deaths

Arizona Governor, Legislature, Rush Through Flawed “Emergency” Opioid Legislation

Late on the night of January 25, the Arizona legislature unanimously approved “The Arizona Opioid Epidemic Act,” introduced at the urging of Governor Doug Ducey (R) just 3 days earlier. The Governor and legislature were in such a hurry that they took no time to request testimony from representatives of the medical profession or from any other experts that might have differing views about the best ways to approach the overdose crisis. The overdose crisis is such an “emergency” that there was no time for that. Yet, most of the Act’s provisions are not scheduled to take effect until 2019.

Among the harmful features of the Act are strict restrictions on the amount and dose of opioids doctors can prescribe to new and postoperative patients. Prescriptions may be for only 5 days, and the dosages are capped. Doctors wishing to exceed these limits must first consult a board-certified pain management specialist which, of course, might take several days. This policy is not evidence-based. It will cause injured patients and those recovering from surgery to suffer needless and agonizing pain. In December, the Arizona Medical Association and the Arizona Osteopathic Medical Association wrote the state Department of Health Services warning of harmful “unintended consequences” that may ensue from one-size-fits-all 5-day limits on prescriptions and dosages for patients in acute pain.

This policy is not just inhumane, it’s dangerous. Desperate patients might seek to get better relief for their undertreated pain by supplementing their prescriptions with alcohol and/or other drugs, or by obtaining drugs through the illegal market, increasing the risk of overdose or death.

Another provision requires all providers to use a state-approved E-prescription system to prescribe opioids, placing a burden on health care providers in remote and rural areas of the state, where broadband internet access is inadequate and where some practitioners lack technological sophistication in their practices.

Terrorism Deaths by Ideology: Is Charlottesville an Anomaly?

One person was murdered in a likely terrorist attack in Charlottesville, Virginia this Saturday when a suspected white nationalist named Alex Fields Jr. drove his car into a group of protesters. Prominent people on both sides of the political spectrum have condemned the politically motivated violence. However, some commentators have pointed out that left wing terrorists and rioters have also committed violence in recent years, though they have not provided any data with which to compare the relative scale of the violence. This blog fills that void by describing terrorist murders and injuries by the political ideology of the perpetrators. Also, though the chance of being murdered or injured in a terrorist attack is minor, there is wide variation in the ideology of terrorists. 

Data and Methodology

This post examines 25 years of terrorism on U.S. soil from 1992 through August 12, 2017. Fatalities and injuries in terrorist attacks are the most important measures of the cost of terrorism. The information sources are the Global Terrorism Database at the University of Maryland and the RAND Corporation. Other organizations seem to count many religiously or racially motivated crimes as terrorist offenses, an overcounting that I attempted to avoid. I estimate the number of murders committed by terrorists in 2017 from online sources although they may be incomplete. As much as possible, I excluded terrorists who died or were injured in their attacks as they are not victims.

I grouped the ideology of the attackers into four broad groups: Islamists, Nationalists and Right Wingers, Left Wingers, and Unknown/Other. Global Terrorism Database descriptions of the attackers and news stories were my guide in organizing the groups by ideology. Islamists and unknown/other straightforward. Left Wing terrorists include Communists, Socialists, animal rights activists, anti-white racists, LGBT extremists, attackers inspired by Black Lives Matter, and ethnic or national separatists who also embrace Socialism. Nationalist and Right Wing terrorists include white nationalists, Neo-Confederates, non-socialist secessionists, nationalists, anti-Communists, fascists, anti-Muslim attackers, anti-immigration extremists, Sovereign Citizens, bombers who targeted the IRS, militia movements, and abortion clinic bombers. Some of the marginal attacks are open to reinterpretation but the ideology of the attackers by death and injury are straightforward in virtually all cases.

Dying to Work in America’s Black Market

The recent deaths of ten illegal immigrants in San Antonio, Texas are a gruesome example of the human costs of severe immigration restrictions. The immigrants wanted to be smuggled into the United States and, presumably, paid somebody for that service. They had no way to enter lawfully because the United States government allows in few temporary migrants to work in a handful of occupations and there is essentially no green card category for low skilled workers. Many of these people face the choice of continued poverty in their home countries or taking a risk at a better life working in the American black market. Attempting to work in the United States is risky and sometimes leads to deaths because of immigration enforcement and more enforcement will result in more deaths. 

These immigrants did make the choice to break American immigration laws but it does not follow that they are the ones to blame for their own deaths, despite what some restrictionists think. Immigration laws are primarily designed to stop Americans from voluntarily hiring, contracting, or selling to willing foreigners. If the immigration laws were concerned primarily with protecting the rights of Americans and those illegal immigrants who died in the Texas heat intended to do harm, had serious criminal records, or there was another excellent reason to think they would have hurt people here, then their deaths could be a defensible cost of a rational system that does more good than harm. At the very minimum, one could claim that the law that incentivized them to enter the black market at great risk was intended to protect people. But nobody familiar with our immigration laws or the net-positive effect of immigrants on Americans can make that argument with a straight face. These illegal immigrants died because of an international labor market regulation.    

Those who die from the heat in shipping containers are only a fraction of all deaths crossing the border. From 1998 through the end of 2016, 6,915 people died crossing the Southwest border. The number of deaths is somewhat up over that time even though the number of apprehensions is way down meaning that the inflow of illegal immigrants does not primarily drive the number of deaths (Figure 1). 

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