Category Archives: drugs

Eliquis, over-prescribed but better than Coumadin.

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Eliquis (apixaban) is blood thinner shown to prevent stroke with fewer side effects than Warfarin (Coumadin). Aspirin does the same, but not as effectively for people over 75. My problem with eliquis is that it’s over-prescribed. The studies favoring it over aspirin found benefits for those over 75, and for those with A-Fib. And even in this cohort the advantage over aspirin is small or non-existent because eliquis has far more serious side effects; hemorrhage, or internal bleeding.

Statistically, the AVERROES study (Apixaban Versus Acetylsalicylic Acid to Prevent Stroke in AF Patients Who Have Failed or Are Unsuitable for Vitamin K Antagonist Treatment) found that apixaban is substantially better than aspirin at preventing stroke in atrial fibrillation patients, but worse at preventing heart attack.

Taking 50 mg of Eliquis twice a day, reduces the risk of stroke in people with A-Fib by more than 50% and reduces the rate of heart attack by about 15%. By comparison, taking 1/2 tablet of aspirin, 178 mg, reduces the risk of stroke by 17% and of heart attack by 42%. The benefits were higher in the elderly, those over 75, and non existent in those with A-Fib under 75, see here, and figure. Despite this, doctors prescribe Eliquis over aspirin, even to those without A-Fib and those under 75. I suspect the reason is advertising by the drug companies, as I’ve claimed earlier with Atenolol.

The major deadly side-effect is hemorrhage, brain hemorrhage and GI (stomach) hemorrhage. Here apixaban is far worse than with aspirin (but better than Warfarin). The net result is that in the AVERROES random-double blind study there was no difference in all-cause mortality between apixaban and aspirin for those with A-fib who were under 75, see here. Or here.

To reduce your chance of GI hemorrhage with Eliquis, it is a very good idea to take a stomach proton pump drug like Pantoprazole. If you have A-Fib, the combination of Eliquis and pantoprazole seems better than aspirin alone, even for those under 75. If you have no A-Fib and are under 75, I see no benefit to Eliquis, especially if you find you have headaches, stomach aches, back pain, or other signs of internal bleeding, you might switch to aspirin or choose a reduced dose.

A Japanese study found that half the normal dose of Eliquis, was approximately as effective as the full dose, 50 mg twice a day. I was prescribed Eliquis, full dose twice a day, but I’m under 70 and I have no A-Fib since my ablation.

Life expectancy has dropped in the US to undeveloped world levels. Biden blames COVID and racism. I think it’s too much drugs, and too few opportunities.

I’m struck by the fact that US life expectancy is uncommonly low, lower than in most developed countries. Lower too than in many semi-developed countries, and our life expectancy is decreasing while other countries are not seeing the same. It dropped by about 3 years over the last 2 years as shown. I wonder why the US has suffered more than other countries, and suspect we are over-prescribed. Too much of a good thing, typically isn’t good.

Robert Buxbaum, September 16, 2022. As a side issue, low dose aspirin may forestall Alzheimers and other dementias. See current article here. Also another study here.

Atenolol, not good for the heart, maybe good for the doctor.

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Atenolol and related beta blockers have been found to be effective reducing blood pressure and heart rate. Since high blood pressure is a warning sign for heart problems, doctors have been prescribing atenolol and related beta blockers for all sorts of heart problems, even problems that are not caused by high blood pressure. I was prescribed metoprolol and then atenolol for Atrial Fibrillation, A-Fib, beginning 2 yeas ago, even though I have low-moderate blood pressure. For someone like me, it might have been deadly. Even for patients with moderately high blood pressure (hypertension) studies suggest there is no heart benefit to atenolol and related ß-blockers, and only minimal stroke and renal benefit. As early as 1985 (37 years ago) the Medical Research Council trial found that “ß blockers are relatively ineffective for primary treatment of hypertensive outcomes.”

End point. Relative risk. 95% CI. All-cause mortality Cardiovascular mortality MI Stroke Carlberg B et al. Lancet 2004; 364:1684–1689.

There lots of adverse side-effects to atenolol, as listed at the end of this post. More recent studies (e.g. Carlsberg et al., at right) continue to find no positive effects on the heart, but lots of negatives. A review in Lancet (2004) 364,1684–9 was titled, “Review: atenolol may be ineffective for reducing cardiovascular morbidity or all cause mortality in hypertension” (link here). “In patients with essential hypertension, atenolol is not better than placebo or no treatment for reducing cardiovascular morbidity or all cause mortality.” It further concluded that, “compared to other antihypertensive drugs, it [atenolol] may increase the risk of stroke or death.” I showed this and related studies to my doctor, and pointed out that I have averaged to low blood pressure, but he persisted in pushing this drug, something that seems common among medical men. My guess is that the advertising or doctor subsidies are spectacular. By contrast, aspirin has long been known to be effective for heart problems; my doctor said to go off aspirin.

The graph at right is from “Trial of Secondary Prevention with Atenolol after transient Ischemic Attack or Nondisabling Ischemic Stroke”, published in Stroke, 24 4 (1993), (see link here). a Thje study involved 1473 at-risk patients, randomly prescribed atenolol or placebo. It found no outcome benefit from atenolol, and several negatives. After 3 years, in two equal-size randomized groups, there were 64 deaths among the atenolol group, 58 among the placebo group; there were 11 fatal strokes with atenolol, versus 8 with placebo. There were somewhat fewer non-fatal strokes with atenolol, but the sum-total of fatal and non-fatal strokes was equal; there were 81 in each group.

“Trial of Secondary Prevention with Atenolol after transient Ischemic Attack or Nondisabling Ischemic Stroke”, published in Stroke, 24 4 (1993).

Newer beta blockers seem marginally better, as in “Effect of nebivolol or atenolol vs. placebo on cardiovascular health in subjects with borderline blood pressure: the EVIDENCE study.” “Nebivolol (NEB) in contrast to atenolol (ATE) may have a beneficial effect on endothelial function …. there was no significant change in the ATE and PLAC groups.” My question: why not use one of these, or better yet aspirin. Aspirin is shown to be beneficial, and relatively side-effect free. If you tolerate aspirin, and most people do, beneficial has to be better than maybe beneficial.

Among atenolol’s ugly side effects, as listed by the Mayo Clinic, there are: tiredness, sweating, shortness of breath, confusion, loss of sex drive, cold fingers and toes, diarrhea, nausea, and general confusion. I had some of these. There was no increase in heart stability (decrease in A-fib). My heart rate went as low at 32 bpm at night. My doctor was unconcerned, but I was. I suspected the low heart rate put me at extreme risk. Eventually, the same doctor gave me ablation therapy, and that seemed to cure the A-Fib.

Following my ablation, I was told I could get off atenolol. I then discovered another negative effect of atenolol: you have to ease off it or your heart will race. If you have A-fib, or modest hypertension, consider aspirin, eliquis, ablation, or exercise. If you are prescribed atenolol for heart issues and don’t have symptoms of very-high blood pressure, consider other options and/or changing doctors.

Robert Buxbaum, August 14, 2022

Curing my heart fibrillation with ablation.

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Two years ago, I was diagnosed with Atrial fibrillation, A-Fib in common parlance, a condition where my heart would sometimes speed up to double its normal speed. I was prescribed metopolol and then atenolol, common beta blockers, and a C-Pap for sleep apnea. None of this seemed to help, as best I could tell from occasional pulse measurements with watch and a finger pulse-oxometer. Besides, the C-Pap was giving me cough and the beta blockers made me dizzy. And the literature on C-Pap did not impress.

So, some moths ago, I bought an iWatch. The current versions allows you to take EKGs and provides a continuous record of your heart rate. This was very helpful, as I saw that my heart rate was transitioning to chaos. While it was normally predictable, it would zoom to 130 or so at some point virtually every day. Even more alarming, it would slow down to the mid 30s at some point during the night, bradycardia, and I could see it was getting worse. At that point, I agreed to go on eliquis, a blood thinner, and agreed to a catheter ablation. The doctor put a catheter into my heart by way of a leg vein, and zapped various nerve centers in the heart. The result is that my heart is back into normal behavior. See the heart-rate readout from my iWatch below; before and after are dramatically different.

My heart rate for the last month, very variable before the ablation treatment, 2 weeks ago; a far less variable range of heart rates in the two weeks following the treatment. Heart rate data is from my iPhone and iwatch — a good investment, IMHO.

The reason I chose ablation over drugs or no therapy was that I read health-studies on line. I’ve go a PhD, and that training helps me to understand the papers I’ve read, but you should read them too. They are not that hard to understand. Though ablation didn’t appear as a panacea, it was clearly better than the alternatives. Particularly relevant was the CABANA study on life expectancy. CABANA stands for “Catheter ABlation vs ANtiarrhythmic Drug Therapy for Atrial Fibrillation – CABANA”. https://www.acc.org/latest-in-cardiology/clinical-trials/2018/05/10/15/57/cabana.

2,204 individuals with persistent AF were followed for 5 years after treatment, 37% female, 63% male, average age 67.5. Prior hospitalization for AF: 39%. The results were as follows:

  • Death: 5.2% for ablation vs. 6.1% for drug therapy (p = 0.38)
  • Serious stroke: 0.3% for ablation vs. 0.6% for drug therapy (p = 0.19)
  • All-cause mortality: 4.4% for ablation vs. 7.5% for drug therapy (p = 0.005)
  • Death or CV hospitalization: 51.7% for ablation vs. 58.1% for drug therapy (p = 0.002)
  • Pericardial effusion with ablation: 3.0%; ablation-related events: 1.8%
  • First recurrent AF/atrial flutter/atrial tachycardia: 53.8% vs. 71.9% (p < 0.0001)

I found all of this significant, including the fact that 27.5% of those on the drug treatment crossed over to have ablation while only 9.2% on the ablation side crossed to have the drug treatment.

I must give a plug for doctor Ahmed at Beaumont Hospital who did the ablation. He does about 200 of these a year, and does them well. Do not go to an amateur. I was less-than impressed with him pushing the beta-blocker hard; I’ll write about that. Also, get an iWatch if you think you may have A-Fib or any other heart problem. You see a lot, just by watching, so to speak.

Robert Buxbaum, August 3, 2022.

Girls are doing better, Boys are doing far worse.

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When I began college in 1972, the majority of engineering students and business students were male. They from the top of their high school classes, and from stable homes mostly; they went on to high paying jobs. Boys also dominated at the bottom of society. They were the majority of the criminals, drug addicts, and high-school dropouts. Many went off to Vietnam. Some, those who were handy, went to trade schools and a reasonable life, productive life. Society did not seem bothered by the destruction of boys in prison, or Vietnam, or by drugs, but there was an outcry that so few women achieved high academic levels. A famous presentation of the problem was called “for every 100 girls.” An updated version appears below showing the status as of October, 2021. A more detailed version appears further down.

From the table above, you can see that women are now the majority of those in college, the majority of those with a bachelors degree or higher, and a majority of those with advanced degrees. Colleges added special tutoring, special grants, and special programs. Each college had a Society of Women Engineers office, and similar programs in law and math. All of these explicitly excluded men or highly discouraged their presence. The curriculum was changed too; made more female-friendly. Dirty, and physical experiments were removed, replaced with group analysis of the social interactions — important aspects of engineers that boys were far-less adept at doing well. Perhaps society and engineering is better off now, but boys (men) are far worse off. This is particularly seem by the following chart, looking at the bottom. Boys/men provide the vast majority of the prison population, of those diagnosed as learning disabled, of those expelled, or overdosed, and among the war dead.

I’ve previously noted that a majority of boys in school are considered disruptive, and that these boys are routinely diagnosed as ADHD and drugged. It is not at all clear that this is a good thing, or that the drugs help anyone but the teacher. I’ve also noted that artwork and attitudes that were considered normal for boys are now considered disturbing and criminal like saying I wish the school was blown up. The cure here, perhaps is worse than the disease. I’m not saying that we should encourage boys to say such things, but that we should acknowledge a difference between an active and a passive wish. And we should find a way to educate boys/men so they don’t end up unemployed, addicted, or dead. Currently boy, particularly those at the bottom are on the scrap-heap of society.

Here is some source material for the above:

Robert Buxbaum, May 28, 2022

Vaccines have not decreased the US COVID death rate

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I’m not sure why this is, but a quick look at the death statistics shows that it is no lower today than it was a year ago. Vaccines seem to help the individual, but they don’t seem to do much for society as a whole.

Johns Hopkins data. COVID 19 death rate in the USA.

That the death rates are the same as last November is bad, especially since one major effect of COVID has been to wipe out nearly all our old folks, decreasing the lifespan of US men by 2-3 years. With a 70% vaccination rate (adults, 60% overall), and few old people, you ‘d expect our death rate this year would be lower than last.

Currently, at least, the trend-line looks positive, but that’s likely a mirage. It is common to add more deaths to the tally, retroactively a few weeks out as many deaths take weeks to report and more weeks to be counted as COVID. For what it’s worth, I’m vaccinated, two shots and a booster. I also take aspirin, and have gotten a pneumonia shot. I think it helps. What do I know?

Robert Buxbaum, November 18, 2021

Deadly incurable viruses abound: The plagues to come.

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As we discuss the effectiveness of the various COIVD vaccines, and ask if we will need another booster in a year, this time for the delta variant, or epsilon, it’s worth noticing that none of these is that deadly, especially if you’ve had a previous version. There are far worse viruses out there, like Ebola-Zaire, for example. This virus kills 60-90% of the people infected, typically by causing the body’s connective tissue to dissolve. Now that’s a deadly virus; imagine an ebola pandemic.

We live surrounded by many really deadly viruses, most of them incurable. In general our protection from them is that they usually show a slow infection rate or a slow progress to death. Drug resistant leprosy is one of these. Here’s the beginnings of a list of deadly viruses we could worry about: Lassa, Rift Vally, Oropouche, Rocio Q Guanarito, VEE, Marburg, Herpes B, Monkey Pox, Dengue, Chikunguanya, Hantavirus, Machupo, Junin, Rabies-like Mokola, drug-resistant leprosy, Duvenhage, LeDantec, Kyasanur, Forest Brain virus, HIV-AIDs, Simliki, Crimean-Congo virus, Sindbis, O’nyongnyong, Sao Paulo, SARS, Ebola Sudan, Ebola Zaire, Ebola Reston, Mid-East Respiratory (MERS), Zika, Delta-COVID. (I got 2/3 of this list from a 1993 book called “The Hot Zone” about the first US outbreak of Ebola — Washington DC in 1989 — a good book, worth a read).

Ebola is a string-like virus with loops. It causes your body to dissolve and bleed out from every pore. The strings form crystals that are virtually immortal.

As an ilk, these viruses are far older than we are, older than the first cellular creatures, and far tougher. They are neither dead nor alive, and can last for years generally without air, water or food if the temperature is right. Though they do not move on their own, nor eat in any normal sense, they do reproduce, and they do so with a vengeance. They also manage to evolve by an ingenious sexual mechanism. In a sense, they are the immune system of the earth, protecting the earth from man or any other invasive life form. We humans have only survived the virus for 100,000 years or so. Long term, the viruses are likely to win.

Zika is a ball-shaped virus. Incurable, it causes encephala. Ball-viruses are not as immortal as string viruses. COVID is a ball virus with spikes, a crown virus.

Some viruses are string shaped; Marburg and Ebola are examples. Such viruses can crystalize and live virtually forever on dry surfaces. Other viruses are ball-shaped, COVID and Zika, for example. These are more easily attacked on surfaces, e.g. by iodine. They become inactive after just a few minutes in air– and are killed instantly by iodine, alcohol, bleach, or peroxide.

Most viruses enter by cuts and body fluids. This is the case with AIDS and herpes. Others, like measles, shingles, and Zika, enter by way of surfaces and the hands. Virus-laden droplets collect on surfaces and are brought to a new host when the surface is touched and hand-transported to the nose or eyes. A few viruses, like SARS, Ebola, and COVID-19 can enter the body by breathing too. I’ve collected some evidence in favor of Iodine as a surface wipe, a hand wipe and as mouthwash in this previous essay.

Dr. Robert E. Buxbaum, November 3, 2021. The US has three facilities where they deal with the most deadly, contagious viruses. One is in Washington DC; they had leak in 1989, a part of the ebola outbreak. China has only one such facility, in Wuhan, China. It’s one block from where the COVID-19 outbreak supposedly originated. Have a nice day.

People would rather get electric shocks than think for 15 minutes.

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A review of some studies on the difficulty of sitting in one’s own thoughts.

There is a joke: what is the opposite of speaking?

It’s waiting to speak.

Most people find it uncomfortable to sit still and be quiet. Even listening is a pain. People sit brewing in their thoughts of what they are going to say. Silence is uncomfortable enough that solitary confinement for a few days is torture.

But what about a few minutes. Almost everyone can sit still and listen for 15 minutes as their friend drones on, especially if they are paid for it. Still, it’s uncomfortable, and a study set out to understand how uncomfortable. It turns out that a majority of men, 67% would rather give themselves electric shocks than sit and think or listen. Women, too find it unpleasant; some 25% of women preferred to give themselves electric shocks rather than sit and think. You’ll find a brief review of this and similar work copied above, or you can read the full study: Wilson et al 2014, “The challenge of the disengaged mind“.

The effect of the COVID-19 lockdowns was to remove virtually every bit of agreeableness, extroversion, conscientiousness, and openness, while fueling neuroticism. Data for 2020.

The effect of the COVID-19 lockdowns has been massive. Those involved in government discussions don’t seem to realize how massive, perhaps because they’re in constant contact with people, speaking and being spoken too. Most of us were not so lucky. We experienced partial isolation. A recent study suggests that almost every measure of happiness disappeared during the summer months of 2020: US agreeableness, extroversion, conscientiousness, and openness all declined dramatically, see data above. Decisiveness too; a lingering effect is an inability to make decisions. My hope is that government officials can resist the temptation for more lockdowns and mandates; mental health is health too.

If lockdowns do come, or if you are depressed for any other reason, you might consider exercise, or lithium, or counseling. At least decide to wake up at a fixed time every morning. Under COVID watch conditions, depression is the new normal. Here’s a joke on marriage counseling.

Robert Buxbaum, October 27, 2021

Exercise helps fight depression, lithium helps too.

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With the sun setting earlier, and the threat of new COVID lockdowns, there is a real threat of a depression, seasonal and isolation. A partial remedy is exercise; it helps fight depression whether you take other measures not. An article published last month in the Journal of Affective Disorders reviewed 22 studies of the efficacy of exercise, particularly as an add-on to drugs and therapy. Almost every study showed that exercise helped, and in some studies it helped a lot. See table below. All of the authors are from the University of British Columbia. You can read the article here.

From “Efficacy of exercise combined with standard treatment for depression compared to standard treatment alone: A systematic review and meta-analysis of randomized controlled trials.” by JacquelineLee1 et al.In virtually every study, exercise helps fight depression.

For those who are willing to exercise, there are benefits aside from mental health. Even a daily walk around the block helps with bone strength, weight control, heart disease, plus the above mentioned improvement in mood. More exercise does more. If you bicycle without a helmet, you’re likely to live longer than if you drive.

For those who can’t stand exercise, or if exercise isn’t quite enough to send away the blues, you can try therapy, medication, and/or diet. There is some evidence that food that are high in lithium help fight depression. These food include nuts, beans, tomatoes, some mineral waters, e.g. from Lithia springs, GA. The does is about 1/100 the dose given as a bipolar treatment, but there is evidence that even such small doses help. Lithium was one of the seven ingredients in seven up — it was the one that was supposed to cheer you up. See some research here.

Robert Buxbaum, October 7, 2021.

1500 people shot in Detroit, 4/5 survive; some thoughts.

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There are two remarkable things about shootings in Detroit. One is how many there are. About 1500 Detroiters last year, about 0.2% of the city’s population. The other remarkable tidbit is that only about 1/5 of them died. More specifically, there were 1173 non fatal shootings. There were also 327 criminal homicides, but many shooting deaths in Detroit are non-criminal, as in self-defense, or police interventions, and there are also many criminal homicides that are done with knives or poison. Put this together and it seems that only about 1/5 or those shot, perhaps 327 out of 1500 total. The headline from June 21, 2020 reads: 1 fatal, 11 non-fatal shootings in Detroit overnight. You almost feel like getting these guys marksmanship lessons, but there seems to be more at play.

Even in photography, a fair percentage of shooters miss simple head shots.

The number of shootings are way up this year, and drugs – alcohol is to blame, here and in other cities. People have lost their jobs to COVID and globalization, more in Detroit than in most cities, but the government has offered checks that are used for alcohol and drugs. Most Detroit shootings begin as arguments that turn violent. There is also some gang shooting, enhanced by a bout of prison releases, because of COVID.

Drugs and alcohol help explain the low death rate. It’s hard to shoot straight when you’re drunk or stoned, and hard even if you’re not, as Alexander Hamilton found. In Detroit, many of these hit were hit in non-vital areas (I tell folks to avoid those areas :). But another part of the low death rate is lower caliber bullets. Military caliber bullets were in short supply this year, and as best as I was able to tell, a fair number of shootings were with 22 and 25 instead of the military cartridges, 9mm and bigger that were popular years ago. A 9mm cartridge is shown as the center picture below, between a 22lr and a 45. Big bullets make for big holes and high death rates.

Per capita, the Detroit shooting rate is about 15 times that of New York City. New York saw roughly the same number of shootings as Detroit, 1,531 in a city 15 times bigger, and 462 criminal homicides The cause does not appear economic. but social. When Detroit’s unemployment rate fell, the murder rate did not. Thanks to COVID, Detroit’s unemployment rate is lower than New York’s. My only thought is that the culture is the difference, that the culture in New York is such that arguments do not turn violent as regularly.

Size comparison; 22, 9mm, 45. Big bullets leave big holes.

Stricter gun laws will not help, I think. Michigan’s gun laws make it hard to own pistols with barrels less than 16″ long. The net result is that most crime in the city is done with illegal guns. In general, countries with strict gun laws have more violent crime, not less. I would like to encourage private citizens to choose smaller bullets for self defense though, 22 or 32, and not military grade, 9mm. As a private citizen, you have to bring in the criminal, or storm a building. Your only goal is to get the criminal to stop without harming yourself. A 22 will get the criminal to stop. It will killl too, just less often. A 22 caliber bullet killed Bobby Kennedy, and Reagan was nearly killed with one. A small caliber bullet is less likely to kill you in an accident, or to kill people standing behind the target. This year, some 11 police forces came to a consensus report on use of the minimum of force necessary; read it here. For a private citizen, that’s a 22. Besides, speaking from my own limited experience, I find it easier to aim a small bullet.

Robert Buxbaum, January 10, 2021

MI hunting: You can arm bears; you just can’t buy bullets.

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Large chunks of Michigan shut down for the prime days of hunting season, from the middle of October to early November. About 8% of the state gets a hunting license each year, some 800,000 people, all trying to “Bag a buck.” Michigan is an open carry state for rifles and holstered pistols, something seen recently in the state capitol, I’d say this was an illegal example since there is also a brandishing law, but it gives a sense of things here. About 29% of the state owns at least one gun, and usually more. There are about as many guns as people. Getting bullets, on the other hand, is near impossible, both for handguns and for most rifles, shotguns excluded.

A lot of the attraction of hunting is that you get to eat what you kill. Mot people do this or donate it to a food back. Hunting is also cheaper than golf. Rural farmers also hunt to protect their crops from crows, squirrels, rabbits, rats, snakes, and raccoons. This is legitimate hunting, in my opinion, even though you typically don’t eat crow. Some people do hunt bear, but that’s a different story (I like to be dressed). It’s possible that the bullet shortage is just a hiccup in the supply chain, “supply and demand” but it’s been going on for 12 years now so I suspect it’s here to stay.

Michigan, was once a Republican, pro-gun stronghold. It has swung Democrat and anti-gun for the last few years. Bulletes have been scare for about that long, at least since the Obama election or the Sandy Hook shooting. Behind this is a general trend of urbanization and class-action law suits. At this point, few sporting stores carry guns or bullets, and those that do, tend to hide them in a back room. Amazon carries neither bullets nor guns, and the same holds at e-bay, Craig’s list, and Walmart on line. Dunhams still sells guns but the only bullets, when I visited today were, 17 caliber, 227 and duck-hunting, shotgun shells. Gone were normal handgun calibers: 22, 25, 32, 38, 45, 357, and 9mm. The press seems OK with duck or moose hunting; not so OK with anything else.

The salesman at Dunham’s said that he had moved to bow hunting, something that’s becoming common, but it’s incredibly difficult even with modern bows. I can rarely hit a non-moving target at 50 feet on the first arrow, and I can only imagine the frustration of trying to hit a moving target after sitting in a cold blind for days waiting for one to appear whose distance and placement is unknown, and that might disappear at any moment, or attack me then disappear.

Part of the problem is that arrows travel at only about 250 ft/s, or about 1/6 the speed of a bullet. Thus, an arrow fired from 50 yards takes about 0.6 seconds to hit. In that time it drops about 6 feet and must be aimed 6 feet above the deer if you hope to hit it. A riffle bullet falls only about 2 inches, about 1/36 as much. Whaat’s more, though an arrow is about three times heavier than a hunting bullet, its slow speed means it hits with only about 1/10 the kinetic energy, about the same as hunting with a 22 from a handgun.

There are those who say the bullet shortage will go away on its own because of supply and demand. That’s true until the government steps in in the name of public safety. Though recreational marijuana and moonshine are both legal, government regulation means that prices are high and supply is limited, with a grey market of people buying high and selling higher. I’m seeing the same with ammunition; there is tight supply, a grey market, and a fair number of people trying to reload spent ammunition using match-tips for primers. Talk about white lightning.

R. E. Buxbaum, December 24, 2020.