Something to watch out for - the first time I tried a ketogenic diet, I developed a terrible rash on my torso after three weeks. After a few fruitless trips to the dermatologist, I found that it was very possibly something called prurigo pigmentosa, a rash that tends to occur in people fasting or in ketosis. Someone even set up a website about it - www.theketorash.com. It's unfortunate, as I had been successfully losing weight. No one really knows how to treat it, except for, well, eating more carbs.
In a similar vein, I got an entire bottle of vicodin prescribed to me after having Lasik surgery. There was virtually no pain, merely discomfort similar to having a dirty contact lens in your eye, which went away after a day. I never used any of the vicodin.
I don't get this mentality at all. I would guess a majority of adults in the US have had Vicodin or similar and I don't know anyone personally who ever got addicted.
In some it causes nausea. You don't like it, fine. But I don't understand how people can be so pro marijuana on one hand, and so anti-opiates on the other. It's pain. It's not noble to suffer needlessly.
It's complete BS that it's harder for a dentist to prescribe a dozen Vicodin after a root canal these days. Or that many doctors will try to pass off 800mg of ibuprofen as a substitute for Vicodin for throwing you back out. That turns a couple of days of "be careful and taken it easy" into a couple of days of laying around on the couch in pain instead.
These drugs are inexpensive, very effective for short term pain management, and the vast majority of people have mild to no side effects, and almost no one has an addiction issue from using them.
It feels like the modern equivalent of Reefer Madness.
> But I don't understand how people can be so pro marijuana on one hand, and so anti-opiates on the other. It's pain. It's not noble to suffer needlessly.
Weed is not addictive, or even if it is in some people, to nowhere near the same level as opiates. It's also not responsible for thousands of overdose cases per year. It seems to me that THC pills would be better for pain management in these situations than opiate pills.
I also don't think you have much personal experience people who have been addicted to opiates. I have. It's not pretty. It's certainly worse than people who are merely potheads. The potheads I knew, when their source dried up or they ran out of money, were irritated, but were otherwise whole, and just waited until they could get their hands on more weed again. People addicted to opiates suffer severe withdrawal, and will do anything to get more pills. They can't simply stop using for a week.
Weed is not physically addictive like opiates are, but people do become psychologically dependent upon it to avoid dealing with stress and anxiety in healthier ways. And it can become difficult to stop if you haven't resolved the underlying problems that you're treating with it.
> I also don't think you have much personal experience people who have been addicted to opiates.
I said as much. Which is a good enough reason to be suspicious of prohibition for me.
And to be clear, I'd find it very difficult to believe anyone gets a two week supply of opiates after surgery and goes all Reefer Madness after following the directions on the prescription. You're talking about people who abuse the drug. Most people who drink don't become alcoholics.
Now maybe you also want to abolish alcohol, in that case I just don't see any common ground.
I've tried pot for a migraine before and it only made me more nauseous. I'd be willing to try it for other types of pain but it certainly wouldn't be my first choice. I find the side effects mostly unpleasant.
I find opiates far more effective at relieving pain (tooth, back, eye pain after PRK surgery, mouth surgery after a car accident), with the fewest side effects. (I've only had light nausea once.) Running out of medication at the end of a course is a non-issue (I actually almost never finish it), and I notice lower levels of impairment than even a single beer.
But I don't abuse it. I take the larger dosage (500 vs 325? I forget exactly), in a maximum of 4 hour intervals (IIRC), and usually whatever the reason for taking them has subsided to the point ibuprofen alone works fine after about 48-hours.
And you would suggest that should end, without a viable alternative, because some other people abuse it? That seems like a very puritanical position to me.
> You're talking about people who abuse the drug. Most people who drink don't become alcoholics
The article is specifically about the effects of withdrawal when a 12 hour dose doesn't last 12 hours - when people are taking it by the prescribed schedule.
Exactly. The article rambles a bit, but the primary point is that when the effects wear off before the 12 hour interval but the patient keeps taking the drug as expected, it causes a cycle of pain and relief, which fosters addiction.
It's like you're suggesting marijuana has no negative downsides at all when millions of people risk their freedom on a routine basis to consume it. Physical/physiological, doesn't make much difference when you're sitting in a cell and your family's financial future is in jeopardy. And I do know some people like that. It is shockingly common.
I don't think drug users in general should be in jail. Even if I think in general people would be better off without them outside of a medical reason.
When you start restricting people's freedom because you think you know what's best for them, and inflict needless suffering in the process, I have a hard time telling you apart from any other prohibitionist.
One of these is not like the other, opioids cause a clinical chemical dependency very quickly (as mentioned by the article, if you 12 hour dose doesn't last the full 12 hours) while the [chemical dependency of marijuana](https://en.wikipedia.org/wiki/Cannabis_use_disorder) is much more subtle.
My point, which mirrored the point of the post to which I responded, wasn't that Vicodin wasn't useful in some cases. It was that it was overprescribed relative to the amount of pain of the particular procedure.
I find this isn't true at all. Especially after the new rules on it a couple years ago. What used to be routine now is looked at with suspicion IME.
And if you have any pain at all after a medical procedure, I see no good reason responsible adults need to suffer at all if there's an inexpensive, effective, safe treatment for the vast majority of them.
I'm not saying we should ban opioids. I have found them useful on occasion too. But to suggest there's no problem with people abusing them is not a helpful stance either.
I don't mean to suggest people abusing them isn't something to address. I just don't think the answer is to make it difficult or inconvenient for people who don't have that issue.
I suppose in the same way I think having to pick up Sudafed from the pharmacy these days is silly.
I'm not a libertarian by any stretch but for me this is a sort of sacrificing freedom for security issue. Assumption of guilt and pre-crime is bad and I don't see any reason why people should be forced to suffer needlessly after a medical procedure, even if it's only temporary, and even if someone else found the pain tolerable.
I got some of that crap years ago. I felt good for about a half an hour, then got really nauseas, which is not something you want after surgery. Switched to ibuprofen. Pre surgery morphine had the same effect. I am not a fan of opioids.
I'm fortunate to have the same problem with alcohol. I can get up to drunk (though I won't feel 100% the next day), but anything beyond that stage and I start to feel ill. Especially back in college, I remember other students regularly getting to stages well past drunk (e.g. "wasted", "trashed", "black-out", etc.), and enjoying it, but I only ever did a few times and was always completely miserable.
In the end it was just my body protecting itself from the stupidities of the brain running it.
The reason Apple's sales in China are slowing is not because of local favoritism. It has more to do with new iPhones being not much different than older models, much more expensive than similar hardware with Android, and competition (like Huawei, Xiaomi, Oppo, Samsung) catching up.
We have also the red queen problem of responding to increased capabilities by adding additional complexities. For example: faster processors and more memory haven't made computing incredibly fast because we add more features or simply more bloat. See also legal contracts, which before the days of word processing, were no more than a couple of pages, and now even simple contracts can be tens of pages and complex agreements can be hundreds of pages long.
Uber drivers get paid an amount based on a subsidy multiplier of the ride value, and they are highly sensitive to these multipliers. According to a driver I talked with recently, Uber takes 20% of the fare, but is currently giving drivers a bonus of about 2.5x. So if a fare is 10 rmb, Uber takes 2 rmb, then pays out 8 * 2.5 = 20rmb. Driving costs these drivers roughly 1-2 rmb/km, and if the subsidy ever fell below 1.3x, the drivers would lose money (these are for People's Uber level of cars, which is the lowest level). Unless the subsidy can ever drop below 1.25x, Uber will be paying for every ride. And if it does, drivers will be parking their cars or switching to another service.
Uber also lost a lot of money through a couple of vulnerabilities that have since been, I believe, patched. Some people were able to figure a way to create fake rides through the app, allowing drivers to get paid without ever driving anyone. They previously also allowed riders to link up Alipay accounts to their Uber accounts, but Uber had no way to ensure the Alipay accounts had funds. So people would take Uber with an empty account, and Uber would have to pay drivers without receiving any money from the riders.
Another side note: there was recently a publicity campaign with some well-known celebrities that had very explicit nationalistic messages encouraging Chinese citizens to use their local service and not the services of an outsider.
The hack needed an extra rooted android phone and a special 'helper' app. It also took advantage of the subsidy they give new users and the driver for new users. (I have no idea if this has been patched)
Another subsidy I heard about gave about $1000 per week if you had over 80 rides. $4000 dollar subsidy a month goes a long way in China.
It really blows my mind that people think this is a sustainable business. Even after you out-spend the competition, who's stopping someone from downloading a new app from a new service? I've seen users in China blast all ride apps at once and just take the first one to arrive. Subsidies won't buy loyalty.
I know there are big ethical problems with my "next step", but do you really care if you're killed by a murderer or a careless police officer? Or a careless safety inspection that leads to an accident?
Incompetence that leads to my wrongful conviction and death is probably just as likely as the incompetence that would lead to my death when I'm supposed to be protected. It's a hell of a lot less likely than the death of those whom I'm not-exactly being protected from, such as the countless victims of "collateral damage".
I'm on the ground here in China. Uber's used their tactic of going head-on against government and regulation when they started out here, and it didn't work. I think they underestimated the speed and ferocity of local competitors, and didn't put enough emphasis on the political savvy needed to get popular and government support. They've recently made some well-connected hires and partnered with some powerful allies like their investors here, but they are now playing catchup. I'd also be concerned that their connections are of the mercenary type, and would be less likely to take up Uber's cause at the expense of heightened political risk, if it came down to it.
Yeah, political mismanagement can even end in your employees getting hit by Chinese gangsters, your company losing their rent contract and webserver without reasons etc. On the other side, if you have government backing your competitors are no problem because they experience these "accidents".
His point about monopolies is widely misquoted and causing a lot of confusion. I think he should have been clearer about distinguishing creative monopolies and what we commonly consider monopolies, in the negative sense. There are nefarious monopolies like Comcast that are insulated from competition because of an unfair advantage. A more nuanced position should entail something like the following:
- We want competition because it allows nefarious monopolies (and other companies) to be overtaken by better companies.
- We don't want to discourage companies from attempting to obtain monopolies in their markets, since this gives them to opportunity to capture monopoly profits. Monopoly profits are not inherently bad. If a company becomes a monopoly, we want them to be a creative monopoly.
- A competitive market in the sense of having low profit margins is very different from a competitive market in the sense of whether or not new entrants can come in and compete.
- It is a bad thing if a company has monopoly power through something other than being a superior company, is capable of preventing new entrants, and is uncreative. We want to preserve the ability of new entrants to come into the market with superior products and overtake monopolies.
He's not misquoted. Read the WSJ op-Ed: http://www.wsj.com/articles/peter-thiel-competition-is-for-l.... He's not talking about companies that enjoy monopoly profits because they offer superior products. He's talking about companies that enjoy monopoly profits because they have no competitors. He does posit the "creative monopoly" companies that have no competitors because they're first to a new market. But that only lasts so long as there are barriers to entry in your market.[1] And now we're back to regular old Econ 101 monopolies. The "nefarious monopolies" I mentioned all came into existence through first mover advantage. But they endured because they were protected from competition. And much of their innovative legacy came well into their "static monopoly" phase.
[1] To use Thiel's terminology, it matters how quickly the market moves back into equillibrium, and that is dictated by the same forces that give rise to static monopolies.
He is talking about companies that enjoy monopoly profits because of superior products: "I'm not interested in illegal bullies or government favorites: By "monopoly," I mean the kind of company that is so good at what it does that no other firm can offer a close substitute."
Distinguishing between "good" and "bad" monopolies is sufficiently complex to deserve more in-depth exploration. Thiel is smart enough to realize that which is why I consider his point to be misquoted. Unfortunately, his view is oversimplified so as to be readily consumed and debated.
He lists characteristics of a monopoly in his book: proprietary tech, network effects, economies of scale, and branding. First mover advantage is mentioned as a "tactic, not a goal" - a chapter is even called "Last Mover Advantage." Google, for one, was clearly not a first mover in the search space.
