Thanks to the men who support women

I scanned the faces of the crowds at the women’s marches and I saw plenty of men combining their voices with ours. And I just wanted to say thanks. We appreciate you. 🙂

http://www.huffingtonpost.com/2014/07/25/famous-male-feminists-men-support-women_n_5564005.html

At a 2006 Equality Now event, “Buffy The Vampire Slayer” creator and “The Avengers” writer [Joss Whedon] took a creative and impactful approach to his speech. He discussed the frustrations of always being asked the question, “Why do you create strong female characters?” In the speech he gave numerous responses, including:

“Because, equality is not a concept. It’s not something we should be striving for. It’s a necessity. Equality is like gravity. We need it to stand on this earth as men and women, and the misogyny that is in every culture is not a true part of the human condition.”

Having witnessed his father physically abuse his mother as a child, Patrick Stewart gave a riveting speech for Amnesty International UK in October 2009. Remembering the impact the abuse had on him as a boy, he spoke to the responsibility men have to end this violence: “Even if she had [done something to provoke my father to hit her], violence is a choice. And it’s a choice that a man makes. We can choose to stop it.”

http://www.bloomberg.com/news/features/2017-01-21/on-the-march-in-trump-s-capital

More signs from the women’s march:

“You’re orange, you’re gross, you lost the popular vote!”

“I’m not usually a sign guy but geez.”

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There’s nothing wrong or sinful about feeling good

I believe we should have access to any and all treatments for pain, including cannabis. But I don’t want pain patients to think that if they switch to cannabis, it will be the only drug or treatment they’ll need to manage their pain. (Any drug is just one part of an overall pain management program.)

I’ve been very lucky to have access to a quality strain of cannabis in the last couple of months — one of those strains that are very hard to find. I’ve wondered if daily use of a good strain would be enough to manage my high pain levels (averaging about a 7 out of 10), but I think that’s about false hope. Cannabis is great, but it’s not a wonder drug. Of course, everyone’s experience will be different, but I think I’ve had enough experience throughout the past 3+ years to reach some conclusions.

If I had a choice (which I do not), I would probably choose a combination of cannabis and a painkiller to treat my pain. The addition of a painkiller would allow me to smoke less cannabis, and the cannabis would allow me to keep my painkiller usage to a minimum. I might even add a muscle relaxer at night, because the muscles in my face deserve more rest than I’m able to provide.

If I was able to add a painkiller to my pain management program, I might be able to take a walk every other day, instead of once or twice a week. I might be able to lose some weight. With a little extra pain relief, I might not think about death so much. I might think that I have some kind of survivable future. There’s even a possibility that I’d be able to regularly clean my toilet. (Okay, maybe not.)

When I was taking a bucket full of prescription medications, I relied on them to manage my pain. Maybe I relied on them too much, but that’s only because, out of all the treatments I’ve tried, prescription medications worked the best. I think that’s true for most people. I think it’s true that a lot of acute and chronic pain is best controlled with painkillers. (Patients aren’t given high doses of antidepressants before surgery.) Maybe the opioid war advocates would agree with me on that, but would disagree about how long we should be allowed to use opioids to manage pain. After all, according to the other side, anyone who swallows a pain pill has a high risk of becoming a drug addict. (And what’s worse than being a drug addict? Maybe a murderer?)

I read an article recently about how cannabis affects the part of the brain that deals with your sense of time. I’ve been thinking about that…

I know that being in constant pain makes time go by very slowly. Twenty-four hours feels like a week, not one day. And then I thought about the occasions that I’ve felt “high” from a drug. You know, the shameful high that almost all pain patients deny they experience with painkillers. The high that drug addicts chase on a daily basis. The high that makes you feel good artificially because it’s from a drug. The feel-good high that is really what the drug war is all about.

Within that high — a possible side effect of some drugs — is a distortion of time. That relief allows time to float, almost fly by, as if you lost 10 pounds and your feet had wings. As if a heavy burden had been lifted just a little, allowing a tiny taste of freedom inside your prison of pain. (Everyone’s prison of pain is different, caused by mental and/or physical pain.)

Does it feel good to get high? You betchya. However, it’s not like that good feeling lasts very long. But it can last long enough to, say, take a walk (or scrub your toilet). Or the high can work as an incentive — a reward for doing the painful thing that you really don’t want to do.

I suppose it’s all about what you do with the high. Those who suffer from addiction will always be chasing the high, and because of the drug war, will always be shamed and criminalized. Looked down on for suffering from a medical condition that most people think is a choice.

Those who suffer from constant pain will always be chasing after relief, and because of the drug war, we are now treated like those who suffer from addiction.

I’d just like to point out that the high I’ve been talking about gives relief to both pain patients and drug addicts. Look down on that high if you will, but it serves a purpose. The pleasure centers in our brains are there for a reason. They’re activated not only by drugs (including caffeine and chocolate), but also by things like friendship, caring, sex, love, risk, and winning.

Good feelings are part of being human. Unfortunately, so is pain. But just like humans are not meant to feel constant pleasure, we’re also not meant to be in constant pain. We’re not meant to feel depressed every single day, and if we do, that means our brains are out of balance. We’re not meant to feel constant fear and anxiety, and if we do, that means our brains need help.

Being human means we have to suffer, but when pain reaches a level where death is preferable to life, then our brains need help. Not help for a couple of weeks or months, but constant help. The pain is constant. The help has to be constant, too.

Sometimes the help we need will include the high from drugs. Let’s stop looking down on the high. There’s nothing wrong or sinful about feeling good.

To cut costs, Medicare adopts CDC’s regulations

I think you’d be surprised at how many federal and state government agencies are a part of the opioid war. As predicted, the CDC’s opioid guidelines are being treated more like regulations than simple guidelines. With the backing of the CDC’s false theories, these agencies are deciding which treatments for pain will be available to patients — and which will label you a criminal. If you’re a pain patient with Medicare, this information will affect you.

http://www.painnewsnetwork.org/stories/2017/1/12/medicare-takes-big-brother-approach-to-opioid-abuse

A new strategy being developed by Medicare to combat the abuse of opioid pain medication will encourage pharmacists to report physicians who may be prescribing opioids inappropriately. Patients that a pharmacist believes are abusing opioids could also be referred for investigation.

The strategy, which has yet to be finalized, was outlined by the Centers for Medicare & Medicaid Services (CMS) last week in a 30-page report on the agency’s “Opioid Misuse Strategy.” It has not been widely publicized by CMS or reported in the news media…

I read a story the other day about a pain patient who was reported to his doctor by the pharmacist for buying alcohol with his prescription drugs. But I don’t think it’s news that doctors and pharmacists have also become an extension of the DEA in the opioid war, just like other government agencies.

Here are some excerpts from CMS’s “Opioid Misuse Strategy” report:

http://www.cms.gov/Outreach-and-Education/Outreach/Partnerships/Downloads/CMS-Opioid-Misuse-Strategy-2016.pdf

Increase the use of evidence-based practices for acute and chronic pain management. Evidence-based practice is an integral part of all of CMS’s priority areas, but expanding the evidence base of effective and alternative treatments for acute and chronic pain is especially vital. CMS stated this priority area specifically to emphasize the need to address the limitations of research that is currently available.

By January 1, 2019, CMS will enforce requirements that the vast majority of prescribers who write prescriptions for Medicare Part D beneficiaries must be enrolled in Medicare or be validly opted out in order for the beneficiaries’ drugs to be covered. This enrollment requirement will allow Medicare to have better oversight of prescriber behaviors and revoke enrollment of providers proven to demonstrate inappropriate behaviors.

The Medicare Part D Opioid Prescriber Summary File, which will build on this Medicare prescriber enrollment requirement, presents information on the individual opioid prescribing rates (for new prescriptions as well as refills) of prescribers of Part D drugs. This public data set will provide information on the number and percentage of prescription claims for opioid drugs, as well as each provider’s name, specialty, state, and zip code. The file can be used to explore the impact of prescribing practices of controlled substances on vulnerable populations.

Finally, through CMS’s Overutilization Monitoring System (OMS), Part D sponsors are provided quarterly reports on high risk beneficiaries and provide CMS with the outcome of their review of each case. Since 2011, the OMS helped sponsors reduce the number of potential opioid overutilizers by 47 percent among Medicare Part D beneficiaries.

Additionally, CMS is addressing the issue of drug diversion by identifying consistent thresholds across programs to flag providers as “high prescribers” and patients as “high utilizers” who may require additional scrutiny.

CMS is in the exploratory phase of identifying metrics to quantify and track progress in each priority area. For priority area 1, metrics are currently under consideration in the following areas:

For prescribers enrolled in Medicare who prescribe Part D drugs:

Percentage of opioid prescriptions:
o Exceeding CDC guideline of 90 morphine milligram equivalents (MME) per day
o Exceeding 7 days of treatment
o Written for extended release/long-acting opioids

Percentage with beneficiaries receiving an opioid prescription without other supportive therapies/treatments

Research would also increase the focus on identifying methods for migrating the significant number of chronic pain patients with long standing opioid use to other medications along with alternative modalities. Without initiating other medications at the same time as alternative therapies, these patients may vigorously resist reducing or giving up the opioids that for many years have allowed them to manage their pain at tolerable levels and lead functional lives. The benefit of tolerable pain levels and functional lives may outweigh the risk of opioid use for these patients.

Recognizing its critical role in promoting and reinforcing appropriate treatment approaches, Medicare, Medicaid, and Marketplace plans would cover therapies that are consistent with CMS’s evidentiary standards.

CMS has a number of initiatives underway to increase the use of recommended evidence-based practices for pain management. CMS provides outreach regarding best practices and technical assistance through the Transforming Clinical Practice Initiative’s Practice Transformation Networks. CMS has distributed publications on evidence-based prescribing practices to providers, often in coordination with other HHS agencies, including the Office of the Surgeon General.

CMS is also playing a part in expanding the evidence base to identify and support effective nonpharmacologic therapies and additional non-opioid pharmaceuticals. The agency’s key role is to identify services that need more evidence to support coverage by Medicare and other health plans. CMS then collaborates with research-focused HHS agencies, such as NIH, who can concentrate research on these need areas.

The focus of CMS’s immediate efforts under this priority area is twofold. First, identify non-covered treatments that already have sufficient evidence in order to quickly expand coverage of those therapies; for example, for certain common pain conditions, such as chronic lower back pain, CMS is exploring ways to streamline coverage of evidence-supported alternative therapies.

Secondly, educate providers and beneficiaries in order to improve provider utilization of evidence-based treatments and adjust patient expectations appropriately.

CMS’s long term priorities focus on broadening coverage and increasing utilization of therapies that are [might be] proven to be effective. This approach will accelerate identification and implementation of effective alternative treatments for pain.

What happens when access to the only adequate treatments for pain are reduced and removed before other “effective” therapies are found? Like, what happens when Republicans repeal Obamacare before having something comparable to replace it with? I think the term “chaos” fits.

http://www.blog.cms.gov/2017/01/05/addressing-the-opioid-epidemic/

“The opioid epidemic is one of the most pressing public health issues in the United States today.” – Health and Human Services (HHS) Secretary Sylvia Mathews Burwell

Really? If more people suffer from untreated chronic pain than suffer from addiction, which is the epidemic? If more people die from suicide than from drug overdoses, which is the epidemic?

Many Medicare and Medicaid beneficiaries and their families have been affected by the consequences of opioid misuse and opioid use disorder, commonly referred to as addiction. Given the growing body of evidence on the risks of misuse, highlighted by the Centers for Disease Control’s (CDC) new guidelines for prescribing opioids that was released earlier this year, and the Administration’s commitment to combatting the opioid epidemic, CMS is outlining our agency’s strategy and the array of actions underway to address the national opioid misuse epidemic. The actions outlined here do not include CMS’s vision for the treatment of cancer and hospice patients.

See, those who suffer from cancer, or are under hospice care, deserve to have their pain treated, while everyone else can just suffer. Thanks, CDC.

Comments are closed.

Of course comments are closed. They don’t want anyone to invade their bubble. But Medicare is on Facebook, along with the agency that oversees it, HHS:

http://www.facebook.com/HHS/

http://www.facebook.com/medicare/

My comment posted today on Medicare’s Facebook page:

The CDC’s opioid regulations, and Medicare’s adoption of them, are forcing tens of millions of Americans to find alternative treatments for pain, like marijuana and kratom. How much savings does that amount to for Medicare?

What happens when you reduce and remove access to the only successfully proven treatment for pain before equally successful alternative treatments are available? How smart is it to repeal before you replace?

Many pain patients are unable to find safe and adequate replacements for opioids. Some will be forced into the underground drug market. Some will choose suicide. Most will survive, but their lives won’t be worth living. Many will just hunker down, suffer quietly, and wait to die — shamed by the opioid war into believing they deserve to suffer.

Has Medicare/CMS identified metrics to quantify and track the destruction being caused by it and the CDC? Like the increase in addiction rates, poisonings, and suicides. The increase in the use of alcohol, cigarettes, acetaminophen and NSAIDs, sugar, and other legal, over-the-counter drugs and supplements. The increase in domestic violence, family break-ups, obesity, kidney and liver disease, disability claims, and homelessness. The increase in anxiety, depression, and PTSD.

Once the government cures addiction (with money and good intentions), what is it going to do about the epidemic of intractable pain? The epidemic of suicides and gun violence? The epidemic of Americans being unable to trust even one government agency in this country?

How do you feel about spanking?

http://www.today.com/parents/france-just-made-spanking-your-kid-illegal-t106715

Studies have shown that spanking basically doesn’t work: It can not only impair a child’s IQ and their overall ability to learn, but it can also lead to low self esteem, aggressive behaviors and substance abuse and addiction problems in later years.

According to a June 2016 study that appeared in the Journal of Family Psychology, more than five decades of research revealed that children who were spanked were more likely to encounter mental health and cognitive difficulties and obstacles, become anti-social and introverted, and were more likely to defy their parents.

Reports have revealed that, since 1986, the practice of spanking children has decreased among women. However, parents across the U.S. say they still approve of spanking as a form of discipline…

I’m very thankful that spanking was not a part of my upbringing. If you hit a stranger, it’s considered criminal battery. Why not the same for your own child? What can a child learn when violence is used as a reinforcement? Spanking is about bullying, not about teaching. It’s about who has the most power in a parent/child relationship.

Don’t hit your kids. Don’t hit your pets. Spanking is not an educational tool. It creates anger and resentment, and just makes the victim want to hit you back. And if they can’t hit you back, they’ll take it out on someone else.

Can long-term pot use cause Alzheimer’s?

I don’t know much about Alzheimer’s, but I did have a grandmother who passed away from that disease. Am I worried about my pot use causing Alzheimer’s? No.

This research was published today in some Alzheimer’s magazine. It centers around a very expensive brain scan (not covered by insurance) which the author has been selling at his California clinic for almost a decade.

At first, I thought there might be something to this research. After all, we’re talking about a brain scan here. But I wondered how they can tell if a brain is acting abnormally when they don’t know what the brain looked like before the so-called long-term pot use.

How much did each person use every day? What kind? Was it homegrown or doused with chemicals from a dispensary? What were the ages and genders of the patients? Did any of them suffer from addiction, depression, PTSD, or chronic pain? Because you can’t blame pot when other medical conditions affect the brain.

In other words, I think this research is full of shit. Yes, we all know that pot can mess with your memory. But so can a bunch of other stuff, including pollution and old age.

So, here’s the information I found. You decide.

http://www.content.iospress.com/articles/journal-of-alzheimers-disease/jad160833

Conclusion: Multiple brain regions show low perfusion on SPECT in marijuana users. The most predictive region distinguishing marijuana users from healthy controls, the hippocampus, is a key target of Alzheimer’s disease pathology. This study raises the possibility of deleterious brain effects of marijuana use.

Authors: Amen, Daniel G.; Darmal, Borhana; Raji, Cyrus A.; Bao, Weining; Jorandby, Lantiea; Meysami, Somayeha; Raghavendra, Cauligi S.

http://www.kpbs.org/news/2015/dec/01/psychiatrists-couch-dr-daniel-amen-md/

The Washington Post wrote that by almost any measure Dr. Daniel Amen is the most popular psychiatrist in America. He is a double board certified psychiatrist, who has written 10 New York Times bestselling books, including the mega-bestseller “Change Your Brain, Change Your Life.”

I’ve never heard of this doctor, but then I don’t buy self-help books.

http://www.sciencebasedmedicine.org/shame-on-pbs/

I used to have a high opinion of PBS. They ran excellent programs like Nova and Masterpiece Theatre and I felt I could count on finding good programming when I tuned into my local PBS channel. No more.

It was bad enough when they started featuring Deepak Chopra, self-help programs, and “create your own reality” New Age philosophy, but at least it was obvious what those programs were about. What is really frightening is that now they are running programs for fringe medical claims and they are allowing viewers to believe that they are hearing cutting edge science.

Neurologist Robert Burton has written excellent articles for salon.com pointing out the questionable science presented by doctors Daniel Amen and Mark Hyman in their PBS programs…

http://www.pbs.org/ombudsman/2008/05/caution_that_program_may_not_b.html

“It’s 10 on a Saturday night and on my local PBS station a diminutive middle-aged doctor with a toothy smile and televangelical delivery is facing a rapt studio audience. ‘I will show you how to make your brain great, including how to prevent Alzheimer’s disease,’ he declares. ‘And I’m not kidding.’

“Before the neurologist in me can voice an objection, the doctor, Daniel Amen, is being interviewed by on-air station (KQED) host Greg Sherwood. Sherwood is wildly enthusiastic. After reading Amen’s book, ‘Change Your Brain, Change Your Life,’ Sherwood says, ‘The first thing I wanted to do was to get a brain scan.’ He turns to Amen. ‘You could start taking care 10 years in advance of ever having a symptom and prevent Alzheimer’s disease,’ he says. ‘Yes, prevent Alzheimer’s disease,’ Amen chimes in.

“Wait a minute. Prevent Alzheimer’s disease? Is he kidding? But Sherwood is already holding up Amen’s package of DVDs on learning your risk factors for A.D., as well as his book with a section titled ‘Preventing Alzheimer’s.’ Then, as though offering a landmark insight into a tragic disease — and encouraging viewers to pledge money to the station — Sherwood beams and says, ‘This is the kind of program that you’ve come to expect from PBS.’

http://www.yelp.com/biz/amen-clinics-costa-mesa-4

Amen Clinics
Counseling & Mental Health; Psychiatrists

5/2/2015
Worst experience ever. Especially when you’re in a extremely depressed state of mind. I did all the tests and it came down to just an internist “reading” my results and pushing their vitamin supplements onto me. Ugh. Don’t go here. They’re no help.

3/3/2016
Beware – Amen Clinics preys on mentally ill people and the families who love them. The clinic will bleed you dry with “off label” treatments, nutrition classes, supplements, charges to fill out insurance paperwork, and routine services that cost 2x what regular providers charge. Amen Clinic’s pushes their expensive services even when they aren’t working…

11/20/2016
The cost associated with said process/treatment is staggering…

http://www.nextavenue.org/can-marijuana-save-aging-brain/

Cannabinoids, the active chemical components of marijuana, can regulate inflammation in the brain and promote neurogenesis — the growth of new neural pathways — even in cells damaged by age or trauma. As more research has indicated that brain inflammation appears to be a cause of several degenerative diseases, marijuana has been getting a closer look as a potential preventive medication.

In a 2006 study published in Molecular Pharmaceutics, a team of University of Connecticut researchers reported that THC, the chemical compound responsible for marijuana’s high, “could be considerably better at suppressing the abnormal clumping of malformed proteins that is a hallmark of Alzheimer’s disease than any currently approved prescription.”

To be clear, most scientists investigating the link between cannabinoids and brain health are not advocating widespread casual marijuana smoking to ward off Alzheimer’s disease. Marijuana possession remains illegal and research has shown that long-term, frequent marijuana use can impair memory, focus and decision-making…

In 2007, Ohio State University researchers published a paper stating that medications which can stimulate cannabinoid receptors in the brain “may provide clinical benefits in age-related diseases that are associated with brain inflammation, such as Alzheimer’s disease.” In 2009, Italian and Israeli researchers found that cannabidiol (CBD), marijuana’s primary non-psychoactive cannabinoid, may also block the formation of the plaques in the brain believed to bring on Alzheimer’s.

Wenk believes that, in humans, “the equivalent of one puff a day” could help ward off dementia. “I have said to older people, ‘Try it,’” Wenk says. “They email me back to say it’s helping. It’s worked in every rat we’ve given it to. We have some happy, intelligent old rats.”

Thinking of you, Curtis Gearhart

http://www.whotv.com/2016/11/10/another-iowa-veteran-suicide-after-family-says-he-was-told-to-wait-for-treatment-by-va/

Then nearly two months ago Curtis went to the V.A. because of recurring headaches. Valesca said, “He previously had a tumor. He was worried about it and they told him it would be five to six weeks.” He couldn’t wait any longer and took his own life Monday, November 7th…

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