Medical marijuana: a boon & a challenge

When my sister Mimi found that marijuana could relieve her severe gastrointestinal distress, years ago, one joint after dinner was all it took. Unfortunately we couldn’t keep up the supply. After one foray into the rather scary realm of pot-dealing in a state (Georgia) where we could have wound up in jail very quickly, we decided that not even such clear relief was worth the risk.

Today, at least in California and 14 other states — with the District of Columbia possibly to be added soon — the risk is minimal but the dosage is fuzzy. The conundrum was outlined by writer Lena K. Sun in the San Francisco Chronicle:

On Tuesday, District of Columbia officials gave final approval to a bill establishing a legal medical marijuana program. If Congress signs off, D.C. doctors – like their counterparts in 14 states – will be allowed to add pot to therapies they can recommend to certain patients, who will then eat it, smoke it or vaporize it until they decide they are, well, high enough.

The exact dosage and means of delivery – as well as the sometimes perplexing process of obtaining a drug that remains illegal under federal law – will be left largely up to the patient. Doctors say that upends the way they are used to dispensing medication, giving the straitlaced medical establishment a whiff of the freewheeling world of weed.

Even in states where marijuana is allowed for medical use, doctors cannot write prescriptions because of the drug’s status as an illegal substance. Physicians can only recommend it, and have no control over the quality of the drug their patients acquire.

Because there are no uniform standards for medical marijuana, doctors have to rely on the experience of other doctors and their own judgment. That, they say, can lead to abuse.

California’s “quick-in, quick-out mills” that readily hand out recommendations have proliferated, worrying advocates. The state, the first to legalize medical marijuana 14 years ago, allows for a wider range of conditions, including anxiety.

To guard against abuse, some doctors say they recommend marijuana only after patients exhaust other remedies. Some doctors perform drug tests as part of pre-screenings.

Mimi died over a year ago. Her last decades, like almost all of her adult life, were spent in the State of Georgia, where medical marijuana is still against the law. I know what her required dosage was; legalization and proper oversight would allow doctors to learn dosages that work for their patients. It seems worse than cruel that thousands of other sick and dying citizens continue to be denied the potential relief that legalized medical marijuana could bring.

Dispensing medical pot a challenge for doctors.

Dementia: stories and sources

The post about dementia sufferers and their tendency to wander (May 6) evoked a host of stories about temporarily lost parents, grandparents, friends and relations. Almost everyone, it seems, has such a story — and unfortunately, those who haven’t may collect one or two in the future.  Reader Cathy Jensen sent a poignant tale of a friend who went wandering in his pajamas during the pre-dawn hours, but was found by the garbage collectors and brought home on the back of their truck. And reader Tom McAfee, en route to see his own mom and hopefully jog memories of children and grandchildren with photos, sent a link to a podcast aired on WNYC in March.

An offbeat idea, the WNYC piece explains, turned out to be a good solution for a nursing home in Germany from which residents were wandering off. Administrators created a bus stop in front of the home, complete with bench and a painted sign for a bus that never came. It provided a place where many wanderers could sit and wait until the urge to go back home, or elsewhere, melted away. Might not work everywhere, but it worked in Dusseldorf.

And reader JTMcKay4 sent, in case you missed them in the comments section, links to the Alzheimer’s Association’s “Safe Return” program and to a source for a long list of related documents. State-specific advance directive forms can also be downloaded, free, from the “Caring Connections” site maintained by the National Hospice and Palliative Care Association site, and this space remains committed to the support of the nonprofit Compassion and Choices, from which forms can also be downloaded.

There is no guarantee against winding up in a memory unit. But a little preparation can go a long way toward helping if the time comes.

When Mom & Dad go wandering: dementia on a relentless rise

“MISSING,” the sign reads. “Distinguished-looking elderly man. 6′ 1” slightly stooped. Gray hair. Wearing dark blue sweater and gray slacks. Name: George; does not always respond. Suffering from mild dementia. Wandered away from the Laurel Village shopping center area. Please call 415-xxx-xxxx with any information.”

The sad, 8″ x 10″ flyer has appeared (once the words were slightly different, but it was clearly the same George) at the bus stop near my home twice in recent months. I kept the number in my wallet for a while, hoping I might spot him because I walk the city myself. But the difference is that I have on a warm jacket — it’s way too cold in San Francisco, especially after dark, for only a sweater — and I know how to get home.  I have wanted to call the number and learn whether George got home, but it seems intrusive.

Last year for the first time, as reporter Kirk Johnson writes in The New York Times, people like George and a 60-year-old Virginia woman named Freda Machett accounted for more missing-person alerts than children and adolescents. They are confused and lost, and often are not found in time.

Ms. Machett, 60, suffers from a form of dementia that attacks the brain like Alzheimer’s disease and imposes on many of its victims a restless urge to head out the door. Their journeys, shrouded in a fog of confusion and fragmented memory, are often dangerous and not infrequently fatal. About 6 in 10 dementia victims will wander at least once, health care statistics show, and the numbers are growing worldwide, fueled primarily by Alzheimer’s disease, which has no cure and affects about half of all people over 85.
It started with five words — ‘I want to go home’ — even though this is her home,” said Ms. Machett’s husband, John, a retired engineer who now cares for his wife full time near Richmond. She has gone off dozens of times in the four years since receiving her diagnosis, three times requiring a police search. “It’s a cruel disease,” he said.
“You have to stop thinking logically, because the people you’re looking for are no longer capable of logic,” said Robert B. Schaefer, a retired F.B.I. agent who cared for his wife, Sarah, for 15 years at home through her journey into Alzheimer’s. He now leads two-day training sessions for the Virginia Department of Criminal Justice Services.

How to deal with dementia is the most bewildering of end-of-life issues, whether for oneself or for a family member. Most of us would choose almost any other scenario for our last months or years, but the choice is often not ours to make. We can file advance directives (mine includes a “Dementia Provision“) and express our wishes and do brain exercises; still, one in seven Americans, according to most fairly recent reports, now suffers from dementia and the numbers are on the rise.

Here’s one interesting perspective. My greatly beloved brother-in-law, who recently relocated with my sister to a retirement community, has Parkinson’s. Though his mobility and function are diminished, the disease has yet to affect his mind. Several weeks ago he told me he no longer fears dementia. “I see people more and more with varying stages of dementia,” he said, “and I believe you can be happy.”

But you can also wander off.

More Wander Off in Fog of Age – NYTimes.com.

Mike Huckabee jumps on anti-abortion bandwagon

The goal: criminalize abortion, make it impossible for a physician in the U.S. to perform an abortion or for a woman in the U.S. to obtain a safe, legal abortion. The progress: excellent. The methods: distortion, sensationalism and more than a few outright lies. The concern for women: zero.

But it’s working. Obviously it’s going to get a lot of conservative Republicans elected.

This just in from Georgia Right to Life:

Today (May 3) Governor Mike Huckabee announced his support for SB 529 in a message that is going out to Georgia constituents asking for their support for SB 529. Governor Huckabee noted the importance of this bill, “SB 529 is a simple bill that prevents a woman from being forced to have an abortion against her will and prohibits the use of abortion as a means of race or gender discrimination. I’m asking you to support SB 529 and to ask your representative to support SB 529.”

Two weeks ago the Georgia Senate passed SB 529 with overwhelming support. On Tuesday, April 13, 2010, SB 529 had a hearing in the House Judiciary Committee, but no vote was taken.

SB 529 was drafted by some of the leading pro-life attorney’s in the nation and was reviewed positively by the American Center for Law and Justice, Liberty Counsel, the Thomas Moore Law Center, Americans United for Life, and Focus on the Family.

Here are just a few interesting factoids: Mike Huckabee is the former governor of Arkansas, currently a regular on Fox News, formerly a candidate for the Republican presidential nomination. Presumably his “constituents” are those who will now support his next presidential — or whatever — bid because of this brave stand against “forced abortion.” Focus on the Family is a Christian organization that is not averse to messing around in political campaigns. The un-subtle message of that “as a means of race discrimination” is the bizarre hook with which abortion foes are seeking to manipulate African Americans, by equating abortion with Black genocide.

It is simply not so. Women do not need pious white guys protecting them from being marched in droves into abortion clinics. African American women do not need anybody telling them what they may or may not do with their bodies.

What we need is the right to life, our lives. The right to choose. The right to control our own bodies. Once the abortion foes win this battle — which gets scarier by the day — those basic human rights will be taken away from American women. Because women get pregnant. Sometimes that pregnancy is a mistake, a threat, a danger. When abortion becomes illegal, women will have no option but the back alley abortionist.

Decreasing numbers of us know what that was like, but I can tell you. Before Roe v Wade, legions of women, for countless valid reasons, needed to terminate a pregnancy. A few found doctors willing to risk their license in order to give a woman a safe choice. But uncounted thousands of us wound up in the filthy, unsafe, demeaning hands of back alley abortionists. Uncounted thousands died. Those who died were white, Black and all shades in between.

Would Mike Huckabee like to see his daughter go through that tragic indignity? That’s where we are headed.

Ex-Justice O'Connor on AZ immigration law: perhaps "a little too far"

Answering questions after a speech at San Francisco’s St. Ignatius College Preparatory School, from which her husband graduated in 1947, former Supreme Court Justice Sandra Day O’Connor said her home state should not be boycotted over its punitive new immigration law.

Still, she said, Arizona “may have gone a little too far in its authority, in encouraging local law enforcement officers to take action” against anyone they reasonably suspect of being an illegal immigrant.

Opponents say the provision invites racial profiling.

“It doesn’t read that way, but it might work that way,” O’Connor said.

Well, yes.

This space doesn’t see the logic in one state boycotting another — as some in California, including State Democratic Senate leader Darrell Steinberg, are suggesting. But Arizona’s law is wrong. And O’Connor is right in saying that “It’s the job of our federal, national government to secure our borders, not a job of state government.”

Now, if the federal government would just get to work…

Drill, baby, drill?

It’s going to be a long time fixing.

The Deepwater Horizon site is pouring some 200,000 gallons (5,000 barrels) of oil daily from a broken pipe into the Gulf of Mexico. Millions of dollars are being added to the leak’s cost, and despite BP‘s assurance that they will pay for the fix, long-term costs are beyond estimating at this point.

PBS NewsHour‘s Judy Woodruff got differing views Monday night from Greenpeace Research Director Kert Davies and Sara Banaszak, senior economist for the American Petroleum Institute. Asked how the current catastrophe will affect his organization’s long-standing opposition to off-shore drilling, Davies said

Well, it reinforces what we have seen worldwide. As we drill for oil, it’s a dirty, dangerous business. And the farther afield we go, deep into the Amazon, into the Arctic, and into deeper water, the greater those risks are, and the worse the impacts when things go terribly wrong.

[daylifegallery id=”1272648400606″]

Things have gone terribly wrong. But not wrong enough to change much, considering our continuing dependence on fossil fuels. Banaszak seemed unshaken:

(A)t this point”, she said, “we don’t know what happened in that incident offshore. And that’s what’s going to be critical to find out.

What the industry has focused on doing over the years is using advanced technologies and multiple safety systems in order to prevent accidents. So, it’s a constant process of using the latest information and the latest technology, to incorporate that into developing technologies that can deliver the oil that we’re consuming in our economy today. And that’s the way the industry has approached the problem.

It was not an encouraging interview (but worth reading the entire transcript.) Banaszak mentioned that 63% of our energy comes from oil and gas, and repeatedly said that dependence will continue for at least the next 20 or 30 years. Davies mentioned, at one point, that if a similar catastrophe were to happen off the Virginia coast, where this writer grew up sailing on a pristine Chesapeake Bay and where offshore drilling could soon begin, damage would hit beaches as far north as New Jersey and beyond.

So far, one glimmer of good news for the west coast: Governor Schwarzenegger is thinking that perhaps opening up the California coast to drilling might not be such a grand idea after all.

Abortion foes' 'Black Genocide' campaign draws one woman's thoughtful response

“Black children are an endangered species” the billboards proclaim — and they are having success. At the bottom of each huge sign is the sponsoring site: toomanyaborted.com, whose stated vision is “to eliminate abortion in America.” Eighty such billboards ran, as a campaign to attract more Black members to Georgia Right to Life; if the newly-concluded effort is deemed a success it is expected to be replicated in other states.

A thoughtful story ran in Sunday’s Women’s eNews, and was forwarded to this space by thoughtful reader Melissa. Set aside the valid physical, emotional, economic and other reasons for terminating a pregnancy, author/scholar Margaret Morganroth Gullette‘s personal story illustrates how a combination of factors can also lead to a considered choice.

Gullette tells of learning from her mother, who was then in her eighties, that she had had an illegal abortion when Gullette and her brother were very young. Unlike this writer, and thousands of others who risked (and often lost) their lives in barbaric procedures because a doctor willing to perform a sterile abortion could not be found, Gullette’s mother was able to have a safe abortion in Manhattan. Her parents were poor and her father’s employment uncertain in those 1940s days, Gullette writes, and felt it would be unfair to add a third child to the already struggling family.

I want to add something–temporality–often forgotten or undervalued in the abortion rights debate, even by pro-choice people.

It is hard to define “life” but one thing we know is that it involves time passing. Life time. If a woman who mothers lives after delivery, she is dedicating some hefty chunk of her life time to being responsible for her child. Usually, two decades. The right to decide whether to proceed with a pregnancy takes into account, and must take into account, that irrevocable pledge of responsibility.

It trivializes this life-course decision-making to suggest my mother’s choice was made on the basis of “convenience.” She decided to make my father’s life easier, to devote her maternal attention to her existing children and to study to further her own and our family’s joint life chances.

Everything proved her decision a correct one. She earned a teaching degree, then went to Bank Street College of Education and earned a master’s degree, got tenure, became a wonderful and happy first-grade teacher and earned a good and secure salary that rose every year.

She and my father together moved us up some inches into the lower middle class so that I could get a good education.

In her 80s, when my mother told me about this episode in her life, it was clear that she had never had any regrets.

The Right-to-Lifers would have us believe that no woman should have the right to terminate a pregnancy, at any moment after conception occurs. That unwanted, possibly unloved and uncared for children must be brought into the world no matter what.

Suppose — just suppose — they were to quit shrieking about eliminating a woman’s right to control her own body, and focus instead on that irrevocable pledge of responsibility. What a gift to the children of the world — black, white, brown, whatever color — that would be.

My Mother’s Abortion Improved All of Our Lives | Womens eNews.

The fears behind Arizona immigration law

If immigration reform has been on the back burner, despite President Obama’s campaign promises to tackle the issue, the May Day marchers hope to move it back to the front, and turn up the heat. They turned out in New York — 5,000+ in Manhattan’s Foley Square, in Los Angeles — fired up by singer Gloria Estefan and Catholic Cardinal Roger Mahony, and here in San Francisco — where the basic fears raised by Arizona’s new law were evident. SB 1070, signed by Governor Jan Brewer last week, makes it a state crime to be in the U.S. illegally.

The (San Francisco) march, part of the annual worldwide May Day workers’ rights demonstrations, stretched four to five blocks and ended at City Hall, where members of the conservative Tea Party and local Golden Gate Minutemen held a counter-protest.

Jim Homer, a business manager for Local 216 of the Laborers International Union of North America, whose 100-member group led the march, said many fellow construction laborers fear Arizona’s SB1070 will spread to California and create cultural hostility toward foreign-born workers.

“The immigration system is set up to blame the workers who come here,” Homer said. “There needs to be reform of the immigration laws that put more focus on the employers and their responsibilities, not just on the people who come to this country to make a living.”

The two primary sides to the immigration issue were in sharp focus on the west coast:

(W)orkers and immigrants at the San Francisco march – and others like it in Oakland and San Jose – said the law will give police the right to check for immigration papers of any brown-skinned citizens.

At the Civic Center counter-protest, Elizabeth Kelly, an Alameda resident who supports the Golden Gate Minutemen, said she also wants immigration reform. The Minutemen are a local branch of the controversial national group that voluntarily patrols the border, trying to stop undocumented immigrants from entering the country.

“Close the border,” she said. “I want to see them go back. That’d be my immigration reform.”

The Golden Gate Minutemen, whose Web site features some scary stuff (May Day! May Day! Invaders Coming!) is part of the fear factor for a number of recent immigrant — some legal, some not — friends of mine. “They’re not going to ask questions first, they’re going to send you to jail or out of the country, and ask questions later,” said one.

Most reports say Obama won’t do much beyond tightening border control in the near future. A lot more is needed. Until we get real reform, including some reasonable guest worker provisions and amnesty for those who have proved themselves good citizens already, we’re going to continue to be a nation not just of immigrants, but of fear. Not a very comfortable social system for anyone.

Big S.F. protest of Arizona immigration law.

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