Elections, elections: that labor can't lose

Why go through all the ups and downs and in and outs -- yada, yada, yada -- and rounds and rounds of labor organizing?

Let your elected legislators do all the hard work for you.
https://onlabor.org/why-not-hold-union-representation-elections-on-a-regular-schedule/ 

All you have to do is show up on election days and vote.
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When are progressives going to wake up to the political possibilities federally mandated cert/recert/decert votes, maybe every four years?

Pushing this issue takes no huge financing -- the central impact on most people's lives comparing to the impact of 1960s anti-segregation impact on minorities alone.

All we need do is talk up the proposal in venues we usually inhabit and watch the political wild fire cross the country.

Should prescribing Zolpidem/Ambien be moved mostly to the realm of psychiatrists?

I have come to believe that prescribing Zolpidem/Ambien ought to be reallocated mostly to the realm of psychiatrists -- because psychiatrists have the training -- and the inclination -- to do the necessary work up and careful follow up -- and primary doctors, more and more clearly in my hearing, definitely do not.

The clear trend in the "physical illness” medical field – I hear about it over and over – is of medical doctors zapping long running prescriptions for Zolpidem without so much as a five minute, intelligent discussion about how much the withdrawal of their sleeping crutch may upset and or even upend patients' whole ways of life.

Logically, one would think that interruption of a long running, successful treatment for a seriously debilitating “condition" (we don’t use the word “illness" here) should necessitate a careful work up and follow up.

It is not like there seems available any routine Zolpidem substitute, like switching from antibiotic to antibiotic.  Therein lies the patients’ dreaded rub.  Candidate substitutes all seem to introduce serious (yucky feeling) drug hangovers for maybe the first half of patients waking hours.  Alternately, patients can spend all their waking hours in a sleep deprived haze (w/o drug).

I mostly need help getting my last two hours of sleep.  I take a 3-4mg dose cut from a Zolpidem tablet after the first five hours and wake up 2 hours later bright eyed and bushy tailed – zero, ZERO, drug hang over.

Five minutes after I wake up I feel perfectly fit to drive a car.  Logistically perfect.  Doctors will fret that the “hypnotic” is still in your blood stream even if you cannot sense anything like that – causing you to make mistakes even if you feel perfect.

After trying one Zolpidem “substitute" (Mirtazapine) I made one major driving error and had to concentrate hard to avoid two others -- two days after I downed it!  But, intellectually I had no problem knowing I was doing some things very wrong.  Ditto, if I drive on five hours sleep -- I am definitely aware that I am a bit short on patience and judgment.  12 years on Zolpidem; I have never received any “intellectual” message that I am driving incorrectly because of the drug.

So a close look at me, anyway, would seem to obviate extra driving accident concerns.

Even if Zolpidem doubled my accident risk – on the road or slipping and breaking my knee in the kitchen – I prefer that to enduring a drug hangover half the day (from a “substitute”) or to living in a sleep deprived daze all day – every day of my life in my case.  I know; I recently did four miserable months alternating between all day sleepiness and half day gradually shedding the feeling of being hit by a truck.  That half day was what I lived for.  

My OTC “substitute” was Diphenhydramine (Benadryl) – recently reported to bestow the maximum risk of developing dementia.
https://www.medicalnewstoday.com/articles/288546

But, this is the caliber of workup and follow up detail that psychiatrists are primed to ferret out.

Memory loss?  Zolpidem doesn’t make you forget anything you have learned already – or anything new about how things work together.  Less than 1% of users have clinically significant memory loss (whatever that means).

Somebody should do a study of 1000 insomnia patients who have been bumped off Zolpidem (most, probably without discussion) – and 1000 who had their dose halved (probably from 10mg to 5 mg) – to see how deep an effect this may have had on their lives, up close and personal.

But, this is the caliber of follow up that psychiatrists are primed for.  (Did I say that already?)

In one internet conversation, a patient was panicking.  He had previously been out of work for three years because he couldn’t sleep.  Now, after a year and a half on Zolpidem, his doctor was leaving and he was afraid he couldn’t get his prescription renewed (I've been there).  Do you think his doctors realized that they were denying him everything else in his life – job, ability to raise a family, pay for entertainment – to make him safer from slipping and breaking his knee in the kitchen?  Did they think all that through?

I have seen one chart (link below) that shows annual Zolpidem prescriptions have dropped from 45 million to 10 million from 2012 to 2020.  Does that mean that 35 million Americans are now walking around in drug hangovers for hours, or in a sleep deprived hazes all day – in insomnia periods?  Could that be?  (The chart is at the end of a blog post mostly on another topic.)
https://jabberwocking.com/health-update-21/

I am nothing if not grandiose.  I envision the day when everyone can go down a checklist that identifies whether or not they likely have what is known as insomnia – and 50 or 60 million patients are taking Zolpidem.