All posts by Tanner Hackney

Medical Marijuana Advocates Want More Research and Patient Rights

By Tanner Hackney

Last year on the day before Easter, Sarah (not her real name) felt a strong pins-and-needles sensation in her legs. She tried to pick up her feet, but couldn’t lift them. By the next day the sensation had risen to her ribcage. She had her brother touch her, but felt no sensation. She managed to step outside and her fear was affirmed.

“I didn’t know what it was, I just knew it wasn’t right,” Sarah said. “I stood barefoot on the concrete porch and I couldn’t feel cold.”

As she bounced between D.C. hospitals, Sarah had already accepted she had multiple sclerosis. Her mother had it and she knew it could be hereditary. It was no shock when the diagnosis came back positive. By the time she was out of the hospital, Sarah was experiencing muscle spasticity and severe pain. She needed a walker just to move short distances. She was on 14 pills at once, some of which were opioids, but they weren’t working.

“They didn’t actually fix me,” Sarah said. “They just put me to sleep.”

As soon as she got her diagnosis, Sarah had thought about using marijuana to treat her MS. Her family was hesitant, but after getting her hands on a joint, the effects became apparent immediately. It took her nearly half an hour to get down the stairs with her walker so she could go outside and smoke. When she was finished she had control over her body again.

“I noticed a big change,” Sarah said. “I went from not walking to going up and down the stairs.”

Sarah is now one of the two million plus patients across the United States enrolled in state medical marijuana programs, according to the Marijuana Policy Project, a lobbying group that works to end marijuana prohibition. There are currently 29 states, including D.C., that have legalized marijuana for medical purposes. Medical marijuana has become an increasingly growing trend, with public approval ratings higher than ever. According to a Yahoo News/Marist Poll report published in April, 83 percent of Americans legalizing the use of marijuana for medical purposes.

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But despite rising popularity, the medical marijuana movement still faces many issues.

A common source of hesitation to legalize medical marijuana is the relatively limited amount of research that has been done on the plant. In addition to current studies, many dispensaries and organizations rely on anecdotal evidence for proof of marijuana’s possible medical benefits. MPP is one of those organizations. Morgan Fox, their Director of Communications, said there’s enough evidence to prove marijuana has medical benefits, but MPP still wants more research conducted.

“We would argue that there’s not enough research to allow patients to take as full advantage of medical marijuana as they could,” said Fox. “All patients, as well as their doctors, could benefit from knowing a lot more about what the substance does and how it could be used.”

Jen Brunenkant is the owner of Herbal Alternatives, a medical marijuana dispensary in D.C. She wishes more research would be conducted so physicians, as well as her and her employees, could isolate different compounds in cannabis and identify what they may be best suited to treat. She also said physicians would be more comfortable recommending marijuana if they knew more about it. But Brunenkant has also seen marijuana’s health benefits first-hand, she said.

“I’ve seen it help across the spectrum,” Brunenkant said. “Anywhere from controlling autoimmune diseases, helping MS patients, cancer patients, anxiety, depression, and healing broken bones.”

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(Herbal Alternatives office building in Dupont Circle. Photo by Tanner Hackney)

Kevin Sabet, president of anti-legalization group Smart Approaches to Marijuana, agrees that there are certain properties from cannabis that have medical benefits. However, Sabet said states should not be legalizing marijuana without more scientific research.

“Medications should be determined by science rather than voted on,” Sabet said.

So many states have legalized medical marijuana because people are compassionate, Sabet said. He said the emotional appeal of the medical movement often overshadows the science and research side.

MPP has lobbied in several states where medical marijuana is now legal, and although Fox is confident in the research they currently have, he agrees much of public support is driven by human nature.

“There’s a compassion aspect,” Fox said. “It’s really hard to look at somebody who could be helped by this law and just say ‘No, no we’re not going to do that’.”

Sabet also sees issue with states opening medical marijuana dispensaries. He said other medications don’t have their own dispensaries and marijuana shouldn’t be an exception. Sabet said opening medical dispensaries often encourages the use of marijuana among recreational users and adolescents.

Fox, however, said there’s substantial evidence that teen use stays the same or decreases when states pass medical marijuana laws. According to an MPP report, 17 states have seen a decrease in teen use since medical legalization.

Brunenkant is also unconvinced by the idea that children and teens are being encouraged to seek out marijuana in response to medical legalization.

“To think that a dispensary wants kids, it’s so absurd, it boggles the mind,” Brunenkant said. “We’re here to help people who have a variety of conditions, including children who may be suffering 100-200 epileptic fits a day.”

The children that receive treatment at Herbal Alternatives must get their cannabis through their parents, who are required to register for a caregiver card.

As a dispensary owner, Brunenkant sees things from the patient perspective. One of her gripes with D.C.’s current medical policy is that dispensaries are not permitted to use cannabis on the premises. This means employees can’t demonstrate how to consume cannabis through the various methods they offer. Brunenkant said this is difficult when new patients are unfamiliar with how to properly consume marijuana. She recalls several patients returning with vaporizers complaining they weren’t working properly, when really the patients were simply unaware of how to use them.

However, a new bill proposed by D.C. Councilmember David Grosso may offer a solution to this issue. The Medical Marijuana Improvement Amendment Act is intended to reduce the limitations of access to medical marijuana, Grosso said. The bill would allow D.C. dispensaries to permit consumption on the premises. It would also allow any D.C. resident over the age of 21 to self-certify, signing an affidavit promising to use marijuana for medical purposes. This would give patients access to medical marijuana without a physician’s recommendation.

The bill was presented before D.C.’s Council on Health at a public hearing on Nov. 9.

“That was a good start,” said Grosso. “Everyone in the industry recognizes the need to access medical marijuana.”

But not everyone is on board with the bill.  Brunenkant is worried about self-certification. Her concern is that this aspect of the bill would undermine current legislation and bring unwanted attention from the Department of Justice.

“The self-certification, I’m kind of torn about, because it endangers the medical program,” Brunenkant said. “We are in the justice department’s backyard.”

Brunenkant said she supports the portion of the bill that would allow safe consumption in the dispensary. Not only would it allow her and her employees to demonstrate the use of different consumption methods, but it would also give patients who can’t consume marijuana where they live a safe haven to medicate, said Brunenkant.

Sarah is one of the patients who could benefit from this aspect of the bill. She lives with her grandmother, who won’t let her smoke in the house. Typically, she steps outside to smoke, but she likes the idea of having a safe place to medicate.

Other patients are harder pressed to find places where they can smoke or otherwise consume marijuana. It is illegal to use marijuana in Section 8 housing, so residents enrolled in the medical program take a risk by medicating in their homes. Brunenkant worries about her patients who live in such housing, as well as general rental units, where marijuana consumption is typically illegal. She said these patients are afraid to smoke marijuana in their apartments, but is glad she can offer them alternatives with less powerful odors.

“We have a lot of people that need medication,” Brunenkant said. “But they’re afraid to take any method, so it’s good seeing different forms coming out.”

Though the bill was received well at the hearing, it will have to be reviewed by the Committee on Judiciary and Public Safety before the D.C. Council can consider passing it, said Grosso. As of now there are no hearings scheduled.

Another barrier to patient access is money. In addition to registration fees for their medical cards, patients are looking at cannabis products that are “cost-prohibitive,” Fox said. This is a barrier Sarah is familiar with. Although she consumes cannabis through various methods, she primarily sticks to smoking the actual plant, as it’s the cheapest option available.

Among the states that have not legalized medical marijuana, there are 19 that recognize certain medical benefits of the substance, but don’t want to go as far as legalization, Fox said. Some of these states have laws that allow limited access to certain types of cannabis products.

“A lot of these unworkable laws are a way for politicians who don’t support medical marijuana to do something that looks good for their constituents without actually doing anything that has impact,” Fox said. “They get to stand in front of TV cameras with really sick kids who might get helped by that law, but are in the vast minority when it comes to all patients who could benefit from an effective medical marijuana program.”

Other states have shown no signs of legalizing, like Idaho and Nebraska, who have instituted no forms of access or decriminalization.

“A lot of it is just cultural,” Fox said. “Across the board there’s public support but sometimes politicians are a little slow to evolve from that drug war mentality where all marijuana is bad.”

This mentality makes it take longer to convince sitting legislators that they can pass an effective medical marijuana law without getting attacked by their constituents, Fox said.

Alaska Representatives Argue for Drilling in Wildlife Refuge

 

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(Committee on Energy and Natural Resources meets in Dirksen Senate Building. Photo by Tanner Hackney)

By Tanner Hackney

Washington, D.C.—Representatives from Alaska testified before the Committee on Energy and Natural Resources in the Dirksen Senate building on Thursday, appealing to encourage resource development, like drilling for oil and collecting natural gasses, in the sector of the Arctic National Wildlife Refuge known as the 1002.

According to the United States Geological Survey, the 1.5-million-acre coastal plain was set aside in 1980 as part of the Alaska National Interest Lands Conservation Act to be used for resource development. As part of recent tax reform, the committee is required to find $1 billion in deficit savings. Resource development in the 1002 could yield 10-20 billion barrels of oil, Rep. Dan Young said.

“All we’re asking for is the benefit of the deal promised long ago,” Gov. Bill Walker said.

Walker said the only way to get revenues for Alaska is through their resources. He said 80 percent of Alaskan communities don’t have roads, and that the money from resource collection in the 1002 could pay for new infrastructure, education, and health services. Since 2015, Alaska has had to reduce their budget by $1.7 billion, which only makes development more necessary, Walker said.

“Alaska is different,” Walker said. “Resource development is in our DNA.”

Samuel Alexander, a representative of the Gwich’in, a First Nations people, said resource development would harm the land and its wildlife.

“The land is essential to our way of life,” Alexander said. “It provides us sustenance and we consider it sacred.”

Alexander said drilling in the refuge will endanger local caribou and porcupine populations, animals the Gwich’in and other tribes rely on. If these wildlife populations are displaced or endangered, the Gwich’in will face food insecurity, Alexander said.

“We’re talking about the destruction of the herd and irreparable damage to our culture,” Alexander said.

Biologist and former Research Professor of Animal Genetics at the University of Alaska Fairbanks Dr. Matthew Cronin said that caribou herds were relatively unaffected in areas of Alaska where oil fields have already been developed. He said there would be minimum impact on herds if activity was limited during calving periods. Cronin acknowledged that some of his research had been funded by oil companies like Exon Mobile and BP, but insisted his work was unbiased.

“Whether it was used to justify future drilling, it was always done with the intent of publishing in the peer-reviewed scientific literature, which we did, and all the references I give in my written testimony are such,” Cronin said.

Senator and Ranking Member of the committee Maria Cantwell said the threat to the wildlife hasn’t become any less of an issue since the 1002 was set aside in 1980.

“There’s no new science that says we don’t have to worry about wildlife,” Cantwell said. “And there is no new science that says that the oil development will take up a smaller footprint.”

Tribal Administrator for the Native Village of Katktovik and President of the Kaktovic Inupiat Corporation Matthew Rexford acknowledged the value of local wildlife to the Alaskan Natives, but said resource development would improve their lives greatly.

“We do not approve of efforts to turn our homeland into one giant national park, which literally guarantees us a fate of no economy, no jobs, reduced subsistence, and no hope for the future of our people,” Rexford said.

The impact of climate change is a major concern among those opposed to development and is viewed as a possible result of resource exploration. Sen. Bernie Sanders argued that further development and exploration will only exacerbate the effects of climate change and that the United States needs to invest more heavily in renewable energies.

“It is especially surprising that in a beautiful state like Alaska, which has been hit so hard by climate change, that you are not leading the world, leading this country, in telling us the damage that has been done and the need to move away from fossil fuel,” Sanders said.

Sen. Joe Manchin said the United State’s dependency on oil cannot be ignored.

“There’s going to be more fossil used in the world than ever before,” Manchin said. “All we can do is find different technologies and different abilities to use it until we find a technology or a new industry that will provide a cleaner energy.”

Rexford said resource development has already been occurring in Alaska and that their strict adherence to regulations ensures safe exploration.

“We Inupiat have the benefit of decades of experience working with the oil and gas industry, to implement stringent regulations to protect the lands through best management practices and the industry has consistently lived up to our standards,” Rexford said.

Marijuana Advocacy Groups Anticipate Amendment Renewal Amidst Policy Efforts

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(Communications Director Morgan Fox at the MPP Office. Photo by Tanner Hackney)

By Tanner Hackney

Washington, D.C.— Local advocacy groups DCMJ and MPP are fighting for improved state and federal marijuana policies as the December renewal process for the Rohrabacher amendment approaches. Failure to renew would allow the federal government to use funds to interfere with state marijuana policies.

“We’re very concerned that if it doesn’t pass, the DOJ will start doing some sort of crackdown on medical marijuana in states where it’s legal,” MPP director of communications Morgan Fox said.

Marijuana Policy Project was founded in 1995 and has since been heavily involved in the legalization of recreational and medical cannabis in dozens of states, including Colorado.  The exclusion of the Rohrabacher amendment from the 2018 fiscal year budget could jeopardize their state efforts.

To ensure the amendment’s renewal, MPP are starting advertising campaigns in the districts of Congress members. MPP hopes the campaign will encourage them to give the Rohrabacher amendment priority. This is in addition to MPP’s “standard” lobbying work, Fox said.

DCMJ co-founder Adam Eidinger is also worried about the amendment falling through, but sees potential benefit to the scenario as well.

“It’ll force Congress to revisit the issue of federal marijuana policy,” Eidinger said.

DCMJ is known for spearheading Initiative 71, a ballot that legalized possession, gifting, home cultivation, and recreational use of marijuana in D.C. in 2014.

Eidinger said things need to get “a little worse” before they get better. This mindset is evident in the political demonstrations DCMJ has performed at the U.S. Capitol, giving away cannabis to those walking by. Eidinger said although gifting cannabis is legal, it still attracts attention from the Capitol police, which DCMJ often expects. He said they use these situations to “test the patience of Capitol police.”

“Giving away cannabis on the Capitol is legal, but we force them to violate our rights because they don’t want to see it,” Eidinger said.

DCMJ will be holding a similar demonstration on Oct. 31 called “Haunted HUD House.” Members will be giving out free cannabis in front of the Department of Housing and Urban Development from a trailer. The demonstration is in protest of federal marijuana restrictions against residents who live in subsidized housing.

Subsidized housing residents may not bring, use or grow marijuana in their homes since HUD is an office of the federal government and adheres to the Controlled Substances Act, which lists marijuana as a Schedule 1 substance.

“That’s something they [subsidized housing residents] voluntarily enter into in the contract, but is it really voluntary?” Eidinger said. “I think you’re coerced to sign that contract because you need housing.”

DCMJ is also focusing on defending Initiative 71. Although it has been in place for three years, a majority vote from the D.C. Council and Mayor Bowser’s signature could repeal it. DCMJ has made custom filter tips with messages that say things like “legalized.” They distribute these filters to both cannabis users and dealers in order to spread their message.

Focusing more on state legislature, MPP is currently creating ballot initiatives in Utah and Michigan, where they aim to legalize adult use and medical use, respectively. Other states they are working on laws for include Rhode Island, Vermont, Delaware, and Connecticut.

MPP’s legislative efforts typically involve searching for bill sponsors by contacting potentially supportive lawmakers. They also work with grassroots activists to design language for the bill that would best fit that state’s demands.

MPP’s work is often undermined by state law enforcement, who face a lot to lose because of legalization, Fox said. The federal grants they received for marijuana arrests are a thing of the past in legal states.

“They also lose the ability to get a lot of money for asset forfeiture that’s pretty easy pickins for a local marijuana bust,” Fox said.

Both groups cite Attorney General Jeff Sessions and the Department of Justice as major obstacles to their efforts.

“Jeff Sessions is one of the worst drug warriors left in government, and he’s totally misguided on marijuana’s efficacy,” Eidinger said.

Sessions sent a letter to Congress in June requesting they repeal the Rohrabacher amendment so the DOJ could have more power over enforcement on the federal level. Fox worries the republican control of Congress will not work in MPP’s favor either.

“Even though this is a very bipartisan issue, it’s still not doing as well among republicans as it is among democrats,” Fox said. “There’s just a little bit of a lag time there, despite the fact that it’s very much an issue of fiscal responsibility and states rights and limited government, things that should appeal to real conservatives.”

Student Advocates for Cannabis Patients

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Robert Kennedy sits in American University’s McKinley building. Photo by Tanner Hackney

Growing up on the north side of Chicago, Robert Kennedy saw street violence on the news almost every night from an early age. His mother often covered the violence as a reporter and his friends were sometimes endangered by it. Not only was Kennedy concerned about the violence, but also how local gangs were drawing their funding from drugs and a “failed enforcement policy.”

“This is a societal issue that’s plaguing people in a way that goes far beyond any social liberty standpoint,” Kennedy said. “Let these people live their lives without having to worry about authorities breaking into their cars and their homes, with their first intention being ‘Do you have any drugs on you?’”

By the time he was in seventh grade, Kennedy was already reaching out to the Illinois chapter of the National Organization for the Reform of Marijuana Laws (NORML). He conducted research throughout high school, but by his senior year, Kennedy had become not only an advocate, but a patient as well.

After a particularly stressful senior year in high school, Kennedy’s Tourrete’s onset. He hadn’t experienced symptoms since he was 12. He said the only medication prescribed to combat Tourette’s is Haldol, a drug used to treat schizophrenia that only alleviates Tourette’s for certain patients. However, Kennedy soon discovered cannabidiol (CBD), an extract of cannabis. Kennedy said CBD alleviates the symptoms of his Tourette’s and allows him to function normally.

“It’s the closest thing that comes to a miracle drug for this,” Kennedy said.

Now a junior CLEG and anthropology student at American University, Kennedy is active in cannabis patient advocacy. Though he works independent of student organizations, Kennedy has attended multiple events, town halls, and often works with people three times his age. Kennedy also represents the cannabis patient movement as the student ambassador for local dispensary Herbal Alternatives.

When he came to D.C., Kennedy applied for a medical marijuana card. It took longer than he expected because he applied using his university address. He was the first student to try this. After weeks of waiting, Kennedy got his medical card and a local policy organization announced that the Department of Health and Human Services now allowed students to apply for a medical card using their universities as a private residence.

However, the use of marijuana still went against school policy. AU told Kennedy they would not make an exception for medical use, but in order to treat his Tourette’s he had to medicate in the dorm regardless. He often worried about being discovered and expelled from AU housing.

“I can’t look at this university the same way anymore without remembering the kind of fear that I had to live in,” Kennedy said.

Although he lives off campus today and is able to medicate legally, he worries about younger students who are experiencing similar conflict on campus. Kennedy said AU should be worrying less about losing federal funding and more about the wellbeing of its students.

One of the bigger problems facing the medical cannabis movement is public perception, Kennedy said. Though he sees the potential for cannabis to treat patients with epilepsy or cancer, Kennedy said the public’s idea of advocates being a bunch of dreadlocked hippies really hurts efforts for change.

“This social perception that continues to be fogged by media perception and political bias has continued to hold back our society, because it means that people like myself are not able to feel comfortable in places like their own university,” Kennedy said.

Kennedy said much of this perception is held by the older generation in positions of power. He said the biggest issue is that members of the HHS are uniformed on the issue and can’t appreciate that it’s a medical program.

“The fact that we have public office holders and public service servants still having that falsified information leftover from an era of fear tactics is impeding at the least,” Kennedy said.

Kennedy sees this especially in President Trump’s administration, which he said has been disrupting the movement. Attorney General Jeff Sessions has voiced his position against marijuana several times while in office. However, Kennedy said the fact that Sessions’ “outdated” views are given such a large platform should make people realize these are real issues.

“If anything, Jeff Sessions’ reaction to this is enticing the argument for cannabis and medical cannabis programs even more,” Kennedy said.

Kennedy hopes commercial marijuana in D.C. will be legal by next year. He said the best way to further the cannabis movement is to educate the public about its patient benefits and to reach out to local congressmen.

“I have hope for the future,” Kennedy said. “And I really do think the tides are changing.”

[REVISED] Robert Lustig Says We’ve Been Hacked

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Robert Lustig speaks at Kramer Books & Afterwords Cafe (Photo by Tanner Hackney)

Washington, D.C.—On Thursday evening in a corner of Kramer Books & Afterwords Cafe, Robert Lustig told a crowd that people in the United States had forgotten the difference between pleasure and happiness, and that it’s making us sick.

“The extremes of pleasure, whether they be substances or behaviors…all lead to addiction,” Lustig said. “You can’t be addicted to too much happiness.”

Promoting his new book, “The Hacking of the American Mind,” Lustig, a pediatric endocrinologist, said food and healthcare industries are spreading ideas that lead not only to a confusion between pleasure and happiness, but also a decrease in physical and mental health.

Lustig has written multiple books on nutrition and health. His video lecture on sugar went viral on YouTube and has over 7 million views.

According to Lustig, some of the bigger culprits include Coca-Cola, which suggests you can buy happiness with their slogan: “Open Happiness.”

The difference between marketing and propaganda is the truth, and Coca-Cola, along with other food companies, are not telling the truth, Lustig said.

“They want you to think you can buy happiness,” Lustig said. “Because that’s how they sell.”

Lustig distinguishes pleasure and happiness with several characteristics. Pleasure is short-lived, “visceral,” an act of taking, and is experienced alone. It can be achieved through substances, triggering a rush of dopamine that can lead to addiction. Happiness, Lustig said, is long-lived, “ethereal,” an act of giving, and is experienced with others. It doesn’t require substances and it triggers a rush of serotonin, which you can’t get addicted to.

The key to knowing the difference is spending less time chasing pleasures, and more time investing effort in your happiness, Lustig said.

Lustig said suicide and suicidal thoughts are at an all-time high in the United States, especially among middle-aged white men. According to Lustig, the conflation between pleasure and happiness has lead to the abuse of illegal drugs and over-consumption of sugary foods.

“Addiction and depression—just two sides of the same coin,” Lustig said.

Lustig said sugar became a much bigger problem during the low-fat craze of the 1980s. He said food tasted “like cardboard,” so companies started adding more sugar. Lustig said the dangers of sugar are often overlooked by the idea that a calorie is a calorie, no matter where it comes from. This school of thought is less about being critical of what you eat, and more about balancing calorie input and exercise. Lustig calls this idea “garbage.”

“Turns out sugar is toxic, unrelated to it’s calories,” Lustig said.

Lustig conducted a study where he reduced sugar in the diets of children from 28% to 10%. He replaced it with an equal amount of starch and kept participants’ fat and protein levels the same. After the nine days, their liver fat, blood pressure and triglycerides went down. Lustig said the break in sugar also allowed their pancreases to “rest,” producing less insulin and thereby reversing their metabolic syndrome.

Lustig says we now face what he calls a public health crisis, with obesity and diabetes rates on the rise globally. And diabetes isn’t just a problem for the obese, Lustig said. According to his research, 40% of people with a healthy body mass index have the same diseases as the 80% of obese who are sick.

Lustig said there is no preventative medicine for chronic metabolic diseases like diabetes.

“We only know how to treat,” Lustig said. “They don’t teach prevention in medical school.”

Lustig said since the healthcare industry doesn’t offer prevention and the food industry is poisoning us with sugar, it’s the responsibility of the citizens to take preventative measures. Lustig proposed a DIY method of preventing disease and poor mental health in what he calls “the four Cs of happiness.” The four Cs stand for connect, contribute, cope, and cook.

“Connect” refers to interacting with people, which facilitates empathy, eliciting serotonin and a sense of contentment. Lustig said the interaction has to take place in real life, as social media generates dopamine and can lead to depression and social isolation.

“Contribute” refers to volunteerism, philanthropy, and altruism. He said helping people with no expectation of personal gain is a big part of being content.

“If money is the only thing that drives you, there’s never enough,” Lustig said.

“Cope” refers to how you deal with stress and depression. Practicing mindfulness can increase your focus and serotonin levels, and exercise can be as good as prescription drugs for alleviating depression, Lustig said.

Discussing the “cook” step, Lustig encouraged healthy cooking with an emphasis on avoiding sugar. He also said cooking can be a medium for the prior three Cs. If you’re cooking for a group of friends or your family, you’re simultaneously connecting, contributing and coping.

Each of these activities requires active effort and dedication. For many, following the four Cs may prove challenging.

“You have to want it more than you want what you’ve got now,” Lustig said.

Robert Lustig Says We’ve Been Hacked

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Robert Lustig speaks at Kramer Books & Afterwords Cafe

Washington, D.C.—On Thursday evening in an intimate corner of Kramer Books & Afterwords Cafe, Robert Lustig told a modest crowd that people in the United States had forgotten the difference between pleasure and happiness, and that it’s making us sick.

“The extremes of pleasure, whether they be substances or behaviors…all lead to addiction,” Lustig said. “You can’t be addicted to too much happiness.”

Promoting his new book, “The Hacking of the American Mind,” Lustig, an endocrinologist,  spoke on how food and healthcare industries are spreading ideas that lead not only to a confusion between pleasure and happiness, but also a decrease in physical and mental health.

Lustig said some of the bigger culprits include Coca-Cola, who suggest you can buy happiness with their slogan “Open Happiness.” The difference between marketing and propaganda is the truth, and companies like Coca-Cola are not telling the truth, Lustig said.

“They want you to think you can buy happiness,” Lustig said. “Because that’s how they sell.”

Lustig breaks down pleasure and happiness into several levels. Pleasure is short-lived, “visceral,” an act of taking, and is experienced alone. It can be achieved through substances, triggering a rush of dopamine that can lead to addiction. Happiness, Lustig said, is long-lived, “ethereal,” an act of giving, and is experienced with others. It doesn’t require substances and it triggers a rush of serotonin, which you can’t get addicted to.

Lustig said suicide and suicidal ideation is at an all-time high in the United States, especially among middle-aged white men. He said the conflation between pleasure and happiness has lead to the abuse of hedonic substances like illicit drugs and sugary food.

“Addiction and depression—just two sides of the same coin,” Lustig said.

Lustig said sugar became a much bigger problem during the low-fat craze of the 1980s. He said food tasted “like cardboard,” so companies started adding more sugar. Lustig said the dangers of sugar are often overlooked by the idea that a calorie is a calorie, no matter where it comes from. This school of thought is less about being critical of what you eat, and more about balancing calorie input and exercise. Lustig calls this idea “garbage.”

“Turns out sugar is toxic, unrelated to it’s calories,” Lustig said.

Lustig and his colleagues found this by conducting a study where they reduced sugar in the diets of children from 28% to 10%. They replaced it with an equal amount of starch and kept participants’ fat and protein levels the same. After the nine days, their liver fat, blood pressure and triglycerides went down. Lustig said the break in sugar also allowed their pancreases to “rest,” producing less insulin and thereby reversing their metabolic syndrome.

Lustig says we now face “a public health crisis,” with obesity and diabetes rates on the rise globally. And diabetes isn’t just a problem for the obese, Lustig said. According to his research, 40% of people with a healthy BMI have the same diseases as the 80% of obese who are sick.

Lustig said there is no medicalized prevention for chronic metabolic diseases like diabetes.

“We only know how to treat,” Lustig said. “They don’t teach prevention in medical school.”

Lustig said since the healthcare industry doesn’t offer medicalized prevention and the food industry is poisoning us with sugar, it’s the responsibility of the citizens to take preventative measures. Lustig proposed a DIY method of preventing disease and poor mental health in what he calls the four Cs of happiness. The four Cs stand for connect, contribute, cope, and cook.

Connect refers to interacting with people, which facilitates empathy, eliciting serotonin and a sense of contentment. Lustig said the interaction has to take place in real life, as social media generates dopamine and can lead to depression and social isolation.

Contribute refers to volunteerism, philanthropy, and altruism. He said helping people with no expectation of personal gain is a big part of being content.

“If money is the only thing that drives you, there’s never enough,” Lustig said.

Cope refers to how you deal with stress and depression. Practicing mindfulness can increase your focus and serotonin levels, and exercise can be as good as SSRIs in alleviating depression, Lustig said.

As an endocrinologist and author of multiple books and studies on food, it’s not surprising Lustig’s final C in his four-step process stands for cook. He encouraged healthy cooking with an emphasis on avoiding sugar, but also said cooking can be a medium for the prior three Cs. If you’re cooking for a group of friends or your family, you’re simultaneously connecting, contributing and coping.

Each of these activities requires active effort and dedication. For many, following the four Cs may prove challenging, and Lustig knows this well.

“You have to want it more than you want what you’ve got now,” Lustig said.