Speaking of mixed feelings.... I learned today that the penalty for not participating will be $95. That's only $15 more than a Portland Parking ticket. Of course, there is the possibility that decent care might result from being covered within this system. But not necessarily. I have a deep distrust, and dislike, of health insurance and what it has done to healthcare in America. Mandating health insurance is... un-American. Letting health insurance control what care is given and to whom is no better than socialized medicine. It simply puts the power in the hands of megacorporations that are already mixed up with our government. And it requires that everyone's personal health information go into an electronic medical record, supposedly to improve care, but potentially useful for other projects. If the government would decide what care to provide based on what has the best outcomes for the most people, I would be less opposed to that. It's not a simple situation, that much is for certain. The best answer is just as the bumpersticker says: don't get sick.
My patients often ask if I think medical marijuana might be helpful. We’ve had some widely ranging conversations about the risks and benefits of this drug. As a naturopathic physician I may not prescribe cannabis even though it is legal for medical use here in Oregon; it is not in the ND formulary. The fact that I cannot prescribe it does not prevent me from discussing it. The issue will not go away, regardless of the laws and the war on drugs. Cannabis is ubiquitous, even though it is federally illegal with varying levels of state permissiveness.
Just last month Colorado and Washington were the first states in America to approve the legalization of marijuana for recreational use. Those who fear it as a gateway drug, and those who advocate its medical use or broader legalization, are all making noise about it. The politics often plays more loudly than the facts. Marijuana is the #1 drug brought our way by Mexican drug cartels, and Mexican weed is likely to contain pesticides and other toxins. Synthetic cannabinoids are being imported from Asia labelled as bath soaps and sold in convenience stores. The war on drugs highlights our incarceration problem and the ugly politics of race. Reasonable medical questions remain unanswered.
Our own government propagated a lot of disinformation back in the 1930’s when the Federal Bureau of Narcotics was created and cannabis was classified as a narcotic (against the advice of the American Medical Association). The original Greek meaning of “narcotic” was any psychoactive substance that induces sleep, but in more recent times it has come to mean opiates and any drug derived from them. Opiates are addictive and are carefully regulated by the DEA. Cannabis is pharmacologically a world apart from opiates, and is no longer thought of as a narcotic, but it is still plagued by the negative reputation engendered by federal prohibition and propaganda, and the War on Drugs. Cannabis was federally prohibited in 1933, the same year that the prohibition on alcohol was rescinded.
In 2009 the AMA did a review of the scientific literature on cannabis and found a few legitimate clinical trials with a grand total of less than 300 study participants. The DEA has refused to grant permission to universities or pharmaceutical companies to research it. The drug is approved by 18 states for medical use, but we have very little scientific information on which to base clinical applications. Anecdotal information about the indications of various strains guide the choices of medical users. The federal ban is still in effect, and current federal enforcement efforts are focused on importers and distributors and not on small scale possession (like they were under Reagan). Employers are within their legal rights to require drug testing. Law enforcement budgets rely on asset forfeitures (police can seize any cash or items likely to be related to drug trade without proof of guilt) which is incentive for police forces to continue to pursue small scale dealers. Medical cannabis programs provide a front for a new domestic black market. That the issue is contentious is an understatement; it is explosive. And we still don’t know what it is good for.
A future email newsletter will focus on known and theoretical risks and benefits of cannabis use. Sign up for the monthly missive here.
Tis the turning of the seasons, for those of us up here in the northern hemisphere. Suddenly it is dark at 6:30pm. The train whistle blows eerily in the distance. The candle is lit in the pumpkin. I enjoy this time of the year. I love the crisp air and the bright rich colors of the maples. I love to nest, to make my homespace warm and lovely, to invite friends over to enjoy early evenings. I like to get extra sleep when the nights are long.
I have a theory about humans and winter. In our culture there is this diagnosis called Seasonal Affective Disorder. This disorder is said to affect people in the winter, when they get SAD because they aren't getting enough daylight. I think that a certain amount of hibernation is normal in humans. When the nights are long, our bodies know what we need. We want to eat more potatoes and less greens. We want to go to bed earlier, or lay cuddled on the couch with a blankie. I think that winter makes us SAD when we do not allow ourselves to retreat inward, to relish our warm homespace. I think that SAD occurs due to a modern idea that the show must go on, we still must go to work for the same number of hours, and do the same amount of extracurricular activities, even if we don't feel like it.
But what would happen if we let our bodies and our instincts guide us? What if instead of making ourselves go to another event that happens after sundown, we stayed home? Got comfy? Lit a candle? Spent a little extra time with a loved one? Would we still be so SAD if we just let it be winter? What if we let winter be a time to hibernate, a time to enjoy warm furs and firelight and quiet times with our closest intimates? I think we might find that the retreat into winter provides us with the restoration that we need to continue living life to its fullest, with great joy.
The word is getting out. On my plane ride home yesterday I sat next to a chiropractor who was in the process of reading a book about human health. She was very excited about what she was learning, and told me all about it. She told me about how human genes can be turned on and off by our environment---what we eat and what we are exposed to influences the way that our genes are expressed. It's called epigenetics, and it's a fast-growing new area for research and rumination. This is not news to me, but it was good to realize that there are popular books out there inspiring people to eat apples and get exercise. People want to be healthy, but after several generations of trusting in technology and medicine, we have forgotten how. We have come to rely too much on external sources that tell us not to worry about our ailments because technology will patch us up. We have forgotten to listen to our own internal intelligence. The time is right for teachings of an old kind, that we are mammals not machines, and that to thrive we need to treat our bodies with respect, even love.
Author: Teresa Gryder
Integrative Physician and Student of Life, Medicine, and the River.