The aches & pains of medical marijuana

An article in Sunday’s New York Times details the struggle in Los Angeles to regulate the cannabis dispensaries which have proliferated around the  city over the past six or eight years, raising the old medical marijuana questions about how to control, whether to tax and how useful it is in the first place. Reporter Solomon Moore cites Oakland, California’s Harborside Health Center as the place to which many are looking for a model.

‘Our No. 1 task is to show that we are worthy of the public’s trust in asking to distribute medical cannabis in a safe and secure manner,’ said Steve DeAngelo, the pig-tailed proprietor of Harborside, which has been in business for three years.

Harborside is one of four licensed dispensaries in Oakland run as nonprofit organizations. It is the largest, with 74 employees and revenues of about $20 million. Last summer, the Oakland City Council passed an ordinance to collect taxes from the sale of marijuana, a measure that Mr. DeAngelo supported.

Mr. DeAngelo designed Harborside to exude legitimacy, security and comfort. Visitors to the low-slung building are greeted by security guards who check the required physicians’ recommendations. Inside, the dispensary looks like a bank, except that the floor is covered with hemp carpeting and the eight tellers stand behind identical displays of marijuana and hashish.

There is a laboratory where technicians determine the potency of the marijuana and label it accordingly. (Harborside says it rejects 80 percent of the marijuana that arrives at its door for insufficient quality.) There is even a bank vault where the day’s cash is stored along with reserves of premium cannabis. An armored truck picks up deposits every evening.

City officials routinely audit the dispensary’s books. Surplus cash is rolled back into the center to pay for free counseling sessions and yoga for patients. “Oakland issued licenses and regulations, and Los Angeles did nothing and they are still unregulated,” Mr. DeAngelo said. “Cannabis is being distributed by inappropriate people.”

I don’t know where Los Angeles will go with all this, or how well Harborside will continue to operate for how long. What I do know is that marijuana serves a real medical purpose. Probably serves a real recreational purpose too, and there’s the rub; but since I missed the pot party — thank heavens, as I am addicted to anything that comes down the pike, and please don’t try to tell me one cannot get addicted to marijuana — I can’t address that issue. Everything I know is anecdotal, but convincing.

Decades ago my beloved sister was suffering acute gastro intestinal distress, much later identified as a symptom of celiac disease but this was before anybody really knew anything about celiac sprue. One day she said, “You know, everybody at X High School either smokes pot or knows where to get it. Could you get me some so I could at least try it?” Well, even though the statute of limitations would probably protect the surviving players I think I won’t go into details of this adventure. But what I learned was: buying and selling illegal pot is a little scary for the novice, but the deal was easy and nobody went to jail. It did indeed give relief to my suffering sister. Though both of us wished she could have that relief on an ongoing basis, we reached a mutual conclusion that the risk was not worth the reward, and that was the end of that.

Fast forward to the 1990s, when everyone I knew with AIDS knew how marijuana could relieve some symptoms of the disease, and most had a supply. I was in San Francisco by then, and celiac disease pales in comparison to AIDS. I don’t even recall how legal it was for this relief; too many other issues were more important. But again, I saw its usefulness.

The Times article quotes Christine Gasparac, a spokeswoman for California Attorney General Jerry Brown, as saying his office is getting calls from law officials and advocates around the state asking for clarity on medical marijuana laws. I know that’s tough, and that the answer will in many cases be left to the courts. I also know that legalizing marijuana, whether here in woo-hoo California or elsewhere, raises a multiplicity of sticky issues.

But still. It’s a useful drug. If Big Pharma were producing and marketing it, it would probably come in a little pill that costs a fortune and would be covered by expensive insurance policies. Every governmental body in the U.S. needs money. Taxes raise money. Are there not some dots that could be connected here?

Right time for gay rights?

President Obama, having repeated his promise to end “don’t ask, don”t tell” on Saturday, got an additional nudge from the National Equality March on Sunday. Tens of thousands of gay rights supporters from across the country poured through the streets of the nation’s capital to demand equal rights for LGBT citizens. They have their work cut out for them. With a few small, scattered gains having been made, there are battlegrounds shaping up everywhere from Maine to California over the issues highlighted by the events of this past weekend.

My friend Joe, who celebrated 35 years with his partner last summer, asked why I haven’t written about gay rights. Boomers and Beyonders, he says, have a unique perspective. “We have won a few battles that won’t have to be fought again, but there’s a long road ahead and the netroots now taking the lead need to have strong support from the veterans.”

So here goes.

While reiterating his promise to end “don’t ask, don’t tell,” Obama  gave no timetable for doing so. It’s time. Given everything else on his plate, those of us who support gay rights may be willing to cut the president a little slack, but this small step toward clearing some of the large injustices gays and lesbians have lived with since approximately forever is one Obama should be taking soon. 2010 sounds about right.

Other gay rights battlegrounds are active in Maine, where a ballot measure would repeal marriage rights for gays and lesbians, in Washington where a referendum must pass if full domestic partnership benefits are retained, and elsewhere. Meanwhile, according to Change.org, the U.S. Conference of Catholic Bishops “is planning a major statement on marriage in November, preparing to issue new language about how the church views same-sex marriage. Unfortunately, the new language is more of the same… hateful, tired and representative of a theology that views people who are LGBT as less than.”

Compared to the record of togetherness set by Joe and Robert, my marital history is pretty lousy. (Up until this, my final marriage, that is, and its extraordinarily happy 17 years.) So it is hard to see my marital state being threatened by theirs being legitimized. Joe and I were also part of an AIDS support group during the 1990s, and witnessed tragic injustices suffered by dying young men whose hospital doors were barred to those who loved them best. A lot more needs changing than just “don’t ask, don’t tell.”

Senate Armed Services Committee Chairman Carl Levin (D-Michigan) was quoted by Elizabeth Williamson and Neil King in Monday’s Wall Street Journal as saying it was “now possible ‘to get a buy-in from the military’ to end a policy opposed by gays and many liberals since it was passed by Congress in 1993.” The monumental pile of global problems to be solved may keep Obama from seizing this good opportunity; gay rights supporters could keep that door open until he does act.

Global issues aside, one home front fact remains: LGBT Americans have been unjustly treated in innumerable ways, for innumerable years.

Getting rid of “don’t ask, don’t tell” seems a very good way to start putting things right.

Presidents, Patriotism & the Blue Angels

The Blue Angels were in town for San Francisco’s Fleet Week in recent days, along with assorted presidents for the President’s Cup golf tournament and planners for the 20th anniversary of the Loma Prieta earthquake, all of which made for a patriotic sort of time. Not to give away the punch line, but two out of the three fell victim to the famous San Francisco fog, which little factoid offers too many metaphors even to think about.

The Blue Angels bring with them, it has to be noted, a lot of ambivalence. Something about all that military might, ear-shattering noise and expensive fuel, plus the radar that lets them know when anyone is considering a quick nap… but then, they are incredibly good at what they do, and strangely beautiful streaking around up there.

Letters to the editor, however, poured in. Against the warrior culture, the display of power, the celebration of aggression and militarism, pollutants in the air. In favor of flyover celebrations and tradition. Nobody mentioned interruption of naps. I remain ambivalent.

A flag-waver to the core, I find myself resentful that flag waving has been hijacked by those who mean God Bless America and the hell with everybody else. I’m even resentful of the hijacking of God Bless America, which is a beautiful song and shouldn’t mean please don’t bless anyone else, Ma’am.

By the end of the weekend, Tiger Woods had come off a hero again, the skies had cleared just enough for a few aerobatics, the spectators had spent a lot of money on extra San Francisco sweatshirts and foot warmers to get them through the festivities and the planners were still planning for the impending earthquake celebration, all proving that Nature bats last. And a few flags of all sorts were out.

Patriotism used to feel good. I yearn for the day when it can feel good again, and we patriots are too busy promoting peace and goodwill around the globe for other stuff. And earthquakes and tsunamis and hurricanes are more to be feared than somebody else’s nuclear missiles. It could happen. Nature, sports and celebrations notwithstanding, does bat last.

Public option still alive: believe it…or not

The fact that there are still believers in the public option, and its inclusion in whatever health bill eventually survives, may say more about the believers than the belief. But Nancy Pelosi hasn’t yet caved, and a few among the many who see this as the only way real reform will happen are still betting on it. Two of those are strategic technology consultant Robert Weiner and his research chief Rebecca Vander Linde who penned an op ed in the San Francisco Chronicle Friday. I’m not a gambler, but I cheer their position.

Opponents’ caricatures have become commonplace – the Republican National Committee video puts House Speaker Nancy Pelosi side by side with James Bond’s villainess, Miss Galore. The Iowa Republican, a party newsletter, on Sept. 18 called Pelosi “inept at her job.” Actor and former Sen. Fred Thompson labeled her “naive.” On Sept. 10, master Republican strategist Karl Rove asked, “How much capital will Speaker Nancy Pelosi have” to pass health care?

Pelosi answered that in a conversation Sept. 29 at House Judiciary Committee Chairman John Conyers‘ 80th birthday party, after the Senate Finance Committee had just rejected the Medicare-like public option for all by a 10-13 vote: “We will not be deterred. We will pass the bill.”

The public option is still viable. The House is set to pass it. It is neither “fading” nor “waning” (New York Times) nor on “life support” (ABC News).

Citing a recent CBS News poll that showed public support for the public option rose from 57 to 68 percent after President Obama’s speech to Congress in September, Weiner and Vander Linde argue that keeping it is the only way to “counter the insurance stranglehold” that makes our current system so dysfunctional — and that Pelosi will keep it in the blended version of the three House bills and eventually see it through.

For those who doubt Pelosi’s ability to pass the bill, know that she has passed every bill she has brought forward, usually with 60-plus margins, since the Democrats recaptured the House in 2006. These include the Recovery Act, Credit Card Bill of Rights, Homeowner Affordability, Lilly Ledbetter Fair Pay, Troubled Assets Relief Program (TARP) and State Children’s Health Program expansion to 11 million youths.

About the Senate…

Senate Finance Chair Max Baucus, D-Mont., said he could not vote for the public option because “I can’t see how we get to 60 votes.” The Constitution and the law require only a majority 51. The Senate amended its rules to require a “supermajority” to end debate. This procedure, called cloture, is a pander to allow special-interest contributors (Baucus has a million dollars from insurance companies) to block bills. Pelosi is right to support Senate “reconciliation,” which would allow a simple majority to pass health reform Americans want.

We believers may turn out just to be dreamers, but we’re still sending e-mails to Speaker Pelosi.

via Public option still alive – believe it.

The Peace prize & the 20th Century

While applauding Mr. Obama, I’m among those who wish the Nobel folks had waited. I do hope peace might actually, some day, happen in the world, but given last century’s record, things are chancy at best.

My father, born in 1897, used to talk a lot about world peace. His father, born just after the end of the Civil War, lost two of his five sons to World War I, but he took comfort in the certainty that peace would abound from then on. He died in the mid-1930s, presumably not looking very closely at Germany.

My father was an eternal, though not unrealistic, optimist. The afternoon we learned that Pearl Harbor had been bombed we gathered around the Philco radio to listen to Mr. Roosevelt, and my father talked about what a terrible thing war was. But for a few years we had that one, the last ‘good’ war. There was optimism after it ended but not much peace, because we plunged right into the Cold War.

In 1953 my father — Earl Moreland was his name, he was a good guy — was president of the Virginia United Nations Association and brought Eleanor Roosevelt to Richmond to speak on — world peace. It was a plum for my fresh-out-of-college first PR job and a memorable time for me, since I got to pick up Mrs. Roosevelt at the quonset hut that passed for Richmond’s airport at the time and watch that singular lady in action. She was eloquent and reservedly hopeful. For a while in the 1950s peace seemed dimly possible, if you could look beyond SEATO and the Geneva Accords and a few issues with Communism, and ignore (as many of us did) the plight of the Palestinians.

Then came Vietnam. If that war seemed endless, which it was, at least after we made our ungraceful exit there was another tiny hope that somehow there might be a little peace… as long as you ignored the North/South Vietnam problems and weren’t looking at Israel and Palestine.

My father was a big fan of Anwar Sadat. When Jimmy Carter managed that little sit-down with Mr. Sadat and Menachem Begin at Camp David, I was visiting my father at his home a hundred or so miles south. This time we hunkered in front of the little living room TV set, and I remember my father saying “By George! I think we could see peace over there one day.” Well, we did hope. Of course, by then it was getting close to time to start looking at Afghanistan, a country many Americans (certainly including this one) thought of more as a storybook land than a real place where one bunch of people have been fighting with another bunch of people since time immemorial.

The rest is (more recent) history. It will be evident that this space is not the History Channel, but more precisely one woman’s view of the 20th century and the peace in our time that didn’t exactly happen. American Nobel peace laureates Teddy Roosevelt, Woodrow Wilson, George Marshall, Martin Luther King Jr., Henry Kissinger — MLK, definitely a peacemaking sort but Henry Kissinger? — and Jimmy Carter didn’t formulate much 20th century peaceable wisdom for their 21st century follower.

Barack Obama is a believer, in hope, and peace, and possibilities. I wish him well.

Safeway carrot-stick plan a boon to reform

There was a little local pride in a key segment of the Senate Finance Committee’s health care bill reported today by Andrew S. Ross of the San Francisco Chronicle:

It’s not every day a local grocery has a congressional amendment named after it. Such an honor has been bestowed on Pleasanton’s Safeway Inc., whose stick-and-carrot health insurance program is the model for a “wellness provision” in a health care reform bill that passed the Senate Finance Committee last week by an unusually bipartisan 18-4 vote.

“Yes, it’s quite fair to call it the ‘Safeway amendment,’ ” said a spokesman for Sen. John Ensign, R-Nev., who co-sponsored the amendment with Sen. Tom Carper, D-Del. “He’s a big advocate of the Safeway program.”The provision, designed to “incentivize Americans to lead healthy lifestyles in order to lower their overall health care costs,” would allow companies with self-insurance programs to reward employees with bonuses and/or premium reductions of up to 50 percent if they follow health guidelines, like undergoing regular screenings, quitting smoking, losing weight, taking cholesterol-reducing medications and so on.

While some question the accuracy of reported cost savings, the measure has strong support among key politicians up to and including President Obama.

As a beneficiary of Kaiser‘s “wellness” program — a constant push toward healthy lifestyles and preventive medicine — I hope this piece of the legislation stays. As long as he’s not going to resign, Senator Ensign might as well be doing something useful over there.

via Safeway plan part of Senate health care debate.

Healthcare coding for Ayurveda – Why not?

Having taken up brain fitness (see below) a few days ago, this space today offers a few notes on Emotional Vibrancy and Wellbeing in this modern day and age. They come straight from a lecture of the same title by Sudha Prathikanti, MD presented by the UCSF National Center of Excellence in Women’s Health and the UCSF Osher Center for Integrative Medicine. Dr. Prathikanti, UCSF Professor of Psychiatry, Consultant in Integrative Medicine and an exceptionally lovely young woman, clearly has achieved balance in her mind/body systems. Plus, she has a power-point lecture clear enough for lay listeners within her mostly-medical-professional audience to comprehend.

Emotional vibrancy and well-being, Dr. Prathikanti explains, “spring from a life lived in balance where one’s spirit is strong and resilient, with the capacity to embrace and grow from the pain and loss which are a natural part of human life.” Whereas western medicine tends to approach disease as a battle to be joined and conquered, she says, almost all other cultures from Native American to Asian have a more holistic approach. If you’re feeling a little out of balance, these glimpses into Ayurveda — the wisdom tradition of India — might help.

Ayurveda, Dr. Prathikanti explains, is a full medical system based on the concept that we humans are made up of the five basic elements (5 Great Bhutas) — earth, fire, water, air and space. We embody three life sources (3 Great Doshas): Vata, Pitta and Kapha. Each dosha has specific expression; we come with all three in unique individual constitutions, and they are initially in balance. It’s when they get out of whack that trouble comes.

OK, perhaps this is sounding obtuse, but stick with it; you may discover something useful.

Vata (air, space, water) is all that moves — the beating heart, the blinking eye, the wandering mind. Pitta (mostly fire, a little water) has to do with heating — those digestive enzymes busy cooking up dinner, the fiery intellect. Kapha (earth/water — think clay) involves all that binds, the joints, body mass, memory. Ayurveda will seek to determine at what point your mind/body function was at its best — say, that summer you worked as a lifeguard on the beach and were doing graduate school classes at night — and keep you in that good balance.

Dr. Prathikanti conjured up three sample people and gave them a case of severe grief to illustrate how the different doshas work when things get out of balance. Vata, slightly built and having a quirky, creative mind, under such stress might wind up jumpy and restless, change jobs too much, have trouble making decisions. Pitta, owns her own business, the fiery mind etc, could wind up smoking and drinking and eating too many hot tamales. Kapha, earthy homemaker, might eat and sleep too much, become listless and withdrawn. The process of recovery would address each of these issues in ways to regain balance.

None of this is likely to make it into the health reform bill. But since we have finally begun to acknowledge that AMA-guided traditional American medicine may not know everything there is to know — Kaiser, when I considered acupuncture recently for a chronic pain issue promptly sent me to their Chinese Medicine class — perhaps a little ancient Indian wisdom will be useful.

By the end of the lecture I had figured out I’m a predominant Vata married to a definite Pitta, and is that good? Dr. Prathikanti assured me that understanding one’s doshas and keeping them in balance is indeed advisable, but she rather gently suggested that having a consultation with an ayurvedic practitioner for starters is wise.

In other words, it’s a good idea to know what you’re talking about. Still, we offer the above as a toast to your health.

Bluegrass for World Peace

A million or so music fans and sun seekers found themselves in Golden Gate Park this weekend listening to the likes of Emmylou Harris, Steve Martin, Hazel Dickens, Earl Scruggs, Boz Skaggs & the Blue Velvet Band, and a long list of other music makers you will recognize if your bluegrass credentials are up to date. There were about 75 bands in all, on six stages scattered around several meadows. I missed The Brothers Comatose, and Booker T & the Drive-by Truckers, and I worried a little about The Flatlanders tooling around these San Francisco hills, but for sheer exuberant free entertainment, Hardly Strictly Bluegrass 9 could hardly have been beat.

The free part is thanks to local billionaire Warren Hellman, a banjo-picker, bluegrass enthusiast extraordinaire and one-man stimulus package — he does a little investment banking on the side — who has thrown this party for the past nine years and has now endowed it so it will be around in perpetuity. The fact that much of the music sung by these musicians is pure anti-billionaire dampens no spirits, Hellman’s least of all.

(The top ticket, of course, was our weekend houseguest Don Betts, faithfully YouTube’d by his wife Annie as he performed that great American classic “I just don’t look good naked any more.” Betts was introduced by Hellman, whose  group The Wronglers kicked off Saturday on Porch Stage. In addition to making money and playing banjo, Hellman is an an avid champion of the sport of Ride & Tie, and Betts is current R&T Association president… but that’s probably another blog. )

A little bluegrass celebration has never been needed more. What with the world having pretty much gone to hell, there is something immensely comforting in hanging out with a few thousand fellow sufferers grooving to songs about bad whiskey and love gone wrong — problems you can identify with and get your mind around. Not to mention damning corporate greed and evil rich guys, pausing every now and then for a standing ovation for one of Them who just dropped a few million in household change on your glorious weekend out. It all somehow fits right in with a tanked job market and universal political comedy.

A few decades back this music — or what sounded exactly like this music — was called Country. It was rousing and redneck and not cool. Bluegrass is cool. Hellman’s buddies came in every race, creed, color and national origin, ranged from in utero to way-80s, recycled everything and smiled whiled jostling for dancing space. I submit bluegrass as palliative care for the world.

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