Tag Archives: patients

As the feds crack down on opioid prescriptions, patients are taking their own lives, doctors are losing their jobs and overdose rates continue unabated.

The Government’s Solution To The Opioid     Crisis Feels Like A War To Pain Patients

By Art Levine

Meredith Lawrence's late husband died by suicide after his opioid pain prescription was severely restricted.

Jay Lawrence, an energetic truck driver in his late 30s, was driving a semitrailer across a bridge when the brakes failed. To avoid plowing into the car in front of him, he swerved sideways and slammed the truck into a wall, fracturing his back. For more than 25 years, he struggled with the resulting pain. But for most of that time, he managed to avoid opioid painkillers.

In 2006, his legs suddenly collapsed beneath him, due to a complex web of neurological factors related to his spinal cord injury. He underwent multiple surgeries and tried many medications to alleviate his pain.

The next year, he began to experience some semblance of relief when his doctor prescribed morphine, one of a class of opioid drugs. By 2012, he was taking 120 milligrams per day.

But this isn’t a story about opioid addiction. Lawrence managed a relatively productive, happy life on the medication for the better part of 10 years.

“This isn’t the life I thought I’d have,” he told his wife, Meredith Lawrence, in December 2016. “But I’m all right.”

Living on disability payments, he could still walk around their two-bedroom trailer home using his cane, take a shower on his own and, on his good days, even help his wife make breakfast.

Then, in early 2017, the pain clinic where he was a patient adopted a strict new policy, part of a wide-ranging national effort to respond to the increase in opioid overdose deaths. 

Citing 2016 guidelines from the U.S. Centers for Disease Control and Prevention, her husband’s doctor abruptly cut his daily dose by roughly 25 percent to 90 mg, Meredith Lawrence said. That was the maximum dose the CDC recommends, though does not mandate, for first-time opioid patients. 

The doctor also told Jay Lawrence that the plan was to lower his dose to 45 mg over the next two months, a cutback of more than 60 percent from what he had been taking.

At the end of that traumatic visit, his wife said, Jay Lawrence’s doctor dismissed their concerns and shared his own fear about losing his license if he continued to prescribe high doses of opioids. (When HuffPost followed up, the doctor declined to comment on the case, citing patient privacy.)

For a month, Lawrence suffered on the 90 mg dose. At times, his pain was so bad that he needed help to get out of the recliner, and when his wife looked over, she sometimes saw tears streaming down his face.

He dreaded his next appointment when his dose would be slashed to 60 mg. In the weeks before that scheduled visit on March 2, 2017, Lawrence came up with a plan.

On the day of his appointment, on the same bench in the Hendersonville, Tennessee, park where the Lawrences had recently renewed their wedding vows, the 58-year-old man gripped his wife’s hand and killed himself with a gun.

Meredith Lawrence sits in the living room of the home in Gainesville, Georgia, that she bought after her husband's death

Dustin Chambers for HuffPost Meredith Lawrence sits in the living room of the home in Gainesville, Georgia, that she bought after her husband’s death.

There are at least nine million chronic pain patients in the United States who take opioid painkillers on a long-term basis. As law enforcement and medical regulatory bodies try to curb the explosion in opioid deaths and the rise in illegal opioid use, they have focused on reducing the overall opioid supply, whether or not the drugs are provided by prescription. 

There’s mounting evidence this won’t work ― that curbing patient access to legal prescription opioids does not stem the rate of overdoses caused primarily by illegal drugs ― and that patients are being denied desperately needed relief. There are also troubling indicators that cutting back on opioids increases the risk of suicide among those with chronic pain.

Some chronic pain patients and advocates have even begun compiling lists of individuals they know who have died by suicide after they were no longer able to treat their pain with opioid medication.

“There is no doubt in my mind that forcibly stopping opioids can destabilize some of the most vulnerable people in America,” said Dr. Stefan Kertesz, a professor of medicine and an addiction researcher at the University of Alabama at Birmingham. “And the outcomes for those folks include suicide, overdose and falling apart medically.”

I mean, people need to take some aspirin sometimes and tough it out a little. Attorney General Jeff Sessions

For a decade or so, government officials in the U.S. have sought to drive down the opioid supply through a range of tactics ― from increased seizures of diverted opioid medications to state crackdowns on “pill mills.” The Trump administration has embraced the hard-line approach.

In late January, Attorney General Jeff Sessions announced a “surge” in Drug Enforcement Administration activity targeting pharmacies and physicians that, in the agency’s view, oversupply opioids. In February, the Justice Department doubled down with the announcement of a new task force that would focus on manufacturers and distributors of opioids. In March, President Donald Trump unveiled a plan to lower opioid prescriptions by a third within three years. And in late June, the federal government arrested 600 people, including 165 medical professionals, for allegedly participating in $2 billion worth of fraud schemes involving opioids.

The Trump administration’s efforts are dramatic even within the context of the CDC’s opioid dose guidelines. The guidelines were originally intended to advise primary care physicians treating chronic pain patients and other pain sufferers. They were urged to exercise caution in prescribing opioids, to use alternatives whenever possible and to prescribe daily doses of no more than 90 morphine milligram equivalents (MME) for new opioid users.

For pain patients like Jay Lawrence who had already been on opioids for years, however, the guidelines simply recommended regularly assessing the harms and benefits of the dosage. They didn’t advise either mandatory cutoffs or any set limits. (The Tennessee Department of Health’s guidelines would also have allowed Lawrence to stay at 120 mg of morphine when prescribed by a pain specialist.)

But “the CDC guidelines have been weaponized,” said Kertesz. The ramped-up enforcement by the DEA and state regulators has led some doctors to choose caution and to overcorrect in their prescribing, lest they lose their ability to practice medicine at all. Kertesz decried these policies as “simplistic” in a definitive new article published last week in the journal Addiction.

In February, Sessions struck a particularly harsh tone by suggesting that the fate of chronic pain patients was not high on his list of concerns. “I am operating on the assumption that this country prescribes too many opioids,” the attorney general said. “I mean, people need to take some aspirin sometimes and tough it out a little.”

Attitudes like that are based on a series of mistaken assumptions about pain, according to Dr. Thomas Kline, a North Carolina-based family practitioner and former Harvard Medical School program administrator. Kline regularly updates a list of pain patients, published on Medium, who’ve killed themselves in the wake of draconian restrictions on pain medication.

“I ask people to imagine the very worst pain they’ve ever experienced in their lives,” Kline said. “And then that they’re denied relief by a doctor with the one medicine proven effective for pain control for 50 centuries.” (Historical records show that people in ancient Mesopotamia cultivated the poppy plant for medical use.)

The CDC guidelines have been weaponized. Dr. Stefan Kertesz

The government’s aggressive focus on doctors and patients is unlikely to address the very real menace of opioid-use disorders and sharply escalating overdose deaths. Fraud ― driven by pharmaceutical company policies ― and diversion ― the phenomenon of prescription medications being sold as street drugs ― initially spurred a wave of opioid abuse in the late 1990s, as some doctors turned their practices into pill mills. But new reports by the CDC and a drug data firm, the IQVIA Institute for Human Data Science, suggest that prescription drugs play a much smaller role in today’s crisis.

The reports show that total opioid prescriptions dropped 10 percent in 2017 ― the sharpest annual decline in such prescribing in 25 years. While opioid prescriptions peaked back in 2010, the studies found that growth rates in opioid-linked deaths, overwhelmingly due to illegal fentanyl and heroin, have skyrocketed in the last seven years.

Indeed, although two-thirds of the 64,000 overall drug overdose fatalities were linked to opioids in 2016 ― the most recent year for which there is data ― more than 80 percent of those opioid drug deaths came from illegal street drugs such as heroin and fentanyl. Prescription opioid drug deaths alone ― excluding methadone ― amounted to less than 15 percent of all drug overdose deaths, or about 9,500 fatalities.

Still, the CDC’s guidelines have triggered restrictive laws in at least 23 states that mandate ceilings on opioid dosage. (Oregon, in fact, is moving to taper dosages down to zero for all Medicaid chronic patients over a year.) That makes relief less attainable for pain patients and threatens the practices of doctors who treat them. These laws have been augmented by the growth of state prescription monitoring programs that use the software NarxCare, which is designed to flag addiction but can also rope in pain patients based on their prescription history and use of multiple doctors.

And in June, the House of Representatives passed over 50 bills that would establish dramatic new restrictions on opioid prescribing, eliciting alarm among patients and some disability rights groups.

The side effects of the current enforcement efforts are disturbing enough, from patients denied relief to drug shortages to suicides.

No health agency has kept track of all pain-related suicides that may be linked to doctors cutting back on prescriptions. But some preliminary findings from Department of Veterans Affairs researchers indicate that VA pain patients deprived of opioids were two to four times more likely to die by suicide in the first three months after they were cut off, compared to those who remained on their pain medications.

“To protect people, you have to take care of the patient, not the pill count,” said Kertesz, who worked on the VA’s April 2017 study but spoke to HuffPost only as an independent researcher. “The findings suggest that the discontinuation of opioids doesn’t necessarily assure a safer patient.”

Even terminally ill cancer patients are increasingly getting less relief, and there are growing shortages of injectable opioids at local hospitals and hospices, spurred in part by DEA-ordered reductions in opioid manufacturing quotas.

Leah Ilten, a 53-year-old physical therapist who lives in Kennewick, Washington, told HuffPost that as her 86-year-old father lay dying of pancreatic cancer in a hospice, the medical staff ignored her pleas to provide appropriate opioid pain relief, even cutting his dosage in half on the last day of his life. A few days earlier, when he was in the hospital, one nurse explained to her that opioids could lead to an overdose or could potentially cause the man, who lay moaning in pain, to “get addicted.”

“I was horrified,” Ilten said.

In mid-April, the DEA responded to the injectable opioid shortage by lifting production quotas. An agency spokesman told HuffPost that it was “a manufacturers’ problem, not the quotas,” while asserting that progress is being made.

There have been production issues, including Pfizer’s foul-ups with a plant in Kansas. But the DEA’s delay in taking action ― shortfalls were flagged in February in a letter from the American Society of Anesthesiologists and other health groups ― definitely contributed to the shortage, according to Dr. James Grant, president of the ASA. He told HuffPost that quotas were among the factors creating the crisis.

I’m not willing to go back to the state I was in before I started treatment. Anne Fuqua

Faced with the hardline national crackdown on opioid prescriptions, people with chronic pain are trying to raise awareness of the suffering caused by the loss of medications. Some are gathering the names of those patients who ended up taking their own lives, both as a memorial to those who died and as a protest against the health establishment that has seemingly abandoned them. Others are seeking comfort from each other on social media.

Lelena Peacock, who declined to name her southeastern city of residence for fear of retaliation from doctors, is struggling with how to treat the pain associated with fibromyalgia. The 45-year-old found that her social media posts drew other pain patients who turned to her for help.

By her own count, Peacock has thus far convinced more than 70 chronic pain patients to call 911 or suicide prevention hotlines instead of killing themselves.

For Anne Fuqua, a 37-year-old former nurse from Birmingham, Alabama, the motivation for compiling a list of chronic pain-related suicides is to track the damage done by what she sees as policies that have left people like her behind. 

“There’s so many people who have died,” she said. “We have to remember them.”

Fuqua has an incurable neurological illness known as primary generalized dystonia that causes Parkinson’s-like involuntary movements and painful muscle spasms. She started taking about 60 mg of Oxycontin a day in 2000. Her doctor began to limit her access to high doses of opioids in 2014, the same year she started chronicling those friends who had killed themselves or otherwise died after being denied pain medications. Her informal list is now up to roughly 150 people, augmented by lists that other pain patient advocates have compiled.

On July 9, Fuqua joined other chronic pain patients at a meeting at the Food and Drug Administration campus in Maryland to express their fears and outrage at the cutbacks. Sitting in the front row in her wheelchair, she told FDA officials about that list and declared, “I’m not willing to go back to the state I was in before I started treatment.”

Anne Fuqua needs exceptionally high doses to manage her pain because of opioid malabsorption.

Courtesy of Anne Fuqua Anne Fuqua needs exceptionally high doses to manage her pain because of opioid malabsorption.

Fuqua’s own difficulties are compounded by the fact that her body does not respond to even large doses of opioids the way others do ― she suffers from severe malabsorption that hampers her ability to benefit from everything from opioids to vitamin D. Since 2012, she has relied on a strikingly high daily regimen of 1,000 MME of opioids, including fentanyl patches, to manage her pain.

But her physician, Dr. Forrest Tennant, was driven to retire this year after a DEA raid and investigation. The Los Angeles-area physician mailed her a final series of prescriptions, which will run out at the end of July.

“It’s terrifying,” she said looking at her future. “If these were people who had asthma or diabetes and weren’t stigmatized because of opioids, this wouldn’t be allowed to happen.”

Another doctor has quietly stepped forward to continue treatment for Tennant’s remaining patients, Fuqua said, although there’s no assurance that this physician won’t also be investigated in the future.

If these were people who had asthma or diabetes and weren’t stigmatized because of opioids, this wouldn’t be allowed to happen. Anne Fuqua

The raid on Tennant’s home and office last November illustrates the hard-line regulatory and enforcement approach that critics say doesn’t distinguish between pill-mill doctors who deserve to be shut down and legitimate pain doctors who use high-dosage opioids. The wide-ranging search warrant served to Tennant essentially accused him of drug trafficking even though he’d earned a national reputation for deft treatment of ― and research about ― pain patients.

“He’s highly respected and prominent in pain management,” said Jeffrey Fudin, a clinical pharmacy specialist who heads the pain pharmacy program at the Albany Stratton VA Medical Center in Albany, New York, and serves as an associate professor at the Albany College of Pharmacy and Health Sciences. “Most of his patients had no other options, and they came from around the country to see him.”

Tennant was known for taking on difficult-to-treat patients, including those suffering from pain as a result of botched surgeries and other forms of malpractice. His research included innovations in the use of hormones to alleviate pain and lower opioid use up to 40 percent, as well as work on genetic testing for enzyme system defects that lead to opioid malabsorption.

“The DEA can trigger an investigation every time they misapply the CDC guidelines without paying attention to the population the physician treats or issues of medical necessity,” said Terri Lewis, a patient advocate and a Ph.D. clinical rehabilitation specialist with Southern Illinois University who trains clinicians on how to manage seriously ill patients with incurable pain.

Special Agent Timothy Massino, a spokesperson for the DEA’s Los Angeles division, declined to comment on the agency’s approach to Tennant. “It’s an ongoing investigation,” he noted.

Tennant’s isn’t alone. Physicians must now balance their prescribing obligations to their patients with legitimate fear for their livelihoods.

DEA enforcement actions against doctors have risen some 500 percent in recent years ― from 88 in 2011 to 449 last year, according to an analysis of the comprehensive National Practitioners Data Bank by Tony Yang, a professor of health policy at George Washington University. Even though that’s a relatively small number of arrests compared to the roughly one million physicians in the country, such arrests can have an outsized impact.

“They make big news, and they serve as a deterrent for physicians whose specialties require them to use a lot of pain medications,” Yang said. “It makes them think twice before prescribing opioids.”

Meredith Lawrence shows the tattoo she got after her husband'€™s death. The bluejay represents her husband, Jay; a cup of cof

Dustin Chambers for HuffPost Meredith Lawrence shows the tattoo she got after her husband’€™s death. The bluejay represents her husband, Jay; a cup of coffee is the way she loves to start her day; and the quote is “Sail away with me, what will be will be.”

Dr. Mark Ibsen of Helena, Montana, found himself in a five-year battle against the state licensing board that’s still not over ― even though a judge last month reversed the board’s decision to suspend his license because of due process violations. The court has remanded the case back to the licensing board for potential further investigation of his opioid prescriptions, but Ibsen has decided he won’t resume his medical practice.

That’s bad news for Montana, which has the highest rate of suicide in the country, according to the CDC. What’s more, chronic pain-related illnesses account for 35 percent of all the state’s suicides, as a recent state health department study found.

In the course of his fight with the medical board, the 63-year-old doctor said three of his former chronic pain patients have killed themselves after he and other doctors stopped prescribing opioids. The first of those patients died shortly after attending a hearing to show his support for Ibsen.

The deaths of pain patients haunt those who treated them and loved them. Meredith Lawrence, who sat with her husband to the very end, said, “It was as horrifying as anything you can imagine.”

“But I had the choice to help him or find him dead someday when I came home,” she added.

Lawrence was arrested and sentenced to a year’s probation for assisting a suicide. Now her goal is to fight restrictions on opioid prescriptions.

“If we don’t stand up, more people will die like my husband.”

If you or someone you know needs help, call 1-800-273-8255 for the National Suicide Prevention Lifeline. You can also text HOME to 741-741 for free, 24-hour support from the Crisis Text Line. Outside of the U.S., please visit the International Association for Suicide Prevention for a database of resources.

Art Levine is the author of Mental Health, Inc: How Corruption, Lax Oversight, and Failed Reforms Endanger Our Most Vulnerable Citizens.

CONTINUE READING…

That study isn’t without flaws. Veterans die by suicide at higher rates than average ― currently accounting for 20 suicide deaths a day ― so they are not a nationally representative sample. And the VA study, which was released at a national opioid summit in early April, has not yet been submitted for peer review.

But another study, published last year in the peer-reviewed journal General Hospital Psychiatry, looked at nearly 600 veterans who in 2012 were cut off from dosages after long-term opioid use and found similar results. Twelve percent of the vets showed suicidal ideation or took violent action to harm themselves ― a rate nearly 300 percent higher than the overall veterans community.

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Today I introduced my bill to allow cannabis use in public housing…

Today I introduced my bill to allow cannabis use in public housing in DC and states where it’s legal for medical and/or recreational use. I signed the bill with Sondra Battle, a DC resident who lives in Section 8 housing and is prescribed cannabis to treat her fibromyalgia. pic.twitter.com/iyvUzpPMvA

— Eleanor Holmes Norton (@EleanorNorton) June 19, 2018

Congressional Bill Would Allow Marijuana Use in Public Housing

Published June 19, 2018  By  Kyle Jaeger

The signing ceremony took place with two members of the pro-legalization group DCMJ as well as Sondra Battle, a D.C. resident who uses cannabis to treat her fibromyalgia, according to a press release.

“I thank Sondra Battle and our DCMJ advocates for joining me to mark the introduction of what I am calling the ‘Sondra Battle Cannabis Fair Use Act,’” Norton said. “Residents like Sondra should not fear eviction from federally-assisted housing simply for using cannabis to treat their medical conditions.”

“Our bill recognized today’s realities and proven needs. Individuals who live in states where medical and/or recreational marijuana is legal, but live in federally-assisted housing, should have the same access to treatment as their neighbors.”

CONTINUE READING…

See the full text of Norton’s new bill below:

Marijuana Public Housing Bill by MarijuanaMoment on Scribd

Marijuana’s effects on young brains diminish 72 hours after use, research says

By Mark Lieber, CNN

Updated 11:17 AM ET, Wed April 18, 2018

(CNN)Marijuana is notorious for slowing certain cognitive functions such as learning, memory and attention span (maybe that’s why they call it “dope”?). But new research in young people suggests that these cognitive effects, while significant, may not persist for very long, even among chronic users.

The meta-analysis, published Wednesday in the journal JAMA Psychiatry, combines data from 69 previous studies that look at the effects of heavy cannabis use on cognitive functioning in adolescents and young adults. It found that those young people who identified as heavy marijuana users scored significantly lower than non-users in a variety of cognitive domains such as learning, abstraction, speed of processing, delayed memory, inhibition and attention.

“There have been a couple of meta-analyses done in adult samples, but this is the first one to be done specifically in adolescent and young adult samples,” said Cobb Scott, assistant professor of psychiatry at the Perelman School of Medicine at the University of Pennsylvania and a lead author of the study.

    “We looked at everything from learning and memory to different aspects of executive functioning such as abstraction ability,” Scott said. “And we basically showed that the largest effects — which was around a third of a standard deviation — was in the learning of new information and some aspects of executive functioning, memory and speed of processing.”

    Weed users found to have poorer verbal memory in middle age

    Weed users found to have poorer verbal memory in middle age

    But when the researchers separated the studies based on length of abstinence from marijuana use, the difference in cognitive functioning between marijuana users and non-users was no longer apparent after 72 hours of marijuana abstinence. That could be an indication “that some of the effects found in previous studies may be due to the residual effects of cannabis or potentially from withdrawal effects in heavy cannabis users,” Scott said.

    The study comes as America continues to debate the merits of marijuana legalization. Recreational marijuana use is legal in nine states. Twenty-nine states and the District of Columbia have legalized some form of medical marijuana use, with at least three additional states potentially deciding on the issue in the upcoming November election, according to Melissa Moore, New York deputy state director for the nonprofit Drug Policy Alliance.

    Studies on the long-term cognitive effects of marijuana use among adolescents and young adults have shown inconsistent results. A 2008 study reported that frequent or early-onset cannabis use among adolescents was associated with poorer cognitive performance in tasks requiring executive functioning, attention and episodic memory.

    A 2014 study also warned against the use of marijuana during adolescence, when certain parts of the brain responsible for executive functioning — such as the prefrontal cortex — are still developing.

    “There have been very important studies showing evidence for irreversible damage (from marijuana use), and so there needs to be more research in this area,” said Kevin Sabet, assistant adjunct professor at the Yale School of Medicine and president of the nonprofit Smart Approaches to Marijuana, who was not involved in the new study.

    “I hope they’re right. We want there to be little effect after 72 hours. But given the other studies that have had very large sample sizes that have been published over the past five years in prominent journals, I think we need to look into that more,” added Sabet, whose group is focused on the harms of marijuana legalization.


    Marijuana legalization could help offset opioid epidemic, studies find

    But a number of recent studies have also shown that the association between marijuana use and reduced cognitive functioning disappears after controlling for factors such as psychiatric illness and substance use disorders, according to Scott.

    In an attempt to make sense of these discordant results, the new research combined data from 69 previous studies, resulting in a comparison of 2,152 frequent marijuana users with 6,575 non-users. Participants ranged in age from 10 to 50, with an average age of 21.

    The researchers found that, overall, the cognitive functioning of frequent marijuana users was reduced by one-third of a standard deviation compared with non-frequent marijuana users — a relatively small effect size, according to Scott.

    “It surprised, I think, all of us doing this analysis that the effects were not bigger than we found,” Scott said. “But I would say that the clinical significance of a quarter of a standard deviation is somewhat questionable.”

    But according to Sabet, even a relatively small effect size could be important, especially in a large meta-analysis such as this one.

    “The small effect size may be meaningful in a large population, and again, all (cognitive) measures are worse for those using marijuana,” Sabet said.

    “The study is pretty bad news for marijuana users,” he added. “Overall, I think this is consistent with the literature that marijuana use shows worse cognitive outcomes among users versus non-users.”

    In an effort to identify other potential factors that could have affected the relationship between marijuana use and cognition, the researchers also separated the studies based on the length of marijuana abstinence, age of first cannabis use, sociodemographic characteristics and clinical characteristics such as depression.

    Of these, only the length of marijuana abstinence was found to significantly affect the association between chronic marijuana use and reduced cognitive functioning. Specifically, cognitive functioning appeared to return to normal after about 72 hours of marijuana abstinence — a threshold identified in previous studies, according to Scott.

    “The reason we chose the 72-hour mark is that in looking at the data on cannabis withdrawal effects in heavy cannabis users, 72 hours seems to be past the peak of most withdrawal effects that occur,” he said.

    Marijuana legalization by the numbers

    However, the 69 studies included in the review did not have a uniform definition for “chronic” or “frequent” marijuana use, one of the study’s main limitations, according to Sabet.

    “When you put all of these studies together that have different definitions of marijuana users and are from different times, it’s not surprising that you’d get a smaller effect size,” Sabet said.

    The studies also relied on a variety of tests to determine cognitive functioning, including the Trail Making Test, the Digital Span Memory Test and the California Verbal Learning test, according to Scott.

    “The other thing that’s important to highlight is that we’re only looking at cognitive functioning. We’re not looking at risks for other adverse outcomes with cannabis use, like risk for psychosis, risks for cannabis use problems or other medical issues like lung functioning outcomes,” Scott said.

    See the latest news and share your comments with CNN Health on Facebook and Twitter.

    But the results still suggest that the negative cognitive effects of marijuana use, while significant in the short-term, probably diminish with time. They also shed light on the need for more research in this area, particularly as cannabis policy in the United States continues to change at a rapid pace.

    “As attitudes change about cannabis use and cannabis use becomes a little bit more accepted in terms of policy and government regulation and medical cannabis use increases, I think we need to have a real understanding of the potential risks and benefits of cannabis use,” Scott said.

    CONTINUE READING…

    The East Mississippi Correctional Facility Is ‘Hell on Earth’

    By Carl Takei, Senior Staff Attorney, ACLU’s Trone Center for Justice and Equality

    March 5, 2018

    E. Mississippi Correctional Fire

    At the East Mississippi Correctional Facility, where Mississippi sends some of the most seriously mentally ill people in the state prison system, even the most troubled patients are routinely ignored and the worst cases of self-harm are treated with certain neglect. The conditions at EMCF have cost some prisoners their limbs, their eyesight, and even their lives.

    In 2013, the ACLU, Southern Poverty Law Center, and prisoner rights attorney Elizabeth Alexander filed a class-action complaint on behalf of all the prisoners held at EMCF. As the case heated up, the law firm of Covington & Burling LLP joined as co-counsel, providing major staffing and support. Despite years of attempts by Mississippi to derail the lawsuit before our clients even saw the inside of the courtroom, the case will finally proceed to trial Monday.

    The lawsuit against EMCF describes horrific conditions at the facility: rampant violence, including by staff against prisoners; solitary confinement used to excess, with particular harm to prisoners with mental illnesses; and filthy cells and showers that lack functional toilets or lights. It also sheds light on a dysfunctional medical and mental healthcare delivery system that puts patients at risk of serious injury and has contributed to deaths in custody.

    Nowhere was this institutionalized neglect more clear than in the life, and death, of T.H., a patient at EMCF with a history of severe mental illness and self-harm. On Jan. 31, 2016, T.H. stuck glass into his arm. Instead of sending him to the emergency room, a nurse merely cleaned the wound with soap and water. The following day, he broke a light bulb and inserted the shards into his arm. This time he required eight stitches.

    Less than two weeks later, he cut himself with a blade hidden in his cell and then tried to hang himself. It was only later that month, after he reopened his arm wound with more glass, that mental health staff finally placed him on special psychiatric observation status.
    Yet, because he wasn’t properly monitored, T.H.’s series of self-injury continued unabated until April 4, 2016. Early that afternoon, he stuck his arm, dripping in blood, through a slot in his cell door and asked to see the warden. A lieutenant saw T.H.’s bloodied arm, but, rather than call for emergency assistance, simply left the area. Two hours later, T.H. was observed unresponsive on the floor of his cell.

    E. Mississippi Correctional Blood on the Door
    In response, the prison warden opted to call for a K-9 team to enter the cell with dogs before letting medical professionals examine the patient. By then it was too late — T.H. was dead, having strangled himself with materials from inside his cell. He never once had a proper suicide risk assessment or any treatment to address his self-harm.

    The lackadaisical and unconstitutional approach that EMCF staff takes toward prisoner healthcare cost T.H. his life and has caused well-documented suffering among countless other mentally ill prisoners. And it all happens in the context of a prison rife with violence, where security staff often react with excessive force to mental health crises and allow prison gangs to control access to necessities of life, including at times food.

    The Constitution requires that if the state takes someone into custody, it must also take on the responsibility of providing treatment for their serious medical and mental health needs. This means, among other measures, hiring qualified medical staff to provide necessary care for people with mental health disorders, creating systems for access to care so sick patients can see a mental health or medical clinician, and making sure that medical care is provided without security staff impeding it.

    The ACLU and our co-counsel are fighting to ensure that such care is available at EMCF, where the state of Mississippi has continued to lock some of the most vulnerable prisoners in dangerous and filthy conditions and deny them access to constitutionally required mental health and medical care.

    I witnessed those conditions firsthand when I visited EMCF in January 2011 with fellow ACLU attorney Gabriel Eber and two medical and mental health experts. At that time, we were horrified to discover that Mississippi’s designated mental health prison was closer to a vision of hell on earth than a therapeutic treatment facility.

    When I walked into one of the solitary confinement units, the entire place reeked of smoke from recent fires. I tried to speak to patients about their experiences, but I could barely hear them over the sounds of others moaning and screaming while they slammed their hands into metal cell doors.

    Despite repeated warnings from nationally renowned experts brought in to assess conditions at the prisons, a meeting with top Mississippi Department of Corrections officials, and an offer by the ACLU to help MDOC pay to diagnose and fix the problems at EMCF, Mississippi officials permitted these conditions to continue unabated. Rather than take responsibility for fixing this prison, these officials merely switched contractors. In 2012, they swapped out private prison giant GEO Group, Inc. and replaced them with another private prison company, Management & Training Corp., which is perhaps best known for its horrific record of abusing and neglecting immigrant detainees. The state has also switched prison medical contractors multiple times, with little improvement from one to the next.

    But the nightmare might soon be over. Over seven years since we first visited the cesspool that is EMCF, our clients will be allowed in court for the first time, asking that their constitutional rights finally be recognized. That recognition won’t undo the great harms they’ve suffered. But by fulfilling the Constitution’s promise of protection, we can stop new harms and horrors at EMCF, of which there have been too many for too long.

    CONTINUE READING…

    MERRY (f/g) CHRISTMAS! “The Jirons now face felony charges of possession of marijuana…” OR.. SANTA CLAUS GOT BUSTED FOR cHRISTMAS!

    Sheriff’s deputies in York County, Neb., stopped a pickup truck on Tuesday when they noticed it driving over the center line and the driver failing to signal.

    During the traffic stop, deputies noticed a strong smell of raw marijuana, the sheriff’s department says.

    Patrick Jiron, 80, and Barbara Jiron, 83, said they were from northern California and were en route to Boston and Vermont.

    Deputies asked the driver, Patrick Jiron, about the odor, and he admitted to having contraband in the truck and consented to a search of the vehicle.

    With the help of the county’s canine unit, deputies searched the Toyota Tacoma. When they looked under the pickup topper, deputies found 60 pounds of marijuana, as well as multiple containers of concentrated THC.

    “They said the marijuana was for Christmas presents,” Lt. Paul Vrbka told the York News-Times. The department estimated the street value of the pot at over $3oo,000.

    The Jirons now face felony charges of possession of marijuana with the intent to deliver and no drug tax stamp. (Nebraska law requires marijuana dealers to purchase drug tax stamp from its Department of Revenue as evidence that the state’s drug tax has been paid.)

    For the friends and family in New England who expected a bag of weed in their stocking this year, it looks like it won’t be a green Christmas, after all.

    CONTINUE READING…

    Federal law clearly prohibits anyone who consumes cannabis—for any reason, and regardless of state legality—from purchasing a firearm

    Surrender Your Guns, Police Tell Hawaiian Medical Marijuana Patients

    Bruce Barcott   November 27, 2017

    The Honolulu Police Department has sent letters to local medical marijuana patients ordering them to “voluntarily surrender” their firearms because of their MMJ status.

    This may be the first time a law enforcement agency has sought out state-registered medical marijuana patients and ordered them to surrender their guns.

    The letters, signed by Honolulu Police Chief Susan Ballard, inform patients that they have 30 days upon receipt of the letter to transfer ownership or turn in their firearms and ammunition to the Honolulu Police.

    The existence of the notices, first reported early today by Russ Belville at The Marijuana Agenda podcast, was confirmed to Leafly News this afternoon by the Honolulu Police Department.

    The startling order comes just three months after the state’s first medical marijuana dispensary opened in Hawaii’s capital city.

    The clash between state marijuana laws and federal firearms law—which prohibits all cannabis patients and consumers from purchasing firearms—is a growing point of legal contention in the 29 states with medical marijuana laws. The Honolulu letters, however, may represent the first time a law enforcement agency has proactively sought out state-registered medical marijuana patients and ordered them to surrender their guns.

    RELATED STORY

    First Medical Cannabis Dispensary Opening in Hawaii

    Federal law clearly prohibits anyone who consumes cannabis—for any reason, and regardless of state legality—from purchasing a firearm. On the US Bureau of Alcohol, Tobacco, and Firearms (ATF) Form 1140-0020, which must be completed by firearm purchasers, applicants are asked if they are “an unlawful user of, or addicted to, marijuana or any depressant, stimulant, narcotic drug, or any other controlled substance.”

    In case it’s unclear to the applicant, the ATF includes this warning in bold type:

    Warning: The use or possession of marijuana remains unlawful under Federal law regardless of whether it has been legalized or decriminalized for medicinal or recreational purposes in the state where you reside.

    RELATED STORY

    Can Medical Marijuana Patients Legally Own Guns?

    Federal Court Upheld the Ban

    Many state laws allow patients to medicate with cannabis, but the federal prohibition on cannabis consumption crosses that legality when it comes to firearms. The supremacy of federal law on this point was upheld last year by the 9th US Circuit Court of Appeals.

    “It may be argued that medical marijuana users are less likely to commit violent crimes, as they often suffer from debilitating illnesses, for which marijuana may be an effective palliative,” the federal ruling stated. “But those hypotheses are not sufficient to overcome Congress’s reasonable conclusion that the use of such drugs raises the risk of irrational or unpredictable behavior with which gun use should not be associated.”

    RELATED STORY

    Guns or Cannabis: Which Is More Strictly Regulated?

    State Law Applies

    The Honolulu Police Department cites state law, not federal law, as the basis for the order. “Under the provisions of the Hawaii Revised Statutes, Section 134-7(a), you are disqualified from firearms ownership,” says the letter.

    Curiously, HRS 134-7(a) makes no specific mention of a person’s medical marijuana status. It’s a blanket statement about federal law:

    134-7(a) No person who is a fugitive from justice or is a person prohibited from possessing firearms or ammunition under federal law shall own, possess, or control any firearm or ammunition therefor.

    Until now, the clash between firearm ownership and patient status has been largely avoided through a de facto “don’t ask, don’t tell” policy. Firearms purchasers are forced to either lie on the ATF form (a federal offense), or tell themselves they’re technically honest—the ATF form asks, “Are you an unlawful user of, or addicted to, marijuana,” and those who quit cannabis yesterday technically were but no longer are unlawful users of marijuana.

    RELATED STORY

    Do Medical Marijuana Patients Give Up Their Right to Bear Arms?

    A number of states issue medical cannabis patient cards or authorizations but do not keep a searchable database of patient names. In some medical cannabis states, like Arizona, firearm purchasers are not required to register with the state.

    Hawaii, though, maintains an electronic database of both firearm purchasers, who must complete both the federal ATF and a state permit application, and medical marijuana patients. That allowed the Honolulu police to cross-check and compile a list of MMJ patients in the state’s firearms registry.

    CONTINUE READING…

    #FREEDAREN DAREN MCCORMICK IS OUT!

    He’s out!

    Here is the latest update on #FREEDAREN !!!

    Released with “conditions” today!

    Here is a live video of his release, thanks to EAST-CanadaFriends !

    Daren OUT

    Daren is out 9.11.17

    Free Daren outside courthouse pt. 3

    He’s out!

    Updates to follow!

    RELATED:

    “I think I had an undercover Cop in my driveway yesterday”…

    What is “Usable Marijuana”?

    Man pleads guilty to having too much medical marijuana

    Dabrowskis.jpg

     

    By Cole Waterman | cwaterma@mlive.com
    Follow on Twitter
    on March 14, 2017 at 8:34 AM, updated March 14, 2017 at 8:35 AM

    BAY CITY, MI — Nearly two years after police raided their Bangor Township house in search of excessive medical marijuana, a couple’s cases have been resolved with plea deals.

    David A. Dabrowski, 65, on Tuesday, March 7, appeared in Bay County Circuit Court and pleaded guilty to one count of delivering or manufacturing marijuana. The charge is a four-year felony.

    In exchange, the prosecution agreed to recommend Dabrowski receive a delayed sentence, during which he’d effectively be on probation. If he receives the delay and is successful on it, he’ll be allowed to withdraw his plea and swap it with a guilty plea to misdemeanor possession of marijuana.

    The same day Dabrowski entered his plea, prosecutions motioned to dismiss the same felony charge faced by his wife, Sandra K. Dabrowski, 64.

    The Dabrowskis, who were arraigned on Sept. 9, 2015, faced trial the day the plea deal was accepted. Their cases date back to April 2015.

    What is ‘usable’ pot under medical marijuana law focus in Bay County couple’s prosecution

    Whether a Bangor Township couple broke the law by having too much “usable” pot in their medical marijuana growing operation is the point of contention in ongoing legal proceedings.

    In a December 2015 preliminary examination, Bay County Sheriff’s Detective Barry Gatza, a member of the Bay Area Narcotics Enforcement Team — or BAYANET — testified he was tasked with investigating an anonymous tip that the Dabrowskis were illegally selling marijuana from their home in the 2900 block of Bangor Road.

    He testified that in the early morning of April 27, he pulled two trash bags from a garbage can at the end of the Dabrowskis’ driveway.

    “There were several items consistent with marijuana grows that we’ve come in contact with,” Gatza said. Among the items were trimmed marijuana leaves. “It was approximately just under 10 pounds, I believe,” he said.

    Gatza obtained a search warrant and later on April 27, approximately a dozen police officers executed it on the Dabrowskis’ property. At the time, David Dabrowski was home selling firearms to two men, Gatza testified. Sandra Dabrowski was not present.

    “There were firearms throughout the house,” Gatza testified, adding David Dabrowski is a licensed federal firearms dealer.

    Police recovered a large amount of marijuana plants and usable pot, most notably in “the entire basement.” Throughout the house, officers found 96 marijuana plants, 37.7 grams of loose marijuana drying in a basket, and another batch on a table weighing approximately 1,400 grams. Police also found one marijuana plant and marijuana branches in a pole barn, Gatza testified.

    In a freezer, police found marijuana oil and several pounds of usable marijuana, Gatza said.

    Gatza interviewed David Dabrowski in a BAYANET van, he said. Dabrowski told him he and his wife were medical marijuana caregivers with five patients each.

    “Between Sandra and himself, they did co-mingle the plants,” Gatza testified. “They didn’t separate them at all. As far as the daily operations needed to maintain the plants, he did most of the farming on the plants, including Sandra’s.”

    Sandra Dabrowski’s jobs included trimming the plants, packaging the crop and setting up purchases, Gatza said David Dabrowski told him.

    “He stated that obviously he does provide marijuana to his patients,” Gatza testified. “I think the rate he charges them was $130 an ounce, then he told me he also provides marijuana to people outside his patient list. He charges them $200 an ounce. He said he always makes sure they’re medical marijuana patients, just not his patients. He always makes sure they have a (medical marijuana) card.”

    Under the state’s Medical Marijuana Act, patients can have 2.5 ounces of usable marijuana and caregivers can grow up to 12 plants producing 2.5 ounces of usable marijuana for each of their five patients and themselves. With both Dabrowskis being caregivers but only Sandra Dabrowski a patient as well, the couple could legally have a total of 132 plants and 27.5 grams of usable, or processed, marijuana.

    Circuit Judge Joseph K. Sheeran is to sentence David Dabrowski at 9 a.m. on Monday, April 17.

    CONTINUE READING…

    9 ways federal marijuana laws are limiting rights of residents in legal weed states

    Federal status of marijuana is affecting both everyday cannabis consumers and people attempting to work in the industry.

    By BROOKE EDWARDS STAGGS / STAFF WRITER

    Published: Feb. 4, 2017 Updated: Feb. 5, 2017 2:45 p.m.

     Derek Peterson, CEO and president of Terra Tech. Just weeks after Prop. 64 passed, Peterson learned the company that for two years had managed Terra Tech's payroll and health benefits would be dropping them, Dec. 31, because of concern over their role in the cannabis industry. “The decision came out of nowhere,” he said. “We have almost 200 employees that spent their holiday season stressed about the possibility of not having their health benefits available in the new year, let alone a reliable pay schedule.” (File Photo by ED CRISOSTOMO, Orange County Register/SCNG)

    Federal law still classifies cannabis as a Schedule I narcotic, a category reserved for drugs such as heroin that are said to be highly addictive and have no medical value. There’s been no movement to ease that stance even though polls show a record number of Americans now believe marijuana should be legal, 28 states now permit medical marijuana and eight more allow recreational use.
    One thing that has changed is the optimism some cannabis enthusiasts expressed prior to the November election.
    As the biggest state in the nation prepared to vote on legalizing recreational use with Prop. 64, the thinking was that California could become a tipping point that would ultimately lead to federal approval of cannabis.
    Prop. 64 easily passed. But confidence in the impact of that vote has dimmed as the reality of a GOP-controlled federal government headed by President Donald Trump – and the prospect of marijuana-opponent Jeff Sessions as Attorney General – has settled in.
    For individuals, the ongoing conflict with federal law can make it harder to get everything from housing to healthcare, even if they use cannabis for medical reasons says Paul Armentano, deputy director of the National Organization for the Reform of Marijuana Laws, or NORML.
    And for Californians who want to make money in the cannabis industry, the differences between state and federal law can affect how they bank, pay taxes and more.
    “It’s a serious hindrance,” said John Hudak, a senior fellow with the Brookings Institution who specializes in marijuana policy.
    “It creates a scenario in which companies are able to get up and running, but not operate like a normal business.”
    Here are nine ways the federal status of marijuana is affecting both everyday cannabis consumers and people attempting to work in the industry, no matter what their state law says.

    PLEASE CONTINUE READING…

    Carol Kerr ~ HAPPY PATIENT in Legal Medical Cannabis State!!

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    Why I choose cannabis…

    November 25, 2010 at 9:21pm

    There are millions of people across this great nation suffering from chronic pain and illness who are legally receiving relief via prescription medications. As a patient that suffers with chronic, debilitating pain from a brain malformation, I can attest to the damage long-term use of prescription medications can do to the human mind and body.

    Just last year I lost my brother due to an accidental overdose of hydrocodone prior to back surgery. He didn’t just slip off into the night after falling asleep. He died clutching his chest and screaming in pain, and there was nothing anyone could do. Yet, there are still pharmacies conveniently located on nearly every corner across the country dispensing the poison every day.

    For the record, I am not a drug addict, nor do not wish to be addicted to ANY substance, however due to the illnesses I have, I must medicate with SOMETHING regularly to achieve any reasonable measure of “quality of life.” And the one prescription medication that provides some relief is full of liver damaging acetaphetamin and isn’t covered by Medicare.

    Plus, the doctor told me that though it relieves my headaches, with regular use it “increases” headaches. Ohhh, so I’ll need more addictive pain medication due to the increased headaches it causes, which will damage my liver all that much faster… are you seeing the RIDICULOUS, vicious circle? Not only are the prescription drugs inadequate and expensive, but I’ve suffered through withdrawal on numerous occasions from addictive pain medications, even spending three days in ICU on a respirator from a Fentanyl patch!

    Cannabis is an effective, NON-ADDICTIVE medication that helps me.  Yet, when I don’t have cannabis, I don’t get the sweats, have increased blood pressure, vomit, itch, cry, and wig out!!! I just hurt, try not to move any more than I have to, and keep to myself… survival mode. Not a healthy or pleasant way to live.

    As a result of prescription medications I have the onset of liver disease. My digestive system is impaired to the point that I literally have no appetite. Without medication I am consumed with pain to the point that my activities of daily living are limited and socialization with others is not an option. Inhaled cannabis quickly sends the cannabinoids directly to the blood stream via your lungs.

    Yet, cannabis doesn’t impair one’s ability to function for long periods of time, cause nausea, or shut down the bowels like prescription pain medications. And while smoking may not be the best option for me, it’s the only one available due to prohibition. For the record, I would prefer to ingest cannabis, but it takes a larger quantity of product to produce a sufficient amount.

    For over a year the American Medical Association has urged the federal government to reconsider its stance on cannabis, to change the classification from a Class 1 drug. This means the AMA recognizes that cannabis has medicinal qualities that could be beneficial to a patient’s health. The AMA also states that cannabis deserves more research.

    A randomized placebo-controlled trial was conducted at San Francisco General Hospital (with) nine doctors and 50 patients involved. Patients suffered from HIV-associated neuropathic pain. “The first cannabis cigarette reduced chronic pain by a median of 72 percent versus 15 percent with placebo. No adverse events reported.” Throughout length of trial “pain was reduced by 34 percent.”

    Conclusion: “Smoked cannabis was well tolerated and effectively relieved chronic neuropathic pain from HIV-associated sensory neuropathy. The findings are comparable to oral drugs used for chronic neuropathic pain.”

    Latest polling shows 65 percent of Americans support medicinal cannabis with doctor supervision. If comparable to pain pills, shouldn’t the doctor be deciding whether cannabis is the better choice for the patient? Patients should not have to fear imprisonment or the horrible side effects of prescription drugs, especially when there are scientific facts that favor the medicinal use of cannabis.

    This matter is not about the legalization of “drugs.” We, as patients, do not condone the use of any drug without doctor supervision. This is about compassion and understanding of others suffering, knowing that cannabis helps them regain their lives and get on with living life to the fullest, not needlessly suffering from the pain of illness or the ugly side effects from pain medications.

    Fifteen states have passed legislation in favor of medicinal marijuana. We are well on our way to helping people understand that cannabis is not the harmful drug previously demonized by well meaning, but ill informed political figures. SB 1381, the compassionate use of cannabis 3-year pilot program is coming up for a vote in Illinois. This is our chance to free our countrymen and women from the ill side effects of pain medications.

    Patients and doctors alike deserve the right to pursue happiness as stated in our Constitution. We must allow patients to choose the best course of action in medical matters without fear of imprisonment. We must take our medicine out of the hands of greedy drug-lords, and allow safe access to good medicine for  sick and suffering patients.

    Cannabis has been proven to help people time and time again. New and fascinating facts about the benefits of medicinally using cannabis are being reported every day. And I am living proof that it works!  This is not an issue of morals, but one of science and compassion for the sick and suffering. We aren’t encouraging anyone to use cannabis. We just want our God-given right to pain relief in the manner which helps us best.

    As a responsible citizen of IL I am appalled that I am forced to pay outrageous prices for medicine, lining the pockets of black market drug dealers.  When as a sick patient I should be receiving quality medicine, regulated by the government, provided by state governed agencies which would benefit patients, while strengthening our economy and providing legitimate jobs! You know, with the right medicine given on a regular basis, I just may be able to work again.. or at least take care of MYSELF without the assistance of others.

    Cannabis relieves the pain, takes my mind off my poor health, gives me an appetite, and helps me to get out enjoy the life I have left without the hangovers and side effects of man-made medications. May the powers that be hear our voices and bring relief to the suffering citizens of Illinois! No patient should be denied safe access to their medication!!

    The fact of the matter is, patients who NEED medicinal cannabis have been and will continue to do whatever they have to, to obtain the medicine they need. The prohibition of medicinal cannabis only punishes us further for being sick at a time when we need love and compassion the most.  Don’t wait till you or someone you love is suffering to investigate this issue.

    Carol Kerr ~ HAPPY PATIENT in Legal Medical Cannabis State!!