- improve their life,
- recover their health,
- retain or regain their loved ones love,
- restore earning ability, and
- avoid conflict with the police
Wednesday, March 30, 2011
Friday, March 25, 2011
American Society of Addiction Medicine
Public Policy Statement on Medical Marijuana
In the last twenty years, both the scientific community and the public have become interested in the therapeutic potential of cannabis and cannabinoids. Scientific interest has been based in large part on the discovery and elucidation of the endocannabinoid receptor system. Popular interest has focused on state initiatives and other legislation decriminalizing the use of smoked cannabis for personal medical use. Because of this legislation, herbal cannabis in various forms is now being distributed by dispensaries to large numbers of individuals with a wide variety of medical conditions. This cannabis is not, in most cases, standardized or quality-controlled; the dosage forms (smoked, vaporized, baked goods, teas, elixirs, etc.) do not provide a known and reproducible dose; and data on efficacy and adverse events are not being collected in a reliable manner.
Cannabinoids are insoluble in water and subject to degradation by temperature and light; thus, optimal delivery systems or dosage forms are difficult to design. As a result, research into their medical applications is technologically challenging and has lagged behind that of the opioids and other modern medications. With improvements in technology and the development of research tools, such as high affinity agonists and antagonists, preclinical research has flourished. At present, however, only a few properly controlled clinical studies, of adequate size and duration, have investigated the use of cannabis or cannabinoid products in specific therapeutic contexts.
The pace of such clinical research is increasing. As corporate sponsors successfully resolve the regulatory and technological challenges, new products will enter the market. These products will be accompanied by extensive quality, pharmacological, toxicity, safety/tolerability, and efficacy data that will allow physicians knowledgeably to prescribe them, thereby making them available to appropriate patients. Risk Evaluation and Mitigation Strategies (REMS) will reduce the likelihood of abuse and diversion by both patients and non-patients, including adolescents.
The FDA approval process ensures that a robust body of data accompanies a product when it becomes available to patients. The FDA has invited industry to develop botanically based products and has set forth the regulatory path that must be followed to ensure that such products meet the standards of modern medicine. It is feasible for cannabis-derived products to proceed down that path. Doing so will enable them to be recognized by the medical community as legitimate treatment options.
Under the current state distribution systems, physicians serve as the gatekeepers of patients’ access to cannabis, yet they lack both information on the quality/composition of the cannabis materials and data on their efficacy/safety. When specific cannabis-derived or cannabinoid medications have passed through conventional regulatory approval processes, and their risk/benefit profile in a particular medical condition is known, physicians can be confident that they are meeting the standard of care when advising patients about potential treatment choices.
“Cognitive dissonance” is a term that aptly describes the current approach to “medical marijuana.” Scientists recognize the public health harms of tobacco smoking and urge our young people to refrain from the practice, yet most cannabis consumers use smoking as their preferred delivery mechanism. The practice of medicine is increasingly evidence-based, yet some physicians are willing to consider “recommending” cannabis to their patients, despite the fact that they lack even the most rudimentary information about the material (composition, quality, and dose, and no controlled studies provide information on its benefit and safety of its use in chronic medical conditions). Pharmaceutical companies are responsible for the harms caused by contaminated or otherwise dangerous products and tobacco companies can be held accountable for harms caused by cigarettes, yet, dispensaries distribute cannabis products about which very little are known, including their source. Efforts are being made to stem the epidemic of prescription drug abuse, including FDA-mandated risk management plans required for prescription medications, yet cannabis distribution sites proliferate in many states, virtually without regulation.
In order to think clearly about “medical marijuana,” one must distinguish first between 1) the therapeutic potentials of specific chemicals found in marijuana that are delivered in controlled doses by nontoxic delivery systems, and 2) smoked marijuana.
Second, one must consider the drug approval process in the context of public health, not just for medical marijuana but also for all medicines and especially for controlled substances. Controlled substances are drugs that have recognized abuse potential. Marijuana is high on that list because it is widely abused and a major cause of drug dependence in the United States and around the world. When physicians recommend use of scheduled substances, they must exercise great care. The current pattern of “medical marijuana” use in the United States is far from that standard.
If any components of marijuana are ever shown to be beneficial to treat any illness then those components can and should be delivered by nontoxic routes of administration in controlled doses just all other medicines are in the U.S.
In order for physicians to fulfill their professional obligations to patients, and in order for patients to be offered the high standard of medical care that we have come to expect in the United States, cannabis-based products must meet the same exacting standards that we apply to other prescription medicines. Members of the American Society of Addiction Medicine (ASAM) are physicians first and experts in addiction medicine with knowledge specific to the risks associated with the use of substances with high abuse potential. ASAM must stand strongly behind the standard that any clinical use of a controlled substance must meet high standards to protect the patient and the public; the approval of “medical marijuana” does not meet this standard.
1. ASAM asserts that cannabis, cannabis-based products, and cannabis delivery devices should be subject to the same standards that are applicable to other prescription medications and medical devices and that these products should not be distributed or otherwise provided to patients unless and until such products or devices have received marketing approval from the Food and Drug Administration.
2. ASAM rejects smoking as a means of drug delivery since it is not safe.
3. ASAM recognizes the supremacy of federal regulatory standards for drug approval and distribution. ASAM recognizes that states can enact limitations that are more restrictive but rejects the concept that states could enact more permissive regulatory standards. ASAM discourages state interference in the federal medication approval process.
4. ASAM rejects a process whereby State and local ballot initiatives approve medicines because these initiatives are being decided by individuals not qualified to make such decisions (based upon a careful science-based review of safety and efficacy, standardization and formulation for dosing, or provide a means for a regulated, closed system of distribution for marijuana which is a CNS drug with abuse potential).
5. ASAM recommends its members and other physician organizations and their members reject responsibility for providing access to cannabis and cannabis-based products until such time that these materials receive marketing approval from the Food and Drug Administration.
6. ASAM asserts that physician organizations operating in states where physicians are placed in the gate-keeping role have an obligation to help licensing authorities assure that physicians who choose to discuss the medical use of cannabis and cannabis-based products with patients:
• Adhere to the established professional tenets of proper patient care, including
o History and good faith examination of the patient;
o Development of a treatment plan with objectives;
o Provision of informed consent, including discussion of side effects;
o Periodic review of the treatment’s efficacy;
o Consultation, as necessary; and
o Proper record keeping that supports the decision to recommend the use of cannabis
• Have a bona fide physician-patient relationship with the patient, i.e., should have a pre-existing and ongoing relationship with the patient as a treating physician;
• Ensure that the issuance of “recommendations” is not a disproportionately large (or even exclusive) aspect of their practice;
• Not issue a recommendation unless the physician has adequate information regarding the composition and dose of the cannabis product;
• Have adequate training in identifying substance abuse and addiction .
Monday, February 28, 2011
Becoming a spiritual being is synonymous with becoming a miracle worker and knowing the bliss of real magic. A spiritual being has a conscious awareness of both the physical and the invisible dimension, while the non-spiritual being is only aware of the physical domain. Here are a dozen beliefs for you to cultivate in order to manifest miracles in your life.
- The non-spiritual being believes that if you cannot see, touch, smell, hear, or taste something, then it simply doesn’t exist. The spiritual being knows that beyond the physical senses, there are other senses available to us. He knows that the soul is beyond limits and defies birth and death.
- The non-spiritual being accepts the existence of a God, not as a force within us but as a separate power. The spiritual being uses his own divine guidance to become a miracle maker.
- The non-spiritual being is focused on external power. The spiritual being is focused on personal empowerment and helping others live in harmony. A mind at peace and centred, is stronger than any physical force in the universe.
- The non-spiritual being feels separated and distinct from all others, a being unto himself. The spiritual being knows that he is connected to all others. Then, the need for conflict and confrontation is eliminated.
- The non-spiritual being believes in a cause/effect interpretation of life. The spiritual being knows that there is a higher power working in the universe.
- The non-spiritual being is motivated by acquisitions. The spiritual being believes the measure of a life is in what is given to others.
- The non-spiritual being has no room for meditation. The spiritual being knows in deep meditation one can leave the body and enter a sphere of magic.
- For the non-spiritual being, the concept of intuition can be reduced to a hunch. For the spiritual being, intuition is guidance and is never taken lightly.
- The non-spiritual being knows what he hates but, in order to manifest miracles, the spiritual being works on what he is, rather than fighting what he is against. Real magic occurs when you have eliminated the hatred in your life, even the hatred that you have against hatred.
- The non-spiritual person feels no sense of responsibility to the universe. The spiritual being has a reverence for life that goes to the essence of all beings.
- The non-spiritual being is laden with grudges and the need for revenge. The spiritual being has no room for these impediments to miracle making. All religions preach forgiveness. One cannot profess to be a member of a particular faith, and then behave in ways inconsistent with its teachings.
- The non-spiritual being views miracles as random happenings but the spiritual being believes in them, and in his ability to experience a world of magic. He believes the forces that have created miracles are still present in the universe and can be tapped into.
Excerpt from Real Magic (William Morrow & Company Inc) by Dr Wayne Dyer. Dr Dyer, based in the US, has a doctorate in counselling psychology, and is a well-known speaker and author. Featured in Harmony Magazine, July 2005.
- We Agnostics (recoveryissexy.com)
- AA and Spirituality (twelvestepfacilitation.com)
- The effects of spirituality in Alcoholics Anonymous on alcohol dependence (alcoholismcoach.com)
- Meetings + Spirituality = Recovery (recoveryissexy.com)
Friday, February 25, 2011
Everyone is in denial about something; just try denying it and watch friends make a list.
Varieties of denial include inattention, passive acknowledgment, reframing and willful blindness.
For Sigmund Freud, denial was a defense against external realities that threaten the ego, and many psychologists today would argue that it can be a protective defense in the face of unbearable news, like a cancer or addictive diagnosis.
D - Don’t
E - Even
N – Notice
I – I
A – Am
L – Lying
In the modern vernacular, to say someone is “in denial” is to deliver a savage combination punch: one shot to the belly for the cheating or drinking or bad behavior, and another slap to the head for the cowardly self-deception of pretending it’s not a problem.
Yet recent studies from fields as diverse as psychology and anthropology suggest that the ability to look the other way, while potentially destructive, is also critically important to forming and nourishing close relationships.
The psychological tricks that people use to ignore a festering problem in their own households are the same ones that they need to live with everyday human dishonesty and betrayal, their own and others’.
And it is these highly evolved abilities, research suggests, that provide the foundation for that most disarming of all human invitations, forgiveness.
Tuesday, February 15, 2011
With Valentine’s Day today, many women will soon be opening heart-shaped boxes of chocolate. This sweet indulgence is a once-a-year splurge for many women. But this customary gift may tell that special woman in your life that you love her, and her heart.
Chocolate has been consumed for centuries, often used as a food staple, medicine, and an offering in religious ceremonies. Chocolate has been the topic of numerous literary works, as well as involved in countless crimes (culinary and otherwise). Chocolate has impacted religion, economics, and culture throughout the world. And now, evidence shows it is a heart-healthy treat.
Full story at - I “Heart” Chocolate | Brain Blogger