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Caseythoughts The brain wanders far and wide this week. And when it notices something of interest, it focuses, at least for a few paragraphs.

The chest-thumper-in-chief appears quite upset about the newest nefarious attempt to trash him and the administration: not just anonymous sources (who should get their own byline these days) but an entire editorial in the NY Times headlined 'The Quiet Resistance Inside The Trump Administration'.

When I was in radio I was performing the difficult and mind-bending work of a talk show in one of the most politically attuned towns in the country outside of Washington DC. Well, at least it seemed that way, and when I concentrated on local or national politics (my bread and butter, many days) was when I received the most criticism from both 'sides'. Brickbats, if you choose to use one word not often used, but appropriate. Criticism (and critics) were a part of the job and I welcomed them, and it (after all, it meant they were not only half-listening but paying attention, as well). But one thing I could never shrug off was the anonymous letter, which being unsigned enabled the writer to say, often, the most vile things (frequently racist, or just plain mean).

My operations manager (my boss, in effect, since I was my own producer and engineer of the show) as well as the station manager/owner, would point out that people who hadn't the guts to put their name on something had no right to be recognized, or acknowledged, especially by reading their diatribe on the air. I remember anonymous anti-Semite and racist screed showing up on local campuses and in my own mailbox, never signed, of course, and how giving the authors the time of day may even have emboldened them. So, I was told to ignore anonymity and 'keep on truckin'.

Funny how the media has for almost two years not recognized that Mr. Trump is actually thriving on their negative stories and sound-bites, as well as purported anonymity. Reminds me of Dr. Joy Browne's thinking on why children frequently 'act out': her theory was that a child will, in many and often extreme circumstances, basically say 'Punish me, hit me, even abuse me, but please do not ignore me.' Trump is basically saying 'Do and say whatever you like, as long as I am the center of your attention, your lead story, your headline. You must not ignore me, and I am getting all of the attention. So, there.' An interview with Yo Yo Ma in this weeks's Financial Times pointed out that an outlandish ego is almost always accompanied by deep insecurity. Makes sense.

But, just one more thought on this, if you please. An Ipsos poll in August (I'm not sure if Ipsos has a 'leaning', as most polls do, depending on clientele and motivation, read: who's paying) found that 43% of Republicans polled believe that 'the President should have the authority to close news outlets engaged in bad behavior' (Ipsos language). Whoa....really?

Historically, John Adams got himself in some deep and pretty hot water when he advocated and signed the Alien and Sedition Acts, feeling that he was being unfairly trashed by some individuals and newspapers in the early days of the Republic. His efforts to silence his critics cost him the 1800 election and gave us some lessons in freedom of speech and the press when talking about the resident of the Executive mansion. His successor (and first 'republican' president, Thomas Jefferson, also had his problems with the press and grumbled publicly about being treated unfairly. Abraham Lincoln went so far as suspending habeus corpus and actually arrested a Baltimore newspaper editor (as well as ordering the arrest of others) but we could, if we wish, cut some slack as it was war time, and all of Lincoln's tenure was conducted during declared war).

Woodrow Wilson? Enabled and enacted some very draconian speech and press limits, basically censorship and restricting free speech during the months we were engaged in declared war in 1917-18, and it was well known that Franklin Roosevelt issued veiled threats to reporters about revealing certain secrets during, again, wartime conditions.

Presidents have always had their troubles (as well as candidates in our history, and some of the songs and such sung and written about candidates would make even 21st century readers almost blush in their ribaldry), no doubt. But I'll be willing to bet there never was a President who said, under his executive breath: 'Bring it on. I love the attention. Keep that spotlight on me.' Almost seems masochistic, doesn't it? But, saying that, I wonder if it's him who is the one saying, in effect, 'hit me again'. The press, the media, the American people almost seem not to realize this reality: he likes it. He did host a 'reality TV show', did he not? As a matter of fact, he loves the attention. The slimier the better. Reminds me of the olf farmer who opined: 'Never argue with a hog: you both get filthy, and the hog loves it.' Who needs the lesson apparent, us or the media?

Another short shot on something read about this week, which you might not have caught wind of:

Ever hear of Dr. Richard Sackler? His family owns Purdu Pharma, the makers, among other drugs, of Oxycontin. They are generous philanthropists, making and giving away billions of dollars to universities, museums, etc. They are also, logically, targets of more than a thousand lawsuits (many local and state governments, including Tompkins County and New York state) and many more individual lawsuits, concerning Purdu's knowledge of the risk of addiction (and the marketing of this pain killer to other than terminal cancer patients since 1995), resulting in 42,000 deaths from opioid overdose in 2016 alone. The amount of associated pain, distress, medical expenses and crime would dwarf our imaginations.

So, what did Dr. Sackler do about this, besides reap a few billion from the sales of Oxycontin? It should be noted that Purdu is a closely held private company in which most of the dividend profits go to eight family members. Dr. Sackler has done what drug manufacturers (both legitimate industrial and criminal laboratories) have done for decades: play with the formula for a drug called bupenorphione. You may know about bupenorphine; it is the drug of choice for treatment centers to assist in managing withdrawal symptoms from opioid abuse. Not to be confused with naloxone which is an antidote for overdose. And, when he and his scientists played with the formulation, they came up with a better formula and then promptly patented it. In my former work with addicts and drug court, I can tell you that bupenorphin is not a panacea by any stretch of the imagination. Some of us wished occasionally that it had never been invented, but that's whiskey under the bridge, as they say. It surely has helped thousands to eventually resume normal lives, as it is hardly addicting in the physical sense, and is not like methadone, which is a narcotic and patients do become dependent upon it, but it is more commonly prescribed in urban settings. Bupenorphine is prescribed in a tightly controlled manner and can be tapered as the patient progresses in treatment, including counseling.

What happens when you tinker with the formula? You have a new drug, you have a new patent-able product, and, voila, you have a new blockbuster drug to treat addiction. By many accounts this new formulation of bupenorphin is much better, much more effective and even dissolves in the mouth in a matter of seconds, instead of minutes, and would probably be difficult to abuse.

Bupenorphine was worth $877 million in sales last year (compare to billions in Oxycontin sales over the years, both legal and illegal) in the US. That's the legal, abovve board number. Underground illegal sale of the drug (which everyone in the treatment field, as well as drug court is intensely aware of) is, of course, un-trackable.

So, the Sackler family has denied for years any culpability in the opioid crisis (after all, they say, through lawyers, they didn't invent addiction or heroin) but they surely profited from years of denial, years of excitedly encouraging their sales people to sell, sell, sell, and encouraged doctors to prescribe, prescribe, prescribe it. And in so doing it denied that they were the chief source of misery, crime and death by claiming it was not 'habit forming' in their formulation. They claimed the risk of abuse or addiction were small.

Now the Sackler family, or at least one or more members, are going to profit and benefit from the potential antidote to their killer drug (which they stopped selling, conveniently, in February 2018). Billions of additional profit? Who knows. In effect they are saying 'We have the disease, and were selling it. Now, we have the potential cure, too, so line up and don't forget to bring your wallet.' The patent application states that the new formulation comes in a wafer that disintegrates quickly, but perhaps not as quickly as the Sackler family's moral compass.

I'm wondering what the brand name of the newly patented drug could be (I have not found out if the formulation has been forwarded to the FDA for human trial). Forget the courts (and associated class action lawsuits) attaching the profits from Purdu from this new patent...wouldn't that be a case of pure justice? It appears that a couple of lawyers have made an attempt to sue the family members themselves, as they had benefited from most of the sales of Oxycontin. But, the victims? No, no justice there. We only have sad and painful memories of their, and our, suffering while we waited for answers from the Sacklerr family, as well as thousands of care providers who prescribed this drug forever form and manifestation of pain, whether appropriate or not, even when signs of addiction were readily apparent. Our tortured society will struggle for decades to come. The answers will be slow in coming, I daresay, as slow as the courts which will eventually deal with this. But, Sackler is bound to profit from his sin, again.

But, in the end, I recognized an obtuse connection between these two stories, although as I said, it may be too obtuse. Bob Woodward's anonymous informant in 1973-4's Watergate story (also noting his latest work full of anonymous 2017-8 sources) was named 'Deep Throat' and this source's mantra was 'follow the money'. In 2016, here's Woodward again with anonymous sources in the White House. I don't know what the moniker might be for the new Purdu/Sackler wonder drug/grand heist, but certainly 'Follow the Money' still has credence as a sad commentary on the present sad state of affairs, whether in the politics business, or the world of drugs.

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