Don't Get High….. Get Well

Archive for the ‘medical marijuana’ Category

I have been asked a number of times about the issue with using alcohol as an extracting compound.

There is no marijuana-specific law re: alcohol, but instead a general Penal Code statute that criminalizes the use of “chemical processes” (the wording may vary slightly) in the production/manufacture of any illegal drug. When the California Legislature created the medical marijuana exceptions to other drug-related statutes (e.g. cultivation, possession), it did not include an exception to this statute. As a result, any extraction process with a solvent other than water is technically a problem.”

In many/most herbal medications, using alcohol is not an issue as they are “legal”, while cannabis is not considered legal.

I am, in fact, additionally concerned about using alcohol from a “judicial” perspective when/if any of us are called to the mat by authorities for “manufacturing” medicines. If we are using the same standards as the pharmaceutical industry, i.e. co2 extraction, we can argue a much, much better case than using alcohol.

The entire issue with “manufacturing” which IS BEING PROSECUTED, is going to be a much tougher sell with alcohol; it just will be.

Finally, 70% alcohol should just not be a part of any medicine. With a tincture that is nearly 60-70% alcohol, a dropper-full taken under the tongue, or sublingually, will give you a feeling of being slightly intoxicated from ALCOHOL. Also, your breath smells like alcohol.

Finally, although in theory a fine extracting solution, I have yet to see a CBD tincture that truly measures out to be 10 mg/cc. I have purchased many and tested them all……still waiting

ASA, Americans For Safe Access, just filed a new ballot initiative to Regulate Control and Tax Medical Marijuana and it looks like it will incorporate the other two ballot initiatives into ONE….I hope as they and the State of Ca want to create a statewide bureau to to oversee Medical Cannabis in California with a 21 member board comprised of people from in and outside the industry including:

“Six Members with experience in the areas of dispensary operations, infused product manufacturing, cultivation practices or lab testing… two members with experience in medical marijuana policy and regulations … licensed physician and nurse … one member with extensive experience on scientific or therapeutic research…”

Section 11362.88 Check out the link and attached document.

http://ag.ca.gov/initiatives/activeindex.php

I would LOVE to be involved with this one.

I am continuing to see, and at times, testing and evaluating, new cannabis tinctures that have a range of effects. Allow me to summarize what is beginning to become available locally and soon through StateWide Collective and Community. (Again, please go there and sign up. If nothing else you are supporting my efforts, and will VERY soon have options with regard to your health insurance. I digress.)

So, there are some fairly balanced CBD/THC tinctures out there:

1. One has around 4.5 mg/cc of THC and CBD and seems to be effective for anxiety and pain, particularly neuritic. There are, however, perhaps 20% of patients where it appears this amount or ratio of CBD/THC is just not high enough. There will soon (a week at most) be available, thanks to ProjectCBD and the catatonic strains, tinctures where the CBD is more than 2X the THC and depending upon lab results I get later today, perhaps??? even a greater value for the CBD/THC.  These tinctures have a psychoactive scale of 6. (remember psychoactive scale from 0 – 10)

2. There has been and will again soon be available THC of 11 and CBD of 2. This was very popular and was better for sedation and a better anti-depressant for others. There was/is some moderate psychoactivity in this group of tinctures and their PsychoActive Scale is around 6.

3. Group of tinctures where there is minimal or no CBD, but have all terpenes present in the plant. So, these are very psychoactive and are placed in the range of psychoactive value of 8.

http://www.greenbridgemed.com 

http://www.certifiedcannabismedicine.org  

http://www.statewidecollective.org

Dear Patient,

I suppose I have no shame, but I must ask your help with two issues.

1. StateWideCollective.org and
2. Dosable Cannabis Medications For All Of Us.

There are closures of stores on a daily basis and it may be getting worse. There are many forces working against providing safe, affordable and dosable cannabis medicines. What happens if the Feds and local governments continue? Who is going to stop them? Are the stores really doing what they should be doing to provide a professional, safe and medical environment? If you are uncertain, as I am, to the answers, please read the opposing column carefully and help us out.

So, as I said there are two things to do:

1. StateWideCollective.org – Please go there and sign up. It is our “Plan B”. SWC has already been launched and committed to Dosable and CBD-Based Medicines. This is what I am committed to. This is what GreenBridge Medical and our 501C3 is committed to. It is at risk and our save dosable medications are at great risk; pharmaceutical companies are driving this entire effort.

2. So, after signing up with the g of StateWide Community, please help us with as little as $5 at:
StateWideMedicine.org

YOU AND I HAVE NO OTHER CHOICE!

Thank you so much,

Allan

Every month I pay around $850 to Blue Shield. I have a pretty typical PPO plan, which means it sucks and it is way too expensive. I have previously blogged on StateWide.EVERYTHING as a Collective, Co-op, or community. In reality, it seems to me we are quickly on our way to completing the community part and already have dozens of patients signed up; we need thousands.

So, yes, even as a physician, I am stating that I advise as a “backup” or “Plan B”, STW as being necessary. Also, SWC has no down side that I can see. I am not “supposed” to advise on a collectives, and rarely do I recommend one; however, this is an exception and a huge part of this exception is based upon the title of this blog. I can now easily see a way in which, with under 100 members of the “community”, we can obtain 50% discounts on our typical high end PPO insurance plans. This is something that must be done and can be done. Linking with a collective just begins making it into a total health care delivery system. As a physician, I see a monumental opportunity for my patients. How can I not advise this? I discuss personal “reimbursement” below, as this is a potential issue.

If the group were to grow to 1000, it is possible that we could get rid of deductibles and/or the patients cannabis medications could be included on a monthly basis! Over time, if our “risk profile” improves, our cost savings will be passed to “The Community” or we will ultimately just self-insure. This makes sense to me. Doesn’t it make sense to you?

Our health care system has failed and the same system is trying to take away our dosable “Real” or “CBD” based cannabis medicines; this is a certainty. So, with one easy signup, you plan on:

1. TAKING a big step towards cutting your health insurance costs in half

2. HOPING to make a statement that the “group” is critical now and we must organize in some manner

3. HOPING TO to protect our medicine even as storefronts are closing daily

4. WISHING TO exploring endless other ways of integrating this huge community.

While we are wishing and hoping; please do the right thing for the medical cannabis community and:

1. Continue to support your local collective

2 Signup with Statewidecollective.org and be certain to enter your email address

You can trust that this entire subject is one I have given much thought to over a very long.  This is an aggressive position for a physician to take but I have studied the subject well. I have been to 37 patient pre-trial hearings and trials, always pro-bono. I have been attacked by the State Of California and the Medical Board and have prevailed. I am entirely committed to helping this effort and I believe in the end there is no possible jury to convict a physician for “aiding and abetting” when he never gains by one cent, is improving his patients’ medications and trying to protect them. I owe it to all of you and myself to not participate in any cash flow; EVER. This gives us all great protection. So, to explain this:

Any and all of my efforts, other than seeing patients directly as part of my daily practice, will not be reimbursed in any manner; you can trust this.

I believe my readers by now trust that I am very serious in this blog and that I am very serious with regard to being 100% financially detached from all potential $$ benefits. To begin with, I really don’t care; I just really don’t.

However, in addition, I must remain neutral on two levels and they are eternally interconnected:

1. The search for the best dosable cannabis medicines is a goal that is just way above money – at least in my world.

2. In fact I do have some self interest; if dosable cannabis medications were to disappear, I truly do not believe I could continue doing what I do every day. Once I entered the dosable world, there is just no going back. I would have to leave and do something else and I just don’t want to do that. I do not mean to slight any physicians practicing cannabis medicine and doing great work. I think I was doing great work before CBD, but I am doing much better work now and how does one go back? Should I go back? Should a physician be forced to go back to a poorer treatment plant? I don’t think a jury will find me guilty of aiding and abetting or “medicine manufacturing” for just helping all the right things happen.

Today, I was able to discuss with a patient over the phone, their CBD/THC ratios on two different tinctures he had obtained as well as that increased Mercine, a Terpene, will make him drowsy. When I hung up the phone, I felt a new world had opened up; I had discussed the dose of a Terpene and the mg/spray of his tincture. WOW!

This is worth saving. I can’t think of anything better to do. I believe patients who take dosable cannabis medications seriously and are serious about their health insurance and other SWC potential benefits, should go to:

http://statewidecollective.org and sign up

AND AGAIN

TO DONATE TO A 501C3 putting every penny into research and improving and guarding dosable medicines, please help all of us.

Thank you all so much. We now have a volunteer social worker helping us.

I just spoke with a health insurance broker who informed me that if there are over 100 patients in a group, the policy that I PERSONALLY HAVE, would drop with Blue Shield from my current $850/month to under $400/month.

I will be meeting with a few more insurance underwriters and get back to all of you. If any of you specialize in this area, let me know and perhaps we can work together?

Another great reason for StateWide Collective or “co-op”

There is a patient of mine who is very ill and is stuck in the system. He is, I believe, clearly entitled to both Medical/SSI or Medicare and full disability.

I am offering all the medical care and follow-up work for no charge.

Any social worker out there available to help us?

Thanks,
Allan

Dean,

I am sure your assistant mentioned that I had called. Anyway, one of my patients saw you last year because I would not give him an illegal “grow certificate”, but you were happy to do so for 99 plants for over $200.

So, of course, now he is in trouble. He SHOULD have known better than to trust you and the ridiculous grow certificate, but he didn’t . However, for certain, you should have known and you in fact do know better. I can imagine you as greedy, but I can’t imagine that you are so ignorant of the laws that you truly believe YOU have the right to give any patient the right to grow 99 plants.

I have no right to expect any reply from you, as you have never been anything but rude to me. However, as you can see, I have copied a few of my friends who would also be interested in such illegal and unethical behavior. (in my prior email to Dr. Weiss)

I do hope you respond to us that you were “unclear about the law” and that you will never do that again. Well, I have not heard anything,so I am sharing my information. I redacted the patient information, but the patient requested I post this.

This is not a threat. This is a warning; if you stop what you are doing, I will back off. Frankly, I have felt like posting it all day, but am going to wait until the morning.

The reason I am so disgusted with you, is that I had to spend most of the weekend with this patient hopefully getting him a good lawyer and help with his defense.

BTW, I do the legal work pro bono.

This is definitely not slander, as it is true and I will post the “Nine-nine” note you wrote on this patient’s Rec. It is redacted and I have his written permission and actual encouragement as he trusted you.

You should really be ashamed, but I presume you are laughing. That is fine, as at least a few more of my friends and the 25,000 that read my blog every month, will know what kind of person you are.

Allan I Frankel, MD

Here is PDF of Rec with “Permission for ninety-nine plants)weissrecgrow

If the “we” were a group of people renting an apartment building that was leaking, had no power, etc…would we pay our rent on time? Of course not, we would all get together, place it into an account and hold it until we got what we wanted. Then we would negotiate how much we would give them.

Think of the cannabis collective situation. “We” are being asked to pay sales tax on a medication which is not generally considered, uhhh “legal”. No medications are EVER taxed. So why cannabis? We are liberals? We think in the grays. We don’t like confrontation. So, we got treated very poorly.

What if on January 1, 2012, all the collectives stopped paying sales tax and contributed it to an escrow fund. We are not getting equal protection under the law; why should we pay taxes for it. If we were guaranteed that the taxes meant we were doing something LEGAL, that was being TAXED, we should receive protection for our establishments so we can “sell” more and pay more taxes.

On the other hand, if the taxes offer no true guarantee, and they don’t right now, let’s consider keeping them, BUT WE MUST CONTROL THE MONEY AND PLACE IT IN A STATEWIDE LEGAL FUND FOR ALL OF US.

Thoughts anyone?

The most exciting aspect regarding my return to work, following return of my Medical License is my “born again” practice. It is waking up,every morning to the wonders of CBD or Cannabidiol. This is an ancient cannabinoid that was always in the plants until a few hundred years ago. It was/is non-psychoactive and it ends up being the “real” medicine of cannabis. When you allow the plant to grow with all it’s genes being expressed, there is ALWAYS a lot of CBD in the plant. We nearly cultivated the CBD out of the plant, but now it is back with a lot of help from the Feds in showing us the true potential value of CBD.

CBD stops stoniness and is an incredible anti-anxiety, anti-depressant, analgesic, neuro-protectant and anti-tumor molecule. It was nearly lost to breeding, with growers over many years,tossing the “medicinal” and keeping the “stony”.

The Feds, with GWPharma in England (backed by Bayer), have been working on cannabis medicines for the past 20 years.

The Feds patented CBD in 2003.

The Feds patented all breakdown products that MIGHT be helpful to their “invention”.

The patent, which I will list at the end, goes as far as stating cannabis is useful for many, many illnesses, including MS and many other degenerative neurological diseases.

They changed the Pharmaceutical schedule for Pharma-based medicines to IB and the rest of us are entirely illegal with non-pharma cannabis meds remaining Schedule I.

55 grow licenses have been granted to pharmaceutical companies in the US by the Feds.

Finally, as if there were any doubt, the “sales” have begun and let’s start with that reference.

http://www.federalregister.gov/articles/2011/11/17/2011-29726/prospective-grant-of-exclusive-license-development-of-cannabinoids-and-cannabidiols-based#p-3

http://michiganmedicalmarijuana.org/topic/35606-us-government-attempting-to-profit-off-of-medical-marijuana/

http://www.opposingviews.com/i/society/drug-law/us-government-profits-medical-marijuana

http://www.greenbridgemed.com/derivative-molecules-patentedsuggested-by-us-patent-enough-already/

http://1.usa.gov/tdMlsS

http://www.greenbridgemed.com/more-us-federal-patents-for-cannabis-products/

http://1.usa.gov/tdMlsS

http://www.cannabis.net/medicine/

Clearly, the Feds, Bayer Pharmaceutical and GW Pharmaceutical in England have been working on and planning all of these patents and inventions with regard to Medical Cannabis.

I would think that the nay-sayers after reading all the above references would at the very least believe the Feds certainly believe cannabis is extremely useful and lucrative.

I have no idea why this story has really never been broken?

The hypocrisy is mind-numbing and at stake is hundreds of thousands of people, mainly minority, in jail. Tens of thousands of arrests in NY, despite NY having de-criminalized cannabis in the 70′s.

There are so many journalists, who are either not aware of this criminal behavior on the part of our government:

Arresting the young minority kids while receiving a lot of money from our own US pharmaceutical companies.

The international “treaty” of 350 countries is certainly not being followed by anyone; it is just being used as an excuse. Many countries are developing “Dosable” cannabis medications. In fact, Sweden just picked 3 strains of cannabis to be their national strains; one rich in THC, another in CBD and another balanced.

Five countries in the world have access to pharmaceutical Sativex. Check Sativex.com

So, the Feds are lending a hand to the Pharmaceuticals; healthcare professionals are holding the hands of their patients while these hands are being cuffed by the tens of thousands.

“SAY IT AIN’T SO??”

Remember, the Designation letter, is a critical form to be filled out and signed by the collective management, or even better, president. This form specifically states that the “designee” is allowed to transport for X patients, or Y weight or even Z volume of “dilute” tincture. The more specific we can be, the more easily we can make our case should the need arise.

Although this Designation letter was written specifically for State Wide Collective and it’s President, Morgan Harrison, it can clearly be easily adapted. I have actually heard that using a notary is necessary, but I think it clears up a lot of potential questions at the time it is being investigated.

Good Designation Letter

The money spent in health care is currently nearly entirely spent on care and tests that are removed from the patient’s primary care physician. This has created a system where the primary care physician, or PCP, is no longer intimately involved in the care at all steps in their patients care.

This “hands off” situation has arisen as insurers have elected to down play the PCP-Patient relationship. The average visit time is around 10 minutes. In general, that is about the time required to get the patient relaxed and feeling safe.

However, as we are all aware, the average PCP now has 10 or so minutes in a visit. If you assume that at least 2 minutes, if not more, is required for charting. That leaves 8 minutes for perhaps 2 or 3 issues the patient is concerned about or issues that require Physician-Patient attention.

The physician has no choice but to out-source the care. This is done generally in two ways:

1. Ordering a lot of tests as a “shotgun” approach to making a diagnosis and “covering” themselves.
2. Referring to “specialists”

The more tests and specialists that become involved with the care of the patient, the more disjointed the care becomes as there is no time allocated or fees paid for “collaboration”. This collaboration always used to be a part of care when physicians had more time and would congregate all the time discussing patient care.

Also, according to the most basic statistical theory of medicine, Bayes Theorem, the more tests done that are not likely to be helpful, in fact lead to a significant level of false positive diagnoses. In my opinion, it is only when the PCP controls the reigns and has adequate patient time, can decent decisions be made.

We suffer from many truly unnecessary tests, consultations and false positive diagnoses all leading to increase fear, poor patient outcomes and a tremendous financial cost.

I would suggest setting up a PCP clinic in an existing UC or county hospital and randomly assign patients to the currently existing clinic or the new “PCP” clinic.

In this new “PCP-intense” clinic, it would be structured to allow adequate times for the PCP-Patient relationship and the Internal Medicine and Family Practice physicians running the clinic, would always be available for consultation while the patient is still in the clinic.

Labs, radiology, etc would be at the same location as the other clinics, but their over-use could be eliminated.

With 60-90 minute initial evaluations, 30 minute routine follow-ups and annual 60 minutes appointments this would be off to a great start.

As the PCP-Patient relationship is restored and is trusting as opposed to oppositional, patients will be more likely to trust their physician that a given procedure is or is not needed. In this manner, a patient with a headache who was told by a friend that it “sounds like a brain tumor”, would be much more likely to trust their PCP IF a scan were not really indicated.

This brings patients and doctors back to the same side, where they belong.

For certain, patient satisfaction would greatly increase but I am equally certain that over a 5 year period, costs would drop significantly.

If physicians have more time, they will also be able to take advantage and learn better and more efficient way to enhance PCP communication and care.

CBD OR CANNABIDIOL IS A MOLECULE OR CANNABINOID SIMILAR IN MANY WAYS TO THC. HOWEVER:

CBD CONTAINING MEDICINES TEND NOT TO BE PSYCHOACTIVE.

CBD CONTAINING MEDICINES DO NOT ALTER YOUR FOCUS

CBD CONTAINING MEDICINES WORKS MUCH BETTER AGAINST ANXIETY

CBD CONTAINING MEDICINES WORKS MUCH BETTER AGAINST PAIN

CBD CONTAINING MEDICINES HAVE A DURATION OF ACTION OF 8-12 HOURS

CBD CONTAINING MEDICINES ALWAYS CONTAIN SOME THC

CBD CONTAINING MEDICINES WITH MORE THC BECOME PSYCHOACTIVE

CBD CONTAINING MEDICINES WHERE THE THC AND CBD ARE ABOUT EQUAL IN CONCENTRATION (SEE MG/CC ON LABEL) TEND TO BE BEST FOR ANXIETY

CBD CONTAINING MEDICINES WITH MORE THC THAN CBD TEND TO ACT AS MILD ANTI-DEPRESSANTS

PSYCHOACTIVITIY IS ASSIGNED A NUMBER FROM 0 -10. A LOW SCORE MEANS THERE IS VERY LITTLE PSYCHOACTIVITY. A VERY HIGH SCORE, SUCH AS 8-10, GENERALLY WOULD MEAN THAT THERE IS MUCH LESS IF ANY CBD IN THE TINCTURE

Well, it is always good to keep “Plan B” on hand. Plan B in this case is not the pill you take the next day when recent plans went awry. It is however, in my opinion, a way to re-shape a part of the cannabis collective world, while remaining a low key no flash dosed medicine only boring collective without any storefront. Boring, but good to have in the medicine cabinet. :)

In fact, much to the possible chagrin of some of my friends, the current collective store model has in fact failed and has failed us.

I have spent an incredible number of hours, without charge as always, working with many collectives stepping up their level of medication – i.e. dosable medications. It is a VERY slow process and is all about education.

In recent weeks, if I ever had any doubt about the need for a HUGE STATE WIDE Collective with tens of thousands if not hundreds of thousands of patients, I am absolutely certain of it at this point in time.

As in the blogs below, I am not against anything as long as it is truly compassionate for my patients. I work with collectives. I work with growers and genetics experts developing new rich CBD strains. I consult with a number of collectives helping them on a number of levels and I will continue these efforts.

I am just concerned that there is a CHANCE that the storefront model MAY either end or change in some substantial ways. This will be a federal issue and is a direct consequence, in large part, on the US based pharmaceutical industry(more so than GW and others). Bayer and 55 others hold a huge stake in whole plant cannabis extract and rich CBD Rich medicines.

I am not in any way bashing pharma nor GW nor anyone. I just want to be certain that when the dust settles, the Medical Cannabis World and all of our patients can obtain access to safe and dosable medications.

With fears of “manufacturing medications” and “tinctures being seen as concentrates” abound, there is a long way to go and there is a lot of resistance. We have not yet begun to see the ultimate Federal resistance. I hope I am wrong. I really do, but If the Feds do the unthinkable, we had better have our “Plan B”.

I know that perhaps this is just a dream, but I believe that what I have posted over the past few days is absolutely not only possible but essential. It is a model that will be incredibly difficult to break at the Federal Level and even if seriously challenged the framework and email list of the SWC collective will be a wonderful option. It is already up and with some work and luck it could even grow to become a PAC or Super Pac. Sounds impossible? I know. Maybe it is. So what?

Check it out:

http://wp.me/psbPB-t1

http://wp.me/psbPB-sT

Also, prior emails as well as this data is information that will finally/ultimately come out in any federal fight over
the so-called “manufacturing” of medicine. I have no clue how/when “manufacturing” and plant medicine extractions became an issue? I realize THIS plant is federally illegal, but what is the logic to distinguish this plant from any other with regard to the manufacturing angle? Thoughts?

These will look very confusing to any jury. I am not saying it is remotely easy. I am saying this may very well be our best option. Anyway, read away and ask yourself if any jury will find a classic collective in violation of anything as the following and much, much more is to come out in court. How will any jury listen to the defense showing the following and find any guilt? I believe the creation of such a collective and purification of the plant into a dosable product is what most of the people on the jury assume IS or SHOULD BE happening.

http://bit.ly/twMovk

http://wp.me/psbPB-sC

http://wp.me/psbPB-sA

http://wp.me/psbPB-rv

http://wp.me/psbPB-q9