The feds have busted 12 shady STD treatment companies—and the Better Business Bureau might be collateral damage
The Food and Drug Administration and the Federal Trade Commission joined forces Tuesday to threaten 12 companies with legal action over the manufacture and sale of products that purport to treat sexually transmitted diseases. The FDA's webpage alone, complete with the video STD Treatments That Don't Work, will prove a devastating assault to most of these businesses. Though it lacks the authority to carry out an IRS-style raid, the FDA has been using its legal department's fearsome prose to bust bad drugs sold as supplements for decades now, and in the past few years we've seen the agency ramp up these efforts as online commerce has driven the problem to epidemic proportions.
So while I expect a steady drumbeat of deadbeat drug bashing, I was instead far more interested to discover a prominent consumer rights nonprofit linked to the mess. The Better Business Bureau lent its considerable credibility to one of the companies the Feds are slamming for endangering the country's public health. What's more, the BBB followed its normal practices and policies in doing so, the organization told me yesterday.
The BBB's involvement became apparent once I decided to take a closer look at the assortment of crappy capsules the Feds are putting on notice. I zeroed in on Medavir, produced by a central-Florida based outfit called The Arenson Group (a.k.a. TAG Health). The internet is littered with TAG's websites selling Medavir under various names. While scrolling along you'll see the usual unsubstantiated claims and endorsements from unnamed physicians that one would expect from shady operators. "Over 90% of outbreaks do not occur when you apply Medavir at first signs of outbreak," one site says. Stop the presses! For your information, that compares to about an 50 to 60 percent chance of future genital herpes outbreaks while on FDA-approved medical treatment (versus a blistering 80 to 90 percent rate without treatment) according to a 2007 meta-analysis of available trial data.
The Arenson Group preys on ashamed kids and unsophisticated adults. Your sexual partner, your doctor, and the public health department need never know!
So how's the the BBB mixed up in this? Take a look at this screen shot from one of the Medavir sites:
As shown in the above screenshot, Medavir prominently displays its BBB Accredited Business logo in the upper left hand corner of its website. Unlike the sprinkling of other certifications and logos on the site that turn out to be illegitimate, BBB's is the real deal. Until earlier today when the organization heard from me and took down their rating, consumers could click on that link to see its A+ rating from the BBB:
The BBB accredited The Arenson Group in January 2009 "based on information provided by the company and our own research," says Holly Salmons, Vice President of BBB of Central Florida.
The bottom line? The BBB is pleased to accredit questionable pill purveyors when they market their mixtures as supplements. Because The Arenson Group's website included the statement "none of these statements have been fully evaluated by the FDA" at the time they applied for accreditation (it still does), the BBB was satisfied to welcome them into its brotherhood of legitimate American businesses. In fact, Ms. Salmons says that while as of Wednesday she has frozen Arenson's status in "update" mode, the BBB will suspend or restore their accreditation only pending their response to the FDA's demands.
Arenson could potentially satisfy federal regulators by removing all medical claims from its websites and packaging and marketing Medavir in some vague manner unconnected to treating herpes sufferers. That would leave little text on their sites indeed. I find it difficult to imagine what a website attempting to sell Medavir without claiming that it treats herpes would look like (what in the world is a "herpes supplement"?), and I'd love to see the original materials the BBB reviewed in 2009.
Once BBB approved Medavir's membership, the company wasn't slated for another review for three years, giving plenty of time for its claims to become progressively more egregious without any oversight. But lack of such frequent review doesn't seem to be the crux of the problem in my own analysis. BBB protests to me that Medavir's January 2009 materials fit classification as a supplement and did not overstep bounds into FDA-regulated territory. After reviewing versions of Medavir.com from January 2009 and the oldest available version from June 2008 over at the Internet Archive, I don't buy their version of events. Take a look back, and make your own call.
The Arenson Group showed off its A+ BBB rating to its vulnerable lot of prospective consumers as an implied seal of approval. This use, even for a health care product, is routine in BBB practice. "Accredited Businesses are permitted to report their rating as long as it is accurate at all times," BBB VP Salmons tells me. Arenson had just two complaints over three years, she says, which is a low complaint volume. Another BBB policy helps explain why Medavir might have so few complaints. BBB only accepts complaints that come with real names and documentation.
People searching out genital herpes cures from the privacy of their own homes are obviously reluctant or unable to do so in the care of actual medical professionals out there in the real world. These consumers must have found some reassurance in BBB's A+ rating, which is why the Medavir site advertised it high above the fold. Medavir had a perfectly marginalized population base from which to draw its A+ record: folks too anxiety-ridden to speak up once they realized they'd been scammed; STD sufferers who didn't think admitting they have herpes to a third party was worth it when that third party took the Hippocratic Oath certainly aren't going to confide their private secrets to the BBB.
The characters behind Medavir made BBB into a Bogus Balms Bureau. To get out of this fix, BBB needs to eject itself from the field of lending credibility to unregulated drug makers entirely. This means excluding health "supplements." It's hard enough for physicians and the FDA to weigh evidence about these agents. BBB ratings are bestowed by an organization with no possible claim to competence in mediating between patients and providers in the unique health care marketplace, as the policies that led to this case prove. Moreover, BBB ratings add nothing of value to any consumer considering what pills to take for an illness. Continuing to offer accreditation to firms like The Arenson Group (aka Medavir Medical Advances) of Windmere, Florida, whether or not they barely skirt FDA enforcement does a disservice to BBB's own heritage.
A new film details the reason the star postponed her recent tour—and will test cultural attitudes about gender, pain, and pop.
“Pain without a cause is pain we can’t trust,” the author Leslie Jamison wrote in 2014. “We assume it’s been chosen or fabricated.”
Jamison’s essay “Grand Unified Theory of Female Pain” unpacked the suffering-woman archetype, which encompasses literature’s broken hearts (Anna Karenina, Miss Havisham) and society’s sad girls—the depressed, the anorexic, and in the 19th century, the tubercular. Wariness about being defined by suffering, she argued, had led many modern women to adopt a new pose. She wrote, “The post-wounded woman conducts herself as if preempting certain accusations: Don’t cry too loud; don’t play victim.” Jamison questioned whether this was an overcorrection. “The possibility of fetishizing pain is no reason to stop representing it,” she wrote. “Pain that gets performed is still pain.”
Girls in the Middle East do better than boys in school by a greater margin than almost anywhere else in the world: a case study in motivation, mixed messages, and the condition of boys everywhere.
Jordan has never had a female minister of education, women make up less than a fifth of its workforce, and women hold just 4 percent of board seats at public companies there. But, in school, Jordanian girls are crushing their male peers. The nation’s girls outperform its boys in just about every subject and at every age level. At the University of Jordan, the country’s largest university, women outnumber men by a ratio of two to one—and earn higher grades in math, engineering, computer-information systems, and a range of other subjects.
In fact, across the Arab world, women now earn more science degrees on a percentage basis than women in the United States. In Saudi Arabia alone, women earn half of all science degrees. And yet, most of those women are unlikely to put their degrees to paid use for very long.
What feels like information overload reveals how little the public actually knows about the probe's findings.
Robert Mueller has stayed busy with his special-counsel investigation all summer, but the rest of Washington took a vacation. And since most information about Mueller’s actions seems to come from leaks outside the Mueller team, that meant there was a stretch of relative silence.
But the lull is over now. The month of September, and particularly the last week, have seen a torrent of new revelations about Mueller’s investigation. The fresh information gives the most complete view of what Mueller is up to and where he might be focusing, and in particular on the person of Paul Manafort, who chaired Donald Trump’s presidential campaign during the summer of 2016. Yet even as they suggest the direction in which the probe is headed at the moment, they don’t offer much insight into the ultimate questions of when Mueller might wrap up and what, if any, charges he might bring or recommend. So where does that leave things?
The foundation of Donald Trump’s presidency is the negation of Barack Obama’s legacy.
It is insufficient to statethe obvious of Donald Trump: that he is a white man who would not be president were it not for this fact. With one immediate exception, Trump’s predecessors made their way to high office through the passive power of whiteness—that bloody heirloom which cannot ensure mastery of all events but can conjure a tailwind for most of them. Land theft and human plunder cleared the grounds for Trump’s forefathers and barred others from it. Once upon the field, these men became soldiers, statesmen, and scholars; held court in Paris; presided at Princeton; advanced into the Wilderness and then into the White House. Their individual triumphs made this exclusive party seem above America’s founding sins, and it was forgotten that the former was in fact bound to the latter, that all their victories had transpired on cleared grounds. No such elegant detachment can be attributed to Donald Trump—a president who, more than any other, has made the awful inheritance explicit.
Long after research contradicts common medical practices, patients continue to demand them and physicians continue to deliver. The result is an epidemic of unnecessary and unhelpful treatments.
First, listen to the story with the happy ending: At 61, the executive was in excellent health. His blood pressure was a bit high, but everything else looked good, and he exercised regularly. Then he had a scare. He went for a brisk post-lunch walk on a cool winter day, and his chest began to hurt. Back inside his office, he sat down, and the pain disappeared as quickly as it had come.
That night, he thought more about it: middle-aged man, high blood pressure, stressful job, chest discomfort. The next day, he went to a local emergency department. Doctors determined that the man had not suffered a heart attack and that the electrical activity of his heart was completely normal. All signs suggested that the executive had stable angina—chest pain that occurs when the heart muscle is getting less blood-borne oxygen than it needs, often because an artery is partially blocked.
More comfortable online than out partying, post-Millennials are safer, physically, than adolescents have ever been. But they’re on the brink of a mental-health crisis.
One day last summer, around noon, I called Athena, a 13-year-old who lives in Houston, Texas. She answered her phone—she’s had an iPhone since she was 11—sounding as if she’d just woken up. We chatted about her favorite songs and TV shows, and I asked her what she likes to do with her friends. “We go to the mall,” she said. “Do your parents drop you off?,” I asked, recalling my own middle-school days, in the 1980s, when I’d enjoy a few parent-free hours shopping with my friends. “No—I go with my family,” she replied. “We’ll go with my mom and brothers and walk a little behind them. I just have to tell my mom where we’re going. I have to check in every hour or every 30 minutes.”
Those mall trips are infrequent—about once a month. More often, Athena and her friends spend time together on their phones, unchaperoned. Unlike the teens of my generation, who might have spent an evening tying up the family landline with gossip, they talk on Snapchat, the smartphone app that allows users to send pictures and videos that quickly disappear. They make sure to keep up their Snapstreaks, which show how many days in a row they have Snapchatted with each other. Sometimes they save screenshots of particularly ridiculous pictures of friends. “It’s good blackmail,” Athena said. (Because she’s a minor, I’m not using her real name.) She told me she’d spent most of the summer hanging out alone in her room with her phone. That’s just the way her generation is, she said. “We didn’t have a choice to know any life without iPads or iPhones. I think we like our phones more than we like actual people.”
What J.R.R. Tolkien’s classic The Hobbit still has to offer, 80 years after its publication
“In a hole in the ground there lived a hobbit.” So began the legendarium that dominated a genre, changed Western literature and the field of linguistics, created a tapestry of characters and mythology that endured four generations, built an anti-war ethos that endured a World War and a Cold War, and spawned a multibillion-dollar media franchise. J.R.R. Tolkien’s work is probably best remembered today by the sword-and-sandal epic scale of The Lord of The Rings films, but it started in the quiet, fictionalized English countryside of the Shire. It started, 80 years ago in a hobbit-hole, with Bilbo Baggins.
Although Tolkien created the complicated cosmological sprawl of The Silmarillion and stories like the incestuous saga of Túrin Turambar told in The Children of Húrin, Middle-earth itself is mostly remembered today as something akin to little Bilbo in his Hobbit-hole: quaint, virtuous, and tidy. Nowadays, George R.R. Martin’s got the market cornered on heavily initialed fantasy writers, and his hand guides the field. High and epic fantasy are often expected to dip heavily into the medieval muck of realism, to contain heavy doses of sex and curses, gore and grime, sickness and believable motives and set pieces. Characters like Martin’s mercenary Bronn of the Blackwater are expected to say “fuck,” and to like fucking. Modern stories, even when set in lands like A Song of Ice and Fire’s Essos that are filled with competing faiths, tend toward the nihilist, and mostly atheist. Heavenly beings are denuded of potency and purity; while the gods may not be dead, divinity certainly is.
Its faith-based 12-step program dominates treatment in the United States. But researchers have debunked central tenets of AA doctrine and found dozens of other treatments more effective.
J.G. is a lawyer in his early 30s. He’s a fast talker and has the lean, sinewy build of a distance runner. His choice of profession seems preordained, as he speaks in fully formed paragraphs, his thoughts organized by topic sentences. He’s also a worrier—a big one—who for years used alcohol to soothe his anxiety.
J.G. started drinking at 15, when he and a friend experimented in his parents’ liquor cabinet. He favored gin and whiskey but drank whatever he thought his parents would miss the least. He discovered beer, too, and loved the earthy, bitter taste on his tongue when he took his first cold sip.
His drinking increased through college and into law school. He could, and occasionally did, pull back, going cold turkey for weeks at a time. But nothing quieted his anxious mind like booze, and when he didn’t drink, he didn’t sleep. After four or six weeks dry, he’d be back at the liquor store.
Physicians rarely agree on anything as strongly as they do that the Graham-Cassidy health-care bill is harmful.
It used to be that when a doctor gave a confident recommendation, patients trusted it. A skeptical person might seek a second opinion, or a third. When they all agreed, the best course seemed clear.
Today, America’s major physician organizations are recommending something, strongly and in unison: The latest health-care bill, known as Graham-Cassidy, would do harm to the country and should be defeated.
Coalitions of health professionals that have spoken publicly against the measure so far include the American Medical Association (“Provisions violate longstanding AMA policy”), the American Psychiatric Association (“This bill harms our most vulnerable patients”), the American Public Health Association (“Graham-Cassidy would devastate the Medicaid program, increase out-of-pocket costs, and weaken or eliminate protections for people living with preexisting conditions”), the National Institute for Reproductive Health (“the Graham-Cassidy bill preys on underserved communities ... a clear and present danger”), and Federation of American Hospitals (“It could disrupt access to health care for millions of the more than 70 million Americans”).
I have been studying the French language, with some consistency, for three years. This field of study has been, all at once, the hardest and most rewarding of my life. I would put it above the study of writing simply because I started writing as a 6-year-old boy under my mother's tutelage. I always "felt" I could write. I did not always "feel" I could effectively study a foreign language.
But here I am, right now, in a Montreal hotel. I spoke French at the border. I spoke French when I checked in. I spoke French when I went to get lunch. I don't really believe in fluency. If there is a such thing, I don't have it. I mishear words. I confuse tenses. I can't really use the subjunctive. Yet.
Something has happened to me and the something is this—I have gotten better. I don't know when I first felt it. I didn't feel it this summer at Middlebury, despite the difference in my entrance and exit scores. I didn't feel it when I first arrived in Paris in January. I felt, as I always feel, like I was stumbling around in the dark. I still feel like that. But I also feel like I am getting better at stumbling.