War, What Is It Good For?: Remarkably Little

...If You're a 'Great' Power on Planet Earth in the Twenty-First Century

by Tom Engelhardt Posted onApril 24, 2023

I was born on July 20, 1944, amid a vast global conflict already known as World War II. Though it ended with the atomic bombings of Hiroshima and Nagasaki in August 1945 before I could say much more than "Mama" or "Dada," in some strange fashion, I grew up at war.

Living in New York City, I was near no conflict in those years or in any since. My dad, however, had volunteered for the Army Air Corps at age 35 on December 8, 1941, the day after the Japanese attack on Pearl Harbor. He fought in Burma, was painfully silent about his wartime experiences, and died on Pearl Harbor Day in 1983. He was the operations officer for the 1st Air Commandos and his war, in some strange sense, came home with him.

Like so many vets, then and now, he was never willing to talk to his son about what he had experienced, though in my early years he still liked his friends to call him "Major," his rank on leaving the military. When his war did come up in our house, it was usually in the form of anger – because my mother had shopped at a nearby grocery store whose owners, he claimed, had been "war profiteers" while he was overseas, or because my first car, shared with a friend, was a used Volkswagen (German!), or my mom was curious to go – god save us! – to a Japanese restaurant!

The strange thing, though, was that, in those same years, for reasons we never discussed, he allowed me briefly to have a Japanese pen pal and, though my dad and I never talked about the letters that boy and I exchanged, we did soak the stamps off the envelopes he sent and paste them into our latest Scott stamp album.

As for evidence of my father’s wartime experience, I had two sources. In the guest room closet in our apartment, he had an old green duffle bag, which he’d go through now and then. It was filled to the brim with everything from Army Air Corps documents to his portable mess kit and even – though I didn’t know it then – his pistol and bullets from the war. (I would turn them over to the police upon his death a quarter-century later.)

Though he wouldn’t talk with me about his wartime experience, I lived it in a very specific way (or at least so it felt to me then). After all, he regularly took me to the movies where I saw seemingly endless versions of war, American-style, from the Indian wars through World War II. And when we watched movies of his own conflict (or, in my early years, replays of Victory at Sea on our TV at home) and he said nothing, that only seemed to confirm that I was seeing his experience in all its glory, as the Marines inevitably advanced at film’s end and the "Japs" died in a spectacle of slaughter without a comment from him.

From those Indian wars on, as I wrote long ago in my book The End of Victory Culture, war was always a tale of their savagery and our goodness, one in which, in the end, there would be an expectable "spectacle of slaughter" as we advanced and "they" went down. From the placement of the camera flowed the pleasure of watching the killing of tens or hundreds of nonwhites in a scene that normally preceded the positive resolution of relationships among the whites. It was a way of ordering a wilderness of human horrors into a celebratory tale of progress through devastation, a victory culture that, sooner or later, became more complicated to portray because World War II ended with the atomic devastation of those two Japanese cities and, in the 1950s and 1960s, the growing possibility of a future global Armageddon.

If war was hell, in my childhood at the movies, killing them wasn’t, whether it was the Indians of the American West or the Japanese in World War II.

So, yes, I grew up in a culture of victory, one I played out again and again on the floor of my room. In the 1950s, boys (and some girls) spent hours acting out tales of American battle triumph with generic fighting figures: a crew of cowboys to defeat the Indians and win the West, a bag or two of olive-green Marines to storm the beaches of Iwo Jima.

If ours was a sanguinary tale of warfare against savages in which pleasure came out of the barrel of a gun, on floors nationwide we kids were left alone, without apparent instruction, to reinvent American history. Who was good and who bad, who could be killed and under what conditions were an accepted part of a collective culture of childhood that drew strength from post-World War II Hollywood.

What Would My Dad Think?

Today, 60-odd years later, having never been to war but having focused on it and written about it for so long, here’s what I find eerily strange: since 1945, the country with the greatest military on the planet that, in budgetary terms, now leaves the next nine countries combined in the dust, has never – and let me repeat that: never! – won a war that mattered (despite engaging in all too many spectacles of slaughter). Stranger yet, in terms of lessons learned in the world of adult culture, every lost war has, in the end, only led this country to invest more taxpayer dollars in building up that very military. If you needed a long-term formula for disaster in a country threatening to come apart at the seams, it would be hard to imagine a more striking one. So long after his death, I must admit that sometimes I wonder what my dad would think of it all.

Here’s the thing: the American experience of war since 1945 should have offered an all-too-obvious lesson for us, as well as for the planet’s other great powers, when it comes to the value of giant military establishments and the conflicts that go with them.

Just think about it a moment, historically speaking. That global victory of 1945, ending all too ominously with the dropping of those two atomic bombs and the slaughter of possibly 200,000 people, would be followed in 1950 by the start of the Korean War. The statistics of death and destruction in that conflict were, to say the least, staggering. It was a spectacle of slaughter, involving the armies of North Korea and its ally the newly communist China versus South Korea and its ally, the United States. Now, consider the figures: out of a Korean population of 30 million, as many as three million may have died, along with an estimated 180,000 Chinese and about 36,000 Americans. The North’s cities, bombed and battered, were left in utter ruin, while the devastation on that peninsula was almost beyond imagining. It was all too literally a spectacle of slaughter and yet, despite ours being the best-armed, best-funded military on the planet, that war ended in an all-too-literal draw, a 1953 armistice that has never – not to this day! – turned into an actual peace settlement.

After that, another decade-plus passed before this country’s true disaster of the twentieth century, the war in Vietnam – the first American war I opposed – in which, once again, the U.S. Air Force and our military more generally proved destructive almost beyond imagining, while at least a couple of million Vietnamese civilians and more than a million fighters died, along with 58,000 Americans.

And yet, in 1975, with U.S. troops withdrawn, the southern regime we had supported collapsed and the North Vietnamese military and its rebel allies in the South took over the country. There was no tie as there had been in Korea, just utter defeat for the greatest military power on the planet.

The Rise of the Pentagon on a Fallen Planet

Meanwhile, that other superpower of the Cold War era, the Soviet Union, had – and this should sound familiar to any American in 2023 – sent its massive military, the Red Army, into… yes, Afghanistan in 1979. There, for almost a decade, it battled Afghan guerrilla forces backed and significantly financed by the CIA and Saudi Arabia (as well as by a specific Saudi named Osama bin Laden and the tiny group he set up late in the war called – yes, again! – al-Qaeda). In 1989, the Red Army limped out of that country, leaving behind perhaps two million dead Afghans and 15,000 of its own dead. Not so long after, the Soviet Union itself imploded and the U.S. became the only "great power" on planet Earth.

Washington’s response would be anything but a promised "peace dividend." Pentagon funding barely dipped in those years. The U.S. military did manage to invade and occupy the tiny island of Grenada in the Caribbean in 1983 and, in 1991, in a highly publicized but relatively low-level and one-sided encounter, drove Iraqi ruler Saddam Hussein’s Iraqi troops out of Kuwait in what would later come to be known as the First Gulf War. It would be but a preview of a hell on Earth to come in this century.

Meanwhile, of course, the U.S. became a singular military power on this planet, having established at least 750 military bases on every continent but Antarctica. Then, in the new century, in the immediate wake of the 9/11 terror attacks, President George W. Bush and his top officials, incapable of imagining a comparison between the long-gone Soviet Union and the United States, sent the American military into – right! – Afghanistan to overthrow the Taliban government there. A disastrous occupation and war followed, a prolonged spectacle of slaughter that would only end after 20 years of blood, gore, and massive expense, when President Biden pulled the last U.S. forces out amid chaotic destruction and disorder, leaving – yes, the Taliban! – to run that devastated country.

In 2003, with the Bush administration’s invasion of Iraq (on the false grounds that Saddam Hussein was developing or had weapons of mass destruction and was somehow linked to Osama bin Laden), the Second Gulf War began. It would, of course, be a disaster, leaving several hundred thousand dead Iraqis in its wake and (as in Afghanistan) thousands of dead Americans as well. Another spectacle of slaughter, it would last for endless years and, once again, Americans would draw remarkably few lessons from it.

Oh, and then there’s the war on terror more generally, which essentially helped spread terror around significant parts of the planet. Nick Turse recently caught this reality with a single statistic: in the years since the U.S. first began its counter-terror efforts in West Africa early in this century, terror incidents there have soared by 30,000%.

And the response to this? You know it all too well. Year after year, the Pentagon’s budget has only grown and is now heading for the trillion-dollar mark. In the end, the U.S. military may have achieved just one success of any significance since 1945 by becoming the most valued and best-funded institution in this country. Unfortunately, in those same years, in a genuinely strange fashion, America’s wars came home.

I doubt, in fact, that Donald Trump would ever have become president without the disastrous American wars of this century. Think of him, in his own terrorizing fashion, as "fallout" from the war on terror.

There may never, in fact, have been a more striking story of a great power, seemingly uncontested on Planet Earth, bringing itself down in quite such a fashion.

Last Words

Today, in Ukraine, we see but the latest grim example of how a vaunted military, strikingly funded in the wake of the collapse of the Soviet Union – and I’m talking, of course, about Russia’s army – has once again been sent into battle against lesser forces with remarkably disastrous results. Mind you, Vladimir Putin and crew, like their American counterparts, should have learned a lesson from the Red Army’s disastrous experience in Afghanistan in the previous century. But no such luck.

There should, of course, be a larger lesson here – not just that there’s no glory in war in the twenty-first century but that, unlike in some past eras, great powers are no longer likely to experience success, no matter what happens on the battlefield.

Let’s hope that the rising power on this planet, China, takes note, even as it regularly organizes threatening military exercises around the island of Taiwan, while the Biden administration continues to ominously heighten the U.S. military presence in the region. If China’s leaders truly want to be successful in this century, they should avoid either the American or Russian versions of war-making of our recent past. (And it would be nice if the Cold Warriors in Washington did the same before we end up in a conflict from hell between two nuclear powers.)

It’s decades too late for me to ask my father what his war truly meant to him, but at least when it comes to "great" powers and war these days, one lesson seems clear enough: there simply is nothing great about them, except their power to destroy not just the enemy, but themselves as well.

I can’t help wondering what my dad might think if he could look at this increasingly disturbed world of ours. I wonder if he wouldn’t finally have something to say to me about war.

Follow TomDispatch on Twitter and join us on Facebook. Check out the newest Dispatch Books, John Feffer’s new dystopian novel, Songlands (the final one in his Splinterlands series), Beverly Gologorsky’s novel Every Body Has a Story, and Tom Engelhardt’s A Nation Unmade by War, as well as Alfred McCoy’s In the Shadows of the American Century: The Rise and Decline of U.S. Global Power, John Dower’s The Violent American Century: War and Terror Since World War II, and Ann Jones’s They Were Soldiers: How the Wounded Return from America’s Wars: The Untold Story.

Tom Engelhardt created and runs the website TomDispatch.com. He was also a co-founder of the American Empire Project and the author of a highly praised history of American triumphalism in the Cold War, The End of Victory Culture. A fellow of the Type Media Center, his sixth book is A Nation Unmade by War.

Copyright 2023 Tom Engelhardt

A Bad Idea Resurfaces: Using the US Military Against Mexico’s Drug Cartels

by Ted Galen Carpenter Posted onApril 25, 2023

There has been a recent flurry of proposals to have the U.S. military launch a full-scale war against Mexican drug cartels – primarily to stem the alleged fentanyl crisis. Former Attorney General William P. Barr initiated the latest campaign with an op-ed in the March 2, 2023, Wall Street Journal. "America can no longer tolerate narco-terrorist cartels," Barr raged. "Operating from havens in Mexico, their production of deadly drugs on an industrial scale is flooding our country with this poison. The time is long past to deal with this outrage decisively."

He praised a Joint Resolution that had been introduced in the House of Representatives that would authorize the president to deploy the US military against cartels inside Mexico. The danger that the trafficking organizations pose to the United States, Barr insisted, requires treating them as "national-security threats, not a law-enforcement matter." According to Barr, such "narco-terrorist groups are more like ISIS than like the American mafia."

He later confirmed that he wanted to use "special ops units" for missions in Mexico. Perhaps the most alarming and provocative aspect of Barr’s scheme was that it would not even allow Mexican officials to have a veto over the operation of foreign troops inside their own country. "It would be good to have the Mexicans’ cooperation," Barr conceded, but "I think that will only come when the Mexicans know that we’re willing to do it with or without their cooperation."

Other militant drug warriors promptly embraced the latest policy panacea. Just days after Barr’s op-ed appeared, Senator Lindsey Graham (R-SC) announced that he would introduce legislation designating the Mexican cartels as "foreign terrorist organizations" and giving the president an Authorization for the Use of Military Force (AUMF) against them. Sen. Tom Cotton (R-AR) had proposed such a step in November 2022, and he now renewed that call.

Such dreadful ideas are not new. US leaders, most notably President Donald Trump, flirted with the military option before. In 2019, Trump reacted to a cartel assault on an American family with a tweet that "this is the time for Mexico, with the help of the United States, to wage WAR (sic) on the drug cartels and wipe them off the face of the earth." In his memoirs, Trump’s Secretary of Defense, Mike Esper, recalled that his boss asked him at least twice in 2020 about the feasibility of launching missiles into Mexico to "destroy the drug labs" and wipe out the cartels. The president considered such a drastic step to be justified because Mexican leaders were "not in charge of their own country."

Not surprisingly, Trump quickly joined the current campaign to attack the cartels. He explicitly embraced the congressional proposals for an AUMF, giving them additional prominence. Rolling Stone reported that Trump "has been asking policy advisers for a range of military options aimed at taking on Mexican drug cartels, including strikes that are not sanctioned by Mexico’s government, according to two sources familiar with the situation."

If true, that development significantly escalates the policy stakes. Public opinion polls show that Trump is currently the leading candidate for the GOP presidential nomination. If he regains the White House in the 2024 election, it is likely that the United States will initiate a military intervention in Mexico.

It is not entirely clear just how extensive a military assault on the cartels the drug warriors contemplate. Options include US Special Forces units working in concert with Mexican troops or operating covertly, attacks employing drone and missile strikes, or (less likely) a full scale US invasion. Rep. Mike Walsh (R-FL), a sponsor of the House AUMF legislation, contends that a military offensive "wouldn’t involve sending US troops to fight the cartels." However, a US military response would include “cyber, drones, intelligence assets, naval assets.”

Even the most restrained interventionist scenarios would create nasty tensions with Mexico. President Andres Manuel Lopez Obrador immediately condemned the latest "irresponsible proposals" for US military action against the cartels. Even if Washington ultimately can bully Lopez Obrador into tolerating such an intrusion, angry reactions from other political factions – and from the Mexican public – is nearly certain. The likelihood of drone or missile strikes killing innocent bystanders (as in Afghanistan, Pakistan, and Somalia) could create an outright crisis in bilateral relations.

Sending troops (even a limited number of Special Forces) would be decidedly more provocative. Mexicans have painful memories of previous US military invasions going back to the Mexican War in the 1840s when James Polk’s administration amputated the northern half of their country. Smaller, but still infuriating, incursions took place in the twentieth century. During Woodrow Wilson’s presidency, US forces occupied Vera Cruz and latter pursued rebel leader Pancho Villa in northern Mexico. Americans may believe that such episodes constitute irrelevant, "ancient history," but many Mexicans do not. A new armed crusade by the "Colossus of the North" against the cartels could easily revive those painful national memories and poison attitudes toward the United States.

Drug warriors refuse to face a depressing, inconvenient truth. Governments are not able to dictate whether people use fentanyl or other destructive substances. Such vices have been part of human culture throughout history. Governments can determine only whether reputable businesses or violent criminal gangs are the suppliers. A prohibition strategy guarantees that it will be the latter – with all the accompanying violence and corruption. The ongoing bloody struggles among rival Mexican cartels to control the lucrative trafficking routes to the United States merely confirm that historical pattern.

Using the US military against targets in Mexico will not change economic incentives or human behavior. Launching an armed crusade against the drug cartels was a bad idea when Trump pondered it as president, and it is a bad idea now. It would severely damage US relations with Mexico while accomplishing nothing worthwhile.

Ted Galen Carpenter is a senior fellow at the Randolph Bourne Institute and a senior fellow at the Libertarian Institute. During a 37-year career at the Cato Institute, Dr. Carpenter also served in various policy positions. He is the author of more than 1,200 articles, as well as 13 books, including The Fire Next Door: Mexico’s Drug Violence and the Danger to America (2012).

The World Is Changing. Is the US Finally Noticing?

by Ted Snider Posted onApril 26, 2023

Recent statements by two Biden administration officials hint that the US is finally noticing that the world around them is changing

On April 11, CIA Director William Burns spoke at Rice University’s Baker Institute for Public Policy. In a somewhat stunning statement that has, perhaps, not been so clearly and publicly articulated before, Burns said that we are in one of "those times of transition that come along a couple of times a century. Today the United States still has a better hand to play than any of our rivals, but it is no longer the only big kid on the geopolitical bloc. And our position at the head of the table isn’t guaranteed."

Burns’ classifying the transition that is now taking place as a "transition that come along a couple of times a century" echoes Chinese President Xi Jinping’s comment to Russian President Vladimir Putin last month that "Together, we should push forward these changes that have not happened for 100 years" and recognizes the significance of the tectonic geopolitical shift that is occurring. The unipolar world is extinct and has been replaced by an evolving multipolar world in which the US "is no longer the only big kid on the geopolitical bloc." As China’s diplomatic role in brokering an agreement between Saudi Arabia and Iran demonstrated to an America caught by surprise, America’s "position at the head of the table isn’t guaranteed."

The ever strengthening partnership between Russia and China has tilted the weight of the world toward a multipolar one. In March, XI visited Putin in Moscow, where they not only "reaffirm[ed] the special nature of the Russia-China partnership," but “signed a statement on deepening the strategic partnership and bilateral ties which are entering a new era.”

But Russia’s and China’s relationships in the new multipolar world are not just bilateral. Countries are lining up to join the Chinese and Russian led multipolar organizations BRICS and the Shanghai Cooperation Organization. And from the call for multipolarity from the many African nations attending the Russia-Africa in a Multipolar World conference in Moscow in March, to Saudi Arabia’s assertion that “We do not believe in polarization or selecting between one partner and another," to India’s continued diplomatic and economic cooperation with Russia and China, to Brazil’s promise to uphold and strengthen multilateralism, to France’s surprising call for Europe to become a "third pole," countries around the world are leaving the US led unipolar world for neutrality in a multipolar world.

One of the mechanisms for multipolarity is emancipation from the monopoly of the US dollar. Most international trade is conducted in dollars, and most foreign exchange reserves are held in dollars. As the US has recently demonstrated in Cuba, Venezuela, Iran and Russia, that position of the dollar allows it to be very powerfully and quickly weaponized.

Sanctions have not only accelerated the evolution of the multipolar world by creating a community of sanctioned countries that turn to each other, forming a second pole, they have also weakened the US led unipolar world by weakening willingness to depend on the dollar.

In the second stunning statement by a US official, Treasury Secretary Janet Yellen said on April 16 that “There is a risk when we use financial sanctions that are linked to the role of the dollar that over time it could undermine the hegemony of the dollar." She explained that "Of course, it does create a desire on the part of China, of Russia, of Iran to find an alternative."

And find an alternative they have. Yellen’s statement suggests that the US is beginning to recognize that escaping the monopoly of the US dollar is gaining momentum as a mechanism for ending, not only the "hegemony of the dollar," but of the US.

Recent demonstrations of the US ability to cut off countries that challenge it has awoken many countries. Several countries and regions, including Russia, China, India, Iran, Brazil, Saudi Arabia, France, Latin America, BRICS, and the Eurasian Economic Union, have all expressed interest in and even made moves towards partially escaping the US dollar.

Russia and China are now conducting 65% of their trade in their own currencies. China and Brazil are now conducting bilateral trade in their own currencies as are China and Pakistan. Iran and Russia are now settling trade in rials and rubles instead of dollars and recently announced that they have circumvented the US financial system by linking their banking systems as an alternative to SWIFT for trading with each other. Saudi Arabia has  said that it sees "no issues" in trading oil in currencies other than the US dollar. The Eurasian Economic Union has agreed on “a phased transition” from settling trade in “foreign currency” to “settlements in rubles.” Robert Rabil, Professor of political science at Florida Atlantic University, says that the United Arab Emirates, Egypt and Israel have all made some movement away from the US dollar.

Brazil has raised the idea of a Latin American currency. And Brazilian President Lula da Silva recently asked "Why should every country have to be tied to the dollar for trade? Who decided the dollar would be the [world’s] currency?" "Why," he suggested, "can’t a bank like the BRICS bank have a currency to finance trade between . . . BRICS countries?" BRICS and the SCO are both considering abandoning the dollar in favor of trade in the currencies of member states.

While US activity suggests a foreign policy that drives on unaware that the terrain has changed, the recent statements by Burns and Yellen suggest that at least some in the Biden administration are beginning to notice that the world is changing. US hegemony, its "position at the head of the table," is no longer "guaranteed."

Ted Snider is a regular columnist on US foreign policy and history at Antiwar.com and The Libertarian Institute. He is also a frequent contributor to Responsible Statecraft and The American Conservative as well as other outlets.

Losing ‘Deterrence’: How Palestinian, Arab Resistance Changed Rules of War With Israel

by Ramzy Baroud Posted onApril 26, 2023

When Israel launched a war against the Gaza Strip in August 2022, it declared that its target was the Islamic Jihad only. Indeed, neither Hamas nor the other Gaza-based groups engaged directly in the fighting. The war then raised more questions than answers.

Israel rarely distinguishes between one Palestinian group and another. For Tel Aviv, any kind of Palestinian Resistance is a form of terrorism or, at best, incitement. Targeting one group and excluding other supposedly "terrorist groups" exposes a degree of Israeli fear in fighting all Palestinian factions in Gaza, all at once.

For Israel, wars in Gaza have proved progressively harder with time. For example, Israel’s so-called "Protective Edge" in 2014 was very costly in terms of loss of lives among the invading troops. In May 2021, the so-called "Breaking Dawn" was an even bigger flop. That war unified the Palestinians and served as a strategic blow to Israel, without considerably advancing Israeli military interests.

Though the Gaza groups provided the Islamic Jihad with logistical support in August 2022, they refrained from directly engaging in the fight. For some Palestinians, this was unexpected and was interpreted by some as indicative of weakness, disunity, and even political opportunism.

Nearly a year later, another war loomed following the release of harrowing footage of Israeli police senselessly beating up peaceful Palestinian worshipers at Al-Aqsa Mosque on the 14th day of the holy month of Ramadan. Like in May 2021, Palestinians rose in unison. This time, it was Resistance groups in Gaza and, eventually, Lebanon and Syria that fired rockets at Israel first.

Though Israel hit back at various targets, it was obvious that Tel Aviv was disinterested in a multi-front war with Palestinians, in order to avoid a repeat of the 2021 fiasco.

The violent and repeated Israeli military raids at Al Aqsa – and limited, though deadly attacks on Jenin, Nablus, and other parts of the West Bank – were meant to achieve political capital for the embattled government of Benjamin Netanyahu. But this strategy could only succeed if Israel manages to keep the violence confined to specific, isolated regions.

Large-scale and protracted military operations have proven useless for Israel in recent years. It has repeatedly failed in Gaza, as it did before in South Lebanon. The unavoidable change of strategy was also costly from the Israeli viewpoint, as it empowered the Palestinian Resistance, and denied Israel its so-called deterrence capabilities.

Indeed, the political discourse emanating from Israel recently is quite unprecedented. Following a security briefing with Netanyahu on April 9, Israel’s opposition leader Yair Lapid left with ominous words. "I arrived at the briefing with Netanyahu worried, and I left even more worried."

"What our enemies see in front of them, in all arenas, is an incompetent government … We’re losing our deterrence," he added. The Times of Israel also quoted Lapid as saying that "Israel is losing the support of the United States and the international community."

Though Israeli politics is inherently divisive, the country’s politicians have always managed to unify around the subject of "security." During wars, Israelis often exhibited unity, and ideological divides seemed largely irrelevant. The fact that Lapid would publicly expose Israel’s weaknesses for political gains further highlights the deterioration of Tel Aviv’s political front.

But more dangerous for Israel is the loss of deterrence.

In an article published in the Jerusalem Post on April 11, Yonah Jeremy Bob highlighted another truth: “Israel no longer decides when wars are fought.”

He writes: “One could have concluded this from the 2014 and May 2021 Gaza wars that Israel stumbled into, and which Hamas used to score various public relations points … but now Hamas learned in a more systematic way … how to instigate its own ring of fire around Jerusalem.”

The writer’s hyped language aside, he is not wrong. The battle between Israel and Palestinian Resistance groups has been largely centered around timing. Though Israel did not ‘stumble’ into a war between 2014 and 2021, it has not been able to control the duration and the political discourse around these wars. Though thousands of Palestinians were killed in what seemed like one-sided Israeli military campaigns, these conflicts almost always resulted in a public relations disaster for Tel Aviv abroad and further destabilized an already shaky home front.

This explains, at least in part, why Palestinians were keen not to expand the August 2022 war, which was also entirely initiated by Israel, while taking the initiative by firing rockets at Israel, starting on April 5. The latest Palestinian action forced Israel to engage militarily on several fronts – Gaza, Lebanon, Syria and, arguably, the West Bank.

Throughout its 75 years of military conflict with Palestinians and Arabs, Israel’s success on the battlefield has been largely predicated on the unhindered military, logistical and financial support from its Western allies, and the disunity of its Arab enemies. This has allowed Israel to win wars on multiple fronts in the past, with the 1967 war serving as the main, and possibly, last example.

Since then, and especially following the considerable Arab resistance in the 1973 war, Israel shifted to different types of military conflicts: strengthening its occupation in the West Bank, Gaza and East Jerusalem, while launching massive wars at singular fronts – for example, Lebanon 1982.

The Israeli retreat from Lebanon in 2000, and the utter failure to re-invading parts of the country in 2006, brought Israel’s military ambitions in Lebanon to a complete halt.

Then, Israel turned to Gaza, launching one devastating war after the other, starting in 2008, only to discover that its military options in the besieged Strip are now as limited as that of Lebanon.

For Lapid, and other Israelis, the future of Israel’s "deterrence" is now facing an unprecedented challenge. If the Israeli military is unable to operate at ease and at the time of its choosing, Tel Aviv would lose its "military edge," a vulnerability that Israel has rarely faced before.

While Israeli politicians and military strategists are openly fighting over who has cost Israel its precious "deterrence," very few seem willing to consider that Israel’s best chance at survival is peacefully co-existing with Palestinians according to the international principles of justice and equality. This obvious fact continues to elude Israel after decades of a violent birth and troubled existence.

Dr. Ramzy Baroud is a journalist, author and the Editor of The Palestine Chronicle. He is the author of six books. His latest book, co-edited with Ilan Pappé, is Our Vision for Liberation: Engaged Palestinian Leaders and Intellectuals Speak Out. His other books include My Father was a Freedom Fighter, and The Last Earth. Baroud is a Non-resident Senior Research Fellow at the Center for Islam and Global Affairs (CIGA). His website is www.ramzybaroud.net.

AI-generated spam may soon be flooding your inbox – and it will be personalized to be especially persuasive

The Conversation
April 24, 2023

Spam (Shutterstock)

Each day, messages from Nigerian princes, peddlers of wonder drugs and promoters of can’t-miss investments choke email inboxes. Improvements to spam filters only seem to inspire new techniques to break through the protections.

Now, the arms race between spam blockers and spam senders is about to escalate with the emergence of a new weapon: generative artificial intelligence. With recent advances in AI made famous by ChatGPT, spammers could have new tools to evade filters, grab people’s attention and convince them to click, buy or give up personal information.

As director of the Advancing Human and Machine Reasoning lab at the University of South Florida, I research the intersection of artificial intelligence, natural language processing and human reasoning. I have studied how AI can learn the individual preferences, beliefs and personality quirks of people.

This can be used to better understand how to interact with people, help them learn or provide them with helpful suggestions. But this also means you should brace for smarter spam that knows your weak spots – and can use them against you.

Spam, spam, spam

So, what is spam?

Spam is defined as unsolicited commercial emails sent by an unknown entity. The term is sometimes extended to text messages, direct messages on social media and fake reviews on products. Spammers want to nudge you toward action: buying something, clicking on phishing links, installing malware or changing views.

Spam is profitable. One email blast can make US$1,000 in only a few hours, costing spammers only a few dollars – excluding initial setup. An online pharmaceutical spam campaign might generate around $7,000 per day.

Legitimate advertisers also want to nudge you to action – buying their products, taking their surveys, signing up for newsletters – but whereas a marketer email may link to an established company website and contain an unsubscribe option in accordance with federal regulations, a spam email may not.

Spammers also lack access to mailing lists that users signed up for. Instead, spammers utilize counter-intuitive strategies such as the “Nigerian prince” scam, in which a Nigerian prince claims to need your help to unlock an absurd amount of money, promising to reward you nicely. Savvy digital natives immediately dismiss such pleas, but the absurdity of the request may actually select for naïveté or advanced age, filtering for those most likely to fall for the scams.


Advances in AI, however, mean spammers might not have to rely on such hit-or-miss approaches. AI could allow them to target individuals and make their messages more persuasive based on easily accessible information, such as social media posts.


Inboxes are already bursting with spam. Epoxydude/fStop via Getty Images

Future of spam

Chances are you’ve heard about the advances in generative large language models like ChatGPT. The task these generative LLMs perform is deceptively simple: given a text sequence, predict which token – think of this as a part of a word – comes next. Then, predict which token comes after that. And so on, over and over.

Somehow, training on that task alone, when done with enough text on a large enough LLM, seems to be enough to imbue these models with the ability to perform surprisingly well on a lot of other tasks.


Multiple ways to use the technology have already emerged, showcasing the technology’s ability to quickly adapt to, and learn about, individuals. For example, LLMs can write full emails in your writing style, given only a few examples of how you write. And there’s the classic example – now over a decade old – of Target figuring out a customer was pregnant before her father knew.

Spammers and marketers alike would benefit from being able to predict more about individuals with less data. Given your LinkedIn page, a few posts and a profile image or two, LLM-armed spammers might make reasonably accurate guesses about your political leanings, marital status or life priorities.

Our research showed that LLMs could be used to predict which word an individual will say next with a degree of accuracy far surpassing other AI approaches, in a word-generation task called the semantic fluency task. We also showed that LLMs can take certain types of questions from tests of reasoning abilities and predict how people will respond to that question. This suggests that LLMs already have some knowledge of what typical human reasoning ability looks like.

If spammers make it past initial filters and get you to read an email, click a link or even engage in conversation, their ability to apply customized persuasion increases dramatically. Here again, LLMs can change the game. Early results suggest that LLMs can be used to argue persuasively on topics ranging from politics to public health policy.

Good for the gander

AI, however, doesn’t favor one side or the other. Spam filters also should benefit from advances in AI, allowing them to erect new barriers to unwanted emails.

Spammers often try to trick filters with special characters, misspelled words or hidden text, relying on the human propensity to forgive small text anomalies – for example, “c1îck h.ere n0w.” But as AI gets better at understanding spam messages, filters could get better at identifying and blocking unwanted spam – and maybe even letting through wanted spam, such as marketing email you’ve explicitly signed up for. Imagine a filter that predicts whether you’d want to read an email before you even read it.

Despite growing concerns about AI – as evidenced by Tesla, SpaceX and Twitter CEO Elon Musk, Apple founder Steve Wozniak and other tech leaders calling for a pause in AI development – a lot of good could come from advances in the technology. AI can help us understand how weaknesses in human reasoning might be exploited by bad actors and come up with ways to counter malevolent activities.

All new technologies can result in both wonder and danger. The difference lies in who creates and controls the tools, and how they are used.

This article was updated to indicate that it was a teenager’s father who learned from Target that his daughter was pregnant.

John Licato, Assistant Professor of Computer Science and Director of AMHR Lab, University of South Florida

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Networks of silver nanowires seem to learn and remember, much like our brains

The Conversation
April 24, 2023

Shutterstock

Over the past year or so, generative AI models such as ChatGPT and DALL-E have made it possible to produce vast quantities of apparently human-like, high-quality creative content from a simple series of prompts.

Though highly capable – far outperforming humans in big-data pattern recognition tasks in particular – current AI systems are not intelligent in the same way we are. AI systems aren’t structured like our brains and don’t learn the same way.

AI systems also use vast amounts of energy and resources for training (compared to our three-or-so meals a day). Their ability to adapt and function in dynamic, hard-to-predict and noisy environments is poor in comparison to ours, and they lack human-like memory capabilities.

Our research explores non-biological systems that are more like human brains. In a new study published in Science Advances, we found self-organising networks of tiny silver wires appear to learn and remember in much the same way as the thinking hardware in our heads.
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Imitating the brain

Our work is part of a field of research called neuromorphics, which aims to replicate the structure and functionality of biological neurons and synapses in non-biological systems.

Our research focuses on a system that uses a network of “nanowires” to mimic the neurons and synapses in the brain. These nanowires are tiny wires about one thousandth the width of a human hair. They are made of a highly conductive metal, such as silver, typically coated in an insulating material like plastic.


Left: microscope image of silver nanowire networks, from our Science Advances paper. Right: strengthened and pruned (weakened) pathways in nanowire networks.

Nanowires self-assemble to form a network structure similar to a biological neural network. Like neurons, which have an insulating membrane, each metal nanowire is coated with a thin insulating layer.

When we stimulate nanowires with electrical signals, ions migrate across the insulating layer and into a neighbouring nanowire (much like neurotransmitters across synapses). As a result, we observe synapse-like electrical signalling in nanowire networks.

Learning and memory

Our new work uses this nanowire system to explore the question of human-like intelligence. Central to our investigation are two features indicative of high-order cognitive function: learning and memory.

Our study demonstrates we can selectively strengthen (and weaken) synaptic pathways in nanowire networks. This is similar to “supervised learning” in the brain. In this process, the output of synapses is compared to a desired result. Then the synapses are strengthened (if their output is close to the desired result) or pruned (if their output is not close to the desired result).

We expanded on this result by showing we could increase the amount of strengthening by “rewarding” or “punishing” the network. This process is inspired by “reinforcement learning” in the brain.

We also implemented a version of a test called the “n-back task” which is used to measure working memory in humans. It involves presenting a series of stimuli and comparing each new entry with one that occurred some number of steps (n) ago.

The network “remembered” previous signals for at least seven steps. Curiously, seven is often regarded as the average number of items humans can keep in working memory at one time.

When we used reinforcement learning, we saw dramatic improvements in the network’s memory performance.

In our nanowire networks, we found the formation of synaptic pathways depends on how those synapses have been activated in the past. This is also the case for synapses in the brain, where neuroscientists call it “metaplasticity”.

Synthetic intelligence

Human intelligence is still likely a long way from being replicated.

Nonetheless, our research on neuromorphic nanowire networks shows it is possible to implement features essential for intelligence – such as learning and memory – in non-biological, physical hardware.

Nanowire networks are different from the artificial neural networks used in AI. Still, they may lead to so-called “synthetic intelligence”.

Perhaps a neuromorphic nanowire network could one day learn to have conversations that are more human-like than ChatGPT, and remember them.

Alon Loeffler, PhD researcher, University of Sydney and Zdenka Kuncic, Professor of Physics, University of Sydney

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Humans weren’t the first engineers, doctors and farmers – bacteria, plants and animals have lots to teach us

The Conversation
April 24, 2023

There are hidden worlds in nature. 

PeopleImages.com/Yuri A/Shutterstock

Life existed without human beings for more than 99.9% of Earth’s history. Yet we often ignore the achievements of species that preceded us by billions of years.

I explore the concept of nonhuman civilizations in my new book, Biocivilizations, which retells the story of life acknowledging the contributions of other species. Bacteria, plants, fungi, insects, birds, whales and other species demonstrate language, engineering, science, medicine, agriculture and more. These are all elements of civilization that we associate with humans.

Speaking nature’s language

Whales communicate with each other using a series of sound clicks called codas. Sperm whales seem to announce themselves using a unique click sequence, or name. By pooling their acoustic datasets, an international team of 27 researchers studying Pacific Ocean sperm whales identified seven sperm whale vocal clans, each with their own dialect and identity codas. Now, scientists from around the world are collaborating as part of the Cetacean Translation Initiative to use powerful AI algorithms and decode the language of sperm whales

Plants communicate with each other using hormones such as jasmonate, which redirects resources from growth to repairing damage. They release hormones into the air when in distress, such as when insects attack them. Neighboring plants then pick up on the signal and respond by preparing for attacks – for example, by releasing toxins to ward off the insects.

Meanwhile, bacteria have been “talking” to each other for billions of years by exchanging chemical messages via hormone-like molecules called autoinducers. They use these chemicals to synchronize action. For example, bacteria may only invade a cell if enough neighbouring bacteria are releasing autoinducers. This is called quorum sensing.

Bacteria also communicate with the cells of other species, including ours. Recent research showed certain chemicals that bacteria release influence the development of our brains, allowing the brain tissue to mature properly. Studies into premature babies have shown the relationship between gut bacteria and human cells are crucial for cognitive development.

Skilled engineers

Our planet also reverberates with construction noise. It is a permanent building site where bacteria, insects and humans alike create cities.

The engineering skills of honeybees are so sophisticated that a honeybee expert and a group of engineers used an algorithm inspired by honeybees to resolve internet traffic problems. They copied the process bees use to distribute foragers searching a floral field for nectar.

Bacteria are skilled engineers too. In one study, scientists used powerful microscopes and time-lapse imaging to record the city-building skills of a bacterial species that lives in human mouths, Streptococcus mutans. Bacteria produce their own building materials when they settle at a new site, normally a hard surface. These materials include carbohydrates, proteins and even DNA secreted by their tiny bodies. The building material is carefully distributed so that the village structure acquires a three-dimensional shape.

Some of these bacteria-settlers remain stationary and meld themselves to the surface that the village is built on, enhancing its structural stability. Bacteria can also move within villages and divide their bodies to increase the population. Villages grow, join together and form bacterial cities and megacities – much like modern London is a collection of former villages and towns.

The communication between bacterial megacities is conducted through electrical impulses. Indeed, the entire planet was turned into a kind of bacterial internet three billion years ago.

Doctors and surgeons

Arguably, bacteria were also the first practitioners of medicine. Viruses invade bacteria and hijack their cellular machinery to make copies of themselves – a process which kills the bacteria. So, three billion years ago, bacteria became “epidemiologists” to defend themselves.

Bacterial bodies produce enzymes that attack and kill virus DNA, a technique known as Crspr. It can target a section of DNA, bind to it and turn the gene off. Scientists only recently discovered this system, and in future hope to use it for cancer treatments and to cure genetic conditions. It has already been used to make COVID-19 detection tests.

Some people think of ants as tiny insects barely worth thinking about. But ants from the species Megaponera analis, found in sub-Saharan Africa, are talented surgeons. These warrior ants specialize in raiding termite nests. The larger ants, majors, break termites’ defensive mud barriers, then their smaller colleagues, minors, rush through these openings to pull termites out of the nest.

After the raids, the ants form orderly columns again and majors carry dead termites back to the ant nest. But entomologists noticed that some majors also transport injured ants, while others treat their comrades’ wounds with antimicrobial chemicals secreted by fellow ants’ glands.

The ants also use their powerful mandibles to remove termites that are clinging to warrior ant bodies by their teeth, and to stitch wounds. These ant surgeons were so effective that patients were spotted on the battlefield the next day.

Successful farmers

Farming in the way humans know it is planting, protecting and harvesting crops for nourishment. Research shows that the soil fungus Morchella crassipes also does this to the bacteria Pseudomonas putida for its carbon, which the soil fungus needs to grow.

In turn, ambrosia beetles transport fungus spores in a pouch-like structure in their gut to tunnels bored into trees. Ambrosia fungi produce asexual fruit only in the presence of the beetles. This fruit is their sole food source, and the beetles even remove “weed” fungus.

Leafcutter ants also farm fungi from the genus Leucoagaricus, and even use antibiotic bacteria to protect their crops from parasites. Ants don’t just stick to agriculture, though; they herd aphids too. Just as we humans milk cows, ants “milk” aphids for the nutritious honeydew they produce.

So, these tiny beings were all farmers millions of years before humans had even thought of it.

Human civilization is the most recent addition to an ever-changing landscape of ancient societies. Learning to value nonhuman civilizations may help reveal the ancient wisdom of species that preceded us. In so doing, this newly discovered wisdom could help us resolve the environmental crisis caused by our civilization.

Predrag Slijepcevic, Senior Lecturer in Biology, Brunel University London

This article is republished from The Conversation under a Creative Commons license. Read the original article.

IT'S CANADA WE'RE USED TO BEING COLD
Study explores link between attachment styles and sexual dysfunction in young adults
2023/04/24


Young adulthood is often associated with exciting developments in intimacy and relationships, but research showing increased sexual dysfunction among the 18-25 age group has emerged in recent years. A study published in The Journal of Sex Research explores how sexual dysfunction in young adulthood may be related to anxious attachment, avoidant attachment, and childhood victimization.

Sexual difficulties are often thought of as something that occurs in old age, but current research shows over 75% of young adults report experiencing some form of sexual dysfunction. Some forms of dysfunction have even been found to be more prevalent in young adults than they are in the elderly.

Previous research has linked sexual difficulties with more maladaptive forms of attachment, such as anxious and avoidant, but this has not been extended and confirmed for a young adult population specifically, which this study aims to address.

For their study, Caroline Dugal and colleagues utilized a sample of 437 French-Canadian emerging adults between the ages of 18 and 25 years old. Participants were predominantly female, Canada-born, heterosexual, and educated. The sample was recruited through social media, email, and community locations.

All participants needed to have at least one sexual or romantic partner in the past 6 months. Participants completed the study online and completed measures on demographics, romantic attachment, sex motives, sexual difficulties, and childhood interpersonal victimization.

Results showed that insecure attachment, including anxious and avoidant attachment styles, can affect sexual dysfunction due to the reasons that people decide to have sex. “Results of the current study shed light on key interpersonal and sexual factors that are associated with sexual difficulties experienced by emerging adults. Specifically, the study suggests that attachment insecurities might play a role in the reasons for which emerging adults engage in sex, which in turn, can shape their experience of sex,” the researchers wrote.

Anxious attachment style is characterized by a fear of abandonment, a preoccupation with the relationship, and a tendency to be emotionally reactive. Avoidant attachment style is characterized by a fear of intimacy and a tendency to distance oneself from emotional connection.

People who reported having sex for pleasure tended to have lower levels of sexual dysfunction. People with anxious attachment styles were more likely to report having sex for partner approval, self-affirmation, and coping motives. Of these, only the partner approval motive was significantly linked with sexual dysfunction.

These relationships varied as a product of childhood victimization. Participants who experienced low levels of victimization in childhood and were anxiously attached were more likely to endorse having sex as a form of coping, which was associated with difficulty achieving vaginal lubrication or erection.

Participants with avoidant attachment who experienced low levels of childhood victimization reported lower arousal and difficulty achieving orgasm regardless of sexual motives. For participants who experienced high levels of childhood victimization, having avoidant attachment was associated with having sex for partner approval, which was related to problems with sex drive, arousal, and the physiological mechanisms associated with sex.

This study took important steps into better understanding how both attachment style and interpersonal childhood victimization related to sexual dysfunction for emerging adults. Despite this, there are limitations to note. One such limitation is that the sample was predominantly female, Canadian, and educated. Future research could utilize a more diverse sample.

Additionally, this study did not explore how correlations may change between relationship statuses; future research could explore differences in sexual dysfunction between single or partnered individuals.

The study, “Romantic Attachment, Sex Motives and Sexual Difficulties in Emerging Adults: The Role of Childhood Interpersonal Victimization“, was authored by Caroline Dugal, Audrey Brassard, Pierre-Yves Kusion, Audrey-Ann Lefebvre, Katherine Péloquin, and Natacha Godbout.

© PsyPost

Researchers discover two psychological traits that connect narcissism to sadism

2023/04/24


Researchers In Italy were curious if sadism and grandiose narcissism may be related and what traits may facilitate this relationship. Their findings indicate that malicious envy and narcissistic rivalry are the characteristics that connect sadism to grandiose narcissism. The research has been published in Personality and Individual Differences.

Sadism refers to the tendency to derive pleasure from the suffering of others. It has been identified as a component of the “dark tetrad” along with Machiavellianism, psychopathy, and narcissism.

The tendency to take control others is a key characteristic of grandiose narcissism and may have a common component with sadism. Researchers have posited that sadistic behavior is not only about seeking pleasure, but also about the desire to assert power and dominance. The relationship between grandiose narcissism and sadism may be explained by two processes: narcissistic rivalry and malicious envy.

The phenomenon of narcissistic rivalry is marked by negative emotions when someone else receives attention, and positive emotions when others fail. Malicious envy arises when people compare themselves unfavorably to others who possess qualities, property, or success. This, in turn, results in feelings of anger and hostility.

In their new study, Guyonne Rogier and colleagues sought to shed light on the complex relationship between sadism and grandiose narcissism, and the psychological traits that link them together.

In a sample of 3,240 Italian university students, various aspects of envy, sadistic personality, and narcissism were measured using self-report questionnaires. The study utilized the Benign and Malicious Envy Scale (BeMaS) to gauge envy levels, while the Assessment of Sadistic Personality (ASP) and Narcissistic Admiration and Rivalry Questionnaire (NARQ) were utilized to measure subclinical sadism and narcissism, respectively. Additionally, the Pathological Narcissism Inventory (PNI) was used to evaluate grandiose and vulnerable narcissism levels.

The findings indicated that the I-BeMaS effectively measured two different dimensions of envy, distinguishing between the positive and negative aspects of the construct, and had strong psychometric qualities. The study also discovered a significant affirmative link between grandiose narcissism and sadism, with both malicious envy and narcissistic rivalry acting as mediators between grandiose narcissism and sadism.

“Narcissistic rivalry is a multidimensional construct that include aggressiveness, struggle for supremacy and joy in response to other’s failures. Individuals with grandiose narcissism would
be therefore prone to experience pleasure when assisting to others’ pain and especially when this pain is related to a position of inferiority. Our results suggest that grandiose narcissism may be related to the seeking of pleasure in provoking or observing pain in others as it would strengthen their positive self-image, eliciting positive feelings of self-worth,” the researchers wrote.

“Regarding malicious envy, a similar interpretation of our results can be formulated. Indeed, malicious envy, in contrast with benign envy, would be triggered by the observation of others’ success and good fortune. Theoretically, in individuals with grandiose narcissism, this perception would elicit hostile feelings towards the fortunate other, as its good fortune would be perceived as an ego threat. This would motivate these individuals to desire other’s failure and the destruction of their superior status.”

The findings have implications beyond the study of pathological personalities, as envy likely plays a role in various psychological and psychopathological outcomes such as depression and anxiety. The study also helps validate the Italian version of I-BeMaS and provides initial evidence of the reliability of the Italian version of ASP items, which assesses the subjugating aspects of sadism. In summary, the study highlights the intricate connections between grandiose narcissism, envy, and sadism, emphasizing the necessity for more research in this area.

The research team acknowledged some limitations to their study. Firstly, only self-report questionnaires were employed, which may not be the best method for investigating ego-syntonic variables. Second, the study found a significant association between narcissistic rivalry and malicious envy, which supports previous research on the topic. The present study employed a cross-sectional design, which makes it difficult to test mediational hypotheses.

The study, “Pathological narcissism and sadistic personality: The role of rivalry and malicious envy“, was authored by Guyonne Rogier, Alessandro Amo, Beatrice Simmi, and Patrizia Velotti.

© PsyPost

'Addiction medicine is primary care': Patients who visit their primary care doctor for opioid addiction treatment reduce their overdose risk, a new study suggests

2023/04/25

LIFE-HEALTH-ADDICTION-TREATMENT-DMT.

- Dreamstime/Dreamstime/TNS

PHILADELPHIA — As a primary care physician at Jefferson Health, Greg Jaffe helps his patients navigate diabetes and high blood pressure, flu shots and annual checkups — standard fare for a family medicine practitioner. But for many of his patients, he also oversees a type of care that most of his colleagues in primary care won't take on: addiction treatment.

Jaffe had no intention of treating patients for addiction when he became a doctor. But in 2021, he began running a small, once-a-week clinic at Jefferson that prescribed patients buprenorphine, an opioid-based addiction medication. After patients are stabilized at the clinic, they are transferred to primary care physicians — including Jaffe — making their long-term addiction treatment more convenient.

Jaffe's new slate of patients has opened his eyes to the benefits of providing addiction medicine along with primary care, as a kind of one-stop shop for patients who often face significant barriers to getting any kind of health care.

New research backs up this idea. Primary care physicians who care for people with addiction can prevent more people from dying of an overdose, according to a new study from the University of Pittsburgh.

People with opioid addiction are often referred to specialty treatment clinics — even if they seek help from their primary care doctor. But offering overdose-reversing drugs and addictiontreatment medication through routine primary care visits could help people with addiction lower their overdose risk and live longer than if they got treatment elsewhere, according to a new study published in JAMA Open Network.

The approach has challenges: Patients may not have an established primary care provider. And doctors may not be trained in addiction treatment. But in Philadelphia, doctors who have already integrated addiction treatment into their practice say it's a strategy with big potential.

Some doctors, Jaffe said, don't know much about addiction medications and may judge people who use drugs.

"Doctors don't want 'those people' in their waiting room," he said, but addiction is widespread enough that it's likely primary care doctors are already treating patients with addiction without realizing it.

Jaffe has grown close with several patients in his addiction clinic who transferred to his primary care practice. He relishes the opportunity to address other health concerns they have outside of their addiction.

"Addiction medicine is primary care," he said. "We can treat their opioid-use disorder, but we can also treat them as whole patients."

The new study out of University of Pittsburgh reinforces what Jaffe has learned from his own practice.

The study used data on drug users, their risk of overdoses and infections, and their likelihood to enter treatment to create hypothetical models that simulated an addiction patient's journey through the treatment system, said Raagini Jawa, an assistant professor of medicine at Pitt and the lead author of the study.

The study tested three scenarios:

1. Patients received buprenorphine, an opioid-based addiction medication from a primary care doctor.

2. Patients received both buprenorphine and kits with tools to reduce the harmful effects of drug use, including sterile syringes and the overdose-reversing drug naloxone.

3. Patients were referred to an outside clinic for addiction treatment. This approach most closely resembled how primary care doctors typically handle patients needing addiction treatment.

Researchers estimated that patients who received addiction medication alone and those who received medication plus harm-reduction tools extended their life expectancy by more than two and a half years. And patients who got both buprenorphine and harm-reduction tools were 33% less likely to die due to an infection from drug use or an overdose.

Jawa said researchers used a hypothetical model because real-world research on primary care and addiction treatment tends to be affected by the same barriers that keep many family doctors from treating opioid-use disorder at their own practices.

"We have plenty of studies where we have tried to implement addiction treatment into primary care. They run into barriers like a lack of time, a lack of program leadership support, stigma, and low interest in treating opioid-use disorder," she said. "A model can tell us what the magnitude of a potential strategy is — what can happen in an ideal world."

Jawa treats addiction at her own primary care clinic and says her patients benefit from being able to address all their health needs at a single office, instead of going elsewhere for addiction treatment.

"For a lot of our patients with substance-use disorder, there's so much stigma when it comes to accessing any sort of health care," she said. "If there's one face that can be their go-to provider, that helps with building trust. It becomes a medical home."