CharonY

Perhaps worse, it has become a part of the identity of quite some folks. Any attempts to change will be seen as an attack on their belief system.

Kendal Principles of Neuroscience was pretty good back in the days (good overview and easy to understand).

Obviously the more appropriate way to approach these things is first to establish the level of evidence for these kind of assumptions. While it has been mentioned already, I think it is important to emphasize again that assumptions of "natural" often conflate physiological (biological) effects learned behaviour. Those are often difficult to discern from low resolution data and in many cases we are only starting to gather necessary information or trying out experimental approaches. It is one of the situations where narratives are much stronger than the available data. Edit: not wanting to move things too astray, but there is also a big push now to remove race/ethnicity- adjusted factors for medical diagnosis, mostly because assumptions of race-based medical factors were often based on limited data and overlaid with a lot of conventional wisdom assumptions (again, imbalance between strength of data and strength of narratives). As a result, especially for black folks misdiagnosis and -treatment has been a huge issue (compared to their white counterparts).

But not a single current German beer on the list. You are really old if you remember when the Heineken family or the founders of the Tsingtao brewery were German (I guess you like Pilsner?)

That would be reasonable start point, wouldn't it? And then if we actually start to observe differences between male and female riders, we would hypothesize that there might be something going on. However, as it is often assumed (also by some members of this board) that there must be a difference and then work their way backwards in order to satisfy their assumption. IIRC there was a paper looking at bet rates showing how folks underrate female jockey performance, which is a bit odd as folks make money with establishing good betting ratios. My conclusion is fairly simple. There is insufficient evidence that indicates a significant impact of the sex of the rider on the outcome. I have provided at least two references that have looked at it. So far your only counter-argument is that you do not believe it to be the case. Skepticism requires data and so far only one side has provided any. A no effect finding requires a lower burden of proof. If a homeopathic drug does not shown an effect compared to a placebo, we would not simply assume that the study was flawed and ask whether they used the correct dilution of nothing or whether the flasks had the right silica composition. If you have any evidence that for some reasons only the male jockeys were sickly, feel free to show it. Otherwise you cannot just selectively dismiss data. Using your approach I could simply dismiss every single study in existence by increasing the burden of proof until I find my bias confirmed. Note that if there is a follow-up that looks at more factors and finds certain associations, that would be a different matter. As it stands, there is no study I could find that contradict these findings. This does not make sense. Here they decide to go further than other studies (which looked at win ratio and could not find evidence of male dominance) and try to look at it mechanistically. Again, here is evidence and you still have provided nothing. In my world, data is crucial and trumps gut feeling. And as iNow explained yet again, one does not simply start with an assumption and then ignores all evidence to the contrary (or only looks for support). If I am generous the one supporting factor could be that there are male winners than female winners. But then we have seen that there many more male jockeys than female ones. So that makes a straight comparison a problem. The other issue is of course that horses are very important. If you put a great jockey on a weak horse, it is unlikely to suddenly turn into a winner. So some folks tried to account for horse rankings and then see if women who ride similar ranked horses as their male counterparts perform worse. But the data does not pan out (so we can not simply assume that it is happening). Then perhaps the effects are subtle and maybe men can slightly but significant improve or at least change how horses perform (does not have to be due to male physiology, for example, potentially men might treat horses differently resulting in performance differences). The last study did not find that, either, except for weak significance related to heart rate, which is difficult to translate into performance increases. So if there are sex specific differences between men and women, they appear to be weak or at least difficult to detect. From this dearth of data to get to the point where we not only assume a difference, but also think that it is due to physiology, is just straight up bad science. It basically has the same level of evidence as claiming that Asians are biologically better suited for maths.

The kick-off for this part of the discussion is actually that despite the fact that it is difficult to assess (in either direction), male superiority in performance is assumed. However data to this effect are muddy at best (in contrast to other athletic performances, for example). I.e. despite a dearth of data, assumptions are being made with real-life impact. Some seem to have taken it as a crusade to establish either male or female superiority, but I see it more of an exercise to figure out where data is actually available to establish a significant impact of sex on performance where there isn't. I.e. how closely do existing narratives actually follow facts (and do we actually know the uncertainty?).

I think you are, as I do not think that many of the criticism would affect the study design much. So to step back a bit, the question is whether rider physiology significantly affects horse performance. Specifically, physiological differences that are tied to sex would somehow improve, or at lest change the performance of the horse. The best study design, as mentioned, would be to have a set of horses ridden by male as well female riders, as obviously the horse itself will have a huge impact on the outcome. The data is actually slightly biased towards men, as among the registered jockeys only 8 were female and 35 were male- there is no paywall). So if anything, one could argue that there are more race-experienced men in the test group compared to the women. The other parameters of the riders that you mentioned should only have limited impact overall, as you have have strongly suggested that the effects would be sex-based. I.e. if a woman would be able to outcompete a man by just being somewhat more experienced or fitter, then it would imply that training and experience would be a stronger factor than sex. We can see it by certain athletic performance, such as running, where large groups of men outperform women and it is not necessary to look at the extremes (where a small group of men outperforms all women, but also almost all other men) to find significant differences. The biggest knock at the study is probably that it has not been peer-reviewed yet, but the basic study design makes sense to me. They also throw in a rather rough comparison between men and women in horse races which is a bit odd for the manuscript, but I suppose that might need a bit more cleaning up when they submit it for review (if it isn't submitted already). But yes, the study is the only one to my knowledge that looks at actual physiological (rather than race) outcomes and the impact of the rider on it. It follows somewhat the controlled design that I mentioned earlier, only that this was a retrospective study. Studies looking at performance by gender are quite a bit older but focus on races, where the comparatively low number of female jockeys can make things difficult. One could flip that on its head, of course and try to find evidence that being a man actually increases horse performance, but the data is even scarcer for that. I seem to recall also that for a given weight male jockeys seem to unhealthier than their female counterpart (due to more dietary restrictions, I believe) but I cannot recall the details anymore.

I think you get a tank with liquid nitrogen with it. By freezing it solid instantly you prevent any from accidentally entering your mouth.

Fair enough, I overlooked (or just forgot) that part. But yes, if we limit it to legal actions alone, which makes sense, it certainly is true. I do think the beecee's argument is based on social norms and pressures though, before Dim just ran with it (as he often does).

It is not really the same, but there is the issue of social pressure, where it can be difficult not to drink alcohol. In Germany drinking age starts at 16 and I still remember vividly how teachers berated me for not having a beer with the others (I did not like the taste of beer). I think the attitude might have changed and being designated driver is a good excuse nowadays. But fundamentally there was significant pressure to conformity when it came to alcohol use behaviour. For most other drugs peer-pressure might still have existed, but it certainly was not that pervasive and limited to fairly small groups of folks.

Almost as if harm reduction measures actually work.

Based on this particular argument it really seem that in order to save lives we should do away with safe areas and rather go for decriminalization.

That actually is also a bad example as studies back to the 80s (at least) show that overall deterrence reduces impairment-related accidents. It does not scale perfectly with severity of penalties and there are regional differences. However data suggests that it is working. However, the argument seems to be that if it does not prevent all adverse events, it is not working. This is of course silly as having perfect laws/policies that solve all the problems 100% are extremely unlikely to exist (with the exception of very simple matters, perhaps). Rather, the benchmark should be whether the situation gets better once it is implemented. If there is a better method to prevent DUIs (or drug-related harm) I'd be happy to see it implemented. Studies over the last 50 years or so have now coalesced to rather show a stark and negative outcome of the war on drugs. Not only does it not prevent drug use, it also created additional issues by exacerbating issues of poverty and related crime. Even the Cato institute and other conservative think tanks have come around to see the policy as failed https://www.cato.org/policy-analysis/four-decades-counting-continued-failure-war-drugs Small wonder then that folks working in the medical field have changed the question to: how can we save lives (cynical voices have mentioned that this change in policy debate was connected to the rise of the opioid crisis in white communities). Experiments on a number of levels ranging from e.g. not charging individuals for possession or drug use if they call in overdoses to local measures (the mentioned safe drug sites) to larger scale decriminalization show that similar to DUI laws or seat belts, they do not solve all the problems, but for the most part they improve outcome.

Actually it is legalized and there is an increasing shift in Canadian drug policing. The latter has been outlined in a well-written book (Busted: An Illustrated History of Drug Prohibition in Canada, by Susan Boyd). So the laws were a mix of real health concerns, but also quite a bit with moral judgement of certain folks (which, as often, incorporates good old racism). And the issue again is a matter of outcome. Do these policy of punishment reduce illegal drug use? Do they have any tangible benefits? A hundred years worth of data point toward no. If a policy does not manage to do what it intends to do, it is just bad policy. The fact that there are other bad policies out there does not change the issue that drug policies simply do not offer benefits, whereas alternatives save lives. From an entirely utilitarian perspectives I figure that a policy that is potentially cheaper and results in overall less dead people is better than one that is more expensive and ends with more folks dead. At least to me whether during the process folks are punished or not is secondary. I just like to see fewer folks dying, ill or otherwise increasing pressure on our health care system. Continuing to do something that just doesn't work with the hope that eventually it will is just not good policy. I am not sure why you think that this a clever remark, but police actions are aimed to contain violence in certain areas. Whether they work or not is a different matter. However, if you are able to develop some policy or law that would ultimately cut down on deaths (even if it remains non-zero) I would probably be in favour of it, unless there are other detrimental effects. As a whole there needs to be an overall cost/benefit analysis of it. And I think the real disagreement here might be that you seem to consider punishment of "bad" guys as a value in itself, which offsets the costs of detrimental health effects. And I simply disagree with that point. Instead I would like to see fewer folks taking harmful drugs to begin with and get those that are addicted away from it as the primary goals.

Well, it is part of the political process and which is why cannabis is being legalized. Note that becee's argument for alcohol was based on majority rule (with a focus on Western society) but seemingly was more against legalization of cannabis, using the same criterion (~90% in USA and Canada were for legalization of cannabis for medical and recreational use, over 60% for recreational use in the US and a fair bit higher in Canada prior to legalization).

It is not a matter of being woke, but rather which outcome you prefer. If you want your moral outrage satiated and punish folks for bad choices (as we did in the past) then we just have to live with more deaths and often also associated crime. If we want to fix it, the public health option seems to be the best way forward, but we would need to forgo some of our moral judgement in exchange. Consider punishing does nothing to reduce drug use I am not sure what such policy do except makes us feel better about not taking drugs and feel superior to those who do. I am looking at the issue entirely from the viewpoint of reducing public health risks. You may call that woke, but I call it sensible. I.e. if something works it works and I do not care much regarding the ideology behind it.

That is broadly the conclusion that the medical community mostly has come around to. Basically re-allocating resources that are used for legal enforcement towards is likely to improve overall public health, relative to criminalization. Moreover, some advocate going a step further toward legalization (depending on how things are handled in various jurisdictions), not for broad commercial distribution, but in order to provide safe supplies of certain drugs to combat overdoses. The latter was mostly forced by the opioid epidemic, where harm prevention is now considered more critical (as criminal persecution did pretty much nothing to improve the situation). It is tricky business and also at the intersection between public health, legal challenges and moral judgement. Drug policies in the past were often passed based on moral judgement, but research has shown that it simply does not improve public health. To spin it positively, we should want a situation where everyone has access to help to get rid of addictions without stigma or prejudice (or fear of legal retribution), where inevitable drug use is at low levels but using safe substances and ideally in a controlled environment. This includes but should not be exclusive to alcohol.

That may be the case and there are similar regulations in Canada (there are lower limits if alcohol is also detected). But it is a simply a regulatory rule which is not based on our best understanding how the drug works. That being said, regulations are obviously always simplifications, but my comment was not meant as a challenge to regulation but rather to your previous assertion that folks stay impaired for days. And it is also to highlight that one cannot easily draw a direct comparison between alcohol and THC- the latter stays in the body longer without exerting measurable effects, so a low level of alcohol in the blood is a much stronger indicator of impairment than a low level of THC.

Peyote has been part of indigenous American traditions, so are coca leaves/tea in South America to give some other examples. Interestingly their interests seems to take a backseat, though. That should be the case with all drugs. Even if it only mitigates issues (as we see with alcohol). The OP was aimed at harm reduction at which point alcohol clear makes the cut for harmful substances. You have mentioned how difficult it is to enforce a ban, though similar things can be extended to other drugs. Portugal was shown as an example where decriminalization actually reduced drug-related harms on many levels and may seem like a decent way forward from a risk/benefit perspective. Policies should be guided based on harm outcomes and not by narratives as has been done in the past (or as political tools). IMO it is a public health and not moral issue, but it has been conflated a lot of it in the past (drug use in high-income classes, for example). It is in fact being legalized (or has already been). As indicated increased use has resulted in increased incidences but not by much and the detrimental effects are not even close to alcohol use. Other drugs like psilocybin are even less habit forming and harmful, for example. That is incorrect. With cannabis THC can be detected in the body for longer than a day (much longer in habitual users). However, acute impairment does not last that long. There are a series of studies involving car simulations or similar tasks and in most studies the time until individuals return roughly to their baseline is around 10 hours for edibles and closer to 5 for smoking. In other words, presence of THC in the body is not very predictive for level of impairment, especially compared to alcohol. This becomes more of an enforcement issue. While there are THC tests, they are being challenged and law enforcement in Canada tend to focus on using field sobriety tests instead (and THC levels just as an additive). I will re-iterate that comparative analyses of drug harm are tricky and obviously you can find harmful effects for virtually all compounds including things that we consume every day. As such looking at as many aspects as possible seems to me currently the only way to get at least a slightly more objective sense of harm caused by the drugs. Drugs referenced in pop culture might appear scarier than they likely are, for example. That being said, most international comparisons of that sort (UK, Australia, USA) put alcohol at the highest level of harm and some other drugs (e.g. mushrooms, LSD) fairly low. So as mentioned earlier the main argument against banning alcohol is that it does not work. But the question remains whether criminalization really has benefits. Some evidence from the war on drugs does not make a great case from a public health perspective. Another aspect is that criminalizing them has put them mostly out of reach for medical and other research. There are advocates that certain psychoactive substances might have benefit over other commonly used medications, for example. But without proper studies it is difficult to figure out. Edit: crossedited with becee's post.

Sorry to hear. The CDC has some resources and links to additional info: https://www.cdc.gov/coronavirus/2019-ncov/long-term-effects/index.html It is still a matter of ongoing research and it is important also to take care to unspecific and neurologic symptoms, such as anxiety and sleeplessness, which are easy to overlook.

I can address those and in fact may have so already in an earlier thread. Fundamentally there are risks associated with cannabis use, but those are generally speaking not higher than alcohol. Some of the associations are in fact correlated with other drug use. In fact, substance used disorders, including alcohol, are highly associated with each other. I.e. folks that drink are more likely to use cannabis, or other drugs (see for example https://doi.org/10.1111/j.1530-0277.1996.tb01953.x). The thinking is that folks who are more likely to have substance use disorders have similar risk factors. As similar theme can be seen when it comes to psychoses and schizophrenia. There are many studies out there that show that in shizophrenic patients or patients with psychotic episodes drug use, including alcohol, is very prevalent. A cause and effect relationship is very difficult to establish, though cannabis as well as alcohol are known to create worse outcomes for psychotic events, and in case of alcohol, they are also more likely to become violent (for cannabis it is still under discussion, but the association, if it exists, is apparently less robust). One of these cohorts looked in Canada for increases in cannabis-induced psychoses post-legalization and basically found none. The same paper also referenced alcohol-induced psychoses. https://doi.org/10.1177%2F07067437211070650 The other combustion related injuries have been somewhat addressed in relation with tobacco smoking and the literature had a bit of a back and forth whether cannabis is equally bad as tobacco or not. Things are further muddled by the fact that many cannabis smokers also smoke tobacco. At this point I think the jury is still a bit out, but I as precaution I would think that covering it under similar rules (also including e-cigarettes even if health effects might be milder) could be overall beneficial. None of those described risks have demonstrated an overall higher risk (legal or not) compared to alcohol (or tobacco), as far as I can see.

These can be achieved by decriminalization alone, though. Civil penalties could (and should) include referrals to treatment programs. That does most make sense for drugs that are highly addictive and/or consumption is very dangerous (e.g. high risk of overdoses, severe health effects etc.). Legalization further allows controlled production, sales and consumption. Here penalties can only be levied under specific circumstances (e.g. DUI) and treatments are can only be forced if something happens under these circumstances. This is the case with alcohol and in some areas cannabis.

Absolutely. But these laws should take a number of things into account, such as what the outcome is. I think quite a few folks have come around to the point that decriminalization would benefits, as the criminalization of drugs has, on balance, create more harm than it has prevented. This is especially true for drugs which have less severe health outcomes. The other point is to see whether those laws are applied equally and fairly. This is linked to the first point where drug laws have been especially harsh on certain groups and applied unfairly. Yet another point, which is more related to OP (but also to the other points above) is the internal consistency. I.e. on what basis do we classify certain drugs as legal or at least punish possession and use less harshly (if at all) than others. One argument is based on harm reduction, but as mentioned alcohol does great harm and remains legal. The main argument seems to be that it is not effective/possible to make it illegal. But that applies to quite a few other drugs, too. Many countries are therefore likely to make less harmful drugs (such as cannabis) legal. One of the reasons why alcohol is underestimated as health risk is of course the fact that it is socially acceptable and as such it is perhaps unsurprising that alcohol causes more deaths than all other drug uses taken together in most industrialized country (taking 2016 data death per 100k people in Canada 16.6 vs 7.3, 23.2 vs 18, UK 30.5 vs 8.5). Same goes for other measures, such as years of life lost (YLL). For disability adjusted life years (a measure of disease burden) it the outcome is a bit more mixed and in some countries impact of alcohol can be more similar relative to all other drugs (e.g. USA 1178.6 alcohol DALY per 100k vs 14603 all other drugs; UK 965 vs 614, Canada 807 vs 693). Perhaps an interesting comparison is Portugal where the discrepancy is quite visible (alcohol vs all drugs per 100k people): death: 68.1 vs 4.9, YLL: 1483 vs 162.4 and DALY 1790 vs 313. (GBD 2016 Alchol and Drug Use Collaborators, Lancet 2018; 5:12 987-1012).

In addition, many areas that have a wastewater treatment plant also have separate storm drains systems. AFAIK, sewage is mostly moved by gravity (including lift stations) or pressurized pipes. In many (especially arid) areas relying on rain would not work well.

Still working my way through the thread so sorry if I am repeating things that others have already mentioned. A couple of things related to that. Ranking intrinsic risks of a given drug is tricky as quite a few things can change the risk assessment. For example, if heroin is pure and consumed under supervision certain risks are minimized (e.g. sharing of dirty needles, fentanyl associated overdose risks and so on). Other personal risks are also associated with likelihood of addiction. Those are fairly high for opiates, but also nicotine (though the former happens faster), while cannabis is quite a bit lower on that scale (takes longer and habit formation is not quite as strong). Addicts to tobacco, tend to smoke quite a bit more to satisfy their addiction, compared to cannabis users. So if we talk about cannabis, the effects and risks are somewhat distinct from tobacco. The most common effects we see shared are likely due to combustion of the wrappers. While we still need more study, the association with cancer appears to be weaker compared to tobacco and long-term use was associated with different biomolecular markers of cardiovascular health than tobacco use. It is not quite clear what long-term effects are, but at least preliminary data shows a seemingly lower risk (or at least no higher than tobacco). While nicotine overdose is (AFAIK) a rare event, cannabis overdoses can happen, usually via edibles or oils. However, alcohol overdose is also fairly frequent and is generally more harmful (as in it can end up being deadly if not treated). In many ways comparison of cannabis and alcohol also makes sense, as part of the risk is impairment and of course the former is legal. With regard to the impact of legalization, which has been brought up a couple of times, I like to refer to Statscan data showing that two years into legal weed, the number of folks indicating to have consumed cannabis at least once in the past three months of a the survey increased slightly, from 14.9% before to 16.8 % in 2019, which remained unchanged in 2020. The number of folks with daily or almost daily used remained unchanged before and after legalization. Likewise, the rate of folks driving within two hours of smoking remained unchanged. In other words, the free availability of cannabis has not resulted in dramatic increases in its use within the population. For issues mentioned above and the fact that an alcoholic might be at different risks than a heroin addict. Alcohol is legal and you can get pure product easily, for example and treatment might be easier to come by. The other issue is that one can only calculate changes in life expectancy (or e.g. years lost) in a population by looking at reduction from the control cohort, but this could be skewed by the number of alcohol vs heroin use. From that perspective, I find the way of ranking by experts in the paper referenced earlier in the thread quite compelling. While clearly they will be biased a bit based on the available expertise, it is probably the closest to a comprehensive comparison we can get, given the many confounding factors.