John Hanno – Page 140 – The Tarbabys Blog

Who’s to blame for climate change? Scientists don’t hold back in new federal report.

USA Today

Who’s to blame for climate change? Scientists don’t hold back in new federal report.

Dinah Voyles Pulver and Doyle Rice – November 14, 2023 President Joe Biden slams 'MAGA Republican leaders,' claims they deny climate change

Climate change is here and prompting unprecedented actions in every state to curb the greenhouse gas emissions fueling warming temperatures, but a new federal report out Tuesday says bigger, bolder steps are needed.

After several years of work by more than 500 authors from every state, Puerto Rico, the Virgin Islands, and Guam, the White House released the massive Fifth National Climate Assessment.

In remarks Tuesday morning, President Joe Biden announced more than $6 billion to bolster the electric grid, update water infrastructure, reduce flooding, and advance environmental justice.

“This assessment shows us in clear scientific terms, that climate change is impacting all regions, all sectors of the United States,” Biden said. “We’ve come to the point where it’s foolish for anyone to deny the impacts of climate change anymore.”

The assessment includes more evidence than ever before to demonstrate the cause and effects of the changing climate, said L. Ruby Leung, one of its authors. It also breaks from previous reports by saying unequivocally that humans are responsible for changes to Earth’s climate.

“It’s important for us to recognize that how much climate change we will be experiencing in the future depends on the choices that we make now,” said Leung, a climate scientist at the Pacific Northwest National Laboratory and lead author on the earth sciences chapter.

All of the impacts people are feeling, like sea level rise and extreme weather events, she said “are tied to the global warming level, to how warm the earth becomes,” Leung said. “And that depends very much on the level of CO2 concentration in the atmosphere.”

In other news, the United Nations released its latest analysis of national climate plans on Tuesday morning and found them “strikingly misaligned” with science. “The chasm between need and action is more menacing than ever,” said Secretary-General António Guterres. “It’s time for a climate ambition supernova in every country, city and sector.”

The impacts of climate change are felt in every corner of the country, the latest National Climate Assessment finds

What is the 2023 National Climate Assessment?

The massive assessment describes the climate and economic impacts Americans will see if further action is not taken to address climate change. The report, issued roughly every four years, was mandated by Congress in the late 1980s and is meant as a reference for the president, Congress, and the public.

“Too many people still think of climate change as an issue that’s distanced from us in space or time or relevance,” said Katharine Hayhoe, an author of the report and chief scientist at The Nature Conservancy.

The assessment “clearly explains how climate change is affecting us here in the places where we live, both now and in the future and across every sector of human and natural society,” Hayhoe said. It also shows that “the risks matter and so do our choices.”

Climate Nexus, a nonprofit communications organization, said the new report is “essential reading,” because it highlights the seriousness of current impacts and shows the existing pace of adaptation isn’t enough to keep pace with future climate changes.

“Without deeper cuts in global net greenhouse gas emissions and accelerated adaptation efforts, severe climate risks to the United States will continue to grow,” the report states. “Each additional increment of warming is expected to lead to more damage and greater economic losses.”

However, greater reductions in carbon emissions could reduce the risks and impacts, and have immediate health and economic benefits, the report states.

Another heat record? Earth is historically and alarmingly hot. Now what?

What are the effects of climate change?

Millions are experiencing more extreme heat waves, with warmer temperatures and longer-lasting heat waves, the report states. It adds climate changes are apparent in every region of the country.

Among the noted effects:

◾ The number of nights with minimum low temperatures at or above 70 degrees has increased compared to 1901-1960 in every corner of the country except the northern Great Plains and Alaska.

◾ Average annual precipitation is increasing in most regions, except the Northwest, Southwest, and Hawaii.

◾ Heavier precipitation events are increasing everywhere except Hawaii and the Caribbean.

◾ Relative sea levels are increasing along much of the coast, except for Oregon, Washington, and Alaska.

◾ In the 1980s, the country experienced on average a $1 billion disaster every four months but now experiences one every three weeks. This year, the country has set a new record with 25 billion-dollar disasters.

Fishers and the warming climate Climb aboard four fishing boats with us to see how America’s warming waters are changing

Climate scientists around the world say 2023 is almost certain to be the globe’s warmest year in recorded human history. The global mean temperature through October was 1.4 Celsius (more than 2.5 degrees Fahrenheit) above the preindustrial average.

So far this year, the nation is experiencing its 11th warmest year on record through October, according to the National Oceanic and Atmospheric Administration. However, 12 states are experiencing their warmest or second warmest year on record.

Growing evidence that humans are changing the climate

This assessment is most notable for the certainty scientists have gained about warming and its impacts, said Leung, who served as the lead author for the report’s Earth Systems Processes chapter, which lays the scientific groundwork and is used to illustrate points throughout the report.

The chapter, a collaboration among more than a dozen authors, was intended to answer such questions as whether humans are causing global warming, whether warming is changing extreme weather and climate events and how much warming the planet might expect to see.

In prior reports, scientists often hedged their statements, for example saying they were 90% sure humans were responsible for the changes being seen,” Leung said. “In this NCA 5 report, we are now saying that we are totally sure.”

Starting from the 1900s, the observed warming has been caused by human activities, she said. “It’s definitive.”

Another key difference is scientists reduced by 50% the uncertainty in how much temperatures would warm if the concentration of carbon dioxide in the atmosphere doubles, she said. In previous assessments that number had hovered around a range from 2.7 degrees to 8 degrees. “It was a pretty big range,” she said. “Our goal has always been to narrow this down.”

Thanks to the increase in instrumental observations, satellite data, the study of the paleoclimate, and higher resolution computer modeling, scientists now have amassed more evidence than ever before, giving them more certainty, she said. “Now we can say that the global warming that is caused by a doubling of the CO2 in the atmosphere should be between 4.5 degrees Fahrenheit and 7.2 degrees Fahrenheit.”

The Fifth National Climate Assessment shows the U.S. has warmed rapidly since the 1970s.

Reducing greenhouse gas emissions

Efforts to adapt to climate change, reduce net greenhouse gas emissions, and be more energy efficient are underway in every U.S. region and have expanded since 2018, the report concludes.

Greenhouse gas emissions in the U.S. fell 12% between 2005 and 2019, mostly driven by changes in the way electricity is produced, the assessment concluded. The nation burns less coal, but more natural gas, which is cleaner. Because of the electrical industry’s 40% reduction in emissions, the transportation sector took the lead as the industry with the most emissions.

Growth in the capacity of wind, solar, and battery storage is supported by the falling costs of those technologies, and that ultimately means even more emissions reductions, the report states. For example, wind and solar energy costs have dropped 70% and 90%, respectively.

While the options for cleaner technologies and lower energy use have expanded, the authors found they aren’t happening fast enough for the nation to meet the goal of achieving a carbon-neutral energy system.

Without deeper cuts in global net greenhouse gas emissions and accelerated adaptation efforts, the scientists found severe climate risks to the United States will continue to grow. Each additional increment of warming is expected to lead to more damage and greater economic losses compared to previous increments of warming, and the risks of catastrophic consequences also increase.

But the report also finds that reducing greenhouse gas emissions and removing carbon dioxide from the atmosphere can limit future warming and associated increases in many risks, and bring immediate health and economic benefits.

What others are saying about the report:

The scientific assessment is “the latest in a series of alarm bells and illustrates that the changes we’re living through are unprecedented in human history,” said Kristina Dahl, a principal climate scientist at the Union of Concerned Scientists and a contributor to the report. “The science is irrefutable: we must swiftly reduce heat-trapping emissions and enact transformational climate adaptation policies in every region of the country to limit the stampede of devastating events and the toll each one takes on our lives and the economy.”

The report illustrates three things, said Arati Prabhakar, director of the White House Office of Science and Technology Policy.

◾ The events Americans have already experienced firsthand are “unfolding as predicted.”

◾ Communities in every state and territory have taken action.

◾ People across the nation can use the assessment to take future actions.

For example, Prabhakar said the report could be used by a water utility manager in Chicago trying to understand extreme rainfall, an urban planner deciding where to locate cooling centers in Texas, or a manager of a Southeastern hospital trying to get ahead of the diseases ticks and mosquitoes are bringing into their region as a result of the changing climate.

What an increase of 3.6 degrees Fahrenheit over pre-industrial temperatures would feel like in the United States.

Why Biden Shouldn’t Run for Reelection—According to Biden Himself

The New Republic

Why Biden Shouldn’t Run for Reelection—According to Biden Himself

Rob Anderson – November 14, 2023

When Joe Biden was deciding in late 2018 whether to run for president, he reached out to his network of would-be supporters with a pithy, pragmatic ask. “If you can persuade me there is somebody better who can win, I’m happy not to do it,” he said, according to The New York Times. It turned out there wasn’t somebody better to take on President Trump—or at least, Biden wasn’t persuaded that there was—and a few months later he officially threw his hat into the ring.

It wasn’t exactly a surprise. Biden, already a twice-failed presidential candidate, had been openly weighing another run for years. In a 2017 speech at Colgate University, he said he regretted “not being president” and that he could have beaten Trump. “I had a lot of data,” Biden said. “I was fairly confident that if I was the Democratic Party nominee, I had a better-than-even chance of being president.” And in January 2019, he said, bluntly, “I don’t see the candidate who can clearly do what has to be done to win.”

Within the next three months, though, the Democratic field ballooned with myriad compelling, experienced candidates, most of whom were far younger and more representative of the party’s diverse coalition. Did Biden, then 76 years old, really still believe he was the best hope to stop Trump? It seemed he did, based on a simple calculus. He had the blue-collar bona fides to win over working-class whites in the Midwest, high support among African American voters, thanks in part to his close relationship with the most popular Democratic president of the modern era, and a folksy charm to win over suburban soccer moms. And the polls agreed.

But Biden’s decision to jump into the race wasn’t just strategic; it was moral. As the candidate best positioned to beat Trump, he owed it to the American people to run. “We are in the battle for the soul of this nation,” he said in his April announcement video. “If we give Donald Trump eight years in the White House, he will forever and fundamentally alter the character of this nation—who we are—and I cannot stand by and watch that happen.”

It was a sound—and winning, it turned out—argument. But if you apply the logic of Biden’s 2020 campaign to today’s presidential race, the conclusion is decidedly different, albeit equally clear: He should not be running for reelection.

First, the idea that Biden is uniquely qualified to unify the factions in the Democratic Party, let alone the nation as a whole, no longer holds true. Black voters are as alienated from the Democrats as they have been in decades. Blue-collar voters are defecting en masse. Suburban voters have turned on him too. And after years of commanding the spotlight himself, Biden can no longer bask in the glow of the now-distant Obama years. Today, his approval ratings are on par with Trump’s and Jimmy Carter’s at this point in their presidencies. Even more troubling, they dip below those of George H.W. Bush, Gerald Ford, Richard Nixon, and Lydon Johnson. Things didn’t turn out well for any of them. Why would Biden be any different?

He’s not. Biden has lost all of his advantages in battleground states, trailing Trump in Nevada, Georgia, Arizona, Pennsylvania, and Michigan. A recent Times/Siena poll showed that among registered voters in those five states plus Wisconsin—all of which Biden carried in 2020—he trails Trump by four points (which is barely within the margin of error). His campaign argues that polls always look bad for incumbents at this stage and that it’s easy to overblow an outlier poll here and there. But the Times/Siena poll wasn’t an outlier. Polling data aggregators have consistently shown Trump beating Biden for over two months now.

Democrats looking for a calm, nuanced explanation for why these polls shouldn’t be troubling will have to look elsewhere than the president, who said on Thursday he simply doesn’t believe he’s trailing in battleground states. Even the Biden of 2018 wouldn’t buy that.

It’s true that a lot could change between now and next November. The Biden optimists often note that Trump could become a convicted felon, but it’s not at all clear whether that would actually hurt Trump in the election. Inflation has eased, but prices are expected to remain high—perhaps for good. Russia’s war in Ukraine is at a stalemate, and one can only guess how much worse the conflict in the Middle East will get.

As much as political commentators like to disdain them for it, Americans ultimately pick their presidents on a feeling. The candidate who wins is the one who best recognizes the national mood and taps into it. After years of Bill Clinton’s slipperiness, the idea of grabbing a beer with George W. Bush sounded a lot better than chilling with the sweater-vested Al Gore and kite-surfing John Kerry. Barack Obama made the electorate feel hopeful after years of wars and recession. And in the end, Donald Trump tapped into a powerful feeling of resentment.

In 2020, voters turned to Biden because he promised competence and normalcy after the chaos and negativity that Trump had wrought. There’s no doubt that Biden delivered on that front—and even passed some historic legislation—but ultimately many Americans are still racked by despair and pessimism. In 2024, just like they have in the past, Americans will pull the lever, wisely or not, for whichever candidate they feel will most likely shake us out of our current malaise just to get us someplace different, for better or for worse.

Seen through this lens, the answer to the question that baffles some pundits—why is Biden so unpopular?—seems fairly obvious. The antidote to a world enmeshed in wars, a leaden economy, and an environmental catastrophe is not a mumble-prone 80-year-old incumbent. There’s no tactful way to say it: We want to face the apocalypse with Bill Pullman’s President Whitmore, not Weekend at Bernie’s.

The country is once again facing more than a 1 percent chance of a second Trump term—indeed, perhaps a greater than 50 percent chance. At the top of the Democrats’ priorities should be nominating someone with an overwhelming chance to stop that from happening. That candidate is not Joe Biden.

To be sure, even if Biden were swayed by my modest proposal, dropping out of the race would cause a host of complications. The deadlines for candidates to file in several primaries have already passed. And the candidates most prepared to step into his place—Kamala Harris, Pete Buttigieg, maybe Dean Phillips—wouldn’t be a likelier bet to beat Trump. But were Biden to drop out, it would clear the way for more promising candidates to step in: Michigan Governor Gretchen Whitmer, Kentucky Governor Andy Beshear, Maryland Governor Wes Moore, New Jersey Senator Cory Booker, Illinois Governor J.B. Pritzker, California Governor Gavin Newsom, Pennsylvania Governor Josh Shapiro. And as the likelihood of a second Trump presidency came into view, Democratic voters, as in the run-up to the 2020 election, would eventually flock to the candidate they felt was most likely to take down Trump.

While the strategic arguments for Biden’s candidacy have all but collapsed, the pressing moral argument he made in 2018 remains as true now as ever. If Democrats lose the White House in 2024, they won’t be turning over 1600 Pennsylvania Avenue to a generic Republican or even a Trump mini me like Ron DeSantis. They will most likely be handing the keys back to Trump himself. And if the Biden of 2019 is to be believed, that will fundamentally alter the character of our nation. If only the Biden of today would listen.

The Two Sides of Donald Trump Are Equally Bad

The New Republic

The Two Sides of Donald Trump Are Equally Bad

Alex Shephard – November 14, 2023

Donald Trump is talking like a Nazi again. Over the weekend, in both a speech and a subsequent social media post, he referred to his enemies as “vermin”—a favorite word of fascists and antisemites of yore—and channeled Hitler, declaring that America’s biggest enemies were domestic foes that needed to be “rooted out” and destroyed. “The real threat is not from the radical right; the real threat is from the radical left, and it’s growing every day, every single day,” he said. “The threat from outside forces is far less sinister, dangerous, and grave than the threat from within. Our threat is from within.”

As if doubling down on the authoritarianism, Axios reported on Monday morning that Trump and his allies had formulated a plan to purge the federal government of ideological opponents. Trump and his allies “are pre-screening the ideologies of thousands of potential foot soldiers, as part of an unprecedented operation to centralize and expand his power at every level of the U.S. government if he wins in 2024,” wrote Mike Allen and Jim VandeHei. Although they note that this plan—which they’ve taken to calling “Agenda 47”—has an “authoritarian sounding” name, Allen and VandeHei (the latter of whom has harbored some authoritarian sentiments of his own), ever eager to ingratiate themselves, observe that those in charge of this plan “are smart, experienced people, many with very unconventional and elastic views of presidential power and traditional rule of law.” For sure!

Finally, to underline the weekend of goose-stepping, Trump spokesperson Steven Cheung responded to the criticism by telling The Washington Post that those “who try to make [the] ridiculous assertion [that Trump is channeling Hitler] are clearly snowflakes grasping for anything because they are suffering from Trump Derangement Syndrome and their entire existence will be crushed when President Trump returns to the White House.” Not exactly a posture aimed at reassuring those who are alarmed by the increasingly fascistic bent of the leading contender for the Republican presidential nomination.

The response to Trump’s “vermin” comments and the revelation of the “Agenda 47” plan have led to a deserved round of hand-wringing about Trump’s authoritarianism, the threat his political project poses to American democracy, and the media’s role in covering both. In 2016, the press failed to adequately capture the sum total of this threat, partly because Trump’s political career was seen as a doomed project and partly because it was still too abstract. Seven years later, Trump’s rhetoric is substantially darker and we’ve had plenty of hard evidence of his willingness to push past the acceptable boundaries of our democracy in his continued insistence that the 2020 election was stolen from him, as well as in the Capitol riots that this rhetoric inspired.

Emphasizing Trump’s authoritarianism—and the related damage he can do to the fabric of the country—will be a necessity both for the press and for Joe Biden. Trump is rather transparently announcing his intentions to purge and weaponize the federal government against his political opponents, immunize himself against legal prosecution, and manipulate the levers of power to preserve his own for as long as possible. Given the threat of physical violence that so often accompanies his words, this is more or less open fascism. But declaiming against it will not be enough to defeat him.

“This is not normal” was a potent rallying cry during Trump’s presidency—it was arguably the defining admonition of that period. In many ways, Trump’s abnormality has only metastasized since voters evicted him from the White House. His rhetoric has grown more extreme. He is facing multiple criminal trials and will likely head into the presidential election as both his party’s nominee and as a convicted felon.

But Trump very much is a normal Republican now. That is true in many frightening ways, certainly. Trump’s political rivals have begun to echo his authoritarianism. Vivek Ramaswamy has arguably an even more insane plan to force the federal bureaucracy to submit to his will (he has suggested firing everyone whose social security number ends in an odd number). Ron DeSantis has called for shooting migrants. Nikki Haley has advocated for invading Mexico. Trump’s positions are the norm in the GOP now, and they will remain that way for the party’s foreseeable future: The GOP has, in eight years, been remade in his image.

But Trump has also become a normal Republican in the traditional sense, in that he’s more or less ended up embracing the long-standing policy positions of his GOP forebears. During his first term in office, his most important legislative accomplishment was a gigantic tax cut for corporations and the rich. Even though it is unlikely that he will staff his second-term office with the same kind of establishment figures—think Rex Tillerson and Steven Mnuchin—who briefly defined the early part of his presidency, one can rightly assume that he will continue to pursue regressive, supply-side economic policies, especially considering that this is what Republicans in Congress will want to do. The domestic agenda of a second Trump term would likely involve the greatest hits of Republican fiscal policy: tax and entitlement cuts, as well as the elimination of various environmental, labor, and economic regulations.

For all the talk of Trump’s abnormality, the fact that he’s always marched to the recognizable, old-school beats of the GOP drum has always been the less celebrated aspect of his time in politics. So there’s a danger in continually casting him as a pathbreaking sort of politician. Voters don’t like the status quo. They’ve repeatedly voted to reject the economic dogmas that have defined Republican policymaking for several consecutive elections. They thought that this was what they were getting from Trump in the first place—and the media did a much better job of selling Trump as a change-of-pace candidate, and clung to the notion that he was an economic populist long after he’d demonstrated no real interest in refreshing the Republican brand.

Democratic messaging needs to account for both Trump’s unique authoritarian leanings and his embrace of vintage Republican ideas. To solely advance the idea that Trump is a unique political figure in American life—a wild departure from the norm—runs the risk of implanting the idea that he is a politician bent on shattering the status quo during a time when many might prefer the short sharp shock of change. Ideally, you want to capture Trump as a chaos agent whose plans to sledgehammer the system won’t lead anywhere fruitful or new, but will more deeply entrench the unpopular ideas for which the GOP has long been known.

The clearest and most potent position for Democrats is to push on reproductive rights—it embodies the new post-Dobbs dystopia with the Republican Party’s decades-long effort to bring it about. Trump has, of late, escaped much attention for his abortion policy, in part because he’s skipped the Republican debates and in part because many of his opponents have adopted even more extreme positions. (Trump claims to oppose a nationwide abortion ban, though it seems highly likely he would sign one if he was given the chance.) More to the point, no one in the country is more responsible for the repeal of Roe v. Wade than Donald Trump, who appointed the three justices to the Supreme Court necessary to do the deed. Still, there is nothing new under the sun. Here we see a normal Republican doing normal Republican stuff. It is both odious and unpopular: Republicans have repeatedly lost elections when abortion is on the ballot. It will be again in 2024.

For Democrats, campaigning against Trump’s reelection will be an exercise in threading a needle between the new threats he poses and bad, old ideas to which he clings. This is something Democrats did successfully in the 2020 presidential election and then refined to great effect in the 2022 midterms; voters said that abortion and threats to democracy were the two issues that were front of mind as they tamed the “red wave” that was supposed to sweep Republicans into power. With less than a year before the election, both Biden and the press are doing a better job of making the case that Trump is a unique danger to the Republic. They should spend a little time reminding voters that he’s just as bad in other, more banal ways, as well.

Trump Campaign Officials Try to Play Down Contentious 2025 Plans

The New York Times

Trump Campaign Officials Try to Play Down Contentious 2025 Plans

Maggie Haberman – November 14, 2023

Republican presidential candidate and former U.S. President Donald Trump speaks during a campaign rally in Claremont, New Hampshire, U.S., November 11, 2023. REUTERS/Brian Snyder (Brian Snyder / reuters)

Two top officials on former President Donald Trump’s 2024 campaign on Monday sought to distance his campaign team from news reports about plans for what he would do if voters return him to the White House.

Susie Wiles and Chris LaCivita, who are effectively Trump’s campaign managers, issued a joint statement after a spate of articles, many in The New York Times, about plans for 2025 developed by the campaign itself, and trumpeted on the trail by Trump, as well as efforts by outside groups led by former senior Trump administration officials who remain in direct contact with him.

Wiles and LaCivita focused their frustration on outside groups, which they did not name, that have devoted considerable resources to preparing lists of personnel and developing policies to serve the next right-wing administration.

“The efforts by various nonprofit groups are certainly appreciated and can be enormously helpful. However, none of these groups or individuals speak for President Trump or his campaign,” they wrote, calling reports about their personnel and policy intentions “purely speculative and theoretical” and “merely suggestions.”

Trump’s team has sought to portray him as the most substantive candidate on policy in the Republican Party. But according to several people with knowledge of the internal discussions, who spoke on the condition of anonymity to discuss private conversations, Trump’s campaign advisers have grown enraged at what they perceive alternately as credit-taking by the groups, and headlines that could be problematic for more moderate voters in a general election.

The statement noticeably stopped short of disavowing the groups and seemed merely intended to discourage them from speaking to the press.

One challenge for the Trump team is that the most incendiary rhetoric and proposals have come from Trump’s own mouth.

For instance, an article in the Times in June explored Trump’s plans to use the Justice Department to take vengeance on political adversaries by ordering investigations and prosecutions of them, eradicating the post-Watergate norm of Justice Department investigative independence from White House political control.

Trump said in June: “I will appoint a real special prosecutor to go after the most corrupt president in the history of the United States of America, Joe Biden, and the entire Biden crime family.”

The Times recently published an extensive article on Trump’s immigration plans for a second term. He has promised what he called “the largest domestic deportation operation in American history” and has used increasingly toxic language to describe immigrants, including saying that they are “poisoning the blood of our country.”

The Times article detailed plans for an immigration crackdown in part based on a lengthy interview with Stephen Miller, the architect of the Trump White House immigration policy. The Trump campaign, after being approached by Times reporters about Trump’s immigration agenda, had asked Miller to speak with them.

President Joe Biden’s 2024 campaign pounced on the article concerning immigration — which described plans for mass detention camps, among other things — saying that Trump had “extreme, racist, cruel policies” that were “meant to stoke fear and divide us.”

Other Times articles have focused on plans being fleshed out by close allies of Trump who occupied senior roles in his White House and are likely to return to power if he is elected.

Those plans include efforts to increase White House control over the federal bureaucracy that are being developed, among others, by Russell Vought, who was Trump’s director of the Office of Management and Budget.

But as the Times noted, Vought’s plans dovetailed with statements Trump made in a video his campaign published on its website, including vowing to bring independent regulatory agencies “under presidential authority.”

The Times series has also examined plans by Trump allies to recruit more aggressive lawyers seen as likely to bless extreme policies. Trump fired the top lawyer at the Department of Homeland Security in 2019 after disputes over White House immigration policies and has blasted key lawyers from his administration who raised objections to his efforts to overturn his 2020 election loss.

The statement from Wiles and LaCivita on Monday said that, “all 2024 campaign policy announcements will be made by President Trump or members of his campaign team. Policy recommendations from external allies are just that — recommendations.”

Joe Scarborough Warns Trump Is ‘Going Full-On Hitler’ After Weekend Rhetoric

HuffPost

Joe Scarborough Warns Trump Is ‘Going Full-On Hitler’ After Weekend Rhetoric

Josephine Harvey – November 13, 2023

MSNBC’s Joe Scarborough said Donald Trump is “going full-on Hitler” after the former president referred to political opponents as “vermin” over the weekend.

The “Morning Joe” host took it as a warning ahead of the 2024 election.

“You look at the language of Donald Trump, you look at what Donald Trump says he’s going to do, and you go back to Maya Angelou saying that ‘when somebody tells you who they are, believe ‘em the first time,’” Scarborough said on his morning show Monday, quoting the late civil rights activist.

“We have to believe him, and we also have to believe that this is the most important election probably since 1864,” he added. That election, during the Civil War, saw Abraham Lincoln elected to a second term.

In a Truth Social post on Saturday, Trump vowed to “root out the Communists, Marxists, Fascists, and Radical Left Thugs that live like vermin within the confines of our Country, lie, steal, and cheat on Elections, and will do anything possible, whether legally or illegally, to destroy America, and the American Dream.”

“The threat from outside forces is far less sinister, dangerous, and grave, than the threat from within,” the leading contender for the Republican 2024 nomination added.

He made similar remarks during a Veterans Day rally in Claremont, New Hampshire.

As commentators in the media have noted, Trump’s rhetoric is reminiscent of Nazi propaganda, which referred to Jewish people as “vermin.”

Last month, Trump drew rebuke after he said undocumented immigrants are “poisoning the blood of our country,” another phrase that echoes language used by Nazi dictator Adolf Hitler.

Why Aren’t More People Getting Married? Ask Women What Dating Is Like.

The New York Times – Guest Opinion

Why Aren’t More People Getting Married? Ask Women What Dating Is Like.

By Anna Louie Sussman – November 11, 2023

An illustration of a woman surrounded by small men. — Credit…Wesley Allsbrook

Ms. Sussman writes about gender, dating and reproduction.Sign up for the Opinion Today newsletter Get expert analysis of the news and a guide to the big ideas shaping the world every weekday morning. Get it sent to your inbox.

Sarah Camino had been in a relationship for two years when she found out she was pregnant. The father, whom she met while they were both working at a restaurant in Times Square, was initially excited. But he had been using drugs lately, and had been fired from his last four jobs; when she ventured that she was scared she might wind up raising the child alone, he got defensive and walked out. She and her daughter now live in Florida with her parents, and he is not a part of their lives.

Ms. Camino, a beautician and hospitality worker, checks all the boxes of the demographic that has been targeted for advice in recent months by an array of columnists and authors, who have argued for the promotion and prioritizing of marriage, sometimes for the sake of overall happiness, but more often for the sake of children’s well-being.

She’s a 37-year-old single mother without a college degree. She cares deeply about her child’s happiness and about providing her with a good future. When I asked what she made of the advice to get married, though, she was skeptical. “I don’t think things are perfect like that,” she told me. She had planned to stay with the father, but that’s not how it happened. “I didn’t think he was gonna leave me like this,” she said.

The most recent wave of commenters have tended to position themselves as iconoclasts speaking hard truths: Two-parent families often result in better outcomes for kids, writes Megan McArdle, in The Washington Post, but “for various reasons,” she goes on, this “is too often left unsaid” — even though policy wonks, and the pundits who trumpet their ideas, have been telling (straight) people to get married for the sake of their children for decades. Brad Wilcox of the Institute for Family Studies, who recently scoffed at “the notion that love, not marriage, makes a family,” has a forthcoming book titled “Get Married: Why Americans Must Defy the Elites, Forge Strong Families, and Save Civilization.” All of these scolds typically rely on the same batch of academic studies, now compiled by economist Melissa Kearney in her new book “The Two-Parent Privilege: How Americans Stopped Getting Married and Started Falling Behind,” which show that kids with two parents fare better on a variety of life outcomes than those raised by single parents, who are overwhelmingly women.

This may well be true. But harping on people to get married from high up in the ivory tower fails to engage with the reality on the ground that heterosexual women from many walks of life confront: that is, the state of men today. Having written about gender, dating, and reproduction for years, I’m struck by how blithely these admonitions to get married skate over people’s lived experience. A more granular look at what the reality of dating looks and feels like for straight women can go a long way toward explaining why marriage rates are lower than policy scholars would prefer.

On the rare occasions that women are actually asked about their experiences with relationships, the answers are rarely what anyone wants to hear. In the late 1990s, the sociologists Kathryn Edin and Maria Kefalas interviewed 162 low-income single mothers in Camden, N.J., and Philadelphia to understand why they had children without being married. “Money is seldom the primary reason” why mothers say they are no longer with their children’s fathers. Instead, mothers point to “far more serious” offenses: “It is the drug and alcohol abuse, the criminal behavior and consequent incarceration, the repeated infidelity, and the patterns of intimate violence that are the villains looming largest in poor mothers’ accounts of relational failure.”

But it doesn’t take behavior this harmful to discourage marriage; often, simple compatibility or constancy can be elusive. Ms. Camino, for her part, has dabbled in dating since her partner left, but hasn’t yet met anyone who shares her values, someone who’s funny and — she hesitates to use the word “feminist” — but a man who won’t just roll his eyes and say something about being on her period whenever she voices an opinion. The last person she went out with “ghosted” her, disappearing without warning after four months of dating. “There are women that are just out here trying, and the men aren’t ready,” she told me. “They don’t care, most of them.” Who, exactly, is Ms. Camino supposed to marry?

For as long as people have been promoting marriage, they have also been observing that a good man is hard to find (see: William Julius Wilson, or early Nora Ephron). But what was once dismissed as the complaint of “picky” women is now supported by a raft of data. The same pundits plugging marriage also bemoan the crisis among men and boys, what has come to be known as “male drift” — men turning away from college, dropping out of the work force, or failing to look after their health. Ms. Kearney, for example, acknowledges that improving men’s economic position, especially men without college degrees, is an important step toward making them more attractive partners.

But even this nod ignores the qualitative aspect of the dating experience — the part that’s hard to cover in surveys, or address with policy. Daniel Cox, a senior fellow at the American Enterprise Institute who recently surveyed more than 5,000 Americans about dating and relationships, found that nearly half of college-educated women said they were single because they had trouble finding someone who meets their expectations, versus one-third of men. The in-depth interviews, he said, “were even more dispiriting.” For a variety of reasons — mixed messages from the broader culture about toughness and vulnerability, the activity-oriented nature of male friendships — it seems that by the time men begin dating, they are relatively “limited in their ability and willingness to be fully emotionally present and available,” he said.

Navigating interpersonal relationships in a time of evolving gender norms and expectations “requires a level of emotional sensitivity that I think some men probably just lack, or they don’t have the experience,” he added. He had recently read about a high school creative writing assignment in which boys and girls were asked to imagine a day from the perspective of the opposite sex. While girls wrote detailed essays showing they had already spent significant time thinking about the subject, many boys simply refused to do the exercise, or did so resentfully. Mr. Cox likened that to heterosexual relationships today: “The girls do extra and the boys do little or nothing.”

Marriage proponents often contrast the stable relationship patterns of the college-educated with the instability of the less-educated, but a bachelor’s degree is hardly a guarantee of a ring. The Yale anthropologist Marcia Inhorn’s recent book, “Motherhood on Ice: The Mating Gap and Why Women Freeze Their Eggs,” argues that educated women freeze their eggs because they’re unable to find a suitable male partner: Ms. Inhorn points to a large gap in the number of college-educated women versus college-educated men during their reproductive years — on the order of several million.

But Ms. Inhorn’s book goes beyond these quantitative mismatches to document the qualitative experience of women who are actively searching for partners — the frustration, hurt and disappointment. “Almost without exception,” she writes, “women in this study were ‘trying hard’ to find a loving partner,” mostly through dating sites and apps. Women in their late 30s reported “online ageism,” others described removing their Ph.D from their profiles so as not to intimidate potential dates; still others found that men were often commitment-averse.

The behaviors were ubiquitous enough that Ms. Inhorn compiled a sort of taxonomy of cads, such as the “Alpha males” who “want to be challenged by work, not by their partners” or the “Polyamorous men” who claim “that their multiple attachments to women are all ‘committed.’” Her breakdown — table 1.1 in the book — reads like a rigorous academic version of all the complaints you’ve ever heard from your single female friends.

One of these friends, with whom I went to college, would like nothing more than to be married. She’s beautiful and successful, and not, as far as I can tell, overly “picky.” She has had long-term relationships in the past, and cherishes the intimacy and stability they provide. To that end, she keeps a post-it note on a bulletin board. On it, she has drawn out 10 lines of 10 circles each. Every time she goes on a date with someone new, she fills in a circle. She’s committed to going on at least a hundred dates as she searches for a male partner with whom she can have a family. In two years, she’s filled in nearly half of the circles, and she’s still single. It’s like an SAT test form where every answer is incorrect. When she asks her male friends to set her up with their friends, they consistently tell her that no one they know would be good enough for her. “It’s like, how bad are you guys?” she marvels.

To be sure, many men are fantastic people and partners, and I’m sure many women are loathsome, creepy or otherwise disrespectful. Many of us know these terrific men — they’re our friends, our relatives, our colleagues — and would love to meet someone similar. Relationships are an important part of life; companionship is lovely and a natural human desire. But rather than chiding people (mostly women, mostly single moms) to get married “for the children,” how about a little empathy that we’re living through a juncture where various forces at play have made meaningful companionship hard to find?

There are policy solutions that can help everyone: family allowances to curb child poverty, child care to support working and single parents, retraining out-of-work men, higher ed reform for people who want to attend college but can’t afford the cost. In the process, these policies might encourage marriage by providing economic stability. But to truly address the decline in heterosexual marriage, we must attend to the details — to acknowledge the qualitative aspects of relationship formation. And, in particular, we should listen to the experiences of women who are attempting to find partners. We should care about the interior lives, not just the educational attainment or the employment status, of the men who could be those partners.

All of this is a much trickier proposition, with no clear policy solution in sight. It requires taking the stories of single women seriously, and not treating them as punchlines — something for which there is little historical precedent, but which a handful of scholars are slowly beginning to do. But unless we pay attention to the granular experiences of people in the dating trenches, simply advising people to marry is not only, frankly, obnoxious for the many women out there trying — it’s also just not going to work.

I Have Never Been to This Israel Before

The New York Times – Opinion

I Have Never Been to This Israel Before

By Thomas L. Friedman – November 9, 2023

A soldier in combat gear walks toward a concrete wall blocking a road. — Credit…Amir Levy/Getty Images

People warned me before I came to Tel Aviv a few days ago that the Israel of Oct. 7 is an Israel that I’ve never been to before. They were right. It is a place in which Israelis have never lived before, a nation that Israeli generals have never had to protect before, an ally that America has never had to defend before — certainly not with the urgency and resolve that would lead a U.S. president to fly over and buck up the whole nation.

After traveling around Israel and the West Bank, I now understand why so much has changed. It is crystal clear to me that Israel is in real danger — more danger than at any other time since its War of Independence in 1948. And it’s for three key reasons:

First, Israel is facing threats from a set of enemies who combine medieval theocratic worldviews with 21st-century weaponry — and are no longer organized as small bands of militiamen but as modern armies with brigades, battalions, cybercapabilities, long-range rockets, drones and technical support. I am speaking about Iranian-backed Hamas, Hezbollah, Islamic militias in Iraq and the Houthis in Yemen — and now even the openly Hamas-embracing Vladimir Putin. These foes have long been there, but all of them seemed to surface together like dragons during this conflict, threatening Israel with a 360-degree war all at once.

How does a modern democracy live with such a threat? This is exactly the question these demonic forces wanted to instill in the mind of every Israeli. They are not seeking a territorial compromise with the Jewish state. Their goal is to collapse the confidence of Israelis that their defense and intelligence services can protect them from surprise attacks across their borders — so Israelis will, first, move away from the border regions and then they will move out of the country altogether.

I am stunned by how many Israelis now feel this danger personally, no matter where they live — starting with a friend who lives in Jerusalem telling me that she and her husband just got gun licenses to have pistols at home. No one is going to snatch their children and take them into a tunnel. Hamas, alas, has tunneled fear into many, many Israeli heads far from the Gaza border.

The second danger I see is that the only conceivable way that Israel can generate the legitimacy, resources, time and allies to fight such a difficult war with so many enemies is if it has unwavering partners abroad, led by the United States. President Biden, quite heroically, has been trying to help Israel with its immediate and legitimate goal of dismantling Hamas’s messianic terrorist regime in Gaza — which is as much a threat to the future of Israel as it is to Palestinians longing for a decent state of their own in Gaza or the West Bank.

But Israel’s war against Hamas in Gaza entails urban, house-to-house fighting that creates thousands of civilian casualties — innocent men, women and children — among whom Hamas deliberately embedded itself to force Israel to have to kill those innocents in order to kill the Hamas leadership and uproot its miles of attack tunnels.

But Biden can sustainably generate the support Israel needs only if Israel is ready to engage in some kind of a wartime diplomatic initiative directed at the Palestinians in the West Bank — and hopefully in a post-Hamas Gaza — that indicates Israel will discuss some kind of two-state solutions if Palestinian officials can get their political house unified and in order.

This leads directly to my third, deep concern.

Israel has the worst leader in its history — maybe in all of Jewish history — who has no will or ability to produce such an initiative.

Worse, I am stunned by the degree to which that leader, Prime Minister Benjamin Netanyahu, continues to put the interests of holding on to the support of his far-right base — and pre-emptively blaming Israel’s security and intelligence services for the war — ahead of maintaining national solidarity or doing some of the basic things that Biden needs in order to get Israel the resources, allies, time and legitimacy it needs to defeat Hamas.

Biden cannot help Israel build a coalition of U.S., European and moderate Arab partners to defeat Hamas if Netanyahu’s message to the world remains, in effect: “Help us defeat Hamas in Gaza while we work to expand settlements, annex the West Bank and build a Jewish supremacist state there.”

Let’s drill down on these dangers.

Last Saturday night, a retired Israeli Army commander stopped by my hotel in Tel Aviv to share his perspective on the war. I took him to the 18th-floor executive lounge for our chat, and when we got into the elevator to go up, we joined a family of four — two parents, a toddler and a baby in a stroller. The Israeli general asked them where they were from. “Kiryat Shmona,” the father answered.

As we stepped out, I joked with the general that he could dispense with his briefing. It took just 18 floors and those two words — “Kiryat Shmona” — to describe Israel’s wickedly complex new strategic dilemma created by the surprise Hamas attack of Oct. 7.

Kiryat Shmona is one of the most important Israeli towns on the border with Lebanon. That father said his family had fled the northern fence line with thousands of other Israeli families after the pro-Iranian Hezbollah militia and Palestinian militias in southern Lebanon began lobbing rockets and artillery and making incursions in solidarity with Hamas.

When might they go back? They had no idea. Like more than 200,000 other Israelis, they have taken refuge with friends or in hotels all across this small country of nine million people. And it has taken only a few weeks for Israelis to begin driving up real estate prices in seemingly safer central Israeli towns. For Hezbollah, that alone is mission accomplished, without even invading like Hamas. Together, Hezbollah and Hamas are managing to shrink Israel.

On Sunday I drove down to a hotel on the Dead Sea to meet some of the hundreds of surviving members of Kibbutz Be’eri, which had some 1,200 residents, including 360 children. It was one of the communities hardest hit by the Hamas onslaught — suffering more than 130 murders in addition to scores of injured and multiple kidnappings of children and elderly. The Israeli government has moved most survivors of the kibbutz across the country to the Dead Sea, where they are now starting their own schools in a hotel ballroom.

I asked Liat Admati, 35, a survivor of the Hamas attack who ran a clinic for facial cosmetics for 11 years in Be’eri, what would make it possible for her to go back to her Gaza border home, where she was raised.

“The main thing for me to go back is to feel safe,” she said. “Before this situation, I felt I have trust in the army. Now I feel the trust is broken. I don’t want to feel that we are covering ourselves in walls and shelters all the time while behind this fence there are people who can one day do this again. I really don’t know at this point what the solution is.”

Before Oct. 7, she and her neighbors thought the threat was rockets, she said, so they built safe rooms, but now that Hamas gunmen came over and burned parents and kids in their safe rooms, who knows what is safe? “The safe room was designed to keep you safe from rockets, not from another human who would come and kill you for who you are,” she said. What is most dispiriting, she concluded, is that it appears that some Gazans who worked on the kibbutz gave Hamas maps of the layout.

There are a lot of Israelis who listened to the recording, published by The Times of Israel, of a Hamas gunman who took part in the Oct. 7 onslaught, identified by his father as Mahmoud, calling his parents from the phone of a Jewish woman he’d just murdered and imploring them to check his WhatsApp messages to see the pictures he took of some of the 10 Jews he alone killed in Mefalsim, a kibbutz near the Gaza border.

“Look how many I killed with my own hands! Your son killed Jews,” he says, according to an English translation. “Mom, your son is a hero,” he adds. His parents can be heard seemingly rejoicing.

This kind of chilling exuberance — Israel was built so that such a thing could never happen — explains the homemade sign I saw on a sidewalk while driving through the French Hill Jewish neighborhood of Jerusalem the other day: “It’s either us or them.’’

The euphoric rampage of Oct. 7 that killed some 1,400 soldiers and civilians has not only hardened Israeli hearts toward the suffering of Gaza civilians. It has also inflicted a deep sense of humiliation and guilt on the Israeli Army and defense establishment, for having failed in their most basic mission of protecting the country’s borders.

As a result, there is a conviction in the army that it must demonstrate to the entire neighborhood — to Hezbollah in Lebanon, to the Houthis in Yemen, to the Islamic militias in Iraq, to the Hamas and other fighters in the West Bank — that it will stop at nothing to re-establish the security of the borders. While the army insists that it is hewing to the laws of war, it wants to show that no one can outcrazy Israel to drive its people from this region — even if the Israeli military has to defy the U.S. and even if it does not have any solid plan for governing Gaza the morning after the war.

As Israel’s defense minister, Yoav Gallant, told reporters on Wednesday: “Israel cannot accept such an active threat on its borders. The whole idea of people living side by side in the Middle East was jeopardized by Hamas.”

This conflict is now back to its most biblical and primordial roots. This seems to be a time of eyes for eyes and teeth for teeth. The morning-after policy thinking will have to wait for the mourning after.

Which is why I so worry about the leadership here today. I was traveling around the West Bank on Tuesday when I heard that Netanyahu had just told ABC News that Israel plans to retain “overall security responsibility” in Gaza “for an indefinite period” after its war with Hamas.

Really? Consider this context: “According to Israel’s official Central Bureau of Statistics, at the end of 2021, 9.449 million people live in Israel (including Israelis in West Bank settlements), the Times of Israel reported last year. “Of those, 6.982 million (74 percent) are Jewish, 1.99 million (21 percent) are Arab, and 472,000 (5 percent) are neither. The Palestinian Bureau of Statistics puts the West Bank Palestinian population at a little over three million and the Gaza population at just over two million.”

So Netanyahu is saying that seven million Jews are going to indefinitely control the lives of five million Palestinians in the West Bank and Gaza — while offering them no political horizon, nothing, by way of statehood one day on any demilitarized conditions.

Early on the morning of Oct. 29, as the Israeli Army was just moving into Gaza, Netanyahu posted and then deleted a message on social media in which he blamed Israel’s defense and intelligence establishment for failing to anticipate Hamas’s surprise attack. (Netanyahu somehow forgot how often the Israeli military and intelligence leaders had warned him that his totally unnecessary coup against the country’s judicial system was fracturing the army and Israel’s enemies were all noticing its vulnerability.)

After being slammed by the public for digitally stabbing his army and intelligence chiefs in the back in the middle of a war, Netanyahu published a new post. “I was wrong,” he wrote, adding that “the things I said following the press conference should not have been said, and I apologize for that. I fully support the heads of [Israel’s] security services.”

But the damage was done. How much do you suppose those military leaders trust what Netanyahu will say if the Gaza campaign stalls? What real leader would behave that way at the start of a war of survival?

Let me not mince words, because the hour is dark and Israel, as I said, is in real danger. Netanyahu and his far-right zealots have taken Israel on multiple flights of fancy in the last year: dividing the country and the army over the fraudulent judicial reform, bankrupting its future with massive investments in religious schools that teach no math and in West Bank Jewish settlements that teach no pluralism — while building up Hamas, which would never be a partner for peace, and tearing down the Palestinian Authority, the only possible partner for peace.

The sooner Israel replaces Netanyahu and his far-right allies with a true center-left-center-right national unity government, the better chance it has to hold together during what is going to be a hellish war and aftermath. And the better chance that Biden — who may be down in the polls in America but could get elected here in a landslide for the empathy and steel he showed at Israel’s hour of need — will not have hitched his credibility and ours to a Netanyahu Israel that will never be able to fully help us to help it.

This society is so much better than its leader. It is too bad it took a war to drive that home. Ron Scherf is a retired member of Israel’s most elite special forces unit and a founder of Brothers in Arms, the Israeli activist coalition that mobilized veterans and reservists to oppose Netanyahu’s judicial coup. Immediately after the Hamas invasion,

Hillary Clinton visits “The View”, says Donald Trump winning in 2024 would be the ‘end of our country’

Entertainment

Hillary Clinton visits “The View”, says Donald Trump winning in 2024 would be the ‘end of our country’

Joey Nolfi – November 8, 2023

“The wreckage is almost unimaginable,” Clinton said on The View.

Hillary Clinton brought a premonition of the United States’ decimation when she visited The View for a summit on current events.

The former Secretary of State stopped by the show Wednesday for a multi-segment interview, during which cohost Sunny Hostin told Clinton that her 2016 election loss to Donald Trump would go down as “one of the most pivotal moments” in U.S. history, and asked the politician to comment on Trump’s potential re-election in 2024 despite multiple indictments against him.

“I can’t even think that, because I think it would be the end of our country as we know it, and I don’t say that lightly. I hated losing, and I especially hated losing to him because I’d seen so many warning signals during the campaign,” Clinton replied, adding that she tried to support Trump as the leader of the country. “Literally, from his inauguration on, it was nothing but accusing people of things, making up facts, denying the size of the crowd at his own inauguration. Everything I worried about, I saw unfolding.”

She said the warning signs are “even worse now” and speculated that he was “restrained” by those around him during his first term from 2016 through 2020 because “they stood up to him.”

The camera then cut to View star Alyssa Farah Griffin, who worked for Trump’s communications team before resigning — and subsequently spoke out against her former boss in 2020.

ABC Hillary Clinton on 'The View' — *ABC Hillary Clinton on ‘The View’*

Clinton went on to predict that, if Trump regained control of the White House, his administration would be filled with “people who have no principles, no conscience, who are totally tied to his fortunes, literally, and therefore would do whatever he said,” she observed. “The wreckage is almost unimaginable.”

The 76-year-old finished her thought by comparing Trump to Adolf Hitler, who was “duly elected” in Germany, Clinton said, as well as other authoritarian and dictatorial leaders in history.

Unlike Trump, though, Clinton stressed that those figures “didn’t usually telegraph” their intentions at first, she stressed. “Trump is telling us what he intends to do. Take him at his word. The man means to throw people in jail who disagree with him, shut down legitimate press outlets, do what he can to undermine the rule of law and country’s values.”

Before throwing the show to commercial, moderator Whoopi Goldberg referenced Trump’s ongoing criminal woes — which he has consistently pushed back against and called a “witch hunt” against him — telling the audience that “he’s not going to do a whole bunch of stuff right now” as he’s tied up in a legal web.

At a live speaking event in New York City in October, Griffin and fellow ex-Trump associate Cassidy Hutchinson, who testified during the House investigation into the Capitol insurrection on Jan. 6, 2021, warned their fellow Republicans about electing Trump in 2024, amid polls indicating that the ex-Apprentice TV host is the party’s leading candidate.

“I think it’s the responsibility of every American to make sure his name is not on the Republican ticket,” Hutchinson said, later adding: “If Donald Trump were to be elected to a second term in office, I fear for the future of our country, I fear for the future of our democracy.” (Trump’s office did not respond to EW’s request for comment.)

Mind-altering ketamine becomes latest pain treatment, despite little research or regulation

Associated Press

Mind-altering ketamine becomes latest pain treatment, despite little research or regulation

Matthew Perrone – November 6, 2023

Dr. Padma Gulur, a Duke University pain specialist, stands for a portrait on Friday, Oct. 27, 2023, in Durham, N.C. Prescriptions for ketamine have soared in recent years as doctors adopt the mind-altering drug as an alternative pain treatment. Gulur and other specialists see potential for ketamine as a pain therapy, but warn it also carries risks of safety and abuse. (AP Photo/Matt Kelley)

Medical equipment used to customize ketamine infusions for patients is seen at the Duke Specialty Infusion Center, Friday, Oct. 27, 2023, in Durham, N.C. Ketamine prescriptions have soared in recent years as an alternative to opioids for pain. But with little research on its effectiveness, some experts worry about the risks of overprescribing another powerful drug that carries risks of safety and abuse. (AP Photo/Matt Kelley)

The Duke Specialty Infusion Center is seen prior to opening for patients, Friday, Oct. 27, 2023, in Durham, N.C. Ketamine prescriptions have soared in recent years as an alternative to opioids for pain. But with little research on its effectiveness, some experts worry about the risks of overprescribing another powerful drug that carries risks of safety and abuse. (AP Photo/Matt Kelley)

Saline fluid runs through a tube demonstrating how ketamine would be administered to a patient at the Duke Speciality Infusion Center on Friday, Oct. 27, 2023, in Durham, N.C. Ketamine prescriptions have soared in recent years as an alternative to opioids for pain. But with little research on its effectiveness, some experts worry about the risks of overprescribing another powerful drug that carries risks of safety and abuse. (AP Photo/Matt Kelley)

A lockbox is held to show where ketamine is placed into while administered at the Duke Speciality Infusion Center, Friday, Oct. 27, 2023, in Durham, N.C. Ketamine prescriptions have soared in recent years as an alternative to opioids for pain. But with little research on its effectiveness, some experts worry about the risks of overprescribing another powerful drug that carries risks of safety and abuse. (AP Photo/Matt Kelley)

WASHINGTON (AP) — As U.S. doctors scale back their use of opioid painkillers, a new option for hard-to-treat pain is taking root: ketamine, the decades-old surgical drug that is now a trendy psychedelic therapy.

Prescriptions for ketamine have soared in recent years, driven by for-profit clinics and telehealth services offering the medication as a treatment for pain, depression, anxiety and other conditions. The generic drug can be purchased cheaply and prescribed by most physicians and some nurses, regardless of their training.

With limited research on its effectiveness against pain, some experts worry the U.S. may be repeating mistakes that gave rise to the opioid crisis: overprescribing a questionable drug that carries significant safety and abuse risks.

“There’s a paucity of options for pain and so there’s a tendency to just grab the next thing that can make a difference,” said Dr. Padma Gulur, a Duke University pain specialist who is studying ketamine’s use. “A medical journal will publish a few papers saying, ‘Oh, look, this is doing good things,’ and then there’s rampant off-label use, without necessarily the science behind it.”

When Gulur and her colleagues tracked 300 patients receiving ketamine at Duke, more than a third of them reported significant side effects that required professional attention, such as hallucinations, troubling thoughts and visual disturbances.

Ketamine also didn’t result in lower rates of opioid prescribing in the months following treatment, a common goal of therapy, according to Gulur. Her research is under review for medical journal publication.

PSYCHEDELIC EXPERIENCE

Ketamine was approved more than 50 years ago as a powerful anesthetic for patients undergoing surgery. At lower doses, it can produce psychedelic, out-of-body experiences, which made it a popular club drug in the 1990s. With its recent adoption for pain, patients are increasingly encountering those same effects.

Daniel Bass, of Southgate, Kentucky, found the visual disturbances “horrifying.” His doctors prescribed four- to six-hour IV infusions of ketamine for pain related to a rare bone and joint disorder. Seated in a bare hospital room with no stimulation or guidance on the drug’s psychological effects, Bass says he felt “like a lab rat.”

Still, he credits ketamine with reducing his pain during the year that he received twice-a-month infusions.

“No matter how horrific an experience is, if it allows me to be more functional, I will do it,” Bass said.

Ketamine targets a brain chemical messenger called glutamate, which is thought to play a role in both pain and depression. It’s unclear whether the psychedelic experience is part of the drug’s therapeutic effect, though some practitioners consider it essential.

“We want patients to disassociate or feel separate from their pain, depression or anxiety,” said Dr. David Mahjoubi, owner of Ketamine Healing Clinic in Los Angeles. “If they feel like they’re just sitting in the chair the whole time, we actually give them more.”

Mahjoubi’s practice is typical of the burgeoning industry: He offers IV ketamine for alcohol addiction, chronic pain, anxiety and post-traumatic stress disorder. The ketamine doses for those indications are well below those used for surgery, but Mahjoubi favors higher doses for pain than for psychiatric conditions.

Patients pay cash because most insurers don’t cover non-surgical uses of ketamine, none of which are approved by the Food and Drug Administration. Mahjoubi’s background is in anesthesiology, not psychiatry or addiction.

Patients can pay extra for ketamine nasal sprays and tablets to use between infusions. Those formulations are also not FDA approved and are compounded by specialty pharmacies.

Sending ketamine through the mail has become its own profitable business for telehealth services, such as MindBloom, which jumped into the space after regulators relaxed online prescribing rules during COVID-19.

Pain specialists who study ketamine say there’s little evidence for those versions.

“The literature for the nasal and oral formulations is pretty scant,” said Dr. Eric Schwenk of Thomas Jefferson University. “There’s just not a lot of good evidence to guide you.”

Demand for ketamine has sent prescriptions soaring more than 500% since 2017, according to Epic Research, which analyzed the trend using a database of more than 125 million patients. In each year, pain was the No. 1 condition for which ketamine was prescribed, though depression has been rising quickly.

The prescribing boom has led to shortages of manufactured ketamine, driving up sales of compounded versions.

There is more evidence for ketamine’s use against depression than for pain. In 2019, the FDA approved a ketamine-related chemical developed by Johnson & Johnson for severe depression. The drug, Spravato, is subject to strict FDA safety rules on where and how it can be administered by doctors.

Guidelines from pain societies note some evidence for ketamine’s use in complex regional pain, a chronic condition that usually affects the limbs. But the experts found “weak or no evidence” for ketamine in many more conditions, including back pain, migraines, fibromyalgia and cancer pain.

THE ‘WILD WEST’ OF KETAMINE PRESCRIBING

While the science behind ketamine is murky, the business model is clear: Physicians can purchase ketamine for less than $100 a vial and charge $500 to $1,500 per infusion.

The recent boom has been fueled, in part, by venture capital investors. Another set of consulting businesses offer to help doctors set up new clinics.

A blog post from one, Ketamine Startup, lists “Five reasons you should open a ketamine clinic,” including: “You want to be your own boss” and “You want to take control of your money-making ability.”

The clinics are facing increasing competition from telehealth services like MindBloom and Joyous, which connect potential patients with physicians who can prescribe ketamine remotely and send it through the mail.

In May, federal regulators were scheduled to roll back the COVID-era policy that allowed online prescribing of high-risk drugs like ketamine and opioids. But the Drug Enforcement Administration, facing backlash for telehealth companies and physicians, agreed to extend the flexible approach through 2024.

The current landscape is a “wild west,” said Dr. Samuel Wilkinson, a Yale University psychiatrist who prescribes both Spravato and ketamine for depression. U.S. physicians have “quite a bit of latitude” to prescribe drugs for unapproved, or off-label, uses.

“There’s good things about that and not-so-good things about that,” he said.

When used at high doses, ketamine can cause bladder damage, sometimes seen in people who use the drug recreationally. Far less is known about the neurological effects of long-term use. Ketamine was linked to brain abnormalities in rat studies, FDA regulators note.

Last month, the FDA warned doctors and patients against compounded versions of ketamine, including lozenges and pills, saying the agency does not regulate their contents and cannot assure their safety. The warning followed a similar advisory last year about nasal spray versions of ketamine.

But most compounding pharmacies are small operations, overseen by state officials, not the FDA.

In April, Massachusetts’ board of pharmacy flagged the FDA’s warning to local pharmacies, but noted that state officials wouldn’t take any steps to stop “the continued compounding and dispensing of ketamine nasal spray.”

The FDA likewise has little leverage over physicians promoting ketamine, even those making exaggerated or misleading claims.

Drugmakers are subject to strict FDA regulation in how they promote their medicines — with requirements to balance risk and benefit information. Those rules don’t apply to physicians.

Even when the FDA has tried to regulate risky in-office procedures, such as unproven stem cell infusions, the agency has had a mixed track record of prevailing in court.

For now, experts say it’s unlikely regulators will go beyond their recent warnings about off-label ketamine.

“There’s an element of whack-a-mole and it’s essentially beyond their regulatory purview,” said Dr. Caleb Alexander, a drug safety researcher at Johns Hopkins University. “These clinics would represent yet another front that they would be hard pressed to manage and address.”

The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Science and Educational Media Group. The AP is solely responsible for all content.

Startup wants to dump planet-saving substance on beaches and in ocean to help clear the air — could it work?

The Cool Down

Startup wants to dump planet-saving substance on beaches and in ocean to help clear the air — could it work?

Susan Elizabeth Turek – November 7, 2023

Ocean waters are already an abundant resource in the battle for clean air, and San Francisco-based startup Vesta hopes to utilize another substance on our beaches and in the ocean to remove 1 billion tons of carbon pollution annually.

Bloomberg reported that the potentially planet-saving substance is olivine, a mineral that removes carbon dioxide (CO2) as part of the natural process that occurs when it dissolves in seawater.

According to IEAGHG, which funds the research and development of carbon capture and storage (CCS) technology, CCS has been around since the 1920s, yet there were only five major CCS projects globally about a decade ago.

Since then, the potential for the technology has gained ground, with a number of new initiatives in development. Scientists are reportedly cautious, however, about investing too much hope in CCS.

Another potential roadblock to the plan? Cost.

The National Academy of Sciences projects it will take between $100 to $150 to remove just a single ton of CO2, per Bloomberg. Yet Vesta reportedly believes it could remove a ton of CO2 for only $21.

If that projection is accurate, the startup’s technology could go a long way in helping our planet.

Our oceans absorb about 31% of harmful carbon pollution. Unfortunately, that can also disrupt the natural balance of the environment and raise the acidity of the ocean, which can harm shellfish, corals, and other marine life, as well as people who rely on fisheries.

Research is ongoing to determine whether dumping large amounts of olivine in the environment would have any negative impacts, but so far, Vesta has discovered “no adverse ecological effect whatsoever” at a test beach in New York’s Hamptons, as Tom Green, Vesta’s CEO, told Bloomberg.

In order to further expand the application of its carbon-capture technology, the startup is reportedly eyeing the Hajar Mountains, which frame the coast of Oman and the United Arab Emirates.

The range has one of the largest deposits of olivine globally, Bloomberg reports, and Vesta believes the warm waters of the region could increase the efficiency of its technology.