On ‘weed day,’ our medical analyst urges caution on recreational marijuana use | CNN



CNN
 — 

As some people mark 4/20 as “weed day,” a day of celebration of marijuana use, I don’t want to bum you out — but I might.

Over the past decade, there has been a trend toward legalizing marijuana in the United States. Currently, at least 37 states, plus Washington, DC, have a comprehensive medical cannabis program. A growing number of states, currently at 21, have legalized recreational marijuana use.

I wanted to learn about the research around marijuana use, including the effects it has on the user and the medicinal uses for cannabis. I turned to CNN Medical Analyst Dr. Leana Wen, who has many concerns about recreational cannabis use, especially for certain populations such as young people and pregnant people.

Wen, who urged users and would-be users to be cautious, is an emergency physician and professor of health policy and management at the George Washington University Milken Institute School of Public Health. She previously served as Baltimore’s health commissioner and as chair of Behavioral Health System Baltimore, where she oversaw policy and services around substances that can cause addiction, including marijuana.

CNN: What are the physiological effects of marijuana?

Dr. Leana Wen: Marijuana is a plant that has many active ingredients. One of the principal ones is a psychoactive compound called tetrahydrocannabinol. Often called THC, it’s similar to compounds that are naturally occurring in the body called cannabinoids and can mimic their function by attaching to cannabinoid receptors in the brain. In so doing, THC can disrupt normal mental and physical functions, including memory, concentration, movement and coordination.

Using marijuana can cause impaired thinking and interfere with someone’s ability to learn, according to the National Institute on Drug Abuse. Smoking cannabis can also impair the function of the parts of the brain that regulate balance, posture and reaction time. And THC stimulates the neurons involved in the reward system that release dopamine, or the “feel-good” brain chemical, which contributes to its addictive potential.

CNN: Marijuana is thought to have some positive and medicinal benefits. How can it be used for therapeutic purposes?

Wen: Short-term, many users report pleasant feelings, including happiness and relaxation. As a result, some people use marijuana to self-treat anxiety or depression. This is not a recommended use. What often ends up happening is that the person develops tolerance, requiring more and more of the drug to get the same effect.

There are some approved medicinal uses of marijuana for very specific indications. The US Food and Drug Administration has approved THC-based medications that are prescribed in pill form for treatment of nausea in patients with cancer undergoing chemotherapy and to stimulate appetite in patients with AIDS. There are several marijuana-based medications that are undergoing clinical trials for conditions like neuropathic pain, overactive bladder and muscle stiffness.

I think it’s really important for these and many more studies to continue. Researchers should continue to look not just at marijuana itself but its specific chemical components, since botanicals in their natural form can contain hundreds of active chemicals and obtaining the correct dosages may be challenging. In the meantime, users should use caution in evaluating supposed medicinal claims and clearly understand the risks of cannabis use.

CNN: What are the risks of marijuana use, and who may be particularly vulnerable to them?

Wen: The main concern about marijuana use is its impact on the developing brain. As the US Centers for Disease Control and Prevention states on its website, “Marijuana affects brain development. Developing brains, such as those in babies, children, and teenagers, are particularly susceptible to the harmful effects of marijuana and tetrahydrocannabinol.”

Numerous studies have linked marijuana use in women during pregnancy to a variety of cognitive and behavioral problems in their children. The CDC even warns against secondhand marijuana smoke exposure, and it also encourages breastfeeding individuals to avoid marijuana use.

Marijuana affects young people throughout adolescence and young adulthood. Much research has shown how marijuana use in childhood impacts memory, attention, learning and motivation. Regular cannabis use in adolescence is associated with higher likelihood of not completing high school and even lower IQ later in life. The negative impacts persist beyond the teen years. Some studies of university students have found that the regularity of marijuana use is correlated with lower grade point average in college.

I want to emphasize here that there is still a lot that we don’t know about the effects of marijuana, in particular long-term consequences. A recent study found that in adults, daily use of regular marijuana can increase the risk of coronary artery disease by as much as one-third. That’s the point, though; all the unknowns are exactly why I and many other clinicians and scientists urge caution.

To be clear, there are many reasons to support policy changes of decriminalizing marijuana, including to rectify the decades-long injustices of disproportionately incarcerating minority individuals for marijuana possession. However, supporting decriminalization should not be equated with believing that marijuana is totally safe. It’s not. Marijuana has the potential to cause real and lasting harm, especially to young people.

CNN: Could someone become addicted to marijuana?

Wen: Yes. There is a condition known as marijuana use disorder. Signs of this disorder include trying but failing to quit using marijuana;, continuing to use it even though it is causing problems at home, school or work;, and using marijuana in high-risk situations, including while driving. Some individuals, especially those who use large amounts, experience withdrawal symptoms when they try to stop.

As many as 3 in 10 people who use marijuana have marijuana use disorder, according to the CDC. The risk of developing marijuana use disorder is greater among those who use it more frequently and for those who started earlier in life.

CNN: Some people say that marijuana is no big deal, especially in comparison with other substances like alcohol and opioids. Would you agree that cannabis use is at least better than using those substances?

Wen: I wouldn’t frame it that way. It is true that marijuana doesn’t cause liver damage the way that high amounts of alcohol does, and it doesn’t have the lethality of opioids. If an adult is using marijuana once in a while, and not while driving, it’s probably not going to have lasting consequences.

However, there are harms associated with more frequent use of marijuana and in particular its use in children. In my opinion, the legalization movement has shifted the conversation so much towards acceptance of cannabis that we are neglecting the fact that it is a drug and, I believe, should be regulated just like alcohol, tobacco and opioids.

There should also be much more messaging and education so that people, including young people and their parents or guardians, can be aware of the harms of marijuana — just as they are aware of the harms of other drugs.

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Biden’s rebuke of a bold, reform-minded crime law makes all Americans less safe

President Joe Biden’s support for a Republican-led effort to nullify the Washington D.C. City Council’s revision of its criminal code, signed into law on Monday, plays into the fear narrative that is being increasingly advanced across the U.S.

Biden could have used his platform and clout to clarify the actual substance of the carefully crafted District of Columbia proposal — and adhere to his campaign commitment to reduce the number of incarcerated Americans.

Instead, the president ignored the glaring problems in D.C.’s existing criminal code, which the 275-page long package of revisions was designed to address. This included reforming the draconian and inflexible sentencing requirements that have swelled the District’s incarceration rate and wasted countless resources imprisoning individuals who pose no danger to public safety. By rejecting this decade-plus effort, the president decided that D.C. residents have no right to determine for themselves how to fix these problems.

There are communities across the U.S. that see virtually no violent crime, and it isn’t because they’re the most policed.

Biden’s decision is the latest backlash to U.S. justice reform coming from both sides of the political aisle.

Instead of doubling down on failed tough-on-crime tactics, Americans need to come together to articulate and invest in a new vision of public safety. We already know what that looks like because there are communities across the country which see virtually no violent crime, and it isn’t because they’re the most policed.

Safe communities are places where people (even those facing economic distress) are housed, where schools have the resources to teach all children, where the water and air are clean, where families have access to good-paying jobs and comprehensive healthcare, and where those who are struggling are given a hand, not a handcuff.

This is the kind of community every American deserves to live in, but that future is only possible if we shift resources from carceral responses to communities and shift our mindset from punishment to prevention. 

Too often it’s easier to advocate for locking people up than it is to innovate and advance a new vision for public safety. 

In the wake of particularly traumatic years, as well as growing divisiveness that has politicized criminal justice reform, it is not surprising that many people believe their communities are less safe. While public perceptions of crime have long been disconnected from actual crime rates and can be heavily influenced by media coverage, the data tells a mixed story. Homicide rates did increase in both urban and rural areas in the wake of the COVID-19 pandemic and record levels of gun sales.

While early available data suggests these numbers are trending down, it’s too soon to tell, especially given the nation’s poor crime data infrastructure. What is clear is that there is no evidence that criminal justice reform is to blame for rising crime, despite well-funded attempts by those resistant to change and who are intent on driving a political agenda to make such a claim stick. 

Yet fear often obscures facts; people are scared for their safety and want reassurance. Too often it’s easier to advocate for locking people up than it is to innovate and advance a new vision for public safety. 

We need leaders who can govern with both empathy and integrity – who can provide genuine compassion to those who feel scared while also following the data about how to create safer communities. And all the data points to the need for reform. 

Mass incarceration costs U.S. taxpayers an estimated $1 trillion annually.

Mass incarceration costs U.S. taxpayers an estimated $1 trillion annually, when you factor in not only the cost of confinement but also the crushing toll placed on incarcerated people and their families, children, and communities. Despite this staggering figure, there’s no real evidence that incarceration works, and in fact some evidence to suggest it actually makes people more likely to commit future crimes. Yet we keep pouring more and more taxpayer dollars into this short-sighted solution that, instead of preventing harm, only delays and compounds it. 

We have to stop pretending that reform is the real threat to public safety and recognize how our over-reliance on incarceration actually makes us less safe. 

Reform and public safety go hand in hand. Commonsense changes including reforming cash bail, revisiting extreme sentences and diverting people from the criminal legal system have all been shown to have positive effects on individuals and communities.

At a time of record-low clearance rates nationwide and staffing challenges in police departments and prosecutor’s offices, arresting and prosecuting people for low-level offenses that do not impact public safety can actually make us less safe by directing resources away from solving serious crimes and creating collateral consequences for people that make it harder to escape cycles of poverty and crime. 

Yet, tough-on-crime proponents repeatedly misrepresent justice reform by claiming that reformers are simply letting people who commit crimes off the hook. Nothing could be further from the truth. Reform does not mean a lack of accountability, but rather a more effective version of accountability for everyone involved. 

Our traditional criminal legal system has failed victims time and again. In a 2022 survey of crime survivors, just 8% said that the justice system was very helpful in navigating the legal process and being connected to services. Many said they didn’t even report the crime because of distrust of the system. 

When asked what they want, many crime survivors express a fundamental desire to ensure that the person who caused them harm doesn’t hurt them or anyone else ever again. But status quo approaches aren’t providing that. The best available data shows that 7 in 10 people released from prison in 2012 were rearrested within five years. Perhaps that’s why crime victims support alternatives to traditional prosecution and incarceration by large margins. 

For example, in New York City, Common Justice offered the first alternative-to-incarceration program in the country focused on violent felonies in adult courts. When given the option, 90% of eligible victims chose to participate in a restorative justice program through Common Justice over incarcerating the person who harmed them. Just 7% of participants have been terminated from the program for committing a new crime. 

A restorative justice program launched by former San Francisco District Attorney George Gascón for youth facing serious felony charges was shown to reduce participants’ likelihood of rearrest by 44 percent within six months compared to youth who went through the traditional juvenile justice system, and the effects were still notable even four years after the initial offer to participate.

Multnomah County District Attorney Mike Schmidt launched a groundbreaking program last year to allow people convicted of violent offenses to avoid prison time if they commit to behavioral health treatment. As of January, just one of 60 participants had been rearrested for a misdemeanor. 

While too many politicians give lip service to reform, those who really care about justice are doing the work, regardless of electoral consequences. We need more bold, innovative leaders willing to rethink how we achieve safety and accountability, not those who go where the wind blows and spread misinformation for political gain. 

Fear should not cause us to repeat the mistakes of the past. When politicians finally decide to care more about protecting people than protecting their own power, only then will we finally achieve the safety that all communities deserve. 

Miriam Aroni Krinsky is the executive director of Fair and Just Prosecution, a former federal prosecutor, and the author of Change from Within: Reimagining the 21st-Century Prosecutor. Alyssa Kress is the communications director of Fair and Just Prosecution.  

More: Wrongful convictions cost American taxpayers hundreds of millions of dollars a year. Wrongdoing prosecutors must be held accountable.

Plus: Senate votes to block D.C. crime laws, with Biden’s support

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Was George Santos The Dashing ATM Robber Gentleman Bandit?

George Santos, who as far as we know may actually be Andy Kaufman [Dok, you say everyone is Andy Kaufman! — Rebecca], allegedly ran a credit-card-skimming operation in Seattle in 2017, according to the man convicted of the crime and deported to Brazil for it. Gustavo Ribeiro Trelha, who roomed with Santos at the time, sent a sworn declaration to US law enforcement agencies detailing the accusation, according to Politico, which obtained a copy of the declaration and also interviewed Trelha by phone.

At this point, we’re ready to believe just about anything about Santos, including the possibility that he’s actually an alien time traveler fucking around with us while he’s on spring break from Tralfamadore Polytechnic.


In the declaration (translated from his native Portuguese), Trelha writes, “I am coming forward today to declare that the person in charge of the crime of credit card fraud when I was arrested was George Santos / Anthony Devolder.” He said that he recognized Santos on TV after he was elected to Congress.

Politico reports that postal receipts show the declaration was sent to the FBI, the US Secret Service, and the US Attorney’s office for the Eastern District of New York, by Trelha’s New York attorney, Mark Demetropoulos.

And by golly, there are some definite connections: Politico reports it’s seen a copy of a lease showing that Trelha rented a room in Santos’s apartment in Winter Park, Florida, starting in November 2016. As Politico notes, Santos

was previously questioned about the Seattle scheme by investigators for the U.S. Secret Service, CBS News has reported. He was never charged, but the investigation remains open. Santos also told an attorney friend he was “an informant” in the fraud case. Trelha insists he was its mastermind.

And golly, what a tale! The two met through a Facebook group for expatriate Brazilians living in Orlando in the fall of 2016. Trelha writes that while he rented from Santos, that was “where and when I learned from him how to clone ATM and credit cards.”

Santos taught me how to skim card information and how to clone cards. He gave me all the materials and taught me how to put skimming devices and cameras on ATM machines.

He alleges Santos had a warehouse in Orlando where he

had a lot of material — parts, printers, blank ATM and credit cards to be painted and engraved with stolen account and personal information.

Santos gave me at his warehouse, some of the parts to illegally skim credit card information. Right after he gave me the card skimming and cloning machines, he taught me how to use them.

We do have to say that while this sounds plausible, the idea that George Santos actually mastered any real skills, even criminal ones, seems out of character. We can see him lying about being a criminal genius, though, and lying well enough to fool someone else into actually doing crimes.

After training under Santos in the ways of the scammer — we can certainly envision a montage here, with hilarious failures and no actual success — Trelha says, he flew to Seattle and got arrested right quick, on April 27, 2017, when a security camera captured him removing a skimming device from a Chase ATM.

At the time of his arrest, Trelha had a fake Brazilian ID card and 10 suspected fraudulent cards in his hotel room, according to police documents. An empty FedEx package police found in his rental car was sent from the Winter Park unit he shared with Santos.

But did they scan it for alien DNA? Big oversight, guys.

It gets, as you’d expect, stupider. Trelha wrote in his declaration that Santos had promised him to split the money from their frauding 50-50, and that it was all very high-tech:

We used a computer to be able to download the information on the pieces. We also used an external hard drive to save the filming, because the skimmer took the information from the card, and the camera took the password.

It didn’t work out so well, because I was arrested.

Has Netflix or HBO snapped up the movie rights yet?

Trelha said Santos visited him in jail in Seattle, and told him “not to say anything about him.” What’s more, he says Santos “threatened my friends in Florida that I must not say that he was my boss.” The friends, he wrote, were “all afraid of something happening to them,” which is why he’s since lost track of them.

Then there’s this, which has the ring of absolute authenticity: Trelha concludes the narrative by saying, “Santos did not help me to get out of jail. He also stole the money that I had collected for my bail.”

That’s our George all right!

Politico adds that in an interview, Trelha said that

before flying to Seattle, Santos had traveled to Orlando to pick up $20,000 in cash he instructed Leide Oliveira Santos, another roommate, to give him from a safe. Santos had promised to hire El Chapo’s lawyer for Trelha, he said.

Again, that’s very Santosian or Santosesque: not just any lawyer, but El Chapo’s lawyer. What’s more, we get a little more documented fibbing by Santos:

In an audio recording of Trelha’s May 15, 2017 arraignment in King County Superior Court, Santos tells the judge he’s a “family friend” who was there to secure a local Airbnb if the defendant was released on bail.

Santos also claimed to the judge he worked for Goldman Sachs in New York, a key part of his campaign biography he later admitted wasn’t true.

They should have asked his wife, Morgan Fairchild, whom he has seen naked more than once.

But nah, it all evaporated. No El Chapo lawyer, not even an el cheapo lawyer. Santos didn’t even call Saul — or Lionel Hutz — and Trelha never heard another word from him. Oliveira Santos couldn’t contact him, either. By then, Santos had run off to Venice, where he took to calling himself Tom Ripley.

Trelha couldn’t make bail, and pleaded guilty to “felony access device fraud,” for which he spent seven months in prison. After that, he was deported to Brazil in 2018, where we hope he’s kept his nose clean.

Trelha says he has witnesses who can back him up on all this, and Politico closes the story thusly:

A federal prosecutor who handled Trelha’s case described the scheme as “sophisticated,” adding that the Seattle portion was only “the tip of the iceberg,” according to court records reported by CBS News. But a person close to the investigation who is not authorized to speak publicly said they saw no evidence that prosecutors did forensic reports on Trelha’s phone or seemed motivated to pursue international co-conspirators.

Hmm!

We tried to contact Rep. Santos about all this, but all we could learn was that the congressman was last seen talking to a detective in Los Angeles who tried to follow him when he realized Santos was Keyzer Söze, but by then he’d vanished.

[Politico / ATM image by Mike Mozart, Creative Commons License 2.0, cropped and digitally altered]

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‘Phishing-as-a-service’ kits are driving an uptick in theft: What you can learn from one business owner’s story

Cody Mullenaux and his family. Mullenaux was the victim of a sophisticated wire fraud scheme that has resulted in $120,000 being stolen

Courtesy: Cody Mullenaux

Banks have spent enormous amounts on cybersecurity and fraud detection but what happens when criminal tactics are sophisticated enough to even fool bank employees? 

For Cody Mullenaux, it meant having more than $120,000 wired from his Chase checking account with little hope of ever recouping his stolen funds.

The saga for Mullenaux, a 40-year-old small business owner from California, began on Dec. 19. While Christmas shopping for his young daughter, he received a call from a person claiming to be from the Chase fraud department and asking to verify a suspicious transaction.

The 800-number matched Chase customer service so Mullenaux didn’t think it was suspicious when the person asked him to log into his account via a secured link sent by text message for identification purposes. The link looked legitimate and the website that opened appeared identical to his Chase banking app, so he logged in. 

“It never even crossed my mind that I was not speaking with a legitimate Chase representative,” Mullenaux told CNBC.

Gone are the days when the only thing a consumer had to be wary of was a suspicious email or link. Cybercriminals’ tactics have morphed into multipronged schemes, with multiple criminals acting as a team to deploy sophisticated tactics involving readymade software sold in kits that mask phone numbers and mimic login pages of a victim’s bank. It’s a pervasive threat that cybersecurity experts say is driving an uptick in activity. They predict it will only get worse. Unfortunately, for victim of these schemes, the bank isn’t always required to repay the stolen funds.

After he was logged in, Mullenaux said he saw large amounts of money moving between his accounts. The person on the phone told him someone was in his account actively trying to steal his money and that the only way to keep it safe was to wire money to the bank supervisor, where it would be temporarily held while they secured his account.

Terrified that his hard-earned savings was about to be stolen, Mullenaux said he stayed on the phone for nearly three hours, followed all the instructions he was given and answered additional security questions he was asked. 

CNBC has reviewed Mullenaux’s cellular records, bank account information, as well as images of the text message and link he was sent.

A team of scammers

Cody Mullenaux, the inventor and founder of Aquaphant, a technology company that converts moisture from the air into filtered water, with his team and family.

Courtesy: Cody Mullenaux

Little recourse for victims of wire scams

Mullenaux said he feels frustrated and defeated about his experience trying to recover his stolen funds.

“No matter what they do to try and safeguard customers, scammers are always one step ahead,” Mullenaux said, adding that his money would have been safer in a shoebox than in a big bank that cybercriminals are targeting.

The Federal Trade Commission advises that any customer who thinks they might have sent money to scammers via a wire transfer should immediately contact their bank, report the fraudulent transfer and ask for it to be reversed.

Time is critical when trying to recover funds sent via fraudulent wire transfer, the FTC told CNBC. The agency said victims should also report the crime to the agency as well as the FBI’s Internet Crime Complaint Center, the same day or next day, if possible. 

Mullenaux said he realized something was wrong the next morning when his funds had not been returned to his account.

He immediately drove to his local Chase bank branch where he was told he had likely been the victim of fraud. Mullenaux said the matter wasn’t handled with any sense of urgency, and a reverse wire transfer attempt, which the FTC suggests customers ask for, wasn’t offered as an option.

Instead, Mullenaux said the branch employee told him he would receive a packet in the mail within 10 days that he could fill out to file a claim. Mullenaux asked for the packet immediately. He filled it out and submitted it the same day.

That claim, along with a second one Mullenaux filed with the executive branch, were denied. The employees investigating the matter said Mullenaux had called to authorize the wire transfers.

Cody Mullenaux and his daughter. Mullenaux had been shopping for Christmas gifts for his daughter when he received a call from a man impersonating a Chase fraud department employee.

Courtesy: Cody Mullenaux

CNBC provided Chase with Mullenaux’s cellular phone records that showed he never made any outgoing phone calls to Chase on the day in question. The records also suggest, when compared with the wire transfer records, that it could not have been Mullenaux who called Chase to authorize the wire transfers because all three were authorized and went through while Mullenaux was still on the phone with the scammers.

However, that didn’t change the bank’s decision and, again, Mullenaux’s claim was denied since he had shared his private information with the criminals.

Scammers exploited regulatory loopholes

Whether the scammers realized they were doing it or not, they successfully exploited two loopholes in current consumer protection legislation that resulted in Chase not being required to replace Mullenaux’s stolen funds. Legally, banks do not have to reimburse stolen funds when a customer is tricked into sending money to a cybercriminal.

However, under the Electronic Fund Transfer Act, which covers most types of electronic transactions like peer-to-peer payments and online payments or transfers, banks are required to repay customers when funds are stolen without the customer authorizing it. Unfortunately, wire transfers, which involve transferring money from one bank to another, are not covered under the act, which also excludes fraud involving paper checks and prepaid cards.

The cybercriminals also transferred funds from Mullenaux’s personal checking and savings accounts to his business account before initiating the wire transfers. Regulation E, which is designed to help consumers get their money back from an unauthorized transaction, only protects individuals, not business accounts.

A representative for Chase said that the investigation is ongoing as the bank tries to recover the stolen funds.

That is something Mullenaux says he is praying for. “I pray that this tragedy is somehow reconciled, that [bank] management sees what happened to me and my money is returned.”

Mullenaux has also filed reports with the local police and the FBI’s Internet Crime Complaint Center, but neither have contacted him about his case.

Sophisticated scamming tactics on the rise

It’s not just Chase customers being targeted by cybercriminals with these sophisticated schemes. This past summer, IronNet uncovered a “phishing-as-a-service” platform that sells ready-made phishing kits to cybercriminals that target U.S.-based companies, including banks. The customizable kits can cost as little as $50 per month and include code, graphics and configuration files to resemble bank login pages.

Joey Fitzpatrick, a threat analysis manager at IronNet, said that while he can’t say for certain that this is how Mullenaux was defrauded, “the attack against him bears all the hallmarks of attackers leveraging the same sort of multimodal tools that phishing-as-a-service platforms provide.”

He expects “as-a-service”-type offerings will only continue to gain traction as the kits not only lower the bar for low- to medium-tier cybercriminals to create phishing campaigns, but it also enables the higher-tier criminals to focus on a single area and develop more sophisticated tactics and malware.

“We’ve seen a 10% increase in deployment of phishing kits in January 2023 alone,” Fitzpatrick said.

In 2022, the company saw a 45% increase in phishing alerts and detections.

But it’s not just phishing schemes on the rise, it’s all cyberattacks. Data from Check Point showed in 2022 there was a 52% increase in weekly cyberattacks on the finance/banking sector compared with attacks in 2021.

“The sophistication of cyberattacks and fraud schemes has significantly increased during the last year,” said Sergey Shykevich, the threat group manager at Check Point. “Now, in many cases cybercriminals don’t rely only on sending phishing/malicious emails and waiting for the people to click it, but combine it with phone calls, MFA [multifactor authentication] fatigue attacks and more.”

Both cybersecurity experts said banks can be doing more to educate customers. 

Shykevich said the banks should invest in better threat intelligence that can detect and block methods cybercriminals use. An example he gave is comparing a login to a person’s digital “fingerprint,” which is based on data such as the browser an account uses, screen resolution or keyboard language.

Best advice: Hang up the phone

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Children’s mental health tops list of parent worries, survey finds | CNN



CNN
 — 

Forty percent of US parents are “extremely” or “very” worried that their children will struggle with anxiety or depression at some point, a new survey finds.

The Pew Research Center report said mental health was the greatest concern among parents, followed by bullying, which worries 35% of parents. These concerns trumped fears of kidnapping, dangers of drugs and alcohol, teen pregnancy and getting into trouble with the police.

Concerns varied by race, ethnicity and income level, with roughly 4 in 10 Latino and low-income parents and 3 in 10 Black parents saying they are extremely or very worried that their children could be shot, compared with about 1 in 10 high-income or White parents.

Nearly two-thirds of the respondents said that being a parent has been at least somewhat harder than they expected, about 41% say that being a parent is tiring, and 29% say it is stressful all or most of the time.

The report captured the perceptions of a nationally representative sample of 3,757 US parents whose children were younger than 18 in 2022.

Experts say mental health issues among children and adolescents have skyrocketed in recent years.

“I would say over the last 10 years, since I’ve been practicing as a general pediatrician, I have seen a shift both in the amount of patients and of all ages dealing with anxiety and depression. And their parents being concerned about this is a key issue,” said Dr. Katherine Williamson, a pediatrician and spokesperson for the American Academy of Pediatrics. “Even before the pandemic, we were seeing skyrocketing numbers of kids and adolescents dealing with mental health issues, and that has increased exponentially since the pandemic.”

Suicide became the second leading cause of death among children 10 to 14 during the Covid-19 pandemic, according to the US Centers for Disease Control and Prevention. Mental health-related emergency room visits among adolescents 5 to 11 and 12 to 17 also jumped 24% and 31%, respectively.

Many parents feel helpless when their children have mental health issues because they don’t feel equipped to offer support in this area.

“They are unable to relieve [mental health issues] and address that as they could if they were struggling with their grades or other things that seem more traditional to for kids to struggle with,” said Allen Sabey, a family therapist at the Family Institute at Northwestern University.

Parents trying to “work out and look at and connect with their own feelings will give them important information about what feels off or OK for their kid,” he said.

When it comes to anxiety and depression in children, pediatricians say, parents can watch for signs like decreased interest or pleasure in things they previously enjoyed, poor self-esteem and changes in mood, appetite or sleep.

Experts also say parents should consider the amount and content of social media their child consumes, as research has found that it can have negative effects on their mental health.

But, they say, having more parents recognize the importance of mental health in children is a step in the right direction.

“I have always felt there’s been so much resistance to seeking care for mental health among the population that I serve. And I am actually happy that since the Covid pandemic, at least people now are recognizing this as a very key and important health need,” said Dr. Maggi Smeal, a pediatrician at Stanford Medicine Children’s Health.

Smeal hopes that “all people that are interacting with children can be aware of these issues and feel empowered to identify and advocate for these children, to tell them to go to their primary care provider and have an assessment just like you do if your kid has a cough or a fever or ear infection.”

The number of parents concerned about gun violence reflects the fact that guns are the leading cause of death among children in the US, research has showed. From 2019 to 2020, the rate of firearm-related deaths increased 29.5% – more than twice the increase as in the general population.

“Gun violence is a real risk to our kids today. And that is both being killed by somebody else as well as suicide in the face of the mental health issues that we’re seeing today,” Williamson said.

The survey found that Black, Hispanic and lower-income parents were most likely to be concerned about gun violence, a finding that’s consistent with the communities most affected. Research has shown that from 2018 to 2021, the rate of firearm-related deaths doubled among Black youth and increased 50% among Hispanic youth. Another study found that children living in low-income areas are at higher risk of firearm-related death.

Direct and indirect exposure to gun violence can contribute to mental health problems.

“Even if they hear gunshots in their community, they hear adults talking, there’s all different ways that children are traumatized and victimized by gun violence. And what we see is all the symptoms of anxiety in even the youngest of children. We see children with somatic complaints – stomachaches, headaches. They have post-traumatic stress disorder,” Smeal said.

Most of the parents in the survey said parenting is harder than they expected, and that they feel judgment from various sources.

“The findings of this of this report were, as a pediatrician and a parent, just exactly what you would expect. Parenting is the hardest thing you’ll ever do, and there are very high levels of stress and fatigue, especially in the parents of young children,” Smeal said.

One of the best things parents can do is lean on fellow parents, experts say.

“The main challenge for parents is our siloed independent nature sometimes, and so we want to find people who we trust and kind of work towards being more vulnerable and open with,” Sabey said. “To where it’s like not just you and your kid, but it’s a kind of a group of people caring and working together.”

Pediatricians emphasize that no parent is perfect and that the most important thing you can do is to just be there for your child.

“We know that the best chance for a child to be successful and happy is for them to have at least one person in their life who believes in them and advocates for them. So I think it’s important for parents to know that there’s no such thing as a perfect parent, because we are all human, and humans are imperfect by nature, but that is OK,” Williamson said.

A parent’s job is to “really make sure that they know how important they are and they have a voice in this world,” she said. “Every child will have their own unique struggles, whether it is academically, emotionally, physically. Our job is to help them with the areas [where] they struggle, but even more, help them recognize their strengths.”

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How to be prepared in case of a shooting without living in fear | CNN



CNN
 — 

At first, Brandon Tsay froze when a gunman aimed a firearm at him, he said. He was sure those would be his last moments.

But then something came over Tsay, who was working the ticket counter in the lobby of his family’s Lai Lai Ballroom & Studio, a dance hall in Alhambra, California.

He lunged toward the armed man and struggled through being hit several times in order to wrestle the gun away, he told CNN’s Anderson Cooper Monday evening.

The gunman had already killed 11 people and injured 10 others before arriving at Tsay’s workplace.

Tsay’s courage saved his life that day, but probably also saved countless more, said Ronald Tunkel, a former special agent with the US Bureau of Alcohol, Tobacco, Firearms and Explosives, who was trained as a criminal profiler.

While Tsay’s actions show heroism and bravery, what he did is more possible than people think, said Dr. Ragy Girgis, associate professor of clinical psychiatry at Columbia University in New York City.

“People have a great capacity for responding to tragedies like these. People wouldn’t realize how heroically they could respond,” he said.

Fortunately, most people will not find themselves in a situation in which they will have to respond to a mass shooter, Girgis said. But incidents like these are all too common and on the rise in the US, according to the Gun Violence Archive.

There is not much research on intervention in mass shootings by civilians, Girgis said.

Still, as the US sees mass shootings on a regular basis, companies, nonprofits and schools are training people about how to respond. Tunkel and Jon Pascal, an instructor for both Krav Maga Worldwide and the Force Training Institute, say they are seeing more training and protocols around active shooting situations for everyday people.

A word of warning: If your awareness around safety starts to contribute to anxiety or interfere with life in a meaningful way, it may be time to consult a mental health expert, said psychiatrist Dr. Keith Stowell, chief medical officer of behavioral health and addictions for Rutgers Health and RWJBarnabas Health.

Tunkel said being able to respond effectively to emergency situations takes two things: awareness and preparation.

Create “a habit of safety,” Pascal recommended. That means that people should routinely make note of the mood of crowds they are in, the exits and entrances, and what tools are available around them in case they need to respond to a scary event.

“We don’t want to walk around paranoid and not live our lives, but I think if we make personal safety a habit, it becomes something normal,” he said.

Your worst-case scenario is probably never going to happen, but being prepared means you have ways to take care of yourself and those around you if it does, Pascal added.

In addition to implementing awareness of your surroundings, Pascal recommends making a plan for how you will respond in case of medical, fire or violent emergencies.

It is always important to look for two ways of exiting a building in case danger or an obstacle is blocking one, he said. And at home or in workplaces, he recommended taking note of doors that can be locked and things that can be used to barricade.

Once you have the plan, practice it, he added. That bookcase might look like the perfect barricade in your head, but then be impossible to move in an emergency, Pascal said. And you want to be sure your escape routes don’t have locked doors you can’t open.

But preparation can also take the form of training — and it doesn’t have to be long-term, intensive and specific to the situation, Tunkel said.

Self-defense or active shooter training can help give you knowledge and strategies to use quickly if ever they are needed, Pascal said. But even more general training can help give you the mental and physical responses needed in case of emergency, Tunkel said.

Weight lifting and team sports can show you that you are physically capable of responding, he said. Yoga and meditation can train your breath and brain to stay calm and make good decisions in crisis, he said.

And in a dangerous situation, acting quickly and decisively is often safest, Pascal said.

It’s hard to be decisive when bullets are flying. Many victims of mass shootings have reported that the events were confusing and that it was hard to tell what was happening, Girgis said.

And if people don’t know what is happening, they often rely on their instincts to make decisions on what to do next, which can be scary, Pascal said.

The human brain likes categories to make things simpler, so it will often default to relating new things to those we have been exposed to before, Stowell said. When a person hears a popping noise, they might be likely to assume the sound is something familiar like a firecracker, he added.

Instead, Pascal advised people — whether they think they hear balloons popping or gunshots — to stop, look around to gather as much information as they can about what is going on around them, listen to see if they can learn anything from the sound, and smell the air.

Because where there are gunshots, there is often gunpowder, Pascal said.

Once someone has gathered what information they can, it is important to trust your perception of danger, Tunkel said.

Knowing there is danger activates a fight-or-flight response, which humans have honed over thousands of years to respond to predators, Stowell said.

But when a person is in a dangerous situation that is so far from anything they’ve experienced before, it is not uncommon for them to freeze, he added.

That is where training of any kind comes in. Even if it doesn’t teach you every detail of how to respond, it gives your brain a set of knowledge to fall back on in a terrifying situation, Stowell said.

Wrestling a gun away isn’t the only way to act when there is a mass shooter, Pascal said.

The US Department of Homeland Security developed a protocol called “Run, hide, fight.”

“Run” refers to the first line of defense — to get yourself away from a dangerous situation as quickly as possible, Pascal said. You can encourage others to run away too, but don’t stay back if they won’t leave with you.

If it isn’t possible to run, the next best option is to hide, making it more difficult in some way for the perpetrator to get to you, he said.

If none of those are an option, you can fight.

“You don’t have to be the biggest, strongest person in the room,” Pascal said. “You just have to have that mindset that no one is going to do this to me and I’m going home safe.”

Even though most people are capable of responding to danger in some way, it is important not to judge how much or how little a bystander or victim acts, Tunkel said.

“What may be reasonable for one person in one situation is not for someone else in another situation,” Pascal said.

No matter how well a person has been trained, mass shootings are “beyond the scope of anything we’ve had to experience in our everyday lives,” Stowell said. “There’s no real expectation of a right response, despite training.”

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Pediatricians are giving out free gun locks to approach the gun violence epidemic as a public health crisis | CNN



CNN
 — 

In a triage waiting room of St. Louis Children’s Hospital in Missouri, a clear basket filled with gun locks sits near the walkway, just noticeable enough to those passing by.

The hospital staff calls it the “No Questions Asked” basket, to encourage gun safety without having to confront gun owners about what can be a sensitive and divisive topic. It holds an assortment of cable gun locks free of charge, available to those who need them, alongside pamphlets explaining how to properly and safely store firearms.

The initiative, aimed at reducing the stigma of addressing gun safety, is part of a growing effort by medical professionals who are treating the country’s gun violence epidemic as a public health crisis.

“It takes standing at the bedside of one child who has been shot to realize that we all have to do more and as the leading cause of death for children in this country, pediatricians need to be front and center of the solution, of all the solutions,” said Dr. Annie Andrews, a professor of pediatrics at the Medical University of South Carolina and an expert on gun violence prevention.

Over the course of two years, thousands of gun locks have been taken from the basket, according to Dr. Lindsay Clukies, a pediatric emergency medicine physician at the hospital.

In the coming weeks, baskets filled with free gun locks will be available at more than 17 locations operated by BJC HealthCare, an organization serving metro St. Louis, mid-Missouri and Southern Illinois, Clukies said. It’s a low-cost and effective way to easily distribute firearm safety devices.

“We’ve had employees as well as patients take our locks, also their families and even a grandmother who took one for her grandson. It’s for anyone who needs them,” Clukies told CNN. In recent years, a rising number of pediatricians across the country have been engaging with the topic of gun safety in medical settings by focusing on safety and prevention, already a natural aspect of their work.

During patient visits, it’s increasingly common for pediatricians to ask the patient’s parents if there are guns at home, and if so, how they are stored. Some hospitals then offer free gun locks, often sourced from donations or police departments and paired with safe storage education.

Some pediatricians, who bear witness to the effects of gun violence on children in their workplace every day, told CNN they see it as their obligation as medical professionals to be part of the solution to the epidemic.

In 2022, 1,672 children and teenagers under 17 were killed by gun violence and 4,476 were injured, according to the Gun Violence Archive, a nonprofit organization tracking injuries and deaths by gunfire since 2014.

“We have just as an important voice in this conversation as anyone else because we’re the ones who have invested our entire careers to protecting children and ensuring that children can grow up to be the safest healthiest version of themselves,” said Andrews.

“It is only natural that we see these things that we understand that they’re preventable, and we want to get involved in finding the solutions,” she added.

So far in 2023, high-profile incidents of children accessing firearms have heeded calls for stronger, more consistent laws nationwide, requiring adults to safely secure their guns out of the reach of children and others unauthorized to use them. They have also highlighted a lack of public education on the responsibility of gun owners to store their guns unloaded, locked and away from ammunition, CNN previously reported.

In early January, a 6-year-old boy was taken into police custody after he took a gun purchased by his mother from his home, brought it to school and shot his teacher at Richneck Elementary School in Newport News, Virginia, police said. Just over a week later, a man was arrested in Beech Grove, Indiana, after video was shown on live TV of a toddler, reportedly the man’s son, waving and pulling the trigger of a handgun, CNN previously reported.

Hundreds of children in the US every year gain access to firearms and unintentionally shoot themselves or someone else, according to research by Everytown for Gun Safety, a leading non-profit organization focusing on gun violence prevention. In 2022, there were 301 unintentional shootings by children, resulting in 133 deaths and 180 injuries nationally, Everytown data showed.

Firearm injuries are now the leading cause of death among people younger than 24 in the United States, according to the Centers for Disease Control and Prevention. The American Academy of Pediatrics released an updated policy statement in October 2022, stating firearms are now the leading cause of death in children under the age of 24 in the US.

The Academy’s statement urged a “multipronged approach with layers of protection focused on harm reduction, which has been successful in decreasing motor vehicle-related injuries, is essential to decrease firearm injuries and deaths in children and youth.”

The Academy has free educational modules for pediatricians to guide them on how to have what can be challenging or uncomfortable conversations about firearms with families, according to Dr. Lois Kaye Lee, a pediatrician and the chair of the Academy’s Council on Injury, Violence and Poison Prevention.

“This shouldn’t be considered as something extra; it should be considered as part of the work that we do every day around injury prevention, be it around firearms, child passenger safety and suicide prevention,” Lee said.

Dr. Georges Benjamin, executive director of the American Public Health Association, told CNN the public health approach to addressing gun violence removes the politics from the issue and “puts it into a scientific evidence-based framework.”

“Physicians have a unique opportunity to engage their patients, the parents of kids or the parents themselves as individuals to make their homes safer,” Benjamin said. “We already do this for toxins under our kitchen cabinets, razor blades and outlets in the wall.”

In the emergency department at St. Louis Children’s Hospital, all patients are screened for access to firearms and offered free gun locks, as well as safe storage education, Clukies said. Gun locks can also be mailed to families, free of cost, through the hospital’s website.

“Every patient that comes into our emergency department, whether it’s for a fever or a cold or a broken arm, is asked about access to firearms,” said Clukies, adding 5,000 locks have been given out since the initiatives were started in 2021.

In a collaborative effort between trauma nurses, physicians, social workers, violence intervention experts and family partners, the hospital created a “nonjudgmental” script for doctors to follow as they ask patients about access to firearms, Clukies said.

During the screening process, pediatricians will ask parents or caretakers questions such as: Do you have access to a firearm where your child lives or plays? How is it stored? Is it stored unloaded or loaded?

“When I first started doing this, I would say, ‘Are there any guns in the home? Yes, or no?’ But I have found and learned from other experts that if you just say, ‘If there are any guns in the home, do you mind telling me how they’re secured?’ it takes away the judgment,” said Andrews, a pediatrician whose hospital, the Medical University of South Carolina, also offers free gun locks to patients.

An assortment of cable gun locks offered free of charge by the Medical University of South Carolina.

Families are asked about firearms in the “social history” phase of a patient visit, during which pediatricians will ask who lives in the home, what grade the child is in, what activities they engage in and where the child goes to school, according to Andrews. When parents indicate their firearms are not safely stored, like on the top of a shelf or in a nightstand drawer, Andrews said those are important opportunities for intervention and education about storage devices such as keypad lockboxes, fingerprint biometric safes and other types of lock systems.

It’s also important for pediatricians to understand the parents’ or caretakers’ motivation for owning a firearm to “inform the conversation about where they’re willing to meet you as far as storage goes,” she added.

Andrews and Clukies said they were pleasantly surprised by the willingness of families to discuss firearm safety, most of whom recognize it is an effort to protect their children.

“I expected more pushback than we received, which is attributed to us really focusing on how we properly word these questions,” Clukies said. “I think it’s because we turn it into a neutral conversation, and we focus on safety and prevention.”

Andrews added it is uncommon for medical schools or residencies to discuss gun violence prevention, which she says is due to the “politics around the issue.”

“Thankfully, that has evolved, and more and more pediatricians are realizing that we have to be an integral part of the solution to this problem,” Andrews said.

At the St. Louis Children’s Hospital, pediatricians followed up with patients who received a free gun lock in a research study roughly two months after they launched the initiative in the fall of 2021 to see if their storage practices changed.

The study found two-thirds of families reported using the gun lock provided to them by the hospital and there was a “statistically significant decrease” in those who didn’t store their firearms safely, as well as an increase in those who stored their firearms unloaded, according to Clukies.

But there is still much more work to be done in the medical community to fight the gun violence epidemic and scientific research on the issue is “woefully underfunded,” Andrews contended.

According to the American Public Health Association’s Benjamin, a multidisciplinary approach by policymakers, law enforcement and the medical community is essential to fostering a safer environment for children.

“Injury prevention is a core part of every physician’s job,” Benjamin said. “It’s clearly in our lane.”

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Visiting El Salvador’s Slums, It’s Clear Bitcoin Country Must Go Further

This is an opinion editorial by Rikki, author and co-host of the “Bitcoin Italia,” and “Stupefatti” podcasts. He is one half of the Bitcoin Explorers, along with Laura, who chronicle Bitcoin adoption around the world, one country at a time.

A few days before this writing, El Salvador’s president Nayib Bukele announced an immense police operation. San Salvador’s satellite city of Soyapango was surrounded by 8,500 military and 1,500 police officers, who went searching from house to house for gang members still hiding in the area. More than 150 arrests were counted.



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