From the Mayo Clinic: Cannabis/Marijuana

Marijuana (Cannabis sativa)

 

Evidence

These uses have been tested in humans or animals. Safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider.

Chronic pain

Cannabinoids have been reported to reduce chronic pain associated with a variety of conditions. Cannabinoids have also been used in patients for whom other pain relief medications are not working. The active components in cannabis exert their effects on the central nervous system and immune cells. Cannabis is approved in some European countries and Canada. In the United States, it is an investigational drug for pain relief in cancer patients.
A

Multiple sclerosis (symptoms)

Research suggests that cannabinoids may improve some symptoms associated with multiple sclerosis (MS), specifically neuropathic pain, muscle spasms, and urinary symptoms.
A

Eczema

Early studies suggest that taking hemp seed oil by mouth may reduce symptoms of eczema, a skin rash also referred to as atopic dermatitis. Additional research is needed before a conclusion can be made.
C

Epilepsy

Early research suggests that epileptic patients may experience fewer seizures when taking cannabidiol (CBD) together with antiseizure medication. Further studies are required before a conclusion can be made.
C

Glaucoma (high fluid pressure inside the eye)

Glaucoma can result in optic nerve damage and blindness. Limited evidence suggests that tetrahydrocannabinol (THC) taken under the tongue may reduce eye pressure. Additional research is needed before a conclusion can be made.
C

Huntington’s disease

Huntington’s disease is a degenerative nerve disorder associated with uncoordinated, jerky body movements and mental deterioration. Early studies suggest that cannabidiol (CBD) may not aid in reducing the severity of uncoordinated body movements associated with Huntington’s disease. Further studies are needed before a firm conclusion can be made.
C

Insomnia

Limited research suggests that cannabidiol may improve sleep quality in those with insomnia (difficulty getting to sleep or staying asleep). More research is needed before a conclusion can be made.
C

Appetite/weight loss in cancer patients

Clinical studies have shown no effect of cannabis-based therapies in the treatment of weight loss associated with cancer. Further studies are necessary before a conclusion can be made.
D

Schizophrenia

In limited research, no effect of cannabidiol (CBD) was seen on symptoms of schizophrenia in patients for whom other treatments were not working. Additional research is needed before a conclusion can be made.
D

Key to grades
A Strong scientific evidence for this use
B Good scientific evidence for this use
C Unclear scientific evidence for this use
D Fair scientific evidence against this use (it may not work)
F Strong scientific evidence against this use (it likely does not work)

 

Uses based on tradition or theory

The below uses are based on tradition or scientific theories. They often have not been thoroughly tested in humans, and safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider.

Acne, addiction, allergies, Alzheimer’s disease, angina (chest pain), angioedema (swelling under the skin), arthritis, antiaging, antidepressant, anti-inflammatory, antioxidant, anxiety prevention, appetite stimulant, asthma, attention-deficit hyperactivity disorder (ADHD), autoimmune diseases, bipolar disorder (mental disorder), blood thinner, bronchodilation (widens airways and eases breathing), burns, cancer, candidiasis (yeast infection), circulation improvement, constipation, cough, detoxification (removal of toxins), diabetes, digestive aid, diuretic (improves urine flow), dystonia (muscle disorder), energy metabolism, fatigue, gastric acid secretion stimulation (increases stomach acid), general health maintenance, genitourinary tract disorders (disorders of the reproductive and urinary systems), hair growth promoter, heart disease, high blood pressure, hormone regulation, immune suppression, increased muscle mass, increasing breast milk, inflammatory bowel disease (Crohn’s disease and ulcerative colitis), intermittent claudication (pain in arms or legs due to inadequate oxygen), interstitial cystitis (bladder disorder), irregular heartbeat, leukemia (cancer of blood cells), lipid lowering (cholesterol and triglycerides), liver protection, lymph flow enhancement, menopausal symptoms, migraine, muscle relaxation, nausea and vomiting, nerve disorders, neural tube defects (birth defects), osteoporosis (bone loss), painful menstruation, pregnancy and labor, psychosis, rheumatism (joint disease), sedative, sexual performance, skin conditions, spinal cord injury, stomach spasms, stroke, tendonitis, uterine stimulant, varicose veins, vitamin C deficiency, weight gain (patients with HIV or cancer), wound healing.

 

Dosing

The below doses are based on scientific research, publications, traditional use, or expert opinion. Many herbs and supplements have not been thoroughly tested, and safety and effectiveness may not be proven. Brands may be made differently, with variable ingredients, even within the same brand. The below doses may not apply to all products. You should read product labels, and discuss doses with a qualified healthcare provider before starting therapy.

Adults (18 years and older)

For nausea and vomiting, five milligrams/m ² of body mass of dronabinol (Marinol®) has been taken by mouth before and after chemotherapy, for a total of 4-6 doses daily.

For weight loss and malnutrition associated with cancer, 2.5 milligrams of tetrahydrocannabinol (THC) with or without one milligram of cannabidiol has been taken by mouth for six weeks.

For eczema, hemp seed oil has been taken by mouth for 20 weeks.

For chronic pain, 2.5-120 milligrams of cannabis has been taken by mouth in divided doses.

For epilepsy, 200-300 milligrams of cannabidiol (CBD) has been taken by mouth daily for up to 4.5 months.

For insomnia, 160 milligrams of cannabidiol (CBD) has been taken by mouth.

For symptoms of multiple sclerosis, 2.5-10 milligrams of dronabinol (Marinol®) has been taken by mouth daily for three weeks. Capsules containing 15-30 milligrams of cannabis extract has been taken by mouth for 14 days. Two and one-half milligrams of tetrahydrocannabinol (THC), together with 0.9 milligrams of cannabidiol (CBD), has been taken by mouth. Cannabinoid-based Sativex® mouth spray has been used at a dose of 2.5-120 milligrams in divided doses. Eight sprays in three hours and up to 48 sprays in 24 hours have been used.

For schizophrenia, 40-1,280 milligrams of cannabidiol (CBD) has been taken by mouth daily for up to four weeks.

For glaucoma (high fluid pressure in the eye), single doses of five milligrams of tetrahydrocannabinol (THC) or 40 milligrams of cannabidiol (CBD) placed under the tongue have been used.

Children (under 18 years old)

There is no proven safe or effective dose for cannabis or cannabis-containing products in children.

CONTINUE READING….

Marijuana Fights Cancer and Helps Manage Side Effects, Researchers Find

Sep 6, 2012 4:45 AM EDT

Mounting evidence shows ‘cannabinoids’ in marijuana slow cancer growth, inhibit formation of new blood cells that feed a tumor, and help manage pain, fatigue, nausea, and other side effects.

Cristina Sanchez, a young biologist at Complutense University in Madrid, was studying cell metabolism when she noticed something peculiar. She had been screening brain cancer cells because they grow faster than normal cell lines and thus are useful for research purposes. But the cancer cells died each time they were exposed to tetrahydrocannabinol (THC), the principal psychoactive ingredient of marijuana.

Instead of gaining insight into how cells function, Sanchez had stumbled upon the anti-cancer properties of THC. In 1998, she reported in a European biochemistry journal that THC “induces apoptosis [cell death] in C6 glioma cells,” an aggressive form of brain cancer.

Subsequent peer-reviewed studies in several countries would show that THC and other marijuana-derived compounds, known as “cannabinoids,” are effective not only for cancer-symptom management (nausea, pain, loss of appetite, fatigue), they also confer a direct antitumoral effect.

A team of Spanish scientists led by Manuel Guzman conducted the first clinical trial assessing the antitumoral action of THC on human beings. Guzman administered pure THC via a catheter into the tumors of nine hospitalized patients with glioblastoma, who had failed to respond to standard brain-cancer therapies. The results were published in 2006 in the British Journal of Pharmacology: THC treatment was associated with significantly reduced tumor cell proliferation in every test subject.

Around the same time, Harvard University scientists ++reported++[http://www.nature.com/bjc/journal/v95/n2/abs/6603236a.html] that THC slows tumor growth in common lung cancer and “significantly reduces the ability of the cancer to spread.” What’s more, like a heat-seeking missile, THC selectively targets and destroys tumor cells while leaving healthy cells unscathed. Conventional chemotherapy drugs, by contrast, are highly toxic; they indiscriminately damage the brain and body.

There is mounting evidence, according to a report in Mini-Reviews in Medicinal Chemistry, that cannabinoids “represent a new class of anticancer drugs that retard cancer growth, inhibit angiogenesis [the formation of new blood cells that feed a tumor] and the metastatic spreading of cancer cells.”

Dr. Sean McAllister, a scientist at the Pacific Medical Center in San Francisco, has been studying cannabinoid compounds for 10 years in a quest to develop new therapeutic interventions for various cancers. Backed by grants from the National Institute of Health (and with a license from the DEA), McAllisterdiscovered that cannabidiol (CBD), a nonpsychoactive component of the marijuana plant, is a potent inhibitor of breast cancer cell proliferation, metastasis, and tumor growth.

In 2007, McAllister published a detailed account of how cannabidiol kills breast cancer cells and destroys malignant tumors by switching off expression of the ID-1 gene, a protein that appears to play a major role as a cancer cell conductor.

The ID-1 gene is active during human embryonic development, after which it turns off and stays off. But in breast cancer and several other types of metastatic cancer, the ID-1 gene becomes active again, causing malignant cells to invade and metastasize. “Dozens of aggressive cancers express this gene,” explains McAllister. He postulates that CBD, by virtue of its ability to silence ID-1 expression, could be a breakthrough anti-cancer medication.

“Cannabidiol offers hope of a non-toxic therapy that could treat aggressive forms of cancer without any of the painful side effects of chemotherapy,” says McAllister, who is seeking support to conduct clinical trials with the marijuanacompound on breast cancer patients.

McAllister’s lab also is analyzing how CBD works in combination with first-line chemotherapy agents. His research shows that cannabidiol, a potent antitumoral compound in its own right, acts synergistically with various anti-cancer pharmaceuticals, enhancing their impact while cutting the toxic dosage necessary for maximum effect.

“Cannabidiol offers hope of a non-toxic therapy that could treat aggressive forms of cancer without any of the painful side effects of chemotherapy.

Investigators at St. George’s University in London observed a similar pattern with THC, which magnified the effectiveness of conventional antileukemia therapies in preclinical studies. THC and cannabidiol both induce apoptosis in leukemic cell lines.

At the annual summer conference of the International Cannabinoid Research Society, held this year in Freiburg, Germany, 300 scientists from around the world discussed their latest findings, which are pointing the way toward novel treatment strategies for cancer and other degenerative diseases. Italian investigators described CBD as “the most efficacious inducer of apoptosis” in prostate cancer. Ditto for cannabidiol and colon cancer, according to British researchers at Lancaster University.

Within the medical science community, the discovery that cannabinoids have anti-tumoral properties is increasingly recognized as a seminal advancement in cancer therapeutics.

Martin A. Lee is the author of Smoke Signals: A Social History of Marijuana – Medical, Recreational and Scientific (Scribner, August 2012). He is the cofounder of the media watch group FAIR, director of Project CBD, and the author of Acid Dreams and The Beast Reawakens. For more information and regular updates, follow Smoke Signals—the book on Facebook.

Like The Daily Beast on Facebook and follow us on Twitter for updates all day long.

For inquiries, please contact The Daily Beast ateditorial@thedailybeast.com.

Advice from a patient!

 

 

 

Ed Bland

ALL NEED 2 KNOW THIS ! —————–>: ♥ ~My name is Ed Bland & live in Somers on Flathead lake. I use 2 have George’s marine service ( father ). I wrecked my motorcycle with no helmet on. Montana told me it was worst wreck 2 live through with no helmet on in Montana. I am not telling you this 4 sympathy, but 2 let you know the severity of it. I broke all ribs on right ( 6 in 3 places each), 7 ribs on left ( 4 in 2 places each). Split brisket, broke right caller bone, broke pelvic bone in 7 places having to be taken to Idaho specialist 2 bolt a brace on pelvic bone. Missoula life flight picked me up at wreck site at Sealy Lake. I died 3 times in that flight, was in a coma for 87 days & if memory serves me right was diagnosed as a 5.5 brain injury. When I woke I had 2 relearn everything. I could not speak but they told me 2 blind 2 for yes & 3 for no. I had 2 go through all 3 rehabs, then got 2 return home. I had next 2 no memory. I didn’t even know what house looked like, or what I had done 4 a living but could tell you how 2 use all tools & equipment in shop. I had a friend come visit me & asked me 2 get a medical card & try cannabis & did. I WAS AMAZED ! My memory not only started returning but stayed ! I have muscle paralisis on right of my body & it is so obvious of my muscles relaxing that all can see it in my walking & hear in my speech. Is hard 2 move tongue 2 speak. But 4 me the big part is how it slows my thought process down enough so can communicate !
I have been doing much research as 2 why it is helping me. I learned early in life that if you want 2 fix something then first you must understand the working of it. I only graduated high school & no more but did best could. The brain has a connection that converts info & passes it on. There lets say is like taking morris code & converting it into words. At that connection there is a goo that covers it. That is what I believe the THC helps make this in the brain. ~ ♥

Nearly 11,500 Kentuckians with Alzheimer’s live Alone

KENTUCKY (3/8/12) – Advance planning for future legal, financial and long-term care needs is critical for the estimated one in seven Americans − or 11,430 Kentuckians − diagnosed with Alzheimer’s Disease and who still live alone, up to half of them without an identifiable caregiver, according to the Alzheimer’s Association® 2012 Facts and Figures Report, released today.
“Alzheimer’s and other dementias take our loved ones through unfamiliar territory, and advance planning in the early stages of the disease allow them to build a care team, make financial plans and prepare for future safety concerns, while they are still cognitively able to do so,” said Teri Shirk, president and CEO of the Greater Kentucky and Southern Indiana Chapter of the Alzheimer’s Association, which offers a variety of resources for individuals with Alzheimer’s as well as their family members and other caregivers.
States need to plan ahead as well: Today’s report projects a 500 percent increase in combined state Medicare and Medicaid spending by 2050 due to the expanding population of Alzheimer’s patients. According to the report, which found that someone in America develops Alzheimer’s every 68 seconds, as many as 6.7 million Americans will be living with the disease by 2025, including 97,000 Kentucky residents (a 31 percent increase over 2000, when 74,000 Kentuckians had Alzheimer’s). Nearly 30 percent of those with Alzheimer’s are on Medicare and Medicaid, compared to just 11 percent of those without dementia.
“Caring for people with Alzheimer’s will cost the United States an estimated $200 billion in 2012, an amount that already threatens to overwhelm federal and state budgets,” Shirk said. “Absent intervention, those costs will grow to $1.1 trillion by mid-century. Then there are the out-of-pocket costs to family caregivers, which are projected to balloon 400 percent by 2050. We simply must have a National Alzheimer’s Plan in place that establishes the resources we need to prevent and effectively treat Alzheimer’s, and to ensure much-needed support for those with Alzheimer’s and their families.” A draft National Alzheimer’s Plan was announced February 22, and comments currently are being sought.
Other Kentucky-related statistics included in today’s report:
• The new report reveals there are 15.2 million friends and family members providing care for individuals with Alzheimer’s and other dementias, including 264,658 caregivers in Kentucky. In 2011, these caregivers provided $210 billion worth of unpaid care nationally; and $3.65 billion in Kentucky (in fact, Kentucky was one of 39 states in which unpaid caregivers provided care valued at more than $1 billion).
• The physical and emotional impact on Alzheimer’s and dementia caregivers is estimated to result in nearly $9 billion in increased health care costs in the United States, including $144.6 million for caregivers in Kentucky.
• About 51,000 residents of Kentucky nursing homes in 2009 had cognitive impairments.
Other national statistics in the Alzheimer’s Association® 2012 Facts and Figures report:
• According to the Alzheimer’s Association report, there are 5.4 million Americans living with Alzheimer’s disease, including 5.2 million people age 65 or older and 200,000 people under the age of 65. And 45 percent of adults 85 and older have Alzheimer’s.
• Medicare payments for an older person with Alzheimer’s or other dementias are nearly three times higher, while Medicaid payments are 19 times higher than for seniors without Alzheimer’s and other dementias.
• While only 4 percent of the general population will be admitted to a nursing home by age 80, for people with Alzheimer’s, 75 percent will be admitted to a nursing home by age 80, posing significant economic challenges to state Medicaid budgets.
• Most people survive an average of four to eight years after an Alzheimer’s or dementia diagnosis, but some can live as long as 20 years with the disease.
• Of family caregivers of people with Alzheimer’s and other dementias, 61 percent rated their emotional stress of caregiving as high or very high.
Alzheimer’s Association’s Facts and Figures
The Alzheimer’s Association’s Facts and Figures report is a comprehensive compilation of national statistics and information on Alzheimer’s disease and related dementias. The report conveys the impact of Alzheimer’s on individuals, families, government, and the nation’s healthcare system. Since its 2007 inaugural release, the report has become the most cited source covering the broad spectrum of Alzheimer’s issues. The Alzheimer’s Disease Facts and Figures report is an official publication of the Alzheimer’s Association®.
SurfKY News
Information provided by Danielle Waller

CONTINUE READING…

Angel McClary Raich is dying of Radiation Necrosis and Brain Tumor…

Angel McClary Raich is dying of Radiation Necrosis and Brain Tumor….

Colorado Patient Chris Bartkowicz Denied Medical Defense by Feds

http://www.theweedblog.com/colorado-patient-chris-bartkowicz-denied-medical-defense-by-feds/

 

 

This was sent to us from our friends in Denver. This is the same person who was busted basically as a result of an interview he did back in February for a local television station. Half of the “plants” he was caught with were not mature but the Feds still counted them to bloat the total and make him look like a big time drug kingpin. I was going to write an article about this today but CTI covered all the bases, including links for contacting politicians in Colorado.

Activists Pressure Congress to Clarify Policy

For more information, contact the: Cannabis Therapy Institute
877-420-4205

Denver – In a ruling on Wednesday (9/22) that is sending chills through
every medical marijuana provider in Colorado and nationwide, patient Chris
Bartkowicz has been denied the use of a medical marijuana defense in
federal court. Chris is facing federal charges of marijuana cultivation
after he was interviewed for a KUSA 9 News story about medical marijuana
cultivation. Chris is facing a mandatory minimum sentence of 60 years in
prison.

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*SHARE THIS LINK*
http://www.cannabistherapyinstitute.com/patients/chrisb/chrisb.pr2.html
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At a motion’s hearing on Wednesday in federal court, it was clear that the
feds have stacked the deck effectively against state rights to regulate
medical marijuana. The Honorable Federal District Judge Philip Brimmer
ruled against Chris’ court-appointed attorney, Joseph Saint-Veltri, on
almost every point. Chris’s prosecutor, Assistant U.S. Attorney M.J.
Menendez, said that marijuana had been on the controlled substances list
“since the beginning of time” and that the feds recognize no exemption for
medical marijuana, even if cultivated in compliance with state law.

Saint-Veltri argued that Chris’ case was selective prosecution, given that
there are hundreds of people in Colorado currently cultivating medical
marijuana who have not yet been raided by the feds. Saint-Veltri pointed
out that Budding Health dispensary owner Josh Stanley was also featured in
the KUSA segment as a marijuana grower, but was never raided or
investigated.

Saint-Veltri argued that Chris was acting in good faith and sincerely
believed that he was in violation of neither state nor federal law. Chris
testified that he felt the federal climate had changed with regard to
federal prosecution of medical marijuana patients after Obama’s election.
Chris testified that he had relied on US Attorney General Eric Holder’s
statements on March 19, 2009 that he would not prosecute dispensaries.
These statements made world-wide news, with the LA Times calling it “a
landmark turnaround from the Bush administration’s policy of zero tolerance
for cannabis use by patients.”
http://articles.latimes.com/2009/mar/19/local/me-medpot19

In addition, Chris relied on a memo of Oct. 19, 2009 from David W. Ogden,
U.S. Deputy Attorney General to selected US Attorneys. The Ogden memo,
which was also widely publicized by the Department of Justice, gave
guidance to federal prosecutors about allocation of resources to prosecute
medical marijuana cases. The Ogden memo said that medical marijuana cases
were “unlikely to be an efficient use of limited federal resources.”
http://blogs.usdoj.gov/blog/archives/192

Saint-Veltri also stated that Chris had been relying on signals from the
state that they had worked out some sort of “accord” with the DEA about not
prosecuting Colorado dispensary owners. Specifically, Saint-Veltri wanted
to question Matt Cook, head of the Department of Revenue’s Medical
Marijuana Enforcement Division, who had stated in a recent Kush magazine
article that “medical marijuana centers or infused products manufacturers
should not be targeted by the DEA.”
http://www.findmypot.com/2010/08/19/kush-magazine-press-release-on-centers-growing-more-than-99-plants/

Saint-Veltri wanted to question Cook about his meetings and conversations
with the DEA regarding enforcement of federal law. Cook fought his subpoena
to testify. Cook’s attorney Pam Rosenberg admitted that Cook had had
conversations with the DEA, but said that his testimony would be
“irrelevant.” Judge Brimmer ruled that Cook did not have to testify based
on a technicality of improper service of the subpoena.

Assistant U.S. Attorney M.J. Menendez said that the feds have every
intention of continuing to prosecute medical marijuana patients and
providers, regardless of state laws. She stated that the DEA has reached
“no accord” with Matt Cook regarding federal prosecutions of medical
marijuana patients or providers.

Menendez stated that Holder statement in March 2009 was just a “loose
remark” and that the Ogden memo states clearly that “this guidance
regarding resource allocation does not . . . provide a legal defense to a
violation of federal law.”

Menendez argued that “a reasonable person would not rely on statements made
by Holder or Obama.”

Menendez concluded that “every statement in the record by the federal
government says the government will continue to prosecute” medical
marijuana patients and providers.

In the end, Judge Brimmer ruled that Chris cannot present a medical
marijuana defense at his trial. “Anyone reading (the memos) would quite
clearly understand that cultivating marijuana is a violation of federal
law,” Brimmer said.

Judge Brimmer says Chris Bartkowicz is one of two medical marijuana
patients currently being prosecuted in his court. It is unknown how many
other patients are currently being prosecuted by the feds.

Chris’ trial is scheduled for Nov. 1. He faces a mandatory minimum of 60
years in prison. He rejected an earlier plea bargain offer because it would
have required him to turn someone else over to the feds. Chris refuses to
become a snitch and will stand up for his rights, and the rights of all
other Colorado patients and providers, at his jury trial.

*TAKE ACTION TO PROTECT PATIENTS*

Call and write your Federal Senators and Representatives:

1) Request that they send a “clarification of policy” letter to the
Department of Justice requesting clarification of their official policy of
prosecuting medical marijuana cases. Tell them Colorado patients need to
know they are safe from federal prosecution.

2) Ask that House Members co-sponsor HR3939, the Truth in Trials Act, which
would provide an affirmative defense for the medical use of marijuana in
federal court. Rep. Jared Polis is currently the only Colorado co-sponsor
of this Bill.
http://www.govtrack.us/congress/bill.xpd?bill=h111-3939

Please send copies of any correspondence to:
info@cannabistherapyinstitute.com

*COLORADO CONGRESSIONAL DELEGATION*

*TOLL-FREE NUMBERS TO CONGRESS*
877-762-8762
866-338-1015
866-220-0044

*COLORADO SENATORS*
(Represent entire state.)

Senator Mark Udall (D-CO)
Email: http://markudall.senate.gov/?p=contact_us

Senator Michael Bennet (D-CO)
Email: http://bennet.senate.gov/contact/

*COLORADO REPRESENTATIVES*
(Represent people by district.)

Find your district:
http://www.votesmart.org/

Rep. Diana DeGette (D-01)
Email: http://www.house.gov/formdegette/dcs_zip_auth_v2.shtml

Rep. Jared Polis (D – 02)
Email: http://polis.house.gov/Contact/ContactForm.htm

Rep. John Salazar (D – 03)
Email: http://www.house.gov/salazar/contact.shtml

Rep. Betsy Markey (D – 04)
Email: http://betsymarkey.house.gov/Contact/

Rep. Doug Lamborn (R – 05)
http://lamborn.house.gov/index.cfm?sectionid=129

Rep. Mike Coffman (R – 06)
http://forms.house.gov/coffman/webforms/issue_subscribe.htm

Rep. Ed Perlmutter (D – 07)
https://forms.house.gov/perlmutter/webforms/contact.shtml

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Help us continue to advocate on behalf of patient rights:
http://www.cannabistherapyinstitute.com/donate.html

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Provided as a Public Service by the:
Cannabis Therapy Institute
P.O. Box 19084
Boulder, CO 80308
Phone: 877-420-4205
Web: http://www.cannabistherapyinstitute.com
Email: info@cannabistherapyinstitute.com

Are hospitals deadlier in July?

http://edition.cnn.com/2010/HEALTH/07/07/hospital.deaths.july/?hpt=T2&fbid=FHjdNH9kOT-

By Sabriya Rice, CNN  July 8, 2010 — Updated 1538 GMT (2338 HKT)

 

(CNN) — More than 16,000 U.S. medical school graduates are awarded M.D. degrees each year, and many enter their residency programs at teaching hospitals in July. Now, a growing body of research suggests that month might be a more deadly time in U.S. hospitals.

According to a recent study from the University of California, San Diego, deaths from medication errors increase by 10 percent during July, a so-called July effect as students graduate from medical school and enter residency programs.

Researchers examined more than 240,000 death certificates of people who died of complications from medication errors between 1979 and 2006, and found mortality rates consistently spiked in July, especially in counties with teaching hospitals.

"No one has been able to suggest anything else besides the appearance of new medical residents. That’s the first month they start their new jobs and have expanded autonomy," says David Phillips, a professor of sociology and lead author of the study. He says although it’s possible that the increase can be linked to administrative or other events specific to July, the most notable link is the start of new medical residents.

"Like with any new person in any new job, it’s the first time you’re having to deploy everything you learned," says Diane Pinakiewicz, president of the National Patient Safety Foundation. She says there is a lot of pressure on medical students to be perfect, and because of that, they may be more afraid to admit what they do not know.

In a report released earlier this year, the foundation issued recommendations for reforming medical school education in ways that reduce the "shame and blame environment" that ultimately affects the care a patient receives.

"There’s a culture of medical school education that doesn’t allow people to speak up, so you come in as a new resident and you’re afraid to make a mistake," Pinakiewicz says.

Others say the problem is exaggerated.

"I don’t want people to be unnecessarily alarmed about going to the hospital in July," says Dr. Thomas Nasca, chief executive officer for the Accreditation Council for Graduate Medical Education. According to Nasca, more than one physician decides what medication a patient receives, and such checks and balances help protect the patient from error.

"I think it is probably true there is a slight increase in July, but it doesn’t mean our patients are less safe," says Michael Cohen, a pharmacist and president of the Institute for Safe Medication Practices.

He says hospitals become more transparent in reporting medication errors, and the study might reflect the increased reports. He also says that besides medical residents, nurses, respiratory therapists and pharmacists all begin around the same time, and it’s unfair to point the finger at new residents.

Even with the staffing changes, he says the new study on the July effect looked at data before electronic prescriptions and reduced hours for medical residents helped to reduce the risk to patients.

Other studies find that there is no increased risk of error and that the reported July effect may reflect the quality of care at certain locations.

For example, researchers at the University of Tennessee Health Science Center looked into a potential July effect on their level I trauma center and found there was no increased risk.

"Anyone on a new job anywhere is going to have increased errors or risk when they make an important decision," says Dr. Thomas Schroeppel, a surgeon and lead author of the University of Tennessee study. "However, I think it all depends on the supervision. With good supervision, errors are reduced."

Bottom line: You can’t necessarily predict when you’ll need to visit a hospital, but experts say there are things you can do any time to reduce your risk of dying from a medical error, whether you visit a hospital in July or January, and whether or not your physician is a resident. They offer these tips:

1. Go straight to the top with your concerns

In every teaching setting, there must be a fully licensed attending physician on staff, Nasca says. He encourages patients who feel uncomfortable or unclear about any aspect of their health care to first ask to speak to the head nurse, who should be able to contact every attending physician caring for patients in the unit. If there are still concerns, he says to ask for the on-call hospital administrator. Their job is to help ensure the hospital is providing adequate medical care to all of its patients.

2. Chose your hospital wisely

Experts say you should research your local hospital just as thoroughly as you would research a school for your child or any other service. They say that before an emergency, it’s a good idea to know whether or not your hospital is accredited and for what procedures, as well as how it ranks in patient safety.

Click here to find out if your hospital is accredited through the Joint Commission, a national organization that evaluates medical facilities based on specific quality, safety and performance standards. Also, both the Leapfrog Group and Healthgrades allow you to compare hospitals based on patient safety ratings, and see which procedures are ranked the safest at a given institution.

Also, teaching hospitals remain an excellent option despite any potential July effect. "Much of the research that develops new treatments or new medications occurs in teaching hospitals," Nasca says. "Generally, the quality of care is considered to be much higher."

You can find a list of the teaching hospitals in your state on the Association of American Medical Colleges website, and you can search the Accreditation Council for Graduate Medical Education’s state-by-state list of all teaching hospitals, medical schools and health systems that run residency programs.

3. Don’t assume the medication you receive is correct

According to Nasca, anytime a physician changes your medication or dosage, take note of it. "With every change, there is an increased risk for error," he warns. Nasca says to ask directly "Are you sure this is my medicine, and why did the doctor change it?" — and don’t take anything until you are clear about the answer.

"Patients should worry about the possibility of medication error and should not assume it’s getting calculated correctly," Phillips says.

The Institute of Medicine estimates medication errors harm at least 1.5 million people annually.

Phillips says he’s OK with being a worry wart, and kindly admits this to his physician when he receives any medication. "I simply say, ‘Do me a favor and check the dosage and make sure this is the right medication because I know sometimes people make mistakes.’ "

Here are five additional ways to avoid medication mistakes

4. Ask Questions

"The best thing for patients to do is be educated, and the internet is a powerful tool," says Schroeppel. He says patients who do their research online beforehand tend to ask more informed questions and obtain better outcomes.

The National Patient Safety Foundation has three questions you should ask whenever you visit your doctor, nurse or pharmacist in order to make sure you understand your diagnosis.

As health systems work to make the transition for new doctors as smooth as possible by increasing supervision and reducing the learning curve that could negatively affect patients, Nasca says, it is important to keep in mind that these future doctors are critical to the future of health care in the U.S.

 

 

"We wouldn’t be able to deliver care especially to the underserved without residents," he says. "They want to do the right thing for their patients, something they’re trying to do under very difficult circumstances."

CNN’s Jennifer Bixler and Carrie Gann contributed to this report.

Medical marijuana laws benefit big business

 Greg Pivarnik – 3/4/08

Marijuana has medicinal uses. Despite numerous scientific studies and the development of synthetic medicines derived from cannabis, the United States government appears to disagree with
this statement. Marijuana remains a Schedule I drug according to the DEA,
which only benefits the pharmaceutical companies who now have a monopoly on
the therapeutic effects of a plant that can be grown with little effort.

Under the Controlled Substances Act, the DEA lists and categorizes drugs, illegal and pharmaceutical, into five categories or schedules.
According to the DEA Web site, the drugs are placed in a schedule based upon “the substance’s medical use, potential for abuse, and safety or dependence liability.” Schedule I drugs are considered the
most addictive and have no medical use and are considered the most dangerous. Schedule II
drugs have some medical benefits but are highly addictive and so on until Schedule V. Marijuana is considered a Schedule I drug, along with heroin and LSD, because it has a “high potential for abuse” and “has no currently accepted medical use in treatment in the United States.” Apparently though,
PCP and cocaine have more of a medical basis considering they are Schedule II drugs.

Unfortunately, the rescheduling of marijuana is something that may be far off in the future, despite research pointing to the possible benefits of medicinal use. Scientists studying its medicinal
properties have already found a number of possible medical uses. Most notably, marijuana can be used to treat pain and nausea associated with a number of diseases. It is mostly prescribed, in states that
allow for its medicinal use, for pain and nausea associated with terminal illnesses. Many times
marijuana has been found to be one of the more effective drugs to treat these symptoms. Extreme pain is
often associated with severe illnesses such as cancers, AIDS and multiple sclerosis (MS). Marijuana also reduces nausea associated with chemotherapy and AIDS patients. It stimulates appetite and
allows patients to eat so they do not lose an excessive amount of weight. Marijuana has been proven to be an effective treatment for neuropathic pain and can control muscle spasms in diseases like MS.

However, MS is not the only disease associated with neuropathic pain. There are many other diseases and disorders that can benefit from possible treatments of marijuana. Marijuana has also been found to
treat patients with glaucoma by relieving pressure in the eyeball and therefore possibly preventing the blindness associated with the disease. Lastly, there are also the well known calming affects of
marijuana that could be used to treat severe anxieties and obsessive compulsive disorder.

The main reason that marijuana remains illegal, or at least not used as medication, is money. Too many companies in the pharmaceutical industry stand to lose too much money from competing with medicinal marijuana. The Pharmaceutical companies do research, create a synthetically made chemical for a treatment of a certain disease and then patent. U.S. patents last around 20 years and
effectively give the company a monopoly on that drug. This in turn drives the price up
for many years after FDA approval, until the patent runs out and generic forms of the drug are made available. The reason that drug companies would not want marijuana manufactured is that it can been
grown cheaply and easily. It could effectively be a less costly alternative to the drug therapies that patients can access now and may treat myriad of disease that could infringe on the consumer
market of other medications.

The amount of money derived from the pharmaceutical industry, and hence the lobbyists that work for them, has led to an inherent hypocrisy in U.S. policy towards marijuana. While listing marijuana
as a Schedule I drug, which supposedly has no medical benefits, the U.S. still allows pharmaceutical companies to conduct research and make products that harness the medicinal powers of THC, the main
psychoactive chemical in marijuana. This already implies that marijuana has medicinal benefit and
therefore should not be listed as a Schedule I drug. One such drug, Marinol, is already available for
prescription use in the U.S. to treat the side effects associated with chemotherapy and AIDS patients. Another marijuana based drug, Sativex, which is used to treat MS, has already been approved in
Canada and has begun trials in the U.S.

It is unfair for the government to conduct a smear campaign against medicinal marijuana, while at
the same time allowing drug companies to purify it and market products for staggering amounts of profit.
For instance, the base cost per year of  Sativex in Canada $4,475. This price is only an estimate before pharmacy costs. On top of that, this estimate only takes into account a minimal amount of doses.
Sativex is a spray administered via the mouth. The average dosage is five sprays a day. However, the dosage is variable up to 14 sprays, which would also increase the costs.

There are those that would say it is beneficial for the drug companies to purify the drugs
because smoking marijuana is itself a health risk. A risk it may be, but taking any medicine is a risk. In
fact, an article in Scientific America esposed a study that concluded that there is no scientific link between lung cancer and smoking marijuana. It was thought that THC “prompts aging
cells to die before coming cancerous.” A more recent study has seemed to confirm this conclusion. In a lab study, mice with tumors were injected with THC and showed a 50 percent decrease in tumor size
after three weeks as compared with untreated mice. Though the studies are preliminary, they still
nonetheless cast doubt on long held myths in marijuana.

In the end the only beneficiaries of the current medicinal marijuana policy in the United States are the drug companies. Patients are forced to dole out money for a synthetic form of a medicine that
could be grown and obtained naturally and possibly far more cheaply.  Of course a side effect of smoking
marijuana is that one would get high. However, these side effects no different from warning labels on
other medications that indicate drowsiness and warn people against driving and operating heavy machinery. In turn, the question can be asked – What makes a synthetically made chemical safer and
more effective than a naturally growing plant?

There is a risk when taking any medication. There have been well-known cases in which people have
died taking prescription drugs. However, it is nearly impossible to overdose on marijuana.

In the end, the only difference between pharmaceutical marijuana and smoking marijuana is that pharmaceutical products create enormous amounts of revenue for big business, while
medicinal marijuana would only benefit the citizens of this country that are in dire need of
cheap and effective medication. And as always, the government sides with big business.

Weekly columnist Greg Pivarnik
is an 8th-semester molecular and cell
biology major. His columns appear on
Tuesdays. He can be contacted at
Gregory.Pivarnik@UConn.edu.

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