You don’t need empathy to support a depressed person

http://karenwriteshere.com/2014/11/30/you-dont-need-empathy-to-support-a-depressed-person/

A depressed person would rather have you say all the worst possible things, rather than not have you at all.

ludabluna says:
December 28, 2014 at 3:52 am

I really admire you for being friends again with the people who vanished from your life when you were ill. I couldn’t do the same. I’ve had two depression episodes, and I just can not continue as if nothing happened or changed, because it did change. They dissapeared when I needed support, and I can not count on their honesty any more. It really felt like I have a plague, you described that very well. Thank you for this post, kind regards from Croatia, and have happy holidays, God bless you!

Please, Don’t Use the Deaths of Famous 12-Steppers to Recommend the 12 Steps

http://www.substance.com/

Options, options, and more options for treatment… that’s what people need.  If one treatment doesn’t work, they should be able to try another. And another. Until they find one that works. No treatment should be mandated, either by doctors or law enforcement.

And we should do away with the term “standard treatment.”

If AA works for you, then great!  If anti-depressants work for you, fantastic!  But both chronic pain patients and those who suffer from addiction need lots and lots of different (and affordable) treatment options — not more of the same (just packaged differently).

Tolerance, Overdoses, and Bud

This is how it works when you run out of medical cannabis…

When you’re finally able to find and pay for a bud refill, it depends on your current pain level as to how it will effect you after an absence of use.

I have found that pain levels tend to fluctuate with or without 24-hour medication to manage and treat the symptoms — it’s just easier to do both with prescription pain medication (along with a home treatment program). It’s also easier to do both when you’re just trying to maintain or decrease your pain by one or two levels.

But when your pain flares out of control, it’s a lot harder to stabilize and manage it with just medical cannabis. (While the work is harder, your mood is better with medical cannabis.) It’s also harder to stabilize and manage pain levels without some kind of consistent medication — as to what kind of drug levels we’re talking about, well, that differs from person to person, depending on your medical condition, all the way up to your DNA.

So, you’ve run out of bud for whatever reason, and the next time you’ve got a supply, let’s say you’re in an average amount of pain — meaning, not in a pain flare-up. Well then, regardless of how much time you’ve been out, the cannabis will work just like it always worked before.

But if you’re in a pain flare-up and it’s been awhile since you had access, or say your dispensary has been out of the good stuff for some time, then it may take more than your usual dose to bring the pain down to a more manageable level.

For me, prescription pain medications worked the same way. In the past, if I had no pain medications for a certain amount of time, then when I had access again, the drugs worked about the same way as I’ve described medical cannabis to work.

In the long-term, it was the length of time I had been in pain (i.e., years) that determined whether the dosage worked or not, not how long I had been with or without medication.

This is what is so confusing to me about the stories I read about drug addicts who are “drug-free” for awhile and then overdose on the same amount/dosage that they used to take…

Are the overdoses mostly due to a combination of drugs, not just opiates? Does Suboxone, buprenorphine, or Narcan have something to do with it?

Is there a doctor in the House that can explain this to me? Anyone seen Hugh Laurie lately?

(This would be a good time to mention that drug overdoses are not a problem with the use of medical cannabis only. So when you think about it, why does a doctor need to be involved with certifying patients? No matter how you argue this issue, it always come down to legalization… just being the right thing to do.)

8/22/2014, Editorial: Overhaul Iowa’s marijuana laws

http://www.press-citizen.com/story/opinion/editorials/our-view/2014/08/22/iowa-needs-overhaul-marijuana-laws/14414041/

For the past few years — as we’ve advocated for a statewide regulatory system for medical marijuana — we’ve stopped short of advocating for legalizing the drug for recreational use. And we still think New Mexico’s medical cannabis program would provide a workable model for how Iowa could help its citizens suffering from chronic illness without falling into the pitfalls of the programs in states such as California…

If it takes more people calling for full legalization to push Iowa into finally making progress toward that compromise on marijuana, then sign us up.

Wow, look what Arizona MMJ patients get…

Program reports!  Let’s see how Arizona compares to New Mexico…

Arizona Department of Health Services, Third Annual Medical Marijuana Report, November 3, 2014

Click to access az-medical-marijuana-program-annual-report-2014.pdf

Program went into effect on April 14, 2011

The first dispensary opened on December 6, 2012.

During state fiscal year July 2013 to June 2014

52,374 qualifying patient and caregiver active cardholders, which included 51,783 qualifying patients and 591 caregivers. During this time period, 904 dispensary agent cards were issued.

Population: AZ – 6.6 million, NM – 2 million

Six hundred fifteen physicians provided certifications to 51,783 patients during this time period. Twenty-five physicians certified approximately 60% of the patients. Forty-five Approval to Operate certificates were issued to medical marijuana dispensaries, and of those approved, 38 dispensaries became operational. Additionally, 34 cultivation sites were approved. Thirty-seven dispensaries applied for and obtained ADHS authorization to sell or dispense medical marijuana-infused edible food products, and 11 dispensaries applied for and obtained authorization to prepare medical marijuana infused edible food products and supply edibles to dispensaries.

As of the date of this report, 100 dispensary registration certificates have been issued; 88 dispensaries have received an Approval to Operate, 83 of which are operational; and 51 cultivation sites have been approved.

PTSD will be added on January 1, 2015 and valid only for palliative care of PTSD symptoms (not treatment).

Beginning July 2013, ADHS developed and distributed a patient newsletter.

And a newsletter too!

Designated caregivers must also hold Registry Identification Cards for each QP who has designated them as a CG. In Arizona, CGs, who must be at least 21 years of age, are limited to serving no more than five QPs. The CG can cultivate, if authorized to do so by his or her QPs, up to 12 marijuana plants per patient if the patient lives more than 25 miles from an operating dispensary.

$150 for an initial or a renewal Registry Identification Card for a QP. QPs may be eligible to pay $75 for initial and renewal cards if they currently participate in SNAP. $200 for an initial or a renewal Registry Identification Card for a CG for each QP (up to five patients). $10 to amend, change, or replace a Registry Identification Card. 

Even with this outrageous expense, the program sure has a lot of members…

During the same period, ADHS conducted 19 complaint inspections of operational dispensaries,
cultivation sites, and infusion kitchens. Evidence of violations or noncompliance with the AMMA or Rules may result in the revocation of a dispensary’s registration certificate. There have been no revocations to date.

Since the passage of the law, in two instances (Laws 2011, Chapter 112 and Laws 2011, Chapter 336), modifications to AMMA were put in place to clarify ADHS’ authority to share doctor information with the various medical boards and required ADHS to allow employer access to the medical marijuana database to verify if employees were valid cardholders. Additionally, Laws 2011, Chapter 94 modified the controlled substances database to include medical marijuana to allow physicians to make more informed decisions about patient care.

Yikes!

Recommendation 2: Given the overwhelming recommendations for patients with “severe and chronic pain”, explore the feasibility of further examining the nature of debilitating conditions. For instance, the current incident rate for cancer in Arizona (5-year average) was 390 per 100,000 (CI: 387.8-392.1) with an average annual count of 25,432 cases. However, in the medical marijuana database, there were only 467 patients with Cancer as a unique debilitating condition.

Year Three Recommendations… Amending the definition of “25 miles” to by road rather than as the crow flies for qualifying patient applicants requesting to cultivate.

Adequate Supply? Sure, in Oz…

Canada:

“More than 13,000 patients have registered with the new licensed producers, which together sold 1,400 kilograms of dried marijuana between Jan. 1 and Oct. 31.”

1,400 kilograms = 1,400,000 grams

1,400,000 grams divided by 13,000 patients = an average of 107.69 grams/patient

Divided by 10 months = 17.69 grams/patient/month

A little over half an ounce for a whole month? Is that right?

New Mexico:

2nd quarter, 2013
Number who purchased this quarter – 13,462
Total yield – 289,338 grams

289,338 grams divided by 13,462 patients = an average of 21.49 grams/patient

Divided by three months = 7.16 grams/patient/month

How can this be right?

4th quarter, 2013
Number who purchased this quarter – 12,260
Total yield – 432,475 grams

432,475 grams divided by 12,260 patients = 35.27 grams/patient

Divided by 3 months = 11.75 grams/patient/month

Okay, I think I might be calculating this wrong, but I was trying to show the difference in the amount of medicine patients have access to (and purchase):

Canada:

17.69 grams/patient/month

New Mexico:

7.16 grams/patient/month
11.75 grams/patient/month

11/19/2013, “The report obtained by the Journal estimates a need of about 11,000 pounds annually to sustain the program. Currently producers are struggling to harvest just 2,200 pounds.”

(453.59 grams in a pound)
11,000 pounds = 4,989,490 grams
2,200 pounds = 997,898 grams

4th quarter, 2013
Total yield – 432,475 grams

2nd quarter, 2013
Total yield – 289,338 grams

New Mexico’s Report Card, 2nd Quarter, 2014

http://www.nmlegis.gov/lcs/lfc/lfcdocs/Agency%20Performance%20Report%20Cards%20
and%20Highlights%20-%20FY14%202nd%20Quarter.pdf

Accountability in Government Selected Performance Highlights
2nd Quarter, Fiscal Year 2014

New Mexico ranks fifth in the country with a suicide rate of 19.2 per 100,000 persons compared to the national rate of 10.5 per 100,000 persons.

• New Mexico’s alcohol-attributable death rate is the worst in the country and its drug overdose death rate is the second highest in the nation.

• New Mexico has the highest teen pregnancy rate in the country with 68 percent of teenaged mothers, 55 percent of mothers between the ages of 20 and 24 years old, and 51 percent of rural mothers having unintended pregnancies.

The 2010 study of senior hunger by the Meals on Wheels Research Foundation, Inc. reports 83,187, or 21.2 percent, of New Mexican seniors, ages 60 and over, are estimated to have food insecurity, which ranks second in the nation.

In the second quarter, alcohol-related traffic fatalities and the number of DWI arrests declined. The number of saturation patrols and enforcement projects conducted by the Department of Public Safety (DPS) were well above last year’s pace, suggesting the decrease in DWI-related fatalities may be related to department efforts.

Wishful thinking?

With a total of 44 in the first half of FY14, alcohol-related fatalities remain far lower than reported in previous fiscal years. The department attributes this improvement to high-visibility law enforcement operations and more intensive DWI enforcement programs.

The DOH’s opinion is rather narrow, isn’t it?  Is this called tunnel vision?

New Mexico now has the lowest effective tax rate for manufacturers in a nine state western region, according to an updated tax competitiveness study by the New Mexico Tax Research Institute and Ernst & Young. The state’s average effective tax rate for manufacturers dropped from 8.1 percent in a 2011 study to 3.3 percent in the updated study after applying tax credits — well below the average of 6.3 percent for the remaining eight states. Yet, the state is lagging the region in job growth.

It’s like they’re saying, gosh, I wonder why?

Comments: The department created the Medical Cannabis Program in its FY13 operating budget but did not identify performance measures for FY13 or FY14. A performance measure regarding timeliness of processing patient applications will be added for FY15. Currently, the program has 23 licensed nonprofit producers who grow and distribute medical cannabis, 3,316 personal production licenses, and 9,333 active patients.

No performance measures for a 5-year-old program?  And the only performance measure to be added in 2015 is “regarding timeliness of processing patient applications”?  Wow, way to push yourself guys…

12/15/2014, Federal government (in Canada) loses appeal…

…to stop medical marijuana patients from growing pot at home

http://www.cbc.ca/news/canada/british-columbia/federal-government-loses-appeal-to-stop-medical-marijuana-patients-from-growing-pot-at-home-1.2874238

More than 13,000 patients have registered with the new licensed producers, which together sold 1,400 kilograms of dried marijuana between Jan. 1 and Oct. 31.

Prices range from as low as $2.50 a gram to as high as $15, though most are between $8 and $10.

12/29/2014, Examining legality of pot use, driving

http://www.abqjournal.com/518350/news/examining-legality-of-pot-use-driving.html

I don’t usually read the Albuquerque Journal because I already know what they’re going to say — on just about any subject.  Let’s see who they chose to talk about driving and medical cannabis…

Rep. Bill Rehm, R-Albuquerque, a retired Bernalillo County sheriff’s captain, has tried for years to get a “drugged driving” law on the books. So let’s turn to him for the specifics.

Okay, but I don’t think I’m gonna like what he has to say…

“The more times you smoke marijuana, the less smoke is needed to become high. Unlike alcohol, smoking marijuana lowers your tolerance to marijuana.”

Hmmm… I’m not sure what he’s trying to say here (but I got a pretty good chuckle out of it, thanks, dude). Is he trying to make alcohol look better than marijuana?  Is he saying that people who drink don’t become tolerant to alcohol?  I’m so confused…

So are drugged drivers prosecuted like DWIs? The short answer is no.

“New Mexico law does not exempt a medical marijuana driver from our DWI law,” Rehm explains. “When we examine our New Mexico DWI law, we see the Legislature set two different standards for court proof. The alcohol standard is ‘unlawful for a person who is under the influence of intoxicating liquor to drive.’ Drugged driving is a higher standard to be proved – ‘under the influence of any drug to a degree that renders the person incapable of safely driving a vehicle.’ ” In Rehm’s mind “there should not be two different standards.”

“We have tested persons to determine what level of alcohol impairs their driving. For drugs, this has not been done, even for prescription drugs. The lack of scientific data is one defense a defense attorney uses in a DWI court hearing.”

Well, I guess that about covers the subject, huh? Let’s not talk about how marijuana can stay in your system for weeks after use, or that medical cannabis patients, if tested, will always fail — are the jails and prisons ready for the influx of disabled medical cannabis patients?

As a member of the new House majority, Rehm says it’s important to look at new studies that show “brain damage as a result of smoking marijuana” as well as consider “who will fund the marijuana cessation programs” similar to those for tobacco smokers?

Dude, please, get a life…

“New Mexico’s DWI problem does not need to be increased by allowing recreational marijuana,” he says. “Colorado has seen an increase(d) number of DWI arrests (that) involve a driver who had just smoked marijuana. We must continue to watch Colorado and now Washington and Oregon.”

And in the meantime, lawmakers should finally address drugged driving.

The Albuquerque Journal never ceases to entertain me — although I don’t think it’s intentional. So much to look forward to with Republicans now in charge, both in New Mexico and in the federal government… I guess this is just a sample.  Oh boy, this is gonna be so much fun…

Let’s get comfortable?

Comfortable, adjective:

1. (of clothing, furniture, etc.) producing or affording physical comfort, support, or ease:
a comfortable chair; comfortable shoes;

2. being in a state of physical or mental comfort; contented and undisturbed; at ease:
I don’t feel comfortable in the same room with her.

Brainy quotes on Comfort

“Luxury must be comfortable, otherwise it is not luxury.” Coco Chanel

“There are risks and costs to action. But they are far less than the long range risks of comfortable inaction.” John F. Kennedy

“If it’s the right chair, it doesn’t take too long to get comfortable in it.” Robert De Niro

“I’ll never feel comfortable taking a strong drink, and I’ll never feel easy smoking a cigarette. I just don’t think those things are right for me.” Elvis Presley

“Don’t get too comfortable with who you are at any given time – you may miss the opportunity to become who you want to be.” Jon Bon Jovi

Let’s get comfortable?

For a chronic pain patient, getting comfortable is easier said than done. Standing, sitting, kneeling, bending over, laying down… when you’re in constant pain, none of these positions offer comfort, especially for any length of time.

Which brings me to a medical condition that I’ve created — and, as it happens, also diagnosed myself with — Sleep Ambivalence.

I didn’t choose to spend my life in constant pain, but I’d like to choose how much time I spend away from that pain — whether it be with drugs, or in sleep. Legal/prescription drugs are no longer available for me to treat and manage the pain, and right now, legal cannabis isn’t either.

So, I’m left with sleep… (Plus aspirin and sugar, of course.)

But staying in one position for hours is something I pay for when I wake up — added stiffness and increased head pain are always awaiting me, no matter how much rest I get.

Most people can choose to sleep in multiple positions — on your back, stomach, or either side. (And there are combinations :D) I have limited range of motion in my neck, so sleeping on my stomach hasn’t been an option for quite awhile. For some reason, it’s more uncomfortable to sleep on my back, with the added pressure of the back of my head against the pillow, than to sleep on either side.

I’m a TMJ patient with constant jaw pain, with only two options for sleeping positions — the left or right side. Bummer.

So, I’m suffering from Sleep Ambivalence.  (Registered trademark)  (Just kidding.)

I’m also suffering from the lack of an ability to be… comfortable.”  (Medical term coming soon.)

My kingdom for some comfort!
Sleep… because it’s comfortable.
Sleep: Not just for healthy people anymore.
Ah, the luxury of comfort…