Is inadequate supply the only problem for Medical Cannabis Program?

From New MexiCann’s Newsletter & Menu For the Week of May 17th, 2015:

The Dept.’s Supply Survey from November 2013 a total need for 4,000,000 grams after calculating for Personal Production.

In my opinion, basing the overall supply needs of the program on the results of one 2013 survey is not only lazy but inaccurate.  This calculation is already incorrect, as you can’t subtract the amount patients are growing on their own (which may or may not be adequate to supply their own needs), from the total supply needed for the state of New Mexico.  In fact, many personal growers have to supplement their supplies with medicine from the dispensaries, having no choice but to pay their exorbitant prices.

Since that time, the Patient count has increased by about 40% from some 10,000 Patients to some 14,000 Patients. Unfortunately, the Survey measured need only – not demand.

I don’t know how any survey could adequately measure need, let alone demand.

It has been estimated that at least 1/3 of Patients (excluding Patients with PPLs who are cultivating) do not purchase from LNPPs – either because the can purchase illicitly from Patients with PPLs or from “the street” at a lower price from “the street” or because of convenience.

What happens when you rely on estimates?  Nothing good.

If we take that into account, the current Patient need may be for 6,000,000 grams but some 2,000,000 grams of that need is being provided by illicit sources. The LNPP yields need to be some 4,000,000 grams – the projected yields with increased plant counts as per my survey.

Based on this, there is no need for additional LNPP licenses from a yield perspective…

I’m too tired to calculate these figures from grams to pounds to… whatever.  Here’s my latest attempt:

https://painkills2.wordpress.com/2015/01/03/adequate-supply-sure-in-oz/

Adequate supply is not the only problem within New Mexico’s Medical Cannabis Program. Quality is a huge problem, and yet, it is never addressed.  Patients are forced to purchase low-grade medical cannabis because there are so few choices, unlike in other states.

As you know, in February, the Dept. announced the new Rules for the Medical Cannabis Program that permitted plant counts up to 450 plants from the current 150 – potentially tripling the yields available to supply Patient needs. These increased counts cost – $10,000 per year for every 50 plants with a 150 plant minimum ($30,000) and a 450 plant maximum ($90,000)…

That is a very hefty fee and many fear this will be passed on to Patients. Personally, I don’t think so. I think that in fact we will see price reductions. If enough LNPPs increase their plant counts, in my opinion, there will be excess supply and with that a competitive market will emerge that should reduce pricing and benefit Patients…

For almost every year that the program has been in existence, producers have been claiming that the prices will go down.  (That last time the plant count was raised, it was supposed to result in a decrease in price for patients.)  They continue to be wrong, but here is yet another prediction which is now forever on the internet, so in the future, we can look back and continue to see why this program is so messed up.

In order to get a handle on that, I put out a survey to all LNPPs. The response was surprising to me and to the Dept. Of the 23 current LNPPs, 20 responded. Below is the data that was transmitted to DoH:
20 of the 23 LNPPs responded
13 expect to renew for 450 plants
2 expect to renew for 300 plants
1 expects to renew for 200 plants
4 expect to renew for 150 plants

How many of these dispensaries are producing quality medicine?  All of these calculations presuppose that each producer is producing the kind of cannabis that patients need, want, and are willing to pay a lot of money for.  As with the issue of adequate supply, the powers that be, the ones making all the rules, continue to be wrong.  But the producers and the DOH aren’t the ones suffering from all of these back-of-the-envelope calculations.  No, it’s the patients with chronic, debilitating medical conditions who are the ones that have to suffer.

New DEA rule leaves patients in pain

http://www.pharmaciststeve.com/?p=10427

Thousands of Americans suffering from chronic pain rely on those drugs to function. The new regulations mean these individuals now face greater difficulties getting their needed medication. In a recent article, the Washington Post reported that the rule is taking a particularly difficult toll on veterans suffering from battlefield injuries like missing limbs and PTSD…

But those in search of pain medications aren’t the only ones who will bear the costs. Since doctors’ offices must now contend with more patients, more appointments, and more paperwork, these changes are likely to increase wait times for all patients.

The debate over drug use in the United States is ongoing. Since the war on drugs began in the 1970s, the U.S. government has played a unending game of “whack-a-mole,” restricting one drug, only to have another drug take its place. Those using prescription painkillers to get high will find other alternatives. The rest of us, however, are stuck with more time at the doctor’s office, higher medical costs, and more difficulty getting medications we need. Those who pay the highest price are the thousands of American men and women who, thanks to the new restrictions, will face an even greater struggle to manage their pain.

Under comments:

Jared Owen ebola131 • 2 days ago
Talks about a man smuggling in something to treat his wife’s cancer obviously because he can’t afford her treatment how often do you see stories similar to that in socialist not for profit healthcare facilities? In my opinion.

http://www.msn.com/en-us/news/crime/man-who-smuggled-oil-into-us-in-wine-bottles-gets-probation/ar-BBjNuHs

http://www.deadiversion.usdoj.gov/chem_prog/advisories/safrole.htm

The Drug Enforcement Administration (DEA) is issuing this notice to inform individuals and businesses handling safrole and essential oils rich in safrole, such as sassafras oil, “brown” camphor oil 1.070, also referred to as Chinese sassafras oil, that they are sometimes used in the manufacture of MDMA…

It is unlawful for any person knowingly or intentionally to possess or distribute safrole, knowing, or having reasonable cause to believe, the safrole will be used to manufacture MDMA.

The Drug Enforcement Administration thanks you for your cooperation in this matter.

https://answers.yahoo.com/question/index?qid=20100427224417AAtcbPO

Safrole is a chemical more properly called 5-(2-propenyl)-1,3-benzodioxole, it is a Schedule I chemical and requires a DEA permit for purchase. What you are looking for is Sassafras Essential Oil. A very good quality sassafras oil contains up to 98% safrole, but 75-80% is much more common…

A Schedule I chemical just because sometimes it’s used in the making of ecstasy.  Jesus.

Physician Suicide and the Elephant in the Room

http://disruptedphysician.com/2015/05/16/physician-suicide-and-physician-wellness-programs-we-really-need-to-start-talking-about-the-elephant-in-the-room/

The ASAM/FSPHP had a major influence on the DSM-V where drug abuse and dependence are no longer separate entities. They are also working behind the scenes to get legislation to randomly drug test all physicians…

FedEx stresses record of cooperating with feds in lawsuit

http://www.pharmaciststeve.com/?p=10412#comment-10733

The company said as far back as 2002, 12 years before it was accused of scheming with “rogue” online drugstores to deliver controlled substances to dealers and addicts, it was assisting federal agencies with investigations of pill purveyors…

The government said in the indictment that the shipping company knew it was delivering drugs to dealers and addicts, with couriers in Kentucky, Tennessee and Virginia expressing concerns to managers that FedEx trucks were stopped on the road by online pharmacy customers demanding packages of pills. Some delivery addresses were parking lots or vacant homes, prosecutors said.

My comment:

painkills2, on May 17, 2015 at 10:39 am said:
Easy to blame chronic pain patients for diversion, when the DEA knows full well that most of the diversion is happening through stories like this.

ABC News Investigation Into Counterfeit Prescription Drug Operations in the US

http://www.pharmaciststeve.com/?p=10416

http://abcnews.go.com/Health/abc-news-investigation-counterfeit-prescription-drug-operations-us/story?id=31077758

A year-long ABC News “20/20” investigation uncovered numerous operations involving the sale of dangerous counterfeit prescription drugs, many of which were sold under the guise of being authentic medication shipped in from Canada, or sold openly on the streets, Flea Markets, or retail stores in Los Angeles.

For the past year, an ABC News’ “20/20” investigation team has been working behind the scenes with U.S. Homeland Security, U.S. Customs and Border Protection, FBI, Los Angeles Police Department, the L.A. Sheriff’s department, among other law enforcement agents to investigate the prevalence of counterfeit goods being sold across the United States. These items range from everyday home goods such as bicycle helmets and perfumes, to more dangerous fakes, such as airbags and prescription drugs…

Under comments:

Gail Fiorini Reston, VA, on May 16, 2015 at 7:03 am said:
I received a supply of a medication with NONE of the active ingredient in it from a mail order pharmacy that my insurance company made me use. I took it to my doctor when it didn’t work. Thought I was correct, not only was no investigation done, but the insurance company would not pay for a replacement prescription. And no, this was not a pain or anxiety medication or anything you would expect for this sort of thing. It was a problem with the cheapest generic drug–cheap because they left the medicine part out of it.

PWB, on May 16, 2015 at 7:31 am said:
That is so scary. I’ve used the mail order pharmacy thru my insurance company too, and they are 90 day scripts. Last time and this time have been like pulling teeth to get them. This article and another one tells me, it’s not worth saving that little bit of money. I need to log in and get all my info off there. They auto refilled one med because it was less than $100 – problem is? My dosage was increased a few days after they sent it and they wouldn’t let me stop it. So I’m stuck with it and need the higher dose. It’s thyroid med, you can’t just cut a pill in half and add to what you take. Things are getting so bad. Do these places want to help us at all?