Wanna grow hemp in Kentucky?


“Kentucky is now accepting applications from local farmers who want to grow industrial hemp in 2015 as part of a pilot program started this year.”

How about Tennessee?

“On Tuesday, the Tennessee Department of Agriculture (TDA) held a hearing regarding said rules for cultivating hemp with the hopes of hammering out the final regulations in time for farmers to hoe rows by spring.”

Let’s party like it’s 2010


“The last time the price of a gallon of regular gas was under $3 nationally was December 2010.”

No, your eyes aren’t fooling you — this picture was taken today.  For prosperity’s sake, I’d like to make a note that today in Albuquerque, NM, the price for a gallon of gas was $2.39.

Thanks President Obama!  (Just kidding.)

Email Scam Alert

I recently received and email that, at first glance, appeared to be from AOL:

Welcome to Aol Customer Support, it said.

From:  “Member Service to you.

When I clicked on the details from the sender, it said:

Elham.alhathli@uqconnect.edu.au  (Hmmm… Looks Australian.)

Then:  You have 10 outstanding incoming messages keep’s going back, the administrator service fined out, You are running at 98.9 gigabytes which as been your limit, All receiving of new messages as been stop until you re-validate your (painkills2) mailbox. Click here below To renew the mailbox

I hope ya’ll know that if you click on the link provided, you will have malware out the ying-yang. But the funniest part was the bottom line of the email:

©2014 Aol Tearm, Inc. All Rights Reserved.

“Tearm” — that’s hilarious. 🙂

ER Antipsych Meds: To Inhale or Not to Inhale?

Soon to be prescribed off-label for pain patients?

From MedPage Today:

Emergency physicians often struggle with acutely agitated patients, balancing the hope that patients will improve with oral medications against the often dangerous options of physical restraint or involuntary medications.

For psychiatric patients, that often means intramuscular (IM) antipsychotic medications such as haloperidol or droperidol, with or without benzodiazepines. The process can be unsafe, scary, or even violent. But faster and safer options may be on the horizon — in March of this year, the FDA approved loxapine (Adasuve) for the treatment of agitation in the setting of schizophrenia and bipolar disorder, thus introducing to the U.S. market the first inhaled antipsychotic.

Prevalence of Psychiatric Disorders Higher in Patients With MS?


The American Academy of Neurology (AAN) has published an evidence-based guideline on the assessment and management of psychiatric disorders in individuals with multiple sclerosis (MS). Despite admittedly weak or insufficient evidence, the message from the guideline is strong: Look for emotional disorders—disturbances of mood or affect—in your patients with MS.

As reported in September of this year:

A leading U.S. medical organization is urging its members not prescribe opioid painkillers to patients suffering from fibromyalgia, low back pain or headaches, because the risk of serious side effects outweighs the benefits of pain relief.

“Whereas there is evidence for significant short-term pain relief, there is no substantial evidence for maintenance of pain relief or improved function over long periods of time without incurring serious risk of overdose, dependence, or addiction,” wrote Gary M. Franklin, MD, in a position paper published in Neurology, the official medical journal of the American Academy of Neurology (AAN).

The Academy represents 28,000 neurologists and other healthcare providers who treat a wide variety of neurological disorders, including neuropathy, migraine, multiple sclerosis, epilepsy, and Alzheimer’s disease.

Q&A with Mr. Kolodny


In the Spotlight. Read our monthly interviews with leaders in the pain management field

Physicians for Responsible Opioid Prescribing. An Interview with Andrew Kolodny, MD.

[Who elected Kolodny as a “leader” in the pain management field?  What are his credentials in pain management?]

This was about ten years ago, and at the time our effort to reduce drug overdose deaths was focused on heroin. Although overdose deaths from opioid analgesics were already beginning to rise, we were unable to appreciate that a new epidemic was developing. To reduce overdoses we worked on expanding access to effective treatment, namely [mostly] buprenorphine.

[10 years ago, Kolodny began focusing on heroin abuse, and how have his efforts paid off? Considering his connections with Big Pharma, I’d say pretty well — for him.]

The task wasn’t easy because many physicians have negative views of people with addiction and are not interested in obtaining their buprenorphine certification.

[“Negative views” is quite an understatement, wouldn’t you say?  In case Mr. Kolodny forgot, drug abuse and addiction are crimes in this country.  As is suicide, by the way.]

According to the CDC, this new opioid epidemic is far worse than the heroin epidemic of the 1970s and the crack cocaine epidemic of the 1980s.

[Did the CDC actually say this?  And what about the current heroin epidemic?]

For myself and many others in the fields of pain, addiction, public health, emergency medicine, toxicology, and the lay public, especially people who have lost loved ones to overdose deaths, we feel that sitting on the sidelines and watching the problem get worse is simply not an option.

[Kolodny is in the field of pain? When did this happen?  Are “people who have lost loved ones to overdose deaths” also in fields of medicine?]

We mainly found each other through research publications. Several of our original members are quite prominent in their respective fields. Individuals like Jane Ballantyne MD, Len Paulozzi MD, MPH, Michael Von Korff ScD, Gary Franklin MD, MPH and Irfan Dhalla MD, MSc, are all well known for their work in this area.

[Good to know.]

What we all had in common was a concern that the epidemic was largely caused by aggressive opioid prescribing for chronic non-cancer pain and that this change in practice was not supported by strong evidence.

[Your “concern” is now public policy, thanks so much, Mr. Kolodny and crew.  But this is a rather narrow focus on a rather large and complex problem.  And when one doesn’t look for evidence, or is selective about which evidence to believe, one usually doesn’t find it.]

We believe that opioids are an important option in palliative care and for acute pain. Although we presume that there might be some patients with chronic non-cancer pain that can benefit from treatment with opioids, we strongly agree with the recent Institute of Medicine’s report’s statement that the effectiveness of opioids for chronic pain is “far from certain.”

Is anything really certain in medicine? I mean, there are many things that work which are “far from certain” (according to the medical industry), like medical cannabis.  And just because something has been determined by one agency as “far from certain,” that doesn’t mean opioids should only be used for end-of-life care and acute pain.  

You “presume that there might be some patients with…”?  Aren’t presumptions (and concerns) also “far from certain”?  

Mr. Kolodny, I assume (or presume) that you and your colleagues don’t suffer from chronic pain (but even if any of you do), so it must be really easy for you to determine what’s best for about 100 million chronic pain patients. (You elitist, egotistical, narrowly-focused, making-money-off-other’s-misery, know-it-all, handsomely-paid, alleged and pretend “expert.”)

Residential Treatment Centers (RTCs)

Excepts from:

Click to access Residential_Treatment_Centers.pdf

However, a recent study that looked at a 7- to 8-year follow-up period found no evidence of positive effects on the outcomes measuring substance use problems, criminal activity, and psychological functioning. Although Phoenix Academy appeared to have short-term effects, no long-term effects were evident…

In 2004, Federal funding supported the placement of 200,000 youths in government or private residential facilities, which include youths not involved in the juvenile justice system (GAO 2008b)…

In addition, the costs of placing youths in residential programs such as RTCs can be substantial to the juvenile justice system (Bettman and Jasperson 2009). A report from the Justice Policy Institute (2009) estimates that reporting States spend an average of $7.1 million a day keeping youths in residential facilities…

In addition to these limitations, many of the treatments and services, whether psychotropic or psychosocial, delivered to youth in RTCs lack a foundation in research (Foltz 2004). For instance, Foltz calls attention to the widespread use of medications that have largely been tested only on adult populations and are prescribed “off label” to adolescents in treatment. Few evidence-based practices have been tested in RTCs, because of, in part, issues such as the lack of fit between Medicaid reimbursement and many evidence-based interventions (Bright et al. 2010). Moreover, a lack of funding can mean that inadequate services are available. In a survey of New York State RTCs, it was found that, because of budget constraints, facilities were forced to hire staff with limited formal education (Baker, Fulmore, and Collins 2008).