Long live the filibuster (at least while Democrats are in power)

Not that the Democrats’ proposed reforms were ever going to actually alter the absurd 60-vote supermajority currently in place, but they were at least a step in the right direction.  How sad that Democrats have now totally dropped any attempt at reform for fear that they will someday be a minority party and want the filibuster.  Chait:

Among the chief revisions that Democrats say will likely be offered: Senators could not initiate a filibuster of a bill before it reaches the floor unless they first muster 40 votes for it, and they would have to remain on the floor to sustain it. That is a change from current rules, which require the majority leader to file a cloture motion to overcome an anonymous objection to a motion to proceed, and then wait 30 hours for a vote on it.

What happened next? Let’s see. First, Republican critics attacked the reforms for doing away with the supermajority requirement even though (sadly) they did no such thing. Then the few conservatives who actually understood what the reforms would do (which, again, was not — NOT, Senator Alexander — prevent the minority from obstructing legislation) admitted they actually made a lot of sense.

And, now, of course, the denouement — Senate Democrats fold like a cheap suit:

Chait’s take (and mine): Republicans aren’t going to so foolishly adhere to tradition next time they get between 51-59 senators.  I’m going to strongly predict that next time there’s a Republican majority in the Senate, the filibuster is gone.  Short term, I’m sure I’ll be unhappy about what they’ll be able to pass.  Long term, no Democracy should be beholden to such an incredibly anti-democratic (especially given the malapportionment of the Senate) voting rule.

Opiates are good

Interesting series from Matt Yglesias on opiates after going through what was apparently some pretty intense dental pain.  Two facts about opiates: 1) There’s nothing better for relieving extreme pain. 2) Lots of people like to abuse opiates for a high.  Due to #2 we make it harder than we probably should for people in extreme pain to get the relief they need.  I’m lucky in that I’ve never experienced the type of intense pain that Yglesias talks about, but I have seen it.  The pain from my mom’s cancer– more so than anything else– reduced her to a shell of a person.  I think she would have been better off if she had taken more of her fentanyl (one of the strongest narcotics out there), but I know that part of her reluctance was all the negative information on opiates.  Of course, with terminal cancer, opiate addiction should probably be far down the list of concerns.

Anyway, Yglesias post actually inspired me to learn more about schedule II versus schedule III drugs.  I just had my first opiate since my wisdom teeth were extracted 16 years ago.  Hydrocodeine plus chlorpheniramine (schedule III) for cough.  I stopped coughing and no signs of addiction :-).  Same for David.  Anyway, schedule III is much less tightly regulated than the purer opiates of schedule II, in large part because they are harder to abuse.  Here’s Stephen Smith (via Yglesias):

Reading The New York Times gives you the impression that it’s simply a popular and effective medicine, but there’s another benefit to the combination found in Vicodin over straight hydrocodone: It’s less regulated.

Pure hydrocodone is a Schedule II drug under the 1970 Controlled Substances Act, whereas hydrocodone compounded with acetaminophen is a more loosely regulated Schedule III drug, supposedly for its lower abuse potential. Wishing to avoid greater scrutiny, doctors prefer prescribing Schedule III substances like Vicodin over purer Schedule II formulations which don’t contain liver-damaging acetaminophen. But why does adding a sometimes-unnecessary ingedient make it difficult (but not impossible) to abuse? For the same reason that the FDA is now regulating it: Because it’s poisonous, and can even cause fatal liver damage in the quantities necessary to sustain a heavy addiction. Researchers refer to it as an “abuse deterrent formulation”—the modern-day equivalent of the government spiking industrial alcohol during Prohibition. Except rather than blindness-inducing methanol, we now use deafness-inducing acetaminophen.

I fairly recently wrote about my interest in Prohibition.  My interest, though, was actually first spiked by Deborah Blum’s account of poisoning and toxicology in early 20th century NY City, The Poisoner’s Handbook. It was kind of amazing to learn that the government was basically poisoning its citizens in a misguided attempt to reduce the drinking of alcohol.  Of course, in the case of acetaminophen, it actually is a pain reliever which may help contribute to the overall efficacy of pain relief.  Kim was prescribed this mix (and by all acounts it worked well) for post-partum pain.  Nonetheless, it is potentially quite toxic and the way it affects the regulation of hydrocodone does present an interesting parallel with prohibition.


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