The National Safety Council has reported that Americans are now more likely to die from an opioid overdose than car crashes for the first time. As Statista’s Niall McCarthy notes, the overall rate of drug overdose deaths in the U.S. increased by 9.6 percent between 2016 and 2017 with the death rate from fentanyl skyrocketing 45 percent. The U.S. […]
I found myself gripping the armrest as my plane attempted a landing in Africa on a remote sandy airstrip, the landing was called off and we needed to circle around several times in order to scare off several resilient giraffes that were occupying the runway. Almost a month later I made a dramatic landing in Bhutan that was like a scene out of Star Wars where my commercial airliner had to bank dramatically to fit in between the narrow, remote mountain terrain………..
You may have been the Mike’s-Hard-Lemonade-in-high-school type. Or the Bud-Light-from-a-keg-in-college type. Or the unlimited-mimosas-at-Sunday-brunch type. But chances are, at some point during your teen and young adult years, you downed a hefty amount of alcohol. While life is most certainly about #balance, unfortunately, no amount of kale or HIIT classes can totally undo the damage excessive drinking has likely done to your brain and body…..
A major new global study published in The Lancet has found that there is no safe level of alcohol consumption. The research looked at levels of alcohol use and its health effects across 195 countries between 1990 and 2016.
It found that even an occasional drink can prove harmful and its authors say that governments should recommend people abstain entirely from alcohol consumption. Consuming alcohol caused 2.8 million deaths in 2016 and it was the leading risk factor for premature mortality and disability among people aged 15 to 49.
Even though moderate drinking has been associated with limited health benefits for years, with a daily glass of red wine seen as being good for the heart, the new research claims that the harmful impact far outweighs any benefits. The following infographic shows the top-10 countries in terms of overall deaths attributable to alcohol and specifically, it highlights the massive gender gap in mortality. In the United States, for example, 71,000 male deaths and 19,000 female deaths were attributable to alcohol in 2016.
Researchers used 694 studies to estimate worldwide drinking patterns and used 592 studies plus 28 million people to learn about alcohol’s health risks between 1990 and 2016 in 195 countries.
They found drinking alcohol was associated with nearly 1 in 10 deaths of people ages 15 to 49 years old. Causes included tuberculosis, road injuries and self-harm. For people over 50, cancers were cited as a leading cause of alcohol-related death (about 27 percent of deaths in women and 19 percent of deaths in men).
Researchers found that the “burden” of alcohol consumption was worse than previously reported. They called for more regulations around alcohol use and said there is no amount of alcohol that is healthy.
More research must still be done to explain how drinking patterns affect health. For example, a glass of wine every evening versus binge drinking. Griswold said there are also unknowns around health once people stop drinking.
The most recent Dietary Guidelines for Americans, a report by the U.S. Department of Health and Human Services and the United States Department of Agriculture, suggests women have no more than one drink daily and men have no more than two. The American Society of Clinical Oncology, made up some of the nation’s top cancer doctors, has said limiting alcoholic drinks is important for cancer prevention.
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The proliferation of retail boutiques in California did not really bother him, Evan told me, but the billboards did. Advertisements for delivery, advertisements promoting the substance for relaxation, for fun, for health. “Shop. It’s legal.” “Hello marijuana, goodbye hangover.” “It’s not a trigger,” he told me. “But it is in your face.”
When we spoke, he had been sober for a hard-fought seven weeks: seven weeks of sleepless nights, intermittent nausea, irritability, trouble focusing, and psychological turmoil. There were upsides, he said, in terms of reduced mental fog, a fatter wallet, and a growing sense of confidence that he could quit. “I don’t think it’s a ‘can’ as much as a ‘must,’” he said.
Evan, who asked that his full name not be used for fear of professional repercussions, has a self-described cannabis-use disorder. If not necessarily because of legalization, but alongside legalization, such problems are becoming more common: The share of adults with one has doubled since the early aughts, as the share of cannabis users who consume it daily or near-daily has jumped nearly 50 percent—all “in the context of increasingly permissive cannabis legislation, attitudes, and lower risk perception,” as the National Institutes of Health put it.
Public-health experts worry about the increasingly potent options available, and the striking number of constant users. “Cannabis is potentially a real public-health problem,” said Mark A. R. Kleiman, a professor of public policy at New York University. “It wasn’t obvious to me 25 years ago, when 9 percent of self-reported cannabis users over the last month reported daily or near-daily use. I always was prepared to say, ‘No, it’s not a very abusable drug. Nine percent of anybody will do something stupid.’ But that number is now [something like] 40 percent.”
They argue that state and local governments are setting up legal regimes without sufficient public-health protection, with some even warning that the country is replacing one form of reefer madness with another, careening from treating cannabis as if it were as dangerous as heroin to treating it as if it were as benign as kombucha.
But cannabis is not benign, even if it is relatively benign, compared with alcohol, opiates, and cigarettes, among other substances. Thousands of Americans are finding their own use problematic in a climate where pot products are getting more potent, more socially acceptable to use, and yet easier to come by, not that it was particularly hard before.
For Keith Humphreys, a professor of psychiatry and behavioral sciences at Stanford University, the most compelling evidence of the deleterious effects comes from users themselves. “In large national surveys, about one in 10 people who smoke it say they have a lot of problems. They say things like, ‘I have trouble quitting. I think a lot about quitting and I can’t do it.
I smoked more than I intended to. I neglect responsibilities.’ There are plenty of people who have problems with it, in terms of things like concentration, short-term memory, and motivation,” he said. “People will say, ‘Oh, that’s just you fuddy-duddy doctors.’ Actually, no. It’s millions of people who use the drug who say that it causes problems.”
Users or former users I spoke with described lost jobs, lost marriages, lost houses, lost money, lost time. Foreclosures and divorces. Weight gain and mental-health problems. And one other thing: the problem of convincing other people that what they were experiencing was real. A few mentioned jokes about Doritos, and comments implying that the real issue was that they were lazy stoners. Others mentioned the common belief that you can be “psychologically” addicted to pot, but not “physically” or “really” addicted. The condition remains misunderstood, discounted, and strangely invisible, even as legalization and white-marketization pitches ahead.
The country is in the midst of a volte-face on marijuana. The federal government still classifies cannabis as a Schedule I drug, with no accepted medical use. (Meth and PCP, among other drugs, are Schedule II.) Politicians still argue it is a gateway to the use of things like heroin and cocaine. The country still spends billions of dollars fighting it in a bloody and futile drug war, and still arrests more people for offenses related to cannabis than it does for all violent crimes combined.
Yet dozens of states have pushed ahead with legalization for medical or recreational purposes, given that for decades physicians have argued that marijuana’s health risks have been overstated and its medical uses overlooked; activists have stressed prohibition’s tremendous fiscal cost and far worse human cost; and researchers have convincingly argued that cannabis is far less dangerous than alcohol. A solid majority of Americans support legalization nowadays.
Academics and public-health officials, though, have raised the concern that cannabis’s real risks have been overlooked or underplayed—perhaps as part of a counter-reaction to federal prohibition, and perhaps because millions and millions of cannabis users have no problems controlling their use.
“Part of how legalization was sold was with this assumption that there was no harm, in reaction to the message that everyone has smoked marijuana was going to ruin their whole life,” Humphreys told me. It was a point Kleiman agreed with. “I do think that not legalization, but the legalization movement, does have a lot on its conscience now,” he said. “The mantra about how this is a harmless, natural, and non-addictive substance—it’s now known by everybody. And it’s a lie.”
Thousands of businesses, as well as local governments earning tax money off of sales, are now literally invested in that lie. “The liquor companies are salivating,” Matt Karnes of GreenWave Advisors told me. “They can’t wait to come in full force.” He added that Big Pharma was targeting the medical market, with Wall Street, Silicon Valley, food businesses, and tobacco companies aiming at the recreational market.
Sellers are targeting broad swaths of the consumer market—soccer moms, recent retirees, folks looking to replace their nightly glass of chardonnay with a precisely dosed, low-calorie, and hangover-free mint. Many have consciously played up cannabis as a lifestyle product, a gift to give yourself, like a nice crystal or an antioxidant face cream. “This is not about marijuana,” one executive at the California retailer MedMen recently argued. “This is about the people who use cannabis for all the reasons people have used cannabis for hundreds of years. Yes, for recreation, just like alcohol, but also for wellness.”
Evan started off smoking with his friends when they were playing sports or video games, lighting up to chill out after his nine-to-five as a paralegal at a law office. But that soon became couch-lock, and he lost interest in working out, going out, doing anything with his roommates. Then came a lack of motivation and the slow erosion of ambition, and law school moving further out of reach.
He started smoking before work and after work. Eventually, he realized it was impossible to get through the day without it. “I was smoking anytime I had to do anything boring, and it took a long time before I realized that I wasn’t doing anything without getting stoned,” he said.
His first attempts to reduce his use went miserably, as the consequences on his health and his life piled up. He gained nearly 40 pounds, he said, when he stopped working out and cooking his own food at home. He recognized that he was just barely getting by at work, and was continually worried about getting fired. Worse, his friends were unsympathetic to the idea that he was struggling and needed help. “[You have to] try to convince someone that something that is hurting you is hurting you,” he said.
Other people who found their use problematic or had managed to quit, none of whom wanted to use their names, described similar struggles and consequences. “I was running two companies at the time, and fitting smoking in between running those companies. Then, we sold those companies and I had a whole lot of time on my hands,” one other former cannabis user told me. “I just started sitting around smoking all the time. And things just came to a halt. I was in terrible shape. I was depressed.”
Lax regulatory standards and aggressive commercialization in some states have compounded some existing public-health risks, raised new ones, and failed to tamp down on others, experts argue. In terms of compounding risks, many cite the availability of hyper-potent marijuana products. “We’re seeing these increases in the strength of cannabis, as we are also seeing an emergence of new types of products,” such as edibles, tinctures, vape pens, sublingual sprays, and concentrates, Ziva Cooper, an associate professor of clinical neurobiology in the Department of Psychiatry at Columbia University Medical Center, told me.
“A lot of these concentrates can have up to 90 percent THC,” she said, whereas the kind of flower you could get 30 years ago was far, far weaker. Scientists are not sure how such high-octane products affect people’s bodies, she said, but worry that they might have more potential for raising tolerance, introducing brain damage, and inculcating dependence.
As for new risks: In many stores, budtenders are providing medical advice with no licensing or training whatsoever. “I’m most scared of the advice to smoke marijuana during pregnancy for cramps,” said Humphreys, arguing that sellers were providing recommendations with no scientific backing, good or bad, at all.
In terms of long-standing risks, the lack of federal involvement in legalization has meant that marijuana products are not being safety-tested like pharmaceuticals; measured and dosed like food products; subjected to agricultural-safety and pesticide standards like crops; and held to labeling standards like alcohol. (Different states have different rules and testing regimes, complicating things further.)
Health experts also cited an uncomfortable truth about allowing a vice product to be widely available, loosely regulated, and fully commercialized: Heavy users will make up a huge share of sales, with businesses wanting them to buy more and spend more and use more, despite any health consequences.
“The reckless way that we are legalizing marijuana so far is mind-boggling from a public-health perspective,” Kevin Sabet, an Obama administration official and a founder of the nonprofit Smart Approaches to Marijuana, told me. “The issue now is that we have lobbyists, special interests, and people whose motivation is to make money that are writing all of these laws and taking control of the conversation.”
This is not to say that prohibition is a more attractive policy, or that legalization has proven to be a public-health disaster. “The big-picture view is that the vast majority of people who use cannabis are not going to be problematic users,” said Jolene Forman, an attorney at the Drug Policy Alliance. “They’re not going to have a cannabis-use disorder. They’re going to have a healthy relationship with it. And criminalization actually increases the harms related to cannabis, and so having a strictly regulated market where there can be limits on advertising, where only adults can purchase cannabis, and where you’re going to get a wide variety of products makes sense.”
Still, strictly regulated might mean more strictly regulated than today, at least in some places, drug-policy experts argue. “Here, what we’ve done is we’ve copied the alcohol industry fully formed, and then on steroids with very minimal regulation,” Humphreys said. “The oversight boards of a number of states are the industry themselves. We’ve learned enough about capitalism to know that’s very dangerous.”
A number of policy reforms might tamp down on problem use and protect consumers, without quashing the legal market or pivoting back to prohibition and all its harms. One extreme option would be to require markets to be noncommercial: The District of Columbia, for instance, does not allow recreational sales, but does allow home cultivation and the gifting of marijuana products among adults.
“If I got to pick a policy, that would probably be it,” Kleiman told me. “That would be a fine place to be if we were starting from prohibition, but we are starting from patchwork legalization. As the Vermont farmer says, I don’t think you can get there from here. I fear its time has passed. It’s generally true that the drug warriors have never missed an opportunity to miss an opportunity.”
There’s no shortage of other reasonable proposals, many already in place or under consideration in some states. The government could run marijuana stores, as in Canada. States could require budtenders to have some training or to refrain from making medical claims. They could ask users to set a monthly THC purchase cap and remain under it. They could cap the amount of THC in products, and bar producers from making edibles that are attractive to kids, like candies. A ban or limits on marijuana advertising are also options, as is requiring cannabis dispensaries to post public-health information.
Then, there are THC taxes, designed to hit heavy users the hardest. Some drug-policy experts argue that such levies would just push people from marijuana to alcohol, with dangerous health consequences. “It would be like saying, ‘Let’s let the beef and pork industries market and do whatever they wish, but let’s have much tougher restrictions on tofu and seitan,’” said Mason Tvert of the Marijuana Policy Project.
“In light of the current system, where alcohol is so prevalent and is a more harmful substance, it is bad policy to steer people toward that.” Yet reducing the commercial appeal of all vice products—cigarettes, alcohol, marijuana—is an option, if not necessarily a popular one.
Perhaps most important might be reintroducing some reasonable skepticism about cannabis, especially until scientists have a better sense of the health effects of high-potency products, used frequently. Until then, listening to and believing the hundreds of thousands of users who argue marijuana is not always benign might be a good start.
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Lawmakers in France recently passed a ban on the use of smartphones in schools, impacting students in their early to midteens. In U.S. school districts where digital device policies are all over the map, parents and teachers are divided on how to curb or permit phone use in the classroom.
Some schools have students stash their phones in their lockers – as they do for middle schoolers in my Northern New Jersey town. Others have kids place them in a canvas “pocket chart” – essentially a hanging shoe organizer – in the classroom.
What most everyone agrees on is that screen-time addiction is a problem for young and old, an issue that companies such as Apple, Google and Facebook are finally tackling with recently announced software updates. You hear all too often how kids who are fixated on smartphone screens are only modeling the behavior of their parents. (It’s also not unheard of that a teacher also may use a phone in the classroom, to check on his or her own family at home.)
According to nonprofit family media watchdog Common Sense Media, 24 percent of kids from 8 to 12 years old have their own smartphone and 67 percent of their teenage counterparts do, with tweens using an average of about six hours’ worth of entertainment media daily.
Compounding the confusion is the age at which families give their kids a phone – often, but not always, when the youngster is about to enter middle school. But what effect does a kid who has a phone that’s visible at school have on a classmate who doesn’t have his or her own handset?
Some schools implement “one-to-one” programs to provide computers, tablets or other mobile devices to each student. Other cash-strapped districts may have to share tech gear in the classroom. And some educators may even encourage students to bring their own devices for class use.
It’s safe to assume that most schools aren’t about to dictate to a parent that a kid can or cannot use a device on the way to or from school, though some do actually ask families to sign commitments to temper tech use.
Keeping all this in mind, here are some of the arguments made for and against a stricter cellphone-use policy in schools.
Why cellphones should be permitted in schools
“Have a plan, not a ban,” says Liz Kline, vice president for education at Common Sense Education in the San Francisco Bay Area, a group whose mission is to help kids thrive in a world of media and technology. “There are legitimate learning contexts for using devices in the classroom,” Kline says, whether students are making movies or studying photography.
Kline acknowledges that digital distraction is “totally real,” and she recognizes that setting up the classroom norms for when it’s appropriate to use a phone – and when it is not – is not a simple matter.
Lisa Highfill, an instructional technology coach at the Pleasanton Unified public and secondary school district in Pleasanton, California, believes letting students have phones helps them prepare for higher education and eventually the workplace. “How many people go to work each day and turn their phone in?” she asks. “To me, getting ready for career and college is learning how to avoid the distraction of your phone.”
Educators should have dialogs with students about when and why kids feel compelled to pick up their devices, she says. “Teach students how to refocus, how to take care of something that is really nagging at them and then move on and put it away … Self-monitoring is a lifelong skill that we have an opportunity to integrate into our lessons.”
Of course, there ought to be times when phones are put away or even collected by teachers, no questions asked, namely during test time. Indeed, some students use the devices to cheat.
Safety concerns are also often given as a reason to let kids have devices at school. When there’s an accident or tragic incident, the presence of phones lets parents get in touch with the kids, and the kids can get in touch with a parent.
“Phones are as much for peace of mind of parents as they are for kids,“ says New York City-based social media coach Sree Sreenivasan, a parent and co-founder of the Digimentors consulting firm.
But parents may also try to reach the youngsters under more routine circumstances.
“I ask kids all the time, who do you normally get texts from during school? Their friends, of course,” Highfill says. “But their mothers are texting them, and it’s actually very practical. ‘Don’t forget to talk to your math teacher’ or ‘don’t forget you have this appointment at the end of the day.’ ”
Kline adds another dimension to the let-kids-have-phones-in-school argument. In some lower-income areas where there’s concern surrounding the digital divide, the school might offer the kind of speedy internet access that is not available at home. “I think there is some nuance around this,” she says.
And then there’s this argument: Restrictions just might not work.
“I really believe that the more rules and restrictions you put on top down, the more kids will just work to try to work around those rules. And they’re good at it, the best hackers,” Highfill says.
When her IT department blocked Snapchat access at school, kids built their own server as a workaround. Highfill also knows of students who put their cellphone cases – but not the phones themselves – inside pocket charts to fool teachers.
The case against phones in class
“When we’re asking these 12 to 13 year olds to carry the phone and not be on them, we 100 percent know that’s not happening,” says Delaney Ruston, a physician and director of the documentary “Screenagers: Growing Up in the Digital Age.” “You can go into any classroom or ask any middle schooler, and they will tell you consistently how they and/or their friends are sneaking being on the phones during class times.”
The consequences? According to the “Away For The Day” initiative Ruston developed with the team behind “Screenagers” to try to institute policies requiring phones to be put away, 56 percent of middle schools allow students to carry phones on them all day, yet 82 percent of parents don’t want their kids using phones there.
The Away For The Day website cites various academic studies that point to potential negative outcomes of classroom phone use. In one such study, 75 percent of teachers reported that the attention spans of students have decreased. In another study, students regularly interrupted by text messages had test scores that were 10.6 percent lower.
Ruston believes that putting the phones away can improve a child’s emotional well-being in school and help with their focus in and out of the classroom.
And while she recognizes that a teacher might ask a kid to pull out a phone during a given lesson, “to do X, Y, Z … the reality is that many of these kids now on their personal device have gotten so many notifications that they’re actually not going to whatever the teacher is saying they should be doing, but instead sending and receiving messages or going onto their video games.”
“You’re already going to have those struggles with (school supplied) educational devices,” Ruston adds, “but it gets exponentially more challenging when it’s a personal device.”
Even if a device on a student’s desk is turned off, the worry is that it still becomes a distraction.
Ruston also dismisses the safety argument. She pointed to an NPR report in which security experts have said that letting a kid have a phone in the classroom during a lockdown makes them less safe, not more. When students should be quiet, for example, a ringing or vibrating phone might alert an assailant where kids are hiding. Parents trying to reach youngsters in an emergency might jam communications and interfere with first responders. And the kids might miss instructions from the authorities.
But Ruston concedes that “that’s not to say there’s not an emotional upside for a parent.”
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As Homer once said, this infamous molecule is both “the cause of, and the solution to, all of life’s problems”.
OK, it was Homer Simpson who said that rather than the classical bard, but it’s no less true or profound for that. Sometimes, the rubbish you come out with when you’re drunk really is quite clever, or funny, or both, so long as you can remember it properly the next morning.
Our ambiguous relationship with alcohol is older than civilisation – in fact there’s a strong argument that it was the cause of civilisation itself. We’ve been drinking it since our dawn as a species, and it probably helped us evolve into humans in the first place. It may even have played a role in the very creation of life on earth. No, I’m not drunk. This is proper science.
For all that time, alcohol has been, as Simpson said so beautifully, both a cause of great pleasure and, for a minority, colossal pain. Our relationship as a society with alcohol swings on a pendulum over time between celebrating the positives and deploring the negatives, and right now we’re over on the temperance side. Between 1785 and 1985, The Times used the term “binge drinking” a total of 49 times. The same paper ran over 300 stories about binge drinking in 2004 alone. Which is odd, because people were drinking much less in 2004 than their ancestors had been at pretty much any point in the preceding two centuries.
This means we live in an age of alarmist misinformation about the perils of booze, with a growing belief that any level of consumption of this “poison” is potentially harmful. If there were any truth to this claim, given the quantities we used to drink in the past, the human race would have been extinct long ago.
So what does alcohol really do to us? And how does it do it? The truth is, neuroscientists are still in the process of figuring this out. To a significant degree, it depends on who you are, what your relationship with alcohol is, what and how you’re drinking, and also, ultimately, what you mean by “drunk”.
Let’s look at the physiological effects first. The active component in booze is ethanol, which as molecules go, has all the sly charm of one of those beery lads who can worm his way past the velvet ropes of any bar in the world. Water soluble and small enough to pass through and between cell walls, ethanol is drawn first to the liver, which immediately begins to break it down. But the liver only works so fast, so surplus ethanol shoots on through to every part of the body and ends up in the brain within minutes. It does all sorts of stuff to our digestive system, our motor functions, our need to pee and much more, but it’s the feeling of drunkenness that fascinates us.
Information and instructions are carried around the brain by neurons – excitable cells that carry data. Neurons don’t touch, but communicate across tiny gaps known as synapses, using chemicals known as neurotransmitters. Simplistically, these fall into two types: “excitatory impulses”, which tell us to do stuff and are carried by glutamate, and “inhibitory signals” which tell us to do less, and travel via gamma-aminobutyric acid, or Gaba. Trillions of these signals are happening all the time, and their net effect is the mind itself, and our sense (some would say illusion) of consciousness.
Ethanol gleefully speeds into the synapses, cascading into the gaps between the neurons, and then sidles up to them, puts its arms around their shoulders and assures them it’s their best mate in the whole world. You might be suspicious if a stranger did this to you in a pub unless you were already gattered, but your neurons totally believe the ethanol molecules, and scientists still don’t really know why.
When it binds to glutamate, ethanol slows it down and stops it from acting, like the pub bore who pins you in the corner and gives you an episode-by-episode recap of Game of Thrones even though you keep saying yes, you’ve seen it, and you really have to go because you just remembered you left the babysitter in the oven. But it behaves quite differently with the depressive Gaba, basically convincing it to switch to shots, grab a kebab and then go on to a club and do Jägerbombs.
This double-bind effect – dulling the active signals and amplifying the sedative ones – is what we really mean when we say alcohol is a depressant: it doesn’t make you depressed – at least not at low levels – but it slows down and depresses your active functions, making the brain slower and more sedate and, given enough time and reinforcements, can accelerate the process until you pass out, or in very extreme cases, forget to breathe. But at the same time, ethanol also jacks up the release of dopamine, exciting the part of the brain that perceives reward. Your brain tells you this reward is related to the ethanol you consumed, so you consume more, depressing your brain function while increasing your sense of euphoria.
Loss of motor function, memory loss, nausea and so on often only kick in at high blood alcohol concentrations. The vast majority of drinking is more moderate, and here, perceptions of tipsiness are not as straightforward as simple brain chemistry. From the 1970s onwards, psychologist Alan Marlatt developed a series of experiments where the taste of a placebo was indistinguishable from that of an alcoholic drink. He gave the placebo to half the subjects and alcohol to the other half. But then he cut the group in half the other way too, telling half they were drinking alcohol and half they were not. So, you had people expecting alcohol and getting it, people expecting alcohol and not getting it, and vice versa with those not expecting alcohol.
Consistently, those who believed they were drinking alcohol – whether they actually were or not – showed signs of intoxication including flushed faces, more animated behaviour and slurring of speech. Those who thought they were not drinking alcohol – even alcoholics, in some of the experiments – did not. Marlatt also showed that the perceived effects of intoxication were far more pronounced in social situations than when subjects were drinking alone.
Why does alcohol make us drunk? When you look at the history of our relationship with it in light of Marlatt’s research, the smart-ass, know-it-all-on-the-bar-stool answer has to be: “Because we want it to.”
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