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Take cocaine as an example. Even doubling the sale price of the coca leaf in the mountains, were that to happen absent a monopsony, would increase the cost to a street purchaser by less than 1 percent. Why? Because of the economics of the supply chain, the sequence by which a commodity is produced and distributed. The principal costs are not for the product, but for the multitude of illegal and expensive steps from the field to the nasal mucosa of the consumer. Wainwright likens efforts to reduce user (end-point) purchases by raising the price of coca leaves to trying to increase the price of expensive paintings by increasing the price of paint. He argues that the way to destroy the drug business is to cut the heart out of its revenues by reducing consumer demand. That might work because, as has been said, "it's the economy, stupid." Control strategies have simply not done the job: drug delivery and access go unfettered, with only momentary interruptions, while the prices users pay are barely impacted and drug use goes unabated. Yet, the principal strategies for drug control pronounced by the Trump administration are to "build a wall" and "get tough on users and dealers." Should all control efforts be suspended? While I greatly support decriminalizing possession of limited quantities of drugs, that is different from controlling such substances as synthetic marijuana (K2 or spice) and crack cocaine and crystal meth. Those are examples of drugs so damaging that we need more than demand reduction alone. But what we have not parsed out is which drugs and which control efforts should be sustained and which should be stopped, and then repurpose that money for prevention and treatment efforts. Budget woes at the federal and state levels are going to preclude sufficient new money for demand reduction, for prevention and treatment, and for us to succeed the funds must come from somewhere. The great 19th and early-20th-century writer M.R. James, for instance, writes in one of his stories about a man experiencing something that we would probably now identify as a panic disorder. At night, he tells us, this man often suffers from exactly the "fear of dying" we discussed above. Yet, with the arrival of the dawn, it vanishes. Describing this character lying in bed at night, James writes: Awake he remained, in any case, long enough to fancy (as I am afraid I often do myself under such conditions) that he was the victim of all manner of fatal disorders: he would lie counting the beats of his heart, convinced that it was going to stop work every moment, and would entertain grave suspicions of his lungs, brain, liver, etc.--suspicions which he was sure would be dispelled by the return of daylight, but which until then refused to be put aside. Perhaps many of us can relate to James' character. After all, as we have seen above, anxiety is not an unusual condition.

Also, it is not a modern one. People from as far back as James' day experienced similar symptoms, even if they did not have the same vocabulary to describe them. Before turning to other matters, however, let us see a few more examples of the typical thought patterns associated with panic attacks connected to other fears. If you were the king or queen and had your act totally together, how would you expect to be treated? What standards would you hold yourself and everyone else to? What behavior would you expect? What would you consider acceptable and unacceptable? Would you accept overinflated egos? Would you accept bad habits? Would you accept complaining? Would you accept excuses? Would you accept acting like a victim instead of taking personal responsibility? Would you accept bad influences? Would you accept rebelling? Probably not. You'd respect your position and expect everyone else to as well. You'd hold everyone accountable, expect appropriate conduct, and wouldn't accept substandard behavior and results. If that's the case, why are you accepting substandard from yourself? Why are you accepting substandard thinking, emotions, behavior, and habits? Why are you accepting substandard results?

Why are you accepting a substandard life? Why aren't you living up to your expectations? You're the leader and the servant. You make and follow the rules. You give and take the punishment. You set and meet the expectations. Be in charge and obedient. Follow your orders. Respect yourself. Behave the way you expect others to. Give yourself something to respect. Give yourself something to follow. Give others a reason to treat you the way you want to be treated. If you want to live like a king or queen, you have to think and behave like it. You have to accept the full responsibility of it. You are royalty. You are in charge. You are at the top. Put up with whatever is necessary to keep crown and stay sitting on your throne. If you want to overcome your anxiety you have to challenge your avoidant behaviour.

As stated earlier, when we are anxious we want to avoid people, places, and things that trigger our anxiety. The idea of avoidance may seem a sensible one - after all, if you feel bad about doing something it makes sense not to do it. However, when you give in to your feelings all you do is give power to the anxiety and you may well find that as your anxiety increases, your life decreases. For example, you may feel anxious about being in a crowd, so you start avoiding crowds. Next, you find that you don't feel comfortable on the underground so you now travel only by bus. One day, you feel a little anxious on a bus and then stop using the buses and, before you know it, your life is limited. In severe cases this kind of behaviour can lead to conditions such as agoraphobia. Avoidance can take many forms including not taking up opportunities when they are presented to you, putting things off, not facing up to problems, or not accepting invitations. If you really want to conquer your anxiety, you need to engage in what is called graded exposure, which means that you start to face those situations you find difficult, engaging in a range of coping strategies to help you deal with your feelings. Research has shown that when you face a feared situation your fear will peak and if you can stay in the situation it will come down after it peaks to a more bearable level. However, when you avoid situations you never get to learn this for yourself. The metaphor the War on Drugs presupposes an enemy outside our borders or a civil uprising threatening the future of the nation. This is where the metaphor--applied to drugs as well as poverty and cancer--fails us from the very start. There is no external enemy. Drugs are what people with addictions use; they are not armies at the gate. Addiction is "self-induced changes in neurotransmission that result in problem behavior." Rather than facing an enemy, we have a powerful convergence of biology and social circumstances, the interplay of nature and nurture, that produces addictions--spanning alcohol, drugs, and a variety of compulsive behaviors such as gambling, video games, and some sexual disorders. How can we prosecute a war on human problems? The conditions to win such a "war" simply do not exist. But the fatal consequences of the ongoing drug war are epidemic and visible. In the film The Untouchables, the salty veteran Irish street cop Jim Malone (Sean Connery) takes a moment to advise the green, ambitious FBI agent Eliot Ness (Kevin Costner) after an eruption of deadly violence.

Malone says, "You wanna know how to get Capone? They pull a knife, you pull a gun. They send one of yours to the hospital, you send one of theirs to the morgue. That's the Chicago way." But it is more than the Chicago way, though that city has certainly been a bleak poster child for violence. Just across the border in Mexico, cartels--such as Los Zetas, Knights Templar, and Sinaloa--enforce order and maintain their market shares through violence, including beheadings, torture, and mass killings. Homicides in Mexico peaked at almost twenty-three thousand a year in 2011, dropped to a bit over fifteen thousand in 2014, and are now on the rebound. Murder pays. And we all suffer, drug users and nonusers alike, from the policies of control and incarceration that have characterized the US approach to addiction for much of our long history. The great British poet of World War I, Siegfried Sassoon, once wrote a poem about his wartime experience that described symptoms we would now recognize as a form of anxiety or panic disorder. Indeed, when soldiers returned from fighting in the trenches in World War I, many reported a common psychological experience of having intense fear reactions to visual and auditory stimuli that reminded them of their experiences in the war. This reaction came to be known as "shell shock." It was the first publicly-recognized and acknowledged the form of what we would now call post-traumatic stress disorder - a form of psychological disturbance (as we saw above) linked to a traumatic personal experience, and which is ignited by certain triggers that put one in mind of the original traumatic event. This example also helpfully illustrates why avoidant responses to panic attacks are often counter-productive. As anyone who has ever played the game "Don't think of an elephant" can tell you, reminding oneself not to think of a specific thing will only succeed in bringing that thing to mind. If you say to someone "don't think of an elephant," the very first thing they picture will, of course, be an elephant. Getting your act together is 90% mental. It starts in your mind and everything follows. Change doesn't occur by: Getting more money and buying a nicer car, nicer clothes, a nicer home, nicer furniture, etc. Reposting inspirational quotes and photos on social media Talking and posting about how you're planning to get your act together Listening to inspirational speeches and videos but never taking action Getting tattoos of inspirational quotes Mindset change begins when you tune out the distractions, stare at yourself in the mirror, and realize and accept you're holding yourself back. It's telling yourself enough is enough, you're not taking any more of your crap, you've caused enough problems, and it's time to knock it off. It's realizing and accepting it's time to make something of yourself, get serious about life, and the fun and games don't come first.