Is the modern workplace at the center of a massive public health crisis?

Stanford University professor Jeffery Pfeffer explores that possibility in his new book, “Dying for a Paycheck.”

Pfeffer, the professor of organizational behavior at Stanford University’s business school, has been studying and writing about the modern workplace for years. But he’s now looking at how office life can be toxic for your health.

Pfeffer estimates that 120,000 deaths may be attributed to workplace conditions, which include work-family conflict, no health insurance, and unemployment. This would in theory make the modern workplace the sixth-leading cause of death in the United States.

Pfeffer found toxic workplace environments permeate all types of companies across multiple industries and in various countries. He found plenty of issues with both old and newer companies, including places like Salesforce, which is currently listed as Fortune’s “Best Place to Work.”

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A humanist has been appointed to lead a team of NHS chaplains, in a move that reflects growing demand for emotional and spiritual support from people who do not identify with any organised religion.

Lindsay van Dijk will lead three Christian chaplains and a team of 24 volunteers, including a Catholic nun, a Buddhist and a Bahá’í, at the Buckinghamshire Healthcare NHS trust. The world-renowned spinal injuries unit at Stoke Mandeville hospital is part of the trust.

Although there are two other humanists among the NHS’s paid chaplains, it is the first time that chaplains in hospitals and hospices will work under a non-religious leader.

Van Dijk, 28, told the Guardian: “A lot of people don’t have an organised faith, but still have spiritual and emotional needs at difficult times. Often people are trying to make sense of their lives and the situations they find themselves in.”

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“Nana, how is suicide okay for some people, but not for people like me?”

Eva Andrade’s teenage grandson, who had previously been hospitalized for suicidal ideation, had asked his grandmother that question recently: Hawaii became the seventh state to legalize physician-assisted suicide April 5, a year after a previous legislative attempt.

Proponents claimed the law would give people with terminal illnesses (and a diagnosis of less than six months to live) the personal autonomy to make that decision. The teenager did not see why the circumstances made a big difference for one group having the legal right to end life on their own terms, while others did not.

“This is a 15-year-old child making this connection on his own, just based on the conversations he was hearing,” Andrade said.

Andrade, spokeswoman for the Hawaii Catholic Conference, told the Register that the “Our Care, Our Choices Act,” which goes into effect Jan. 1, 2019, threatens negative social repercussions and will have a “very detrimental effect on our community.”

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A church in Salisbury will host a “service of cleansing and celebration” after the poisoning of the former Russian spy Sergei Skripal and his daughter, Yulia, in the city last month.

St Thomas’s, in the centre of Salisbury, will hold the service at 3 p.m. on Sunday, metres away from the site of the bench where the Skripals were found outside the Maltings shopping centre. The Rector of St Thomas’s, the Revd Kelvin Inglis, said that the service would end with a procession to the spot where the pair were found.

The Skripals are believed to have been poisoned with the nerve agent Novichok, and the fallout from the attack on them has resulted in the expulsion of Russian diplomats from the UK and its allies, since the Government concluded that it was “highly likely” that the blame lay with Moscow (News, 16 March, 23 March). More than 20 countries around the world expelled Russian diplomats: the UK required 23 to leave; and the United States, 60.

On Tuesday, it was reported that Ms Skripal had been discharged from hospital, and that Mr Skripal was also making good progress and would leave “in due course”.

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The suicide rate among UK students is higher than among the general population of their age group, say researchers.

A study from the Centre for Suicide Research and Prevention says it means for the first time students have a higher suicide rate than non-students.

The Hong Kong-based researchers say that female students were particularly likely to have a higher suicide rate.

Researcher Edward Pinkney says it shows a “real problem in higher education”.

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I went to medical school, at least in part, to get to know death and perhaps to make my peace with it. So did many of my doctor friends, as I would find out. One day—usually when you’re young, though sometimes later—the thought hits you: You really are going to die. That moment is shocking, frightening, terrible. You try to pretend it hasn’t happened (it’s only a thought, after all), and you go about your business, worrying about this or that, until the day you put your hand to your neck—in the shower, say—and … What is that? Those hard lumps that you know, at first touch, should not be there? But there they are, and they mean death. Your death, and you can’t pretend anymore.

I never wanted to be surprised that way, and I thought that if I became a doctor and saw a lot of death, I might get used to it; it wouldn’t surprise me, and I could learn to live with it. My strategy worked pretty well. Over the decades, from all my patients, I learned that I would be well until I got sick and that although I could do some things to delay the inevitable a bit, whatever control I had was limited. I learned that I had to live as if I would die tomorrow and at the same time as if I would live forever. Meanwhile, I watched as what had been called “medical care”—that is, treating the sick—turned into “health care,” keeping people healthy, at an ever-rising cost.

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It’s time to rethink the quest to control aging, death, and disease—and the fear of mortality that fuels it, writes @victoriasweet. https://t.co/bZAkKMw046 pic.twitter.com/z0hhk8IW5X

— The Atlantic (@TheAtlantic) April 10, 2018

By the time Thomas Hodorowski made the connection between his marijuana habit and the bouts of pain and vomiting that left him incapacitated every few weeks, he had been to the emergency room dozens of times, tried anti-nausea drugs, anti-anxiety medications and antidepressants, endured an upper endoscopy procedure and two colonoscopies, seen a psychiatrist and had his appendix and gallbladder removed.

The only way to get relief for the nausea and pain was to take a hot shower.

He often stayed in the shower for hours at a time. When the hot water ran out, “the pain was unbearable, like somebody was wringing my stomach out like a washcloth”, said Hodorowski, 28, a production and shipping assistant who lives outside Chicago.

It was nearly 10 years before a doctor finally convinced him that the diagnosis was cannabinoid hyperemesis syndrome, a condition that causes cyclic vomiting in heavy marijuana users and can be cured by quitting marijuana.

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Marjuana linked to 'unbearable' sickness across US as use grows following legalisation https://t.co/oqn7f87r8M

— The Independent (@Independent) April 9, 2018

“It has taken a long, long time to get anyone to pay attention to this issue and take it seriously,” said Luke Montagu, a media entrepreneur and co-founder of the London-based Council for Evidence-Based Psychiatry, which pushed for Britain’s review of prescription drug addiction and dependence.

“You’ve got this huge parallel community that’s emerged, largely online, in which people are supporting each other though withdrawal and developing best practices largely without the help of doctors,” he said.

Dr. Stockmann, the psychiatrist in East London, wasn’t entirely convinced withdrawal was a serious issue before he went through it himself. His microtapering strategy finally worked.

“There was a really significant moment,” he recalled. “I was walking down near my house, past a forest, and I suddenly realized I could feel the full range of emotions again. The birds were louder, the colors more vivid — I was happy.”

“I have seen lots of people — patients — not being believed, not taken seriously when they complained about this,” he added. “That has to stop.”

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Many people taking antidepressants discover they cannot quit. https://t.co/9MXPbpE7nn pic.twitter.com/kuh6cNVXVi

— Duke University (@DukeU) April 9, 2018

Pot may be on its way to beating pop. (Editor’s note: Yes, we know it’s called “soda” out here on the West Coast, but we didn’t want to mess with this writer’s lead.)

The U.S. legal cannabis industry is expected to reach $75 billion in sales by 2030, according to research firm Cowen & Co. That’s almost as large as the North American carbonated soft drink market in 2017.

With the industries’ diverging trajectories, weed may be poised to take the mantle as the larger industry. Cannabis is growing rapidly as more states legalize the plant. Nine states and Washington, D.C. now allow for recreational pot use. That means more than one in five American adults can smoke, vape, eat or drink it however they please. Cowen previously predicted that the market, assuming federal legalization, would reach $50 billion by 2026. That seems small now, according to analyst Vivien Azer.

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The Brickendens are one of the few couples in Canada to receive a doctor-assisted death together, and the first to speak about it publicly.

They wanted to explain what it meant to them to die at a time and place of their choosing, as at least 2,149 Canadians and likely hundreds more have done since assisted dying became legal in this country.

The Brickendens are at the vanguard of patients and families who are creating new rituals around dying in Canada – the kind of rituals that are only possible when death comes at a previously appointed hour.

But cases like theirs also raise uncomfortable questions about whether the vague eligibility criteria in Canada’s assisted-dying law are sometimes being interpreted more broadly than the government intended.

One of the most controversial stipulations in the law is that a patient’s natural death must be “reasonably foreseeable,” – something that could plausibly be said of every nonagenarian. The law dictates other requirements, including intolerable suffering and irreversible decline, but those concepts can be elastic, too.

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A Globe+Mail profile Story of the medically assisted suicide of a Couple Married 73 yrs https://t.co/OQAykxs9ZA #canada #death #law #lifethics #politics '1 of the most controversial stipulations in the law is that a patient’s natural death must be “reasonably foreseeable"'

— Kendall Harmon (@KendallHarmon6) April 5, 2018

While the United Nations has a stated commitment to protecting and promoting the lives of those with Down Syndrome, the Holy See believes some in the international community are abetting what one Washington Post columnist recently termed a “genocide” against such individuals.

At a United Nations event on Tuesday in anticipation of World Down Syndrome Day on March 21, Archbishop Bernardito Auza, the apostolic nuncio to the United Nations, charged delegates with failing to uphold protections enshrined in international agreements to protect those with disabilities.

“Despite the commitments made in the Convention on the Rights of Persons with Disabilities to promote, protect and ensure the full and equal enjoyment of all human rights, including that of the right to life, by all persons with disabilities, so many members of the international community stand on the sidelines as the vast majority of those diagnosed with Trisomy-21 have their lives ended before they’re even born,” Auza said.

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Today on #Crux by @cwwhite212: #Vatican stages UN event to protest ‘genocide’ against Down Syndrome https://t.co/95jIWjMAIA pic.twitter.com/jeBLz1b5aO

— Crux (@Crux) March 22, 2018

Julie Shulman decided to study linguistics because she wanted to help people with speaking disorders. She never imagined how personal this mission would become. After graduating from Israel’s Bar-Ilan University in 2000, the Maine native headed to Massachusetts for a master’s degree and job in speech therapy. Her husband, Ayal Shulman, worked as a business-development manager for an Israeli startup in Brookline. They returned to Israel in 2009—with promising careers and three young children.

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Relatively modest drives are afoot in Washington state and California, where organizations have launched education campaigns on how people can fill out instructions for future caregivers to withhold food and drink, thereby carrying out an option that is legal to anybody: death by starvation and dehydration. (It is often referred to as the “voluntarily stopping eating and drinking” method.)

The boldest bid is taking place in Quebec. Prompted by a 2017 murder case involving the apparent “mercy killing” of a 60-year-old woman with Alzheimer’s by her husband — who smothered her with a pillow — the provincial government is studying the possibility of legalizing euthanasia for Alzheimer’s patients. Unlike medically assisted suicide, a medical doctor would administer the fatal dose via injection. A survey in September found that 91 percent of the Canadian province’s medical caregivers support the idea.

“The process that could lead to [legislative] changes has already begun,” said Marie-Claude Lacasse, a spokeswoman for the Quebec Ministry of Health and Social Services.

Somewhere between these points is Oregon, where several lawmakers are trying to push the right-to-die envelope.

Under the current law, eligible patients can obtain prescriptions for lethal barbiturates. Qualified patients must be diagnosed with a terminal illness, have a prognosis of six or fewer months to live, and self-ingest the drug. The vast majority — more than 70 percent, according to the Oregon Health Authority — have cancer; most others have either heart disease or amyotrophic lateral sclerosis, also known as Lou Gehrig’s disease.

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The University of Notre Dame caved in. It will partly obey the Obama Care mandate requiring employer health-care plans to cover the cost of contraceptives and abortifacient drugs. Rejecting the Trump administration’s religious exemption, Notre Dame announced last month that it will provide “simple contraceptives” to students and employees through its insurance program.

Notre Dame’s president, the Rev. John Jenkins, deserves praise for discontinuing coverage of abortifacients. Yet he justified the birth-control decision by saying, in part, that Catholic tradition requires respect for “the conscientious decisions of members of our community.” Of course, Notre Dame community members can exercise their consciences without receiving university-provided contraception. And there is also the serious possibility that Notre Dame abused the legal process when it sued the Obama administration for relief. If the university had standing on religious-freedom grounds, how can it now explain its decision to facilitate coverage of birth control?

While these issues are concerning, as a graduate of Our Lady’s university, I take the recent news personally. I chose to attend Notre Dame because its essential Catholicism makes​it different from other outstanding American universities. Serious young Catholics may no longer look at Notre Dame the way I did, and with good reason.

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[Meg] Watwood is part of America’s rapidly growing surrogacy movement. The number of babies born through surrogacy in the United States, though still relatively small, has quadrupled in just over a decade. And despite ethical questions surrounding the practice, demand isn’t slowing.

According to the American Society for Reproductive Medicine, surrogates gave birth to 2,807 babies in 2015, up from 738 in 2004. Nearly all were conceived by IVF and carried by women with no genetic connection, a process called “gestational surrogacy.” (In “traditional surrogacy,” the only option prior to IVF but one rarely used today, the carrier would also be the genetic mother of the baby.)

IVF and surrogacy are becoming more normalized in the US just as other countries have shut down foreign surrogacy enterprises, dual trends that have made the US a top surrogacy destination. High demand for surrogates, who typically earn more than $20,000 per birth, has attracted many evangelical women, who often fit the profile of the “ideal” surrogate and are drawn to the idea of using their fertility to bless others.

But laws and ethical discussions surrounding surrogacy haven’t kept up with the industry’s growth, and pastors and churches appear largely ill-equipped to guide women and couples through the high-stakes decisions involved in third-party reproduction.

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There’s more bad news about the nation’s devastating opioid epidemic.

In just one year, overdoses from opioids jumped by about 30 percent, according to a report released Tuesday by the Centers for Disease Control and Prevention.

The overall increase in opioid overdoses seen in hospital emergency rooms between the third quarter of 2016 and the third quarter of 2017 occurred across the nation. Some parts of the country experienced far greater increases, while a few have reported declines, the analysis shows.

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"We have an emergency on our hands," says acting CDC Director Anne Schuchat. "The fast-moving opioid overdose epidemic continues and is accelerating."https://t.co/qxBJtYxhUF

— All Things Considered (@npratc) March 6, 2018

Divine Physician, your Name is blessed for the work and witness of the Mayos and the Menningers, and the revolutionary developments that they brought to the practice of medicine. As Jesus went about healing the sick as a sign of the reign of God come near, bless and guide all those inspired to the work of healing by thy Holy Spirit, that they may follow his example for the sake of thy kingdom and the health of thy people; through the same Jesus Christ, who with thee and the Holy Spirit livest and reignest, one God, now and for ever. Amen.

Morning Prayer 3.6.18, William Mayo, Charles Menninger & Sons, Pioneers in Medicine https://t.co/t2syNNN4S3 pic.twitter.com/xOqfVW7dlQ

— Josh Thomas (@dailyoffice) March 6, 2018

Watch and enjoy it all.

A recent study in the journal Health Affairs had some dismal news for U.S. children: They have a 70 percent greater chance of dying before they reach adulthood than their peers in comparable developed nations. While child death rates in the United States are still much lower than they were 50 years ago, children still face unique risks that resulted in an estimated 600,000 preventable deaths from 1961 to 2010.

Why is the United States so exceptionally dangerous for children? The report suggests that there are three primary groups of U.S. children at risk: children of all ages who die in car crashes, teenagers killed by guns and babies who die before their first birthday.

The first group—representing about 1,000 children younger than 13 per year—is both the least complex and the most difficult to change. Passage or stricter enforcement of laws requiring that children be properly restrained in cars may help, as roughly 20 percent of child deaths in car accidents occur in situations where the victims are not wearing a seatbelt or in a safety seat. Also, about 20 percent of child deaths in car accidents are related to drunk driving, and any interventions to reduce drunk driving will also help to reduce child deaths related to the same. But Americans will continue to make most trips by car as long as our government subsidizes highways and encourages sprawl with all sorts of housing-related restrictions. As long as we are driving fast everywhere, we are going to keep getting into accidents, and it is not going to be easy to dramatically shift where we live and how we get around.

In the second group, there are 1,000 or more children who are killed by guns every year in the United States. Incidents such as the mass shooting at a high school in Florida on Feb. 14 are depressingly common, but gun deaths from suicide are now even more common than those from homicide.

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Eight Anglican bishops have called for a halt to the End of Life Choice Bill, which proposes legalising medically-assisted suicide and euthanasia in Aotearoa New Zealand.

In their submission to the Justice Select Committee on David Seymour’s End of Life Choice Bill this week, the bishops recommended no change to existing laws, and called for more funding of palliative care and counselling support for patients and their whanau.

Rather than introducing assisted dying as proposed in the Bill, the bishops believe our government should ensure New Zealanders have access to the best quality palliative and psycho-social care when faced with terminal illness.

They cite Australian doctor Karen Hitchcock who in her 12 years of work in large public hospitals has often heard patients express a wish to die, but says the cause of that desire is seldom physical pain,

“[It] is often because of despair, loneliness, grief, the feeling of worthlessness, meaninglessness or being a burden. I have never seen a patient whose physical suffering was untreatable,” she said.

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[Kate] Bowler tells how while she was still in hospital a neighbour came the door and told her husband ‘Everything happens for a reason’. ‘I’d love to hear it,’ the husband replied. ‘Pardon?’ said the woman. ‘The reason my wife is dying,’ was the response. The neighbour said nothing but handed over a casserole.

Bowler lists three life lessons that people try to teach her. The first is that death is just the gateway to heaven. The second is that suffering is ‘an education in mind, body and spirit’. And the third is that attitude determines destiny; just have faith and you will survive. Even atheists find a lesson in suffering. It can show us that we live in an uncaring world and should give up any search for meaning.

Bowler finds no explanation for her suffering but this does not destroy her faith in God. She tells of a ‘free-floating feeling’ that stayed with her for months and conveyed God’s presence to her.

“At a time when I should have felt abandoned by God, I was not reduced to ashes. I felt like I was floating, floating on the love and prayers of all those who hummed around me like worker bees, bringing notes and flowers and warm socks and quilts embroidered with words of encouragement. They came like priests and mirrored back to me the face of Jesus.”

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Mr [Stephen] Evans is chief executive of the National Secular Society, the church militant of atheism. Like all extremist organisations, it’s a coalition of the ignorant and the spiteful. Let me address the ignorant first. I get it: male circumcision sounds weird, even offensive. In the Jewish case, a Mohel removes the foreskin of a baby on the eighth day after his birth, a decision taken by adults that the boy has to carry for the rest of his life whether he believes in the Almighty or not.

It sounds like it contradicts some of the basic tenets of a liberal society: children’s rights, bodily autonomy and choice.

But choice is a complicated thing. As Claire Fox argued on the Maze, parents do stuff to their kids all the time – pierce their ears, feed them McDonald’s –that we don’t ban because we don’t want the state to take on the role of parent. Why?

Because that would subvert another very important kind of choice: the right of mums and dads to raise their children how they wish. Across the world, they make the free choice of male circumcision without controversy. The World Health Organisation estimates that about a third of men aged 15 or over have gone under the knife; it’s probably the vast majority of that demographic in the United States, where it became popular post-war.

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One of the most well-known friendships in literature is that between Wilbur the pig and Charlotte the spider in the popular children’s book Charlotte’s Web. Near the conclusion of the story,Wilbur shares his heart with Charlotte’s babies, who hatch just after their mom’s death. Listen intently as Wilbur speaks to them:

“Welcome to the barn cellar. You have chosen a hallowed doorway from which to string your webs. I think it is only fair to tell you that I wasdevoted to your mother, Charlotte…I shall always treasure her memory. To you, her daughters, I pledge my friendship, forever and ever…”

The story continues, “… A spring pig — a runt, no less — surrounded by friends, was welcoming his second spring. And all because he saw what no one else was able to see: the grace and beauty and remarkable talent of a common gray spider. It is not often that someone like Charlotte comes along who is a true friend.”

In this endearing children’s story, Charlotte, the humble spider, weaves three webs that save Wilbur’s life. Charlotte’s loving but strenuous efforts cause her to die prematurely. They also can serve as a metaphor of Christ, who came to earth and– through his own life, death and resurrection– brought new life to us.

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The most affecting chapter in When Harry Became Sally is devoted to the personal stories of individuals who “detransitioned,” returning to identification with their biological sex after having previously identified with the opposite sex. The transgender movement’s response to such cases is either to pretend they don’t exist or to insist that these men and women were never really transgender in the first place. Of course, since doctors believed them when they said they were, and acted accordingly, these “not really” patients would have a pretty good case for accusing their former physicians of malpractice. And since declared feelings of being “born into the wrong body” are the only basis of a diagnosis that can lead from a change of wardrobe to the surgical excision of healthy sexual organs, no doctor can ever be sure that his patient will not one day wish to detransition. And what could he possibly do then to put things right?

These are truly awful tales of intense suffering. They are the personal stories of men and women, boys and girls, who went to medical professionals with terrible confusion and distress and received only harm where they sought relief. Now, in telling the truth about what happened to them, they attract the abuse and invective of the transgender movement’s ideologues. Some of them, understandably, prefer to tell their stories anonymously. All of them should be applauded for their courage and candor and thanked for their contribution to public understanding.

Anderson writes in his conclusion that these stories, more than anything else, led him to write When Harry Became Sally. “I couldn’t shake from my mind the stories of people who had detransitioned. They are heartbreaking. I had to do what I could to prevent more people from suffering the same way.”

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Read it all–cited by yours truly in the morning sermon. also, you may find another article there.

Later that morning, Emily Avin called 911 from her home in Aiken to report a suicide.

She then picked up a gun, walked outside and pulled the trigger before anyone could reach her. She was 26.

Scrolling through her daughter’s phone in the following days, Sue Ann Avin found a prophetic cartoon. It depicted an EMS worker illustrated to resemble a ticking time bomb, saying, “Traumatic calls, burn out, compassion fatigue — that stuff never gets to me.” The paramedic wore a badge that said “denial.”

Suicides such as Emily Avin’s were once overlooked by firefighters and paramedics eager to maintain an image of bravery and invincibility. But that’s changing as the profession acknowledges a deadly scourge that claims more lives than the perils firefighters face in the line of duty.

Long a taboo topic in firehouses, suicide was recently labeled by the U.S. Fire Administration as a “critical” issue that’s being “faced more squarely by the fire service.”

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#Firefighter #suicides outnumber line-of-duty deaths. How S.C. first responders are trying to save their own–heartbreaking front page story #1stresponders #death #SouthCarolina #suicide https://t.co/3QzdFAR7sL

— Kendall Harmon (@KendallHarmon6) February 18, 2018

Last week Joy Behar, co-host of the ABC show “The View,” did something that has become an escalating trend in our popular culture over the past 10 years — she mocked religiosity.

In a segment about Vice President Mike Pence and his belief that he hears the voice of God, Behar quipped: “It’s one thing to talk to Jesus. It’s another thing when Jesus talks to you. That’s called mental illness, if I’m not correct . . . hearing voices.”

The audience of “The View” clapped and laughed along with her.

But outside the entertainment bubble, in places like Cumberland, people were horrified.

“I am not sure what shocked me the most, that Behar mocked one of the core beliefs of Christianity or the reaction of the studio audience,” said Tim McGregor, pastor at the Lighthouse of Hope, a non-denominational Christian church here in western Maryland.

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I will take comments on this submitted by email only to KSHarmon[at]mindspring[dot]com.

This week, research was published showing that spending as little as ten minutes a day talking to someone with dementia can make a real difference to their quality of life, alleviating their anxiety and sense of isolation in a strange and fearful world.

Increased levels of dementia have been the price we pay for the rise in life expectancy in recent decades. And it’s tough: for the sufferers themselves, their carers, and for members of their family. It can be almost unbearable to find that your parent can’t recognise you, their child. And people can become fatalistic about it, thinking that there’s nothing you can do to make things better. But that’s beginning to change.

Three weeks ago, my wife Elaine and I visited, in his home in Philadelphia, Aaron Beck, co-founder of Cognitive Behavioural Therapy, one of the most effective forms of psychotherapy practised today. 96 years old and physically frail, he was still wonderfully young in mind and spirit. He told us that he’d always believed that his methods could help many people but not those with dementia, but now – though the research is still in its early days – people were beginning to find that it could help them too.

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They huddled against the biting wind, pacing from one corner to another hoping to score heroin or pills. But a different drug was far more likely to be on offer outside the train station downtown, where homeless drug users live in tents pitched on the sidewalk.

“Everybody has meth around here — everybody,” said Sean, a 27-year-old heroin user who hangs out downtown and gave only his first name. “It’s the easiest to find.”

The scourge of crystal meth, with its exploding labs and ruinous effect on teeth and skin, has been all but forgotten amid national concern over the opioid crisis. But 12 years after Congress took aggressive action to curtail it, meth has returned with a vengeance. Here in Oregon, meth-related deaths vastly outnumber those from heroin. At the United States border, agents are seizing 10 to 20 times the amounts they did a decade ago. Methamphetamine, experts say, has never been purer, cheaper or more lethal.

Oregon took a hard line against meth in 2006, when it began requiring a doctor’s prescription to buy the nasal decongestant used to make it. “It was like someone turned off a switch,” said J.R. Ujifusa, a senior prosecutor in Multnomah County, which includes Portland.

“But where there is a void,” he added, “someone fills it.”

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Survivors of abuse and their allies are continuing to press the Church of England to set up an independent safeguarding body to handle the issue.

Before a debate at the General Synod on Saturday morning, survivors held a protest outside Church House, Westminster. They called on Synod members to join them in a period of silence to “affirm the intention of the Church to act justly towards victims of abuse both now and in the future”, in the words of Andrew Graystone, the activist who organised the event.

Several bishops, including the Bishop of Gloucester, the Rt Revd Rachel Treweek, and the Bishop-elect of London, the Rt Revd Sarah Mullally, appeared at the protest.

The survivors also gave every Synod member a leaflet of their experiences in their own words: We Asked for Bread but You Gave Us Stones….

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