This month I tried to live like a shut-in, with few
exceptions like going to work visiting elderly shut-ins and attending educational excursions. One weekend, I joined Chinese Culture Center’s walking tour out
on the alleys and streets of San Francisco Chinatown! After all, San Francisco Chinatown is age-friendly: seniors (age 60+) make up 35% of its
residents, while seniors make up 20% of San
Francisco
“Chinese seniors make the best of urban life and public space …They hold exercise classes inWashington
Square Park Portsmouth
Square Andria Lo, photographer and writer of Chinatown
Pretty
“Chinese seniors make the best of urban life and public space …They hold exercise classes in
“Diligence is the path
Up the mountain of knowledge
Hard work is the boat
Across the endless sea of
learning”
This Confucian aphorism, at City College of San
Francisco’s Chinatown campus,
expresses traditional Chinese values: the emphasis on diligence and hard work
in continuous self-cultivation through education,
to elevate society for peace on earth!
Docent Julia holds up Chinese character for king (wang in Mandarin; wong in Cantonese): 3 horizontal strokes represent Heaven, Man
and Earth; the vertical stroke is the king, one who connects them together.
Chinese philosophy
is influenced by 3 sages and their distinct reactions to tasting vinegar:
- Confucius with sour
face – belief that present world out of harmony with past, so remedy by
ethical self-cultivation (jen)
and observing codes of human conduct (li)
- Buddha (from
- Lao
Tzu (founder of Taoism) with smiling face - belief that
universe is governed by natural laws, which acceptance leads to
understanding and peace of mind
These traditional schools
of thought influence how we live/age: cultivation, detachment, or acceptance? (According to Vinegar Connoisseurs International:
“Fresh vinegar has a very sharp and biting taste. Its true
quality is best revealed by aging. During aging, it becomes more mellow. The
esters and ethers of the vinegars are allowed to mature, and many of the finer
qualities emerge… The longer it is aged, the more these subtle qualities will
developed.”)
No longer banished to
the southern parts of the City, I now do home visits with seniors in the
Central City (South of Market Area and Tenderloin neighborhoods). One occupational hazard of my work in this
area is frequent exposure to second-hand smoke from clients smoking marijuana and/or tobacco.
Both plants traditionally have medicinal value, but I can’t handle the
lingering smoke even after I request that clients refrain from smoking in my presence.
Medical marijuana
Seniors, who are increasingly vulnerable to opioid
addiction and higher prescription drug costs, are increasingly turning to
medical marijuana as an alternative treatment for anxiety, depression, sleep disorders and pain.
At San Francisco Main Library, Laurie Vollen, MD,
of Naturally Healing MD,
presented a talk on the science of medicinal marijuana. She included a historical context of medical
marijuana: Chinese written record of its
medical use 4,700 years ago; 100 medical conditions treated with cannabis 2,000
years ago; medical cannabis heads west 300 years ago. From 1840 to 1930, cannabis was America
Dr. Vollen has prescribed medical marijuana for
patients with conditions such as cancer,
headaches, multiple sclerosis, digestive disorders, arthritis, etc. Marijuana’s effects on humans are analgesic (reduces pain), relaxant (anti-spasmodic),
antiolytic (anti-anxiety), soporific (hypnotic), mood enhancer (euphorant),
anti-nausea, and anti-convulsant. Effects
depend on dosing the right amount to get relief, not get high: LESS IS MORE, START LOW & GO SLOW.
Treatments that
don’t get you stoned: topical lotions (for arthritis), suppositories (for patients unable to eat) and non-psychoactive products (for epilepsy).
“Return to traditional values”: In 1971, President Richard Nixon launched the
War on Drugs,
which was escalated by President Ronald Reagan and his wife Nancy. During a visit to a West
Oakland elementary school in 1982, First Lady Reagan started “Just
Say No” campaign in response to a schoolgirl who asked what to do if she was offered
drugs. Their efforts contributed to mass
incarceration of drug offenders, including the school-to-prison pipeline.
When Dennis Peron’s partner became ill with AIDS in
1980s, he used marijuana to ease his pain and nausea. After his partner died, Peron advocated for medical marijuana use by authoring
our country’s first medical marijuana bill, San Francisco
In 2011, California
Marijuana smells remind me of visits to my high school restroom in Honolulu
Relief
when nature calls: age-friendly public toilets from Biblical times!
I thought about the traditional role of communal
toilets in creating a more age-friendly place for shut-in clients with urinary
incontinence. Many clients with enlarged
prostate (benign prostatic hyperplasia), neurogenic bladder or other incontinence issues have agoraphobia due to anxiety over not being
able to make it to a toilet in a timely manner; instead, if they must leave
home to attend an appointment, some carry a cup to pee in when convenient.
Since 2002, public urination in San Francisco
Until the 1800s, there was little expectation of privacy when using the bathroom. In ancient Greco-Roman Empire, large-scale public latrines were unisex and communal.
Middle-aged parents are now more likely to smoke weed than their teenaged kids
ReplyDeleteBy Christopher Ingraham
September 2
…The research, released this week by the Centers for Disease Control and Prevention, found that only 7.4 percent of Americans aged 12 to 17 years old smoked marijuana regularly in 2014, a 10 percent decline since 2002. But 8 percent of 35 to 44 year olds used marijuana regularly in 2014, surpassing use among teens for the first time since at least 2002. (Survey data prior to that year aren't directly comparable, as the methodology changed.)
And it's not just middle-aged folks who are indulging more often. Since 2002, regular marijuana use among Americans age 45 to 54 has jumped by nearly 50 percent. Among those ages 55 to 64, it's jumped by a whopping 455 percent (no, that's not a typo).
And among seniors, age 65+, monthly marijuana use is up 333 percent since 2002.
"During the last 13 years, marijuana use (i.e., past-month marijuana use) has steadily increased in the United States, particularly among people aged 26 years or older," said report author Alejandro Azofeifa in an email. "Older groups had a significant increase of marijuana use in the past month."
To put it another way: If trends continue like this, marijuana use among 50- and even 60-somethings could be higher than use among teens in a few years.
Much of the debate around marijuana legalization focuses on the drug's potentially negative effects on teens: "what about the children?" as the common refrain goes. This makes a certain amount of sense, since the still-developing minds of adolescents and young adults are most susceptible to the potential long-term harms of heavy marijuana use. But the federal survey numbers on marijuana use suggest that voters considering whether to legalize pot should be asking themselves a different question: "what about grandpa?"
There are several factors that could explain rising marijuana use rates among the middle-age-and-up crowd. The first is the growing prevalence of medical marijuana, which is now allowed in 25 states and D.C. Older Americans are increasingly turning to medical pot to treat some of the common ailments of old age, like sleeplessness, aches and arthritis pain (here's looking at you, Rep. Dana Rohrabacher (R.-Ca.)).
Research shows, for instance, that Medicare prescriptions for a number of common drug types -- painkillers chief among them -- are falling in states that allow medical marijuana. This suggests that a significant number of seniors in those states are opting for pot over more traditional medications.
Another explanation: Aging Boomers seem to be taking advantage of loosening restrictions on marijuana use -- particularly in states where the drug is fully legalized -- to relive some of the recreational indulgences of their youth.
National survey data bears this out: the Boomer generation were big supporters of legalization in the 1970s. But as they got jobs, had kids and settled down in the 1980s, their support for legalization plummeted. It began to rebound in the 1990s, and as of 2013, half of Boomers supported legalization.
The marijuana industry is taking note of these shifts, and in places like Colorado and Washington companies are actively marketing toward aging Boomers looking to give weed another chance. Roughly one quarter of marijuana purchasers in Washington state, for instance, are over the age of 40.
So while supporters and opponents of marijuana legalization in California and elsewhere tussle over the impacts of legalization on children, these numbers suggest that legalization would bring the biggest changes to the lives of kids' parents -- and their grandparents, too.
https://www.washingtonpost.com/news/wonk/wp/2016/09/02/middle-aged-parents-are-now-more-likely-to-smoke-weed-than-their-teenaged-kids/
The Surprising Way Aging Pain Patients Can Get Off Opiates
ReplyDeleteBy Phillip Smith
November 3, 2016
…Half of older adults who live on their own report suffering from chronic pain. For people in elderly care facilities, that figure jumps to somewhere around 80%.
An aging population with its associated aches and pains is one reason opioid pain prescriptions have increased so dramatically this century…despite the well-known problems with them, primarily addiction and lethality. They can ease your pain, but they can also kill you or get you strung out. And opiate users report other problems less severe, but still affecting quality of life, such as constipation and foggy-headedness.
In recent years, we have seen increasing evidence that one substance can reduce both pain and the reliance on opioids to treat it, and that its use can have a positive impact on fatal opioid overdoses. That substance is marijuana.
As the Johns Hopkins Bloomberg School of Public Health reported in 2014, "In states where it is legal to use medical marijuana to manage chronic pain and other conditions, the annual number of deaths from prescription drug overdose is 25% lower than in states where medical marijuana remains illegal."
Now, new research findings from Care By Design, one of California's leading medical marijuana producers, add more evidence of the positive role marijuana can play in treating chronic pain and reducing dependence on opioid pain medications. The study surveyed 800 patients, mostly between 50 and 70, more than 80% of whom reported suffering from chronic pain, half of whom reported suffering from acute pain, and more than 40% of whom reported suffering from both.
These patients …tried a number of pain management tools—opiates, medical marijuana, anti-inflammatory agents (NSAIDS), nerve blockers, exercise/physical therapy, and surgery—with respondents reporting trying an average of four of them. A quarter of patients reported having tried all six.
The patients reported that marijuana was very effective for pain, with few negative side effects. That was in striking distinction to opiates, which patients also said were effective for pain, but had a significant negative impact on quality of life for a significant number of them. …
"This survey brings some very important information to light," said Care By Design spokesman Nick Caston. "We see here in our patient data that cannabis is improving the quality of life of our patients—particularly elderly patients suffering from age-related pain—and that it does so without the dangerous side effects of other pain management modalities.
…The study also found while marijuana, opiates, exercise/physical therapy, and NSAIDS all provided noticeable pain relief in more than half the patients, marijuana was the only pain management tool where there were no reports of worsening pain. And half of the patients using opiates reported that they had a negative impact on overall well-being, interfering with mood, energy, sleep, and functional abilities.
More than half of the patients reported using both marijuana and opiates to manage pain. But as noted above, nine out of 10 reduced or eliminated their opiate consumption after beginning to use marijuana. And nearly two-thirds (63%) said they were now off opiates altogether…
"A tenet of healthcare in the United States is 'First, do no harm,'" the study concluded. "Patient reports of cannabis’ efficacy together with its low side effect profile suggest that it should be considered as a first-line treatment for pain and/or as an adjunct treatment to opiates rather than as a medication of last resort."
In other words, if we want to reduce the reliance on opioids, with all their negatives, for the management of pain in an aging population, we should be easing access to medical marijuana. With medical marijuana legal in 25 states, we're halfway there.
http://www.alternet.org/drugs/surprising-way-aging-pain-patients-can-get-opiates
How Long You Stay On Opioids May Depend On The Doctor You See In the E.R.
ReplyDeleteBy Jenny Gold
February 15, 2017
…Within the same hospital, some doctors are three times more likely to prescribe an opioid than other doctors, and patients treated by high-prescribing doctors are more likely to become long-term opioid users, according to a study published Wednesday in the New England Journal of Medicine.
“Physicians are just doing things all over the map,” says Dr. Michael Barnett, an assistant professor at the Harvard T. H. Chan School of Public Health and one of the study’s authors. “This is a call to arms for people to start paying a lot more attention to having a unified approach.”
The study looked at how many opioid prescriptions emergency physicians gave to about 377,000 Medicare beneficiaries from 2008 through 2011. The lowest-prescribing quartile of doctors prescribed opioids to just 7 percent of patients, while the highest prescribed opioids to 24 percent — more than three times as often.
Patients who saw a high-intensity prescriber were about 30 percent more likely to end up with a long-term opioid prescription of at least six months within the year following their hospital visit. They were also more likely to return to the hospital in the next 12 months with an opioid-related fall or fracture, a risk factor for seniors who take the powerful painkillers.
Overall, about one in every 48 Medicare patients prescribed an opioid in the study were likely to become a long-term opioid user.
There is a growing consensus among doctors that opioids have long been overprescribed. In 2010, there were enough prescriptions written to supply every American adult with hydrocodone for a month, according to the Centers for Disease Control and Prevention.
Part of the problem, Barnett believes, is that there isn’t enough guidance for doctors on when it’s appropriate to prescribe an opioid. Much of the evidence for when they are appropriate comes from small studies sponsored by drug companies.
“It’s kind of a grey area and there’s not very clear evidence around what you should do, so we use our own judgement. And there’s a huge gulf between what one doctor thinks and another,” Barnett explains.
Take, for example, a patient who comes to the emergency room complaining of back pain. There’s evidence that opioids are not necessary in that situation, but many doctors prescribe them anyway, said Barnett. “The world of pain treatment outside of opioids is limited and can take time to figure out. Opioids are an easy fix.”
The problem, he said, is that “even one prescription for opioids carries risks with it, that from my own experience as a provider, we tend to underestimate and under-explain to patients.”
…The study did not look at whether the opioids were correctly prescribed in each incidence. Dr.Carla Perissinotto, a geriatrician at the University of California San Francisco, worries that some of the doctors in the lowest quartile might be under-prescribing. “We have to be careful to not make assumptions too quickly and assume they’re bad prescribers, because it could be the opposite,” said Perissinotto, who also was not involved in the study.
Usually, a patient is prescribed just a handful of pills by a doctor at the emergency department to tide them over until the patient can visit his or her primary care physician.
But many primary care doctors simply refill the opioid prescription for another 30 days or longer, a phenomenon Barnett calls clinical inertia. “There’s this cognitive bias to keep going with the flow especially if the patient still feels they’re in pain.”
That can have long-term implications: One-third of people who have taken prescription opioids for at least two months say they became addicted to or physically dependent on them, a recent Washington Post-Kaiser Family Foundation survey found.
http://californiahealthline.org/news/how-long-you-stay-on-opioids-may-depend-on-the-doctor-you-see-in-the-e-r/
Seniors Increasingly Getting High, Study Shows
ReplyDeleteBy Carmen Heredia Rodriguez
December 6, 2016
Baby boomers are getting high in increasing numbers, reflecting growing acceptance of the drug as treatment for various medical conditions, according to a study published Monday in the journal Addiction.
The findings reveal overall use among the 50-and-older study group increased “significantly” from 2006 to 2013. Marijuana users peaked between ages 50 to 64, then declined among the 65-and-over crowd.
Men used marijuana more frequently than women, the study showed, but marital status and educational levels were not major factors in determining users.
The study by researchers at New York University School of Medicine suggests more data is needed about the long-term health impact of marijuana use among seniors. Study participants said they did not perceive the drug as dangerous, a sign of changing attitudes.
The study was based on 47,140 responses collected from the National Survey on Drug Use and Health.
Joseph Palamar, a professor at the NYU medical school and a co-author of the study, said the findings reinforce the need for research and a call for providers to screen the elderly for drug use…
Growing use of the drug among the 50-and-older crowd reflects the national trend toward pushing cannabis into mainstream culture. Over 22 million people used the drug in 2015, according to the Substance Abuse and Mental Health Services Administration. Eight states have legalized the drug for recreational as well as medicinal use, according to Marijuana Policy Project, a non-profit advocacy group dedicated to enacting non-punitive marijuana policies across the United States. The drug has also proved to be a financial boon for state economies, generating over $19 million in September in Colorado.
…More people living with medical conditions also sought out marijuana. The study showed the number of individuals living with two or more chronic conditions who used the drug over the past year more than doubled. Among those living with depression, the rate also doubled to 11.4 percent.
Palamar says the increase among the sick could be attributed to more individuals seeking to self-medicate. Historically, the plant was difficult to research due to the government crackdown on the substance. The Drug Enforcement Administration classifies the plant as a Schedule I substance, “defined as drugs with no currently accepted medical use and a high potential for abuse.”
Benjamin Han, assistant professor at the New York University School of Medicine and the study’s lead author, fears that marijuana used with prescription drugs could make the elderly more vulnerable to adverse health outcomes, particularly to falls and cognitive impairment.
“While there may be benefits to using marijuana such as chronic pain,” he said, “there may be risks that we don’t know about.”
The push and pull between state and federal governments has resulted in varying degrees of legality across the United States. Palamar says this variation places populations at risk of unknowingly breaking the law and getting arrested for drug possession. The issue poses one of the biggest public health concerns associated with marijuana, Palamar says.
But unlike the marijuana of their youth, seniors living in states that legalized marijuana for medicinal use now can access a drug that has been tested for quality and purity, said Paul Armentano deputy director of NORML, a non-profit group advocating for marijuana legalization. Additionally, the plant is prescribed to manage diseases that usually strike in older age, pointing to an increasing desire to take a medication that has less side effects than traditional prescription drugs.
The study found over half of the users picked up the habit before turning 18, and over 90 percent of them before age 36.
http://californiahealthline.org/news/seniors-increasingly-getting-high-study-shows/
When Retirement Comes With a Daily Dose of Cannabis
ReplyDeleteBy WINNIE HU
FEB. 19, 2017
…Hebrew Home at Riverdale, is taking the unusual step of helping its residents use medical marijuana under a new program to treat various illnesses with an alternative to prescription drugs. While the staff will not store or administer pot, residents are allowed to buy it from a dispensary, keep it in locked boxes in their rooms and take it on their own.
From retirement communities to nursing homes, older Americans are increasingly turning to marijuana for relief from aches and pains. Many have embraced it as an alternative to powerful drugs like morphine, saying that marijuana is less addictive, with fewer side effects.
For some people, it is a last resort when nothing else helps.
Marijuana, which is banned by federal law, has been approved for medical use in 29 states, including New York, and the District of Columbia. Accumulating scientific evidence has shown its effectiveness in treating certain medical conditions. Among them: neuropathic pain, severe muscle spasms associated with multiple sclerosis, unintentional weight loss, andvomiting and nausea from chemotherapy. There have also been reports that pot has helped people with Alzheimer’s disease and other types of dementia as well as Parkinson’s disease.
Across the nation, the number of marijuana users who are in their later years is still relatively limited, but the increase has been significant, especially among those 65 and older, according to recent studies.
“It’s a bigger issue than we thought,” said Brian Kaskie, a professor of health policy at the University of Iowa who co-wrote a study published in January, “The Increasing Use of Cannabis Among Older Americans: A Public Health Crisis or Viable Policy Alternative?”
…A medical marijuana education and support club started by residents of Rossmoor Walnut Creek, a retirement community east of San Francisco, has grown to 530 members …
…In March, an influential group of medical providers, AMDA — The Society for Post-Acute and Long-Term Care Medicine, will tackle the issue at its annual conference…
…as older people come to represent an emerging frontier in the use of marijuana for medical purposes, questions are being raised about safety and accessibility. Even in states where medical marijuana is legal, older people who stand to benefit often cannot get it. Most nursing homes do not openly sanction its use, and many doctors are reluctant to endorse pot use, saying not enough is known about the risks in the oldest age groups.
…While there is no shortage of research on marijuana, relatively little of it has focused explicitly on older users even as their numbers grow …
…Most nursing homes have also taken a cautious position, often resorting to a “don’t ask, don’t tell” approach.
“If residents are taking it, they are taking it undercover without the staff knowing so it’s not part of their care plan,” said Dr. Cheryl Phillips, senior vice president for public policy and health services for LeadingAge, an industry group representing more than 2,000 nursing homes. “I think that creates a safety problem.”
Fred Miles, a Colorado lawyer who represents nursing home operators, said nursing homes — unlike assisted living facilities — were regulated by the federal government, and were fearful of jeopardizing their Medicare and Medicaid funding…
https://www.nytimes.com/2017/02/19/nyregion/retirement-medicinal-marijuana.html
The Inside Dope on Jean Quan’s Pot Club
ReplyDeleteThe former Oakland mayor faces neighborhood opposition over a proposed medical cannabis dispensary in the Outer Sunset.
Joe Kukura
Wed Mar 15th, 2017 5:18pm
Yes, former Oakland mayor Jean Quan is planning to open a marijuana dispensary in San Francisco. But the reality of the arrangement is a little more complex, and community opposition has made the outcome far from certain.
Quan and her husband, Dr. Floyd Huen, are teaming up with the Apothecarium, a high-end cannabis dispensary, to open the first such shop in San Francisco’s Outer Sunset district. Quan would not be the sole owner; rather, she and her husband would be part-owners of the new Apothecarium expansion. (Currently, the Apothecarium has one San Francisco location at Market and Dolores streets, with another in Las Vegas and a proposed expansion in Berkeley.)
And just as the Apothecarium is an elegant niche dispensary, this proposed Outer Sunset location would serve a unique demographic. Quan and Huen intend to employ a bilingual staff fluent in Mandarin or Cantonese, and familiar with the practices of traditional Chinese medicine. They believe this would be San Francisco’s first partially Chinese-owned marijuana dispensary.
“Until recently, it was hard for me to get my own Chinese patients to consider using [cannabis]” Dr. Huen tells SF Weekly. “For the same reason, the community is not as interested in the product.”
The exact location has already been secured: a storefront at Noriega Street and 32nd Avenue that’s been vacant for three years.
…This opposition from the predominantly Asian neighborhood might explain why Quan has been brought into the project. While Quan was voted out after one term and even faced a recall effort, she was also an accomplished Oakland city councilperson for eight years and an eight-year Oakland School Board member before that.
And she’s a whiz with marijuana policy, having written Oakland’s medical cannabis dispensary policy in 2004. Quan has extensive community contacts, and a long history of winning over cannabis skeptics.
…Huen is a longtime gerontologist and regularly prescribes chronic pain medicine. While he describes himself as “not a pot doc,” he has been a cannabis convert in recent years.
“I came into this through searching for some alternatives to opiate use, which is really wreaking havoc on our patients in the East Bay,” Huen says.
…Still, the Sunset is not exactly San Francisco’s most bohemian neighborhood. It’s relatively conservative and full of families, which is likely why no dispensaries have ever opened there. But that’s where the Apothecarium sees a need.
“We have more than 3,000 patients in the Sunset already,” Dobris tells SF Weekly. “That’s just our patients. There have got to be many others.”
“They deserve access to their medicine in their neighborhood,” he adds.
The neighborhood has historically voted pro-cannabis. Election results from District 4, designated as the Sunset/Parkside district, showed strong majorities in favor of the 1996 Proposition 215 that legalized medical marijuana and last year’s Proposition 64 that legalized recreational cannabis use.
Now the neighborhood’s first dispensary is in the preliminary stages of its application, which it expects to complete in a few weeks. An up-or-down decision from the San Francisco Planning Commission is expected in late spring or early summer.
The first dispensary in the largely Chinese-American neighborhood is likely to see more cultural resistance, but Huen feels it would be right at home.
“Cannabis has a long history in China, going back to 6000 B.C.,” he says, pointing to a rack of the Apothecarium’s large, glass water pipes and bongs. “You walk around villages in China, pipes like that are everywhere.”
http://www.sfweekly.com/news/suckafreecity/the-inside-dope-on-jean-quans-pot-club/
An Overlooked Epidemic: Older Americans Taking Too Many Unneeded Drugs
ReplyDeleteBy Sandra G. Boodman DECEMBER 12, 2017
For decades, experts have warned that older Americans are taking too many unnecessary drugs, often prescribed by multiple doctors, for dubious or unknown reasons. Researchers estimate that 25 percent of people ages 65 to 69 take at least five prescription drugs to treat chronic conditions, a figure that jumps to nearly 46 percent for those between 70 and 79. Doctors say it is not uncommon to encounter patients taking more than 20 drugs…
Unlike the overuse of opioid painkillers, the polypharmacy problem has attracted little attention, even though its hazards are well documented. But some doctors are working to reverse the trend.
At least 15 percent of seniors seeking care annually from doctors or hospitals have suffered a medication problem; in half of these cases, the problem is believed to be potentially preventable. Studies have linked polypharmacy to unnecessary death. Older patients, who have greater difficulty metabolizing medicines, are more likely to suffer dizziness, confusion and falls. And the side effects of drugs are frequently misinterpreted as a new problem, triggering more prescriptions, a process known as a prescribing cascade.
The glide path to overuse can be gradual: A patient taking a drug to lower blood pressure develops swollen ankles, so a doctor prescribes a diuretic. The diuretic causes a potassium deficiency, resulting in a medicine to treat low potassium. But that triggers nausea, which is treated with another drug, which causes confusion, which in turn is treated with more medication.
For many patients, problems arise when they are discharged from the hospital on a host of new medications, layered on top of old ones…
“This problem has gotten worse because the average American is on a lot more medications than 15 years ago,” said cardiologist Rita Redberg, a professor of medicine at the University of California at San Francisco... A 2015 report found that the share of Americans of all ages who regularly took at least five prescription drugs nearly doubled between 2000 and 2012, from 8 percent to 15 percent. University of Michigan researchers recently reported that the percentage of people older than 65 taking at least three psychiatric drugs more than doubled in the nine years beginning in 2004. Nearly half of those taking the potent medications, which include antipsychotic drugs used to treat schizophrenia, had no mental health diagnosis.
Redberg and other doctors are trying to counter the blizzard of prescriptions through a grass-roots movement called “deprescribing” — systematically discontinuing medicines that are inappropriate, duplicative or unnecessary.
…in the United States, bolstered by physician-led efforts, such as the five-year-old Choosing Wisely campaign. The Beers Criteria, a list of overused and potentially unsafe drugs for seniors first published in 1991, has been followed by other tools aimed at curbing unnecessary drug use.
“Lots of different medications get started for reasons that are never supported by evidence,” said Redberg, editor in chief of JAMA Internal Medicine. “In general, we like the idea of taking a pill” a lot better than non-drug measures, such as improved eating habits or exercise….
Kathryn McGrath, a Philadelphia geriatrician, said she tries to begin every appointment with a review of medications, which she asks patients to bring with them. “I think having the pill bottles” is much more powerful than a list, said McGrath…
…Mishori said that she deprescribes only one medication at a time so she can detect any problem that arises from that change. And, she adds, “I never take people off of a medication without doing something else.” …
Maust, the geriatric psychiatrist, recommends that doctors actively focus on “the big picture” and carefully weigh whether the benefits of a drug outweigh its risks.
“In geriatrics,” he said, “less is more.”
https://khn.org/news/an-overlooked-epidemic-older-americans-taking-too-many-unneeded-drugs/
Dennis Peron, activist who helped legalize medical marijuana, dies
ReplyDeleteBy Lizzie Johnson
Saturday, January 27, 2018
Dennis Peron, an activist who helped legalize medical marijuana in California, died Saturday afternoon in a San Francisco hospital. He was 71.
Peron was a force behind a San Francisco ordinance allowing medical marijuana, a win that later helped propel the 1996 passage of Prop. 215, which legalized medical use for the entire state. A Vietnam War veteran, Peron spent some of the last years his life on a 20-acre farm in the rolling hills of Lake County, growing and giving away what he once sold: medical marijuana.
“A man that changed the world,” Jeffrey Peron wrote in a Facebook post, along with a photo of his brother — impish and good-looking — dressed in a gray suit and a blue striped tie. “This is the Dennis I want to remember.”
Throughout his long and checkered career, Peron was a gay activist, pot enthusiast and sometimes-vigilante at odds with the law. He was among the first to argue for the benefits of medicinal marijuana for AIDS patients as the health crisis overtook San Francisco. The epidemic also took his partner, Jonathan West, in 1990.
San Francisco’s Board of Supervisors recognized Peron, suffering with late-stage lung cancer, with a certificate of honor last year.
“The father of medical marijuana,” one supervisor called him in the meeting.
“I came to San Francisco to find love and to change the world,” Peron said in reply, leaning on his walker. “I found love, only to lose him through AIDS. We changed the world.”
But once, Peron was just a “gay kid from Long Island who joined the Air Force to get away from home,” as he described it in his 2012 book, “Memoirs of Dennis Peron.” He then moved to a commune in the Haight, where he befriended Supervisor Harvey Milk and began selling marijuana in the Castro.
In 1991, Peron founded the first public cannabis dispensary in the country — originally called the San Francisco Cannabis Buyers Club — during the height of the U.S. drug war.
He, along with “Brownie” Mary Rathbun, formed a resistance, doling out the herb to AIDS patients and shifting the public conversation about how it should be used. He was busted more than four times for illegally dealing the drug, spent time in jail and was once shot in the leg by a police officer. The club, which served 9,000 clients, was closed by a San Francisco Superior Court judge in 1998.
“The city and the country has lost a cannabis leader who lived life on the edge,” said Terrance Alan, a member of the city’s Cannabis Commission. “He lived his whole life on the edge, and that’s what allowed us to lead in cannabis. Not many people would have had the courage at the time that he took up the mantle.”
After the club was shut down, Peron moved to the country. He changed his business model and began providing living plants to patients. Eventually, after being diagnosed with lung cancer, he moved back to the Castro Castle, a former bed-and-breakfast he owned with his husband, John Entwistle.
http://www.sfgate.com/bayarea/article/Dennis-Peron-called-father-of-medical-12531260.php
Nice post. Well what can I say is that these is an interesting and very informative topic on Health with Cannabis
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