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.

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…

Who says you're poor?

The U.S. government thinks you’re doing okay if, in a family of four, you’re pulling in something over $22,000 a year. It might be a little tough to get by on that these days. But the way poverty is measured, and plans made around the measurements, are obtuse and arcane at best.

Exactly who qualifies for state and federal assistance varies. More important than today’s index though, unless you are someone missing out on help, is tomorrow: plans for adequate housing, food stamp and other assistance programs are all based on some very old data. When the current federal index was set, for example, some 3% of the family budget went for food; today’s actual food costs are more like 10%.

A group of California seniors converged on the state capitol a few days ago with an eye toward bringing that state’s poverty line and real-time poverty closer together. The group is enthusiastically supportive of a far more accurate index developed by the UCLA Center for Health Policy Research.  They were careful to be “advocating and educating” only in meetings with legislators — the Senior Leaders Program is funded by the nonprofit California Wellness Foundation and lobbying is a no-no. But they would like to see AB 324, a bill crafted by Assembly Member Jim Beall, finally pass. Beall has watched it pass the Legislature twice, only to meet a Schwarzenegger veto; he told the seniors he thinks this time around the governor’s objections have been addressed.

This particular senior fails to see any reason to stick with inaccurate data when accurate data is available. The main argument against adopting a better measurement has centered around the cost issue — If we update the index, we might find more poor people. Hello? A town builds housing for 10 people and 100 people knock on the door?

Whether or not there are any incipient seniors in your family (we seem to make up a substantial percentage of the poor, by any measurement) you might want to see what’s going on in your state. Maybe, some day, the U.S. Government will even go for poverty line fact over fiction.

Medical marijuana: a painful issue all around

Courtesy of http://prospect.rsc.org/blogs/cw/?p=655She is 46, a breast cancer survivor for four long years, a regular user of medical marijuana. She told me — as we were introduced by a mutual friend and she was updating the friend — a horror story too ridiculous even for an ‘Only in California’ tale. Her name is not Emily, but I’ll call her Emily to protect the innocent.

Emily has a solid career in social services with a California nonprofit. For years their funding has come partly through federal grants. This has been fine with Emily’s regular use of medical marijuana, which is legal in California and which keeps her chronic pain — a result of cancer and several other issues — under control. She smokes one joint in the morning, and four at night. (An editorial caveat here: I’ve not tried marijuana, which is wise since I’m addicted to anything that comes down the pike, so I know from nothing about dosages, etc. I’m just repeating what she explained.)

Not long ago, a new project was offered Emily’s organization and she was named as its head. Only problem? Everyone would have to take the federally-mandated drug test. Only solution? get Emily off of the weed for six weeks in order for her to pass the test. She had done that, finishing it all and passing the test and starting the project, a few months earlier. It was not fun.

“In order to get through all this,” she said, “I was prescribed a total of six different pain-relief drugs which I took every day. They were expensive, but the only way I could have made it. So for six weeks I poured six different toxins into my system at an obscene cost, both financially and physically. But hey, you do what you have to do.”

Emily is now back to growing, and smoking, her own.

California voters, thanks to a ballot issue certified yesterday by our secretary of state, will decide next November whether to legalize marijuana for any adult use. The issue is being rather hotly debated elsewhere on True/Slant and I frankly have no idea where I’ll come down when the dust settles and I read the whole business. Friends tell me it’s fine, others tell me it’s addictive, the state needs the money, who knows where legalization and regulation could lead? Neither does much to curb alcohol abuse, but then, I quit drinking years ago so it’s easy to be holy about alcohol abuse; some of us can handle the booze, some of us can’t.

But all of us need pain relief. Marijuana is a proven pain-relief drug. Why in the world it should be denied those who need it boggles this increasingly boggled mind.

Homeless & still grinning

President Obama’s proposed budget for FY2011 includes a broad range of programs addressing homelessness, from provision of new services to the “Zero Tolerance” initiative for homeless veterans; I wish them all well. Aside from national efforts, most of us struggle with our personal relationship to the growing numbers of homeless citizens: Look the other way? Drop coins in cups? Buy snacks? Volunteer with the Food Bank? Most of us try to give something.

Occasionally, we get something more. This is such a story.

My friend Kevin left our neighborhood park in December, bound for Bakersfield in California’s central valley. “The Saint Vincent de Paul bought me a ticket,” he said. I worried about who would look after him. In our neighborhood he could sit in the sun and watch the birds on the lake, the joggers and strollers, and children on the playground. On rainy days he could sit on a corner bench inside the library. He never asked for money, but many of us gave him a dollar or two whenever we met. “Oh, I think he’ll be okay,” said one of the dog-walkers who is also among the Mountain Lake Park regulars. “He’ll find a meeting, and they’ll help him. He’s been doing really well with his drinking.”

Turns out it was not really Kevin I was worried about, but myself. Things were not the same. I would finish the hop kick on my loop around the parcourse fitness trail, and Kevin was supposed to be there. Instead, I would encounter an empty bench, or a disinterested stranger preoccupied with someone at the other end of a cell phone line. I missed the “How you doin’?” or the “Where you been ?! I ain’t seen you in a long time!” The occasional pause to sit beside him in the sun and pay attention to the feasts of nature everywhere.  Most of all I missed the wide, semi-toothless grin and the parting “Have a guht one!” that sent me brightly on toward the push-up bars just around the next bend in the trail. I was bereft.

Then a couple of weeks ago, headed from the chin-up station (I wish), I spotted a vaguely familiar figure walking slowly toward me. Decked out in a puffy new jacket (Kevin’s fashion tastes lean toward multiple bulky layers) and a new, bright blue cap, his beard somewhat trimmed, I did not recognize him until the great, toothless grin broke across his face. I ran down the trail, catching myself at the very last minute to restrain the hug I felt – this, I think, would’ve been too much for Kevin to handle – but grabbing both of his mittened hands.

“Kevin!” I said. “I thought you’d left us, gone off to Bakersfield forever!”

“Naw,” he said. “It’s too wahm in Bakersfield.”

So there it was. We were redeemed by the perpetually mild weather of the San Francisco Bay, where it seldom gets too warm and on rainy days one can find refuge in the library.

Did he have a good time in Bakersfield? “Oh, yes.” Did he get to see family? “Mmm.”

I still don’t know all the answers, or whether one day I’ll get to the hop kick station and find him gone again, for good.

What I do know is that for now the universe is proceeding as it should. And that one man with seemingly nothing to celebrate has brought the spirit of celebration back to Mountain Lake Park. It’s a great gift.

Can geezer drivers become better drivers?

This is the initial report from the field re geezer drivers and brain exercise. This space hereby goes on record as a believer. Just a minimal believer, but I — a certified geezer driver — actually think aging brains can become better-driving brains.

I recently downloaded, accessed, stored, signed in and completed whatever else one must do to begin the Posit Science DriveSharp program, an initial exercise in brain sharpening for computer Luddites. There are other programs out there to sharpen the skills of geezer drivers, and plenty of computer-game exercises aimed at the same goal. Posit Science (I am not on their payroll) offered me their program without charge, and little by little I plan to get all the way through.

For now, I have only done some initial roaming around and a few of the exercises. But an interesting thing has happened. Much of this is about how, as one ages, one’s “useful field of view” diminshes. So one might see the stop sign but miss the car speeding around the corner to the left. (If that’s a texting driver, you’re toast.)

I don’t think I’ve improved my useful field of view. But on an extended driving trip with my husband and a friend — in his wife’s fancy Lexus — this past weekend, I was actually complimented on my skills (ever try the two-lane, pothole-filled miles over the mountains from Hwy 101 to California’s Lost Coast?) by the car’s owner who had retired to the back seat. I think just the awareness of what “useful field of view” means makes a difference. Plus, I think brain exercises, even if they’re just teasers (Teasers for Geezers, this could be a new hit) build awareness of the complex issues drivers can face.

Try thinking about that “useful field of view” business, taking a test or doing a few brain exercises before your next drive, and see if you notice any difference. If I can ever find some actual time to do so I will undertake a few hours of actual DriveSharp program and report back.

Meanwhile, hang up the phone, please, and watch out for texters and geezers behind the wheel.

Anthem Blue Cross 'doing the right thing'?

In testimony before the California Assembly Health Committee yesterday, Anthem Blue Cross President Leslie Margolin said of her company, “I think we do the right thing, and we try to do the right thing every day.”

What that means is, turn a profit for the company every day. If you are in business to make money, that is the right thing to do.

On the other hand, when Margolin says the company’s goal is to provide “care, comfort and coverage to those in need,” that is simply not true. Physicians and health care professionals provide care and comfort. Anthem provides coverage which sometimes pays for these things and often does not, if they can help it.

Is there no way to connect those dots? Care and comfort for those who need and deserve it — i.e., every human being — are not going to happen until we get the coverage people out of the equation.

OK, not going to happen any time soon. It could happen in California, except for Governor Schwarzenegger‘s probable veto. It should happen in Washington, except for the money and muscle of the coverage people. In lieu of those realities, a health bill that takes a tiny step in the right direction would be welcome.