percent. Another research team²⁰ concluded in Pain Medicine that opioid therapy for chronic pain patients (note: in absence of prior or current drug abuse) resulted in a 0.19 percent incidence of abuse.

The language used by the media as well as PROP contributes to misunderstanding; using words like addiction, tolerance, dependence, abuse or opioid use disorder as if they mean the same, directs the casual observer to bias. It’s clear that PROP never was an independent, neutral entity advising the CDC, yet they ended up dictating federal policy, based on flawed evidence. Dr. Ballantyne, Dr. Franklin, and Dr. Kolodny in Politico.com²¹ in March 2018: “We agree with Satel that the answer is not to force millions of chronic pain patients to rapidly taper off medications they are now dependent on (Italics mine). But then, neither is the answer to absolve overprescribing for pain.”

I’m not a linguist, but in that essay, PROP uses the word “addiction/addicted” 16 times, and “dependence” twice. The CDC could have ensured that patients with severe to intractable pain (no such distinction is made) would not lose access to their medications. And yet, that is exactly what happened. Stable patients on long-term opioids were tapered against their will, as the CDC “Guidelines” state it is undesirable to titrate above or equal to 90 morphine milligram equivalent²² daily (aka MME/day). But this was meant for opioid-naive patients, not those on long-term opiate therapy. Primary care providers, who were forced to follow these “Guidelines,” either stopped prescribing opioids altogether or forced patients to rapidly taper to below 90 MME.

Dr. Ballantyne is correct in her remarks that it isn’t realistic to expect zero pain levels, especially for acute pain that is expected to resolve quickly, like a sprain or an uncomplicated fracture. But people with severe to intractable pain are condemned to a world of suffering. Recall my patient with the five back surgeries? I wonder about him. He was working full time, on 180 MME a day, but in his mid-fifties, arthritis would worsen soon. My own story did not end well; I ended up with yet another spinal cord lesion, a benign hemangioma at chest level, which causes “central neuropathic pain syndrome.” My old cauda equina syndrome morphed into “severe, chronic adhesive arachnoiditis.” This is an incurable, intractable, progressive neuroinflammatory disorder whose pain is considered on par with having terminal cancer pain. Still, I try to make the best of it, see my essay, On Being Bedbound.

The CDC and PROP came for me: after using opioids exactly as prescribed, and less than 30 MME daily, my primary care clinic was forced to stop my opioid prescription, and that of all patients. I was not accepted in any pain management clinic, in an urban area of almost one million. Pain clinics here no longer provide “medical management,” yet perform epidural steroid injections ($3000 a pop), which may have contributed to, or worsened my adhesive arachnoiditis syndrome. I’m lucky to live in an urban area, where the academic hospital’s pain team took over my prescription.

But what about elderly and impoverished patients, or those in rural areas? PROP and the CDC claim primary care providers “overprescribe” and are responsible for most of the opioid prescriptions. But they fail to publicly acknowledge that pain management clinics no longer accept patients. This epidemic of undertreated patients will become known as one of the cruelest moves by a Federal agency on an already compromised population. I do feel for teenagers and adults who become addicted. Yet there ought to be a different, more sensible approach towards legitimate, chronic pain patients who need opioid medications, as well as people who develop a substance use disorder, who deserve our help and sympathy.

It is a conundrum of extraordinary proportions. At a time when managed care and Electronic Health Records dictate the length and quality of an office visit, there is less and less time to sit down and connect with a patient. Not just with chronic pain patients. Medicine and society would benefit greatly from the extra time clinicians deserve, to encourage exercise, eat healthier, lose weight, stop smoking and assess if a patient needs other support, like therapy.

In my opinion, it is loneliness, the feeling of not being connected to humanity in a meaningful way, combined with economic hardship, that leads to unhealthy lifestyle choices, as witnessed by the Rustbelt being hit hardest. Research shows that rats who were offered spring water or water laced with heroin, choose heroin. When those same rats were given ample toys, space, and other rats to play and have sex with, they did not choose the heroin laced water. That’s right, happy rats don’t need no heroin!

It cannot be denied that in previous decades, pain was both undertreated, and opioid medications prescribed for relatively minor, self-resolving aches and pains. Forget for a moment, the narrative that places blame on overprescribing, the opioid manufacturers, or the pharmaceutical distributors that, for example, flooded impoverished communities like those in West Virginia.²³ Forget all that, and focus on what is going on. Ultimately, patients with intractable pain pay the price of ignorance by scientists, journalists, politicians, and laypeople alike.

For this humanitarian crisis, there are no perfect answers. For example, as Red Lawhern, Ph.D. and prominent pain advocate²⁴ recently communicated with me (12/3/2018): “there is promise in genetic testing but hasn’t yet been fully reduced to routine practice and may not be covered by insurance.” Luckily my DNA testing was covered, on the condition it tested for depression. I also discovered that ketamine infusions help me most, but will leave that topic for my upcoming book, The Queen of Ketamine. Sadly, amidst the opioid paranoia, non-invasive alternatives like ketamine infusions aren’t mentioned for neuropathic or intractable backpain, which often has a neuropathic component. Research also shows that adding an anti-seizure medication to an opiate mediation provides better neuropathic pain contral, with less morphine²⁵.

In the end, I don’t think Tai Chi, Tylenol and Cognitive Behavioral Therapy is going to cut it for meningeal inflammation or other (neuropathic) pain syndromes. I believe the tide is turning. It will take time, and in that time, patients with intractable pain will choose to end their lives. But we are not alone, and it helps to know that courageous voices, notably the Alliance for Treatment of Intractable Pain, are speaking up for us. The print and online magazine Reason²⁶ has long been a voice of, well, reason. As Red Lawhern stated in a must-listen November 2018 radio interview,²⁷ “We must address underemployment, socioeconomic despair and hopelessness which are a vector for addiction. And end the War on Pain patients.”

Love, Kaatje

Kaatje Gotcha, model and stuntwoman-turned-Physician Assistant, found comedy, writing and advocacy after developing Adhesive Arachnoiditis. This spinal cord disease causes intractable neuropathic pain and leaves her mostly bedridden. Prior to that diagnosis, she’d survived a nighttime skydiving accident, landing at 70 mph. This caused Cauda Equina Syndrome; a subsequent lumbar puncture and epidural steroidal injections may have exacerbated her previous injuries.

Kaatje’s courageous spirit led to writing “The Queen of Ketamine,” available on Kindle in February. This is a comedic yet pragmatic memoir  on adhesive arachnoiditis, the opioid “epidemic,” neuropathic pain, dating with a disability, while offering hope and practical advice. Kaatje’s 2018 TEDx talk and book publication will be posted on her Facebook page, at www.kaatjegotcha.com and Instagram @kaatjegotchacomedy. Find her essays on Medium, and follow her on twitter.

Cauda Equina Syndrome https://emedicine.medscape.com/article/1148690-overview

Opioid Metabolism https://www.medscape.com/viewarticle/771480

Controlled Substance Act https://www.dea.gov/controlled-substances-act

Alcohol Epidemic https://www.niaaa.nih.gov/alcohol-health/overview-alcohol-consumption/alcohol-facts-and-statistics

Opioid Epidemic Deception https://www.acsh.org/news/2017/10/12/opioid-epidemic-6-charts-designed-deceive-you-11935

Overdose Deaths by Heroin/Fentanyl 71percent https://www1.nyc.gov/assets/doh/downloads/pdf/epi/databrief89.pdf

Washington Legal Foundation and PROP https://www.forbes.com/sites/wlf/2015/12/15/cdc-bows-to-demands-for-transparency-and-public-input-on-draft-opioid-prescribing-guidelines/#c82eda135bc3

Physicians for Responsible Opioid Prescribing http://www.supportprop.org/

Dr Kolodny refers to “Heroin” Pills https://www.healthline.com/health-news/secondary-drug-industry-booming-amid-opioid-epidemic#2

Dr Ballantyne’s Narrative https://www.statnews.com/2015/11/30/chronic-pain-intensity-scale/

Millennium Opioid Metabolite DNA Test https://www.millenniumhealth.com/services/test-offerings/

Opioid Serum Measurements http://paindr.com/serum-opioid-monitoring-wheres-the-evidence/

Medical Advisory Committee https://steverummlerhopenetwork.org/our-team/

NYT: Addiction Treatment with a Dark Side https://www.nytimes.com/2013/11/17/health/in-demand-in-clinics-and-on-the-street-bupe-can-be-savior-or-menace.html

Sharp Rise in Buprenorphine ER Visits https://www.samhsa.gov/data/sites/default/files/DAWN106/DAWN106/sr106-buprenorphine.htm

Heroin and Buprenorphine Molecular Profile http://paindr.com/heroin-hydrocodone-buprenorphine-prop-aganda/#comment-334500]

Q&A with Dr. Kolodny, Phoenix House https://www.kolmac.com/2015/12/qa-dr-andrew-kolodny-chief-medical-officer-phoenix-house/

Fentanyl, as Reported by CNN https://www.cnn.com/2018/07/12/health/fentanyl-opioid-deaths/index.html

NIH Estimates Pain Patient “Addiction” 5 Percent https://medlineplus.gov/magazine/issues/spring11/articles/spring11pg9.html

Pain Patient “Opioid Use Disorder” without Risk Factors 0.19 percent https://academic.oup.com/painmedicine/article/9/4/444/1824073

Rebuttal by Dr. Kolodny and Dr. Ballantyne https://www.politico.com/magazine/story/2018/03/13/opioid-overprescribing-is-not-a-myth-217338

Morphine Equivalent Dosing https://www.wolterskluwercdi.com/sites/default/files/documents/ebooks/morphine-equivalent-dosing-ebook.pdf?v3

https://www.wvgazettemail.com/news/cops_and_courts/drug-firms-poured-m-painkillers-into-wv-amid-rise-of/article_99026dad-8ed5-5075-90fa-adb906a36214.html

Red Lawhern, PhD and nationally known Pain Patient Advocate http://face-facts.org/lawhern/

Combining epilepsy drug, morphine can result in less pain, lower opioid dose. https://www.sciencedaily.com/releases/2014/09/140915153613.htm

Jacob Sullum, Reason journalist and syndicated writer https://reason.com/archives/2018/03/08/americas-war-on-pain-pills-is#comment

“Unleashed” Matt Connarton Interviews Red Lawhern 11/28/18 https://www.spreaker.com/user/ipmnation/matt-connarton-unleashed-11-28-18

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THIRTY WAYS TO EFFECTIVELY SAVE MONEY AS A UNIVERSITY STUDENT — 05.12.17

University is a weird, interesting experience — one minute you’re out at a bar, drinking with your friends, and the next you’re eating ramen, and only ramen for weeks. With various expenses like books, rent, and tuition, it seems impossible that as a student, you would even have any money left over to save — but it is possible. By being frugal, smart, and aware of your spending habits, you can easily start saving money for further experiences or maybe some food that isn’t just instant noodles as a post secondary student! Read on for thirty excellent tips on how to save money while away at university.

1. Have a budget.

A basic, but necessary tip is to have a budget. By putting aside money for certain things like rent, bills, groceries, and other mandatory amenities, it leaves you with an amount to utilize for other important, but not necessary things like entertainment, shopping, and travel. It’s important to set the budget and follow it, however, so make sure you’re not just setting a budget to go over it each month! You can create a budget through Excel, or if that is too daunting, just start by tracking your expenses to see where the bulk of your money goes so you can adjust accordingly.

2. Take better care of your things.

Another easy tip is to simply take better care of your stuff. This saves you money in the long run because you won’t be going out and repurchasing replacement items as often. If you’re someone who ruins their charger cords in a month or breaks headphones in a matter of weeks, it’s time to be more careful and take better care of your items, not only for your sake, but your wallet’s sake as well! Instead of throwing clothes on the floor when you get home, hang them up; put your laptop in a case; clean your shoes every once in a while! These tips can ensure that you will save money in the long run by having your items for longer.

3. Put a certain % of your paycheck in a savings account you don’t touch.

If you currently work a job, an effortless way to save some cash is to put a percentage of your paycheck into savings each month. Whether it’s 5% or 50%, the savings will accumulate and help you budget the money you do have for spending more accordingly.

4. Thrift everything.

I am a firm believer that if you need an item, you can thrift it. From clothing to appliances to even furniture, your local thrift store has decent quality items for a cheap price that will not only please you, but your wallet. You would be surprised at the amazing selection some thrift stores have and how much money you’ll save buying used instead of new.

5. Only shop fast fashion clothing on sale.

I usually only shop fast fashion twice a year — before school starts and on my birthday — but if you’re someone who doesn’t like thrifting (for whatever reason) or is aching for a traditional shopping spree, only shop in the sale section. If you’re just shopping to shop, its better to pay less with sale and discounted items than to go crazy and buy an expensive t-shirt that would cost you $50 from Urban Outfitters. Just try to make sure you’re buying clothing items you need or will wear, or else you’re really throwing your hard-earned money down the drain on absolute trash.

6. Stop eating out.

Or eat out less. Making your own food can save you an exponential amount of money, while also being much healthier for you in the long run. Forbes.com reports that cutting out restaurant trips for a month can save upwards of $200, which equals $2400 yearly.

7. DIY everything.

Have experience building furniture? DIY your own! You can also DIY your own clothing, home décor, beauty products, and accessories. r/DIY is my favourite resource to find DIY ideas that don’t break the bank.

8. Only drink water.

If you’re already paying for your water in your bills, you might as well drink it. Coffee, alcohol, pop, and juices can add up to a hefty penny every month; switching to water will not only save you calories, but a significant amount of cash as well. The Simple Dollar found that you can save around $70 dollars by switching to water each month, accumulating to a staggering $840 annually.

9. Buy a water filter.

Taking the previous tip up a notch, cut out buying bottled water and switch to using a water filter.  Assuming you drink your eight glasses a day, the Treehugger reports that you spend $1400 on bottled water a year. Crazy, right? Buying a filter can save you that money, along with the environmental stressors plastic bottles harbour onto our ecosystems.  

10. Quit smoking.

If there already weren’t enough reasons to quit smoking, the fact that someone smoking a pack a day spends about $91 a week on cigarettes, which is over $4745 each year should be enough to reconsider this dangerous habit.

11. Get a library membership.

Instead of buying books, rent them from the library for free. If you’re a massive bookworm, this tip will save you more money as compared to someone who reads minimally.

12. Stop buying lottery and scratch tickets.

Since I turned 18 in 2016, I haven’t purchased one scratch ticket. With the very slim chances of winning, one can spend their saved money from not buying lotto tickets on more important things.

13. Buy reusable bags.

Another environmentally friendly tip, buying reusable shopping and grocery bags may not save you a lot, but it will eventually add up in the long run. If your grocery store gives back a reusable bag credit (usually 5 cents or so), this tip can also make you money, though not a staggering amount.

14. Have a meatless Monday!

Meat is delicious, but also staggeringly expensive. If the thought of going vegan or vegetarian terrifies you, start off by having a “Meatless Monday”, which depending on the number of people in your household, can save you upwards of $520 a year.

15. Switch to cloths and rags instead of purchasing paper towels.

Paper towels are stupid expensive and quite wasteful when you consider using rags or dishcloths instead. Growingagreenfamily.com reports that ditching paper towels in favor for washcloths can save a family around $1000 in five years.  

16. Ditch your debit and credit cards and start paying only with cash.

I noticed when I shop with my debit card, I am much more likely to spend a higher amount of money than when I use cash. When you can physically see the money you’re taking out, you have a conscious reflux to spend less of it as compared to using debit or credit.

17. Make your own coffee.

The Simple Dollar reports that the average coffee runs between $2 to $5 dollars and making your own home brew will save you around $2.50 per coffee. Assuming you drink one coffee a day, everyday, you would save a whopping $887 a year, which in Toronto is equivalent to one month of rent in a two-bedroom apartment shared with your roommate. Absolutely crazy.

18. Have a no spend day, week, or month.

Really hurting for some money? Stop spending it entirely. Survive off of what you already have for a day, week, or month and save a good amount of cash.

19. Buy things from the dollar store.

I love the dollar store. I buy everything I can there, from groceries to medicine to beauty products. Instead of purchasing at the grocery or traditional store, check to see if the dollar store has your favourite items for a cheaper price. It’ll save you a lot in the long run!

20. Stop drinking and doing drugs.

Like cigarettes, alcohol and drugs are a dangerously expensive habit. Whether it’s drinking less, making your own drinks, or cutting out alcohol and drugs completely, each will save you a good chunk of cash to place in your savings.

21. Grow your own food!

It’s amazing how easy you can grow fruit and vegetable plants from scraps. If you can, start growing your own spices and seasonings to start, and progress onto fruits and vegetables for maximized savings.  Follow this guide for information on how to do it!

22. Do your own manicures and facemasks.

While the saying that beauty is pain might be true, it should be changed to beauty is money instead. If on average you’re spending $30 bucks a manicure twice a month, getting your nails done can cost around $720 a year, while facials can cost much more. DIY instead and see much more money in your pocket!

23. Walk, bike, or take public transit.

Owning a car and paying for it is expensive. If you can, walk or bike to school or work instead to save you a significant chunk of money per day instead of wasting it on gas.

24. Handmake presents and cards.

Why pay $5 for a card when you can make one yourself? With a little bit of creativity, you can give wonderful handmade cards to your family and friends instead of buying them. If you’re handy and very thoughtful, you can also DIY gifts, like making handmade soaps, necklaces, etc. Your family members will likely appreciate these more than store-bought varieties because of the hearty amount of thought and personality you put in. Cute!

25. Hang your clothes to dry instead of using the dryer.

Hanging your clothes up, either in your room or backyard, can save you a little bit of change from your bills while also conserving energy.

26. Use less.

A pretty vague tip, but using less water, electricity, and gas can save you some good money long term. You can also save more by using less of everyday items — shampoo, cleanser, dish soap, food, paper, ink for your printer — you get the idea.

27. Switch your feminine hygiene products.

If you menstruate, switching from tampons to a device like the Diva cup can save you around $120 a year assuming you spend $10 on sanitary products each month. Not to mention the environmental impact it’ll have! Check out the Diva cup here.

28. Buy higher quality items.

Though it sounds counter-intuitive, buying high priced, quality items will last you longer as compared to a cheaper alternative, saving you money from not having to repurchase as often. Buying nicer quality jeans and shoes are a good example of this.

29. Use the thirty-day rule.

Browsing online out of boredom and find something you “absolutely have to have!!!” like a cute shirt or new video game? Wait it out for thirty days to dispel any impulsiveness. If you’re still thinking about the product after a month, you can buy it.

30. Stop using your phone’s data.

Nowadays, there is wifi basically everywhere. Unless it’s an emergency, turn off your data and scour for wifi hotspots instead.

So those are my thirty tips for effectively saving money while in university! Any tips you’re anxious to try? Let me down in the comment section below.

Ambitiously,

Amanda

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As I’ve been seeing more of the world’s countries legalize drugs like cannabis, I can’t help but think about all the other addictive substances and behaviors people are already addicted to. I feel like legalizing less harmful drugs can be a good thing for other social reasons(especially harsh criminal sentencing), but substance abuse is still a very real issue that affects us. Even if you’re not actively using a substance, chances are you have a loved one or friend who has gone through some substance abuse issues.

I recently read this article on how Iceland is helping to stop substance abuse, and it blew my mind. A small team in Denver formed a program to give classes(music, dance, art, martial arts) and life-skills training to kids that had issues with drugs and petty crimes. They started with the idea that people can get addicted to anything related to behavior that changes your brain chemistry—not just the drugs we’re all told are addictive. It seems like a pretty simple way of thinking, but it’s surprising how many places around the world are resistant to that. Rather than using the unsuccessful methods of ‘drug education,’ this program started from asking what the kids actually wanted to learn.

The successful methods used in the Denver program eventually made their way to Iceland, where it helped form a national plan called ‘Youth in Iceland.’ It brought parents into the picture as well, including pledges like not buying alcohol for minors. And state funding was increased for sports and arts—encouraging group activity and giving kids another option of feeling good. They’ve been pretty great at keeping up their survey data as well. These positive results show some encouraging things:

Between 1997 and 2012, the percentage of kids aged 15 and 16 who reported often or almost always spending time with their parents on weekdays doubled – from 23 per cent to 46 per cent – and the percentage who participated in organised sports at least four times a week increased from 24 per cent to 42 per cent. Meanwhile, cigarette smoking, drinking and cannabis use in this age group plummeted.

Isn’t that what every drug abuse program would want? Definitely. After more positive data came back, other cities and nations soon tried implementing similar programs—but no other city has had the scale of effects seen in Iceland.

Reading about programs like this gives me hope for what’s possible in other parts of the world. But for other nations to adopt similar models, it will take time and some open minds. What Iceland has done takes quite a shift in thinking for many people—that successful prevention and/or recovery from substance abuse doesn’t depend solely on one person. To give them good alternatives, there has to be long-term funding and social support. It works best when it’s shared between friends, families, the public, and governments. That’s where the importance of their model lies—having a sense of responsibility for these conditions.

- Matt