Over the years, I’ve taken care of women with locally advanced breast cancer so advanced that it’s eroded through the skin, forming huge, nasty ulcers filled with stinky dead cancer tissue that’s outgrown its blood supply, leaving the patient in chronic pain. If the patient is fortunate, her cancer has not metastasized beyond her axillary lymph nodes (the lymph nodes under her arm), and her life might still be saved by a combination of chemotherapy, radical surgery, and radiation. If the patient is not fortunate, either the cancer has metastasized and she is doomed or hasn’t metastasized yet, but it’s invaded into the chest wall and the nerves in her axilla (the structures under the arm), making it impossible to remove surgically but not likely to kill her any time soon. In the latter case, chronic pain, infection, and blood loss is what the patient will look forward to until the cancer either metastasizes or invades a vital structure. Fortunately, I’ve only seen a handfull of these patients over the last 20 years. Fortunately, the number of such patients whom I’ve taken care of has been small.
I fear that, before long, I m going to bee seeing a lot more of them. There are two reasons. The first is that at least half of these patients with nasty, neglected breast cancers that I’ve encountered had relied on the treatments of naturopaths before coming to the attention of real oncologists and surgeons at a time long after their ability to help was seriously limited by how advanced the cancer has become. The second reason is yet another attempt by naturopaths to expand their scope of practice. Worse, this is happening in my state through Michigan House Bill 4531, which has been approved by the Michigan Committee on Health Policy and referred to the full House for consideration. It’s all about a renewed push by naturopaths, fueled by supplement industry money, to get laws licensing them as real health care professionals in multiple states, including Michigan.
The last time I wrote about naturopaths trying to expand their scope of practice in my state was in 2013 in the form of a bill that was not as broad as HB 4531, namely HB 4152. Fortunately, it went nowhere and, in contrast to HB 4531, didn't even make it out of the Committee on Health Policy.
Although Jann has already ably discussed the bill and fellow Michigan physician and bud Peter Lipson has referred to naturopaths as fake doctors in white coats (which is true), as well as why naturopathy is unscientific and how he as a primary care internist not infrequently has to clean up the messes left when local naturopaths treat patients incompetently, this is my state, and I can't help but chime in myself. Unfortunately, it’s not difficult to predict the potential consequences if HB 4531 passes and expands the scope of practice to be nearly as broad as that of MDs practicing primary care medicine, at least in oncology. More Orange Men, for one thing. I will do that by looking at real world examples of naturopathic shenanigans and disasters both within our very own state, because these are the people with whom the reins of primary care will be shared if HB 4531 were to pass.
Naturopathy: The pseudoscience that is "natural medicine"
Although I’ve written extensively about naturopathy in the past, I have to give props to what is perhaps the definitive explanation of why naturopathy is pseudoscience and quackery, which was written 13 years ago by Kimball Atwood (who, alas, no longer blogs for SBM) for Medscape and entitled "Naturopathy: A Critical Appraisal." You can also find much more about naturopathy from this very blog.
Naturopaths like to represent naturopathy as "natural medicine." In reality, naturopathy is the modern day iteration of the 19th century "natural living" movement in Germany. Early naturopaths objected to contemporary science-based medicine, particularly germ theory and vaccinations, instead advocating the "water cure," fasting, herbs, homeopathy (or, as I like to call it, The One Quackery To Rule Them All), colonic "detoxification," and other popular methods of the era. Unfortunately, little has changed in naturopathic practice in 150 years, although naturopaths are much better at cloaking their quackery in scientific-seeming trappings, and some of them have embraced laboratory tests in a big way as part of their embrace of the dubious specialty of functional medicine.
Despite the efforts of modern naturopaths to argue that their profession is scientific, in reality naturopathy is now, as it was in the 19th century, rooted in prescientific vitalism. Basically, naturopathy is based on a belief in the "healing power of nature":
The body has an inherent ability to establish, maintain, and restore health. The healing process is ordered and intelligent; nature heals through the response of the life force. The physician's role is to facilitate this process, to identify and remove obstacles to health and recovery, and to establish or restore a healthy internal and external environment.
For those of you who aren't familiar with the lingo, any time you hear someone refer to the "life force," you're looking at vitalism, the idea that there is some sort of mysterious, yes, "life force" that is present in living matter and makes it alive. In essence, vitalism is the philosophical doctrine that states that life has a quality (the "life force," "vital force," or any of a number of other terms such as "life energy") independent of physical and chemical laws, such as an immaterial soul. Many forms of alternative medicine are based on vitalism. For instance, chiropractic posits an "innate intelligence" whose properties are very similar to the "vital force." This "innate intelligence" flows from the central nervous system but can be blocked by subluxations, which chiropractors claim to relieve. Acupuncture claims that sticking needles into "meridians" through which qi (the life energy or force) flows will redirect the flow and relieve symptoms and/or cure disease. Reiki practitioners claim that they can direct life energy from the "universal source" into patients for healing effect, which is why I like to say that if you replace the term "universal source" with "God" you have faith healing. Basically all "energy medicine" claims that its practitioners can somehow manipulate "life energy" to healing effect. Not surprisingly, naturopathy embraces pretty much all of these modalities, and more.
Particularly popular among naturopaths is a belief that disease is caused by "toxins." These toxins are seldom validated by science. In many cases, they aren't even identified. Yet, "detoxification" is a major theme in naturopathic treatments, with unscientific and sometimes dangerous treatments, such as chelation therapy (to "detoxify" heavy metal overload) and colon cleanses, including the infamous coffee enemas, being advocated to help patients "detoxify."
Basically, if you peruse some of the links above (and, as you will see as I examine what naturopaths really advertise on their websites), you will learn that naturopathy is nothing more than a hodge-podge of mostly unscientific treatment modalities based on vitalism and other prescientific notions of disease. As a result, typical naturopaths are more than happy in essence to "pick one from column A and one from column B" when it comes to pseudoscience, mixing and matching treatments including traditional Chinese medicine, homeopathy, herbalism, Ayurvedic medicine, applied kinesiology, anthroposophic medicine, reflexology, craniosacral therapy, Bowen Technique, and pretty much any other form of unscientific or prescientific medicine that you can imagine.
Within naturopathy, there are two types of practitioners, traditional naturopaths and "naturopathic physicians." In reality, from my perspective there is little difference between the two, other than that "naturopathic physicians" have graduated from "accredited" schools of naturopathic medicine and hold the "ND" degree for "naturopathic doctor" (or, as I like to call it, "not a doctor"). Both naturopaths and NDs embrace a wide variety of quackery, which they mix with some sensible lifestyle and diet advice, which is "rebranded" as somehow being unique to naturopathy. In a way, NDs are worse in that they are much better than traditional naturopaths at cloaking their activities under the mantle of science and have added to their armamentarium a wide variety of unproven or disproven diagnoses and treatments that sound medical, such as treatments for "adrenal fatigue" and "chronic yeast overgrowth".
Despite their affinity for non-science-based medical systems, naturopaths crave the imprimatur of science. As a result, they desperately try to represent what they do as being science-based, and they've even set up research institutes, much like the departments, divisions, and institutes devoted to "complementary and alternative medicine" (CAM) that have cropped up on the campuses of legitimate (and prestigious) medical schools, academic medical centers, and even community hospitals, like so many weeds poking through the cracks in the edifice of science-based medicine. Naturopaths also really, really don't like it when they encounter criticism that their "discipline" is not science-based. I discovered this a year and a half ago when I managed to get a review article on the pseudoscience of "integrative oncology" published in a high profile journal.
This incident was particularly instructive, as well, because a lot of the criticism came from physicians who have become advocates of integrative oncology, who particularly objected to my criticism of homeopathy as pseudoscience. Their responses boiled down to, "Oh, no, we would never approve of the use of homeopathy. We know it's total pseudoscience." I responded by pointing out that naturopaths (one of whom co-authored the Society for Integrative Oncology's (SIO) "evidence-based" guidelines for breast cancer care) learn homeopathy as an integral part of their training and that, indeed, they are tested on it as part of the NPLEX, the naturopathic licensing examination. I further responded by pointing out that one of the co-authors of their guidelines (Dugald Seely) was the principal investigator for an N-of-1 study of homeopathic treatment of fatigue in patients receiving chemotherapy. Basically, real, honest-to-goodness MDs, who have fallen under the spell of "integrative medicine" and are happy to collaborate with naturopaths, don't even know what naturopathy is or what naturopaths really do.
Oddly enough, I haven't seen a retort from the SIO yet. Maybe they need to speak with Britt Marie Hermes, a real naturopathic doctor who realized how full of quackery naturopathy is and left it behind.
Unfortunately, because of the lack of knowledge most people (and physicians) have about what naturopathy really is and how naturopaths really practice, videos like this Indiegogo campaign for the Michigan Association of Naturopathic Physicians (MANP) are effective:
As you will see, the shiny happy video above is a massive distortion of what naturopaths are and do.
What HB 4531 does
Before you can understand why those of us in Michigan who support SBM are alarmed by this bill, it's necessary to take a look at it. Unfortunately, naturopathy is a licensed medical profession in 17 states, the District of Columbia, and the United States territories of Puerto Rico and the United States Virgin Islands. Jann explained that, if passed, SB 4531 would give naturopaths in Michigan one of the broadest scopes of practice in the US, essentially equaling that of a family practice MD or DO.
As Jann recounted, HB 4531 defines "naturopathic medicine" as:
...a system of practice that is based on the natural healing capacity of individuals for the diagnosis, treatment, and prevention of disease.
And I can't help but recount and revise my retort to that definition, which is simple. The invocation of "natural healing capacity" as something that naturopaths uniquely utilize to treat disease is nonsense. Think of it this way. Science-based medicine relies on the natural healing capacity of individuals for the diagnosis, treatment, and prevention of diseases. Setting broken bones would be pointless if the body weren't able to heal itself naturally and knit the two bone ends together. Surgery itself (my specialty) relies on the ability of the body to heal itself; otherwise cutting into the body to rearrange its anatomy for therapeutic intent would be the gravest of folly. The very definition of naturopathy is a false dichotomy between conventional medicine and "natural healing." Of course, as I discussed above, what naturopaths mean by "the natural healing capacity" is a mystical vitalism that is based in prescientific religious belief systems about life and disease.
That being said, HB 4531 would amend 1978 PA 368, entitled "Public health code," (MCL 333.1101 to 333.25211) by adding section 16348a and part 186 to create a board of naturopathic medicine to license and regulate naturopaths. In doing so, HB 4531 would also grant naturopaths who have graduated from an "accredited" naturopathy school (like, for instance, Bastyr University), attained the degree of "doctor of naturopathic medicine" or "doctor of naturopathy," and have passed the NPLEX the authority to diagnose, treat and prevent disease in any patient, of any age, with any disease or condition. Here is the key passage:
SEC. 18615. A NATUROPATHIC PHYSICIAN MAY DO ANY OF THE FOLLOWING, CONSISTENT WITH HIS OR HER NATUROPATHIC EDUCATION AND TRAINING:
(A) ORDER AND PERFORM PHYSICAL AND LABORATORY EXAMINATIONS FOR DIAGNOSTIC PURPOSES, INCLUDING, BUT NOT LIMITED TO, PHLEBOTOMY, CLINICAL LABORATORY TESTS, ORIFICIAL EXAMINATIONS, OR PHYSIOLOGICAL FUNCTION TESTS.
(B) ORDER DIAGNOSTIC IMAGING STUDIES.
(C) DISPENSE, ADMINISTER, ORDER, OR PRESCRIBE OR PERFORM ANY OF THE FOLLOWING:
(i) FOOD, EXTRACTS OF FOOD, NUTRACEUTICALS, VITAMINS, AMINO ACIDS, MINERALS, ENZYMES, BOTANICALS AND THEIR EXTRACTS, BOTANICAL MEDICINES, HOMEOPATHIC MEDICINES, ALL DIETARY SUPPLEMENTS, OR NONPRESCRIPTION DRUGS AS DEFINED BY THE FEDERAL FOOD, DRUG, AND COSMETIC ACT, 21 USC 301 TO 399D.
(ii) PRESCRIPTION OR NONPRESCRIPTION MEDICINES AS DESIGNATED BY THE NATUROPATHIC FORMULARY COUNCIL.
(iii) HOT OR COLD HYDROTHERAPY; NATUROPATHIC PHYSICAL MEDICINE; ELECTROMAGNETIC ENERGY; OR THERAPEUTIC EXERCISE.
(iv) DEVICES, INCLUDING, BUT NOT LIMITED TO, THERAPEUTIC DEVICES, BARRIER CONTRACEPTION, OR DURABLE MEDICAL EQUIPMENT.
(v) HEALTH EDUCATION OR HEALTH COUNSELING.
(vi) REPAIR AND CARE INCIDENTAL TO SUPERFICIAL LACERATIONS OR ABRASIONS.
(vii) MUSCULOSKELETAL MANIPULATION.
(D) UTILIZE ROUTES OF ADMINISTRATION THAT INCLUDE, BUT ARE NOT LIMITED TO, ORAL, NASAL, AURICULAR, OCULAR, RECTAL, VAGINAL, TRANSDERMAL, INTRADERMAL, SUBCUTANEOUS, INTRAVENOUS, OR INTRAMUSCULAR CONSISTENT WITH HIS OR HER NATUROPATHIC EDUCATION AND TRAINING
(E) OTHER NATUROPATHIC THERAPIES AS APPROVED BY THE BOARD.
Basically, the only things NDs couldn't do that MDs can if HB 4531 were to pass would be to prescribe controlled substances; do surgical procedures other than office procedures as described elsewhere in the bill (such as suturing small lacerations or doing punch biopsies of the skin); administer general or spinal anesthetics; use laser devices or ionizing radiation therapeutically; perform surgical procedures involving the eye, ear, tendons, nerves, veins, or arteries; and, of course, chiropractic manipulation (which would intrude on the turf of licensed chiropractors). Basically, in practice, with the exception of the power to prescribe controlled substances, HB 4531 would grant naturopaths roughly the same scope of practice as primary care physicians have.
As Jann pointed out, the naturopathic board proposed in the bill would consist of three naturopaths, two licensed MDs or DOs, and two public members who have never been licensed health care professionals and do not have any financial or legal interest in "naturopathic education, business, or practice." Jann is correct to be concerned that the naturopaths on the board outnumber real physicians and that the governor could potentially easily be influenced to appoint as members from the general public people who are sympathetic to alternative medicine.
How naturopaths in Michigan actually practice
In her post, Jann pointed out how naturopaths practice, but only briefly looked at Michigan naturopaths. Since I live in the actual state, I really wanted to look more closely at naturopaths whose patients I might see or who might see my patients with breast cancer. Having over the years seen women with locally advanced, neglected cancers who had been relying on naturopaths to treat their disease until it started ulcerating through the skin to produce a painful, bleeding, stinking mess, I am very concerned with the legitimization of quackery that Michigan HB 4531 would produce. So I perused the MANP website to find NDs in Michigan, and then I perused their websites to see what they advertise. Of course, I included NDs that I have already discussed before, in particular Doug Cutler, who runs the largest naturopathic practice I know of in the state, Cutler Integrative Medicine.
Let's take a look at a few naturopathic practices in Michigan, in alphabetic order, and see the sorts of practitioners whose scope of practice would be widened to treat pretty much anyone as a primary care provider:
Cutler Integrative Medicine, Bingham Farms. Doug Cutler is the granddaddy of Michigan naturopaths and runs what is, to my knowledge (and I could be mistaken, but there's no doubt that Cutler is very successful), the largest naturopathic practice in the Detroit area, if not in the state. He is well-known nationally among naturopaths and was a major contributor to the discussions within the NatChat naturopathic discussion group whose contents were leaked on two occasions. He is very, very antivaccine (in my opinion), and, if you have any doubt that this is true, please go and read some of his comments in NatChat about "toxins" and a variant of the "too many, too soon" trope. Of course, the vast majority of naturopaths are antivaccine, with very few exceptions, and some of those exceptions still flirt with being antivaccine.
He offers constitutional and colon hydrotherapy; applied kinesiology; The One Quackery To Rule Them All (homeopathy); Nambudripad Allergy Elimination Technique (NAET); and, of course, TrueRife Technology. I had never heard of NAET before; so I looked it up. Nambudripad's Allergy Elimination Technique is described as a "non-invasive, drug free, natural solution to alleviate allergies of all types and intensities using a blend of selective energy balancing, testing and treatment procedures from acupuncture/acupressure, allopathy, chiropractic, nutritional, and kinesiological disciplines of medicine." In other words, NAET is clearly nonsense. As for TrueRife, Rife is a form of electricity quackery whose proponents use to treat a variety of diseases, including cancer, with electromagnetic impulses at different frequencies. There is no compelling scientific evidence that it is efficacious for treating any disease or condition, including cancer.
Healing Paths Naturopathic Care, Flint. This is the practice of Michelle Hoppe, ND. She offers (of course) clinical nutrition, even repeating "Let thy food be thy medicine and thy medicine be thy food"; botanical medicine; traditional Chinese medicine, particularly acupuncture; The One Quackery To Rule Them All (homeopathy); and NAET as well.
Holistic Care Approach, Grand Rapids. This practice includes several practitioners, but the naturopath there is AnnAlisa Behling, ND. Behling touts her training in homeopathy, hydrotherapy, oriental medicine, naturopathic manipulation, low level laser therapy, physical medicine, botanical medicine, as well as psychological and lifestyle counseling. She treats, among other conditions. She also treats "parasites" and, of course, candida, both of which represent favorite fake diseases in naturopathy, just like adrenal fatigue.
Huron Valley Naturopathic Clinic, Ann Arbor. This is the practice of Michelle Loewe, ND. Sadly, Loewe is apparently employed at nearby Madonna University, "where she teaches workshops to teachers on integrating nutrition and movement into the curriculum to enhance student wellness and academic achievement." She offers the usual services, such as "nutrition"; herbal medicines; "detoxification" and fasting; The One Quackery To Rule Them All (homeopathy); and hydrotherapy, among others.
Naturopathic Health Services, Clarkston, MI. This is the practice of Nancy Caruso, ND. She offers a typical roster of naturopathic therapies, first and foremost being nutrition. Of course, when a naturopath talks about using "nutrition" to treat disease, she doesn't mean what a physician does. She means using "personalized diets, vitamin and mineral supplements, and enzyme therapies are implemented in each treatment plan." Caruso also offers homeopathy (again, The One Quackery To Rule Them All); biotherapeutic drainage to 'restore normal physiology through detoxification and re-education of organs to bring the body back homeostatic balance'; hydrotherapy; and aromatherapy. She also offers something I've never heard of before, Ortho-Bionomy, which is basically a form of musculoskeletal manipulation that sounds a lot like a lot of the other forms of musculoskeletal manipulations out there. Of course, anyone who offers homeopathy cannot be considered a science-based practitioner.
Sleeping Bear Natural Health, Traverse City, MI. The naturopath here is Abigail Ellsworth, ND, who offers: The One Quackery To Rule Them All, homeopathy, along with the other usual naturopathic nonsense. What is interesting about Ellsworth is that she takes pains to point out that she is "unable to legally practice medicine and/or offer services to the full scope of: her training and that she does not "provide Primary Care, diagnose or treat disease or prescribe medications." Imagine if HB 4531 passes and naturopaths like her become able to provide primary care.
Troy Naturopathic, Troy. This is the practice of Dimpi Patel, ND, who offers botanical medicine; The One Quackery To Rule Them All (homeopathy); supplements; hydrotherapy; and traditional Chinese medicine.
I could go on, but you get the idea. Wait. I should mention one more: William Beaumont Hospital, a very large private hospital system in the Detroit area, which added naturopaths to its staff in 2008 and offers naturopathy to this day, complete with The One Quackery To Rule Them All, which is described on Beaumont's site thusly:
Homeopathy is based on the understanding that natural substances, prepared in very diluted doses, can prompt the body to self correct. Symptoms that may respond well to homeopathy include auto-immune conditions, allergies, trauma recovery and conditions that don't fit into a clear conventional diagnosis.
Yes, this is the website of a respected hospital touting homeopathy as something that is pure quackery. Seriously, go and read the Beaumont Hospital webpage on naturopathy. It might as well have been written by one of the private naturopaths in Michigan. Oh, wait, it probably was. Worse, a representative for Beaumont Health System testified in favor of HB 4531.
Certain recurring themes are apparent in these practices around the state. The first is that nearly all of them offer The One Quackery To Rule Them All (homeopathy) plus a selection of other pseudoscientific and mystical therapies, such as acupuncture, other traditional Chinese medicine, detoxification, "personalized" diet advice, and others. The second recurring theme is that many of these naturopaths are unhappy that they cannot practice to the "full extent" of their "educations." Personally, I'm glad that that is true, and remain amazed that any of them, in any state, can do so. Like Peter Lipson, who deals with the fallout from naturopathic mismanagement of patients far more than I ever have, I truly fear what might come to pass for my patients and other patients at my cancer center if HB 4531 were to pass.
Who wants HB 4531 to pass?
How has this effort to license naturopaths with a very expansive scope of practice has somehow been resurrected, this time to the point of actually making it out of the House Committee on Health Policy to the full House for consideration? Obviously, the MANP has been pushing for licensure and an expanded scope of practice all along, but that's to be expected. Also not unexpected is who introduced this bill: Representative Lisa Posthumus Lyons, who represents District 86, which encompasses a rural area in the western Lower Peninsula. As was the case last time with HB 4152, the predecessor of HB 4531, I perused her Facebook and House page and was unable to find any mention of HB 4531, even though she seems to tout everything else she does there. One might almost think she's ashamed of having sponsored HB 4531.
In any case, this time around, instead of just one co-sponsor, Rep. Lyons (R-Alto) has persuaded four additional Representatives to co-sponsor HB 4531 with her, a bipartisan group: Andy Schor (D-Lansing), George Darany (D-Dearborn and co-chair of the Committee on Health Policy), Jeff Irwin (D-Ann Arbor), Brandon Dillon (D-Grand Rapids), and Kathy Crawford (R-Novi). One notes that Brandon Dillon resigned late last year to become the Chairman of the Michigan Democratic Party. The interesting thing here is that searching for all of these Representatives plus either "naturopathy" or "HB 4531" turned up a whole lot of nothing. Not only did I fail to find much in the way of any of them bragging about introducing this legislation (as most legislators do when they introduce anything), finding news stories on HB 4531 that mention much beyond some very basic facts is almost impossible. Also odd is that this bill was introduced more than a year ago, as a naturopath named Kelly Hassberger exulted on Facebook:
Now, I realize that the wheels of government grind slowly. But what happened recently, a year after HB 4531 was introduced, to push it through the Committee on Health Policy to the floor of the House? The video I cited above mentions that the MANP hired a lobbyist to push HB 4531 through the legislature. MANP also lists various sponsors at various levels, such as Platinum ($5,000 a year), Gold ($2,500 a year), Silver ($1,00 a year), and Bronze ($500 a year). Donors include Commonwealth Labs, the manufacturer of a breath test for "Small Intestinal Bacterial Overgrowth," or "SIBO" (Platinum Sponsor); Designs for Health, a supplement manufacturer (Gold Sponsor); Viotron International, LLC, another supplement manufacturer (Silver Sponsor); and Integrative Therapeutics, yet another supplement manufacturer (Bronze Sponsor). So supplement manufacturers and the maker of a test for a questionable condition are supporting MANP's campaign? Color me surprised.
So are Madelon and Kurt Hassberger. Remember that there is some sort of link between the Hassbergers and Rep. Lyons. Kelly Hassberger, who appears to be Madelon and Kurt Hassberger's daughter, owns Grand Rapids Natural Health. Whatever's going on, the forces pushing for naturopathic licensure in Michigan have gotten further than they ever have before. To figure out why, perhaps we should look at the other side of the equation.
Who opposes HB 4531?
HB 4531 is a danger to patients in the state of Michigan. Of that there is no doubt. Licensing naturopaths would add nothing to the quality of health care in Michigan, but would under the Affordable Care Act possibly force insurance companies to reimburse for the services of naturopaths and at the same time legitimize a whole lot of quackery. So you'd think that our major medical societies in the state would be very much against HB 4531, wouldn't you? So are they? I don't know. Certainly, it's very hard to find any mention of this bill at all. For example, the Michigan Health & Hospital Association lists various pending bills and its positions on the bills, ranging from support to neutral to oppose to no position. What does the MHHA say about HB 4531? It says, "To Be Determined." Come on, MHHA! You've had a year to figure out whether you oppose or support this bill. In contrast, it sure does oppose a bill that would require the development of an acuity system and staffing plan for nurses!
What about the Michigan State Medical Society? One notes that a search on its website for "naturopath" or "HB 4531" reveals exactly zero mentions of either. Now, I've taken MSMS to task before for its intractable opposition to a bill that would expand the scope of practice of advanced practice nurses (a.k.a. nurse practitioners) to be in line with their training. I've called out MSMS for this being nothing more than an example of turf protection by physicians. I note that MSMS appears to have taken down its videos and material opposing this bill since then, but I'd be willing to bet that's just because the bill being opposed was successfully scuttled. In contrast, I note that the MSMS did not testify against HB 4531 or even offer a statement opposing it when it was debated before the Committee on Health Policy on May 3, 2016. At the very same meeting, an MSMS representative did submit written testimony opposing HB 5587, a bill that would allow a pharmacist to refuse to dispense a prescription for a controlled substance if there is reason to believe the prescription was not written in good faith or would not be used for legitimate medical purposes.
I note that MSMS stated unequivocally that every "discussion in Lansing about health care and health policy should start and end with what is best for Michigan patients." Its silence in the face of HB 4531 is directly the opposite of that nobly expressed sentiment. I can only concluded that its silence is because MSMS is either ignorant of the contents of HB 4531 (a charitable interpretation), ignorant of what naturopaths actually do (another charitable interpretation), or doesn't view naturopaths as a threat to its turf (the cynical interpretation). Take your pick of one or more. It's hard for me not to take the cynical interpretation, though, given how much effort and expense MSMS plowed into opposing Senate Bill 2, which would have expanded the scope of practice of nurse practitioners to be appropriate to their training, compared to its silence on HB 4531.
It's not all bad news, though. Other Michigan medical societies did better than MSMS. For example, during that aforementioned May 3 meeting of the Committee on Health Policy, the Michigan Academy of Family Physicians, the Michigan Osteopathic Association, and the Michigan Orthopedic Society each submitted a testimony card in opposition to HB 4531. At an earlier meeting of the committee on April 19, the Michigan Academy of Nutrition and Dietetics testified in opposition to the bill. Unfortunately, they did so for the wrong reason:
Yes, it was turf protection. Note how the Academy stated that it is "not opposed to the licensure of naturopaths, we feel Michiganders should have the freedom and ability to keep receiving the great care they are getting from their trusted health care practitioners." Ugh.
If there's one thing I've learned about Michigan politics, it's that our legislature is very good at passing bills "under the radar." For instance, I had no idea that our "right-to-try" law had passed until two weeks after, when Governor Snyder signed it into law, this despite having had Google Alerts set up and checking local news sites on a near-daily basis. I fear the same thing happening with HB 4531, which has received very close to zero news coverage even in local newspapers and other news outlets.
The answer is sunlight. When light is shed on bills like HB 4531, good things can happen. This is true not just in Michigan, but anywhere naturopaths try to expand their scope of practice. For physicians, that means pressuring your state medical societies, particularly ones to which you belong, to put their full muscle behind opposing bills like HB 4531. For lay people and physicians both, it means contacting your legislators and letting them know that you don't want practitioners of unscientific, prescientific, and pseudoscientific medicine to be legitimized by state licensure. Remember that these efforts by naturopaths are not going away. Naturopaths play the long game. When they fail, they wait until the time is right and try again, as they are doing now in Michigan.
If we advocates of science-based medicine don't mobilize, the state of Michigan could well be licensing fake doctors soon, and I could be seeing a lot more patients like that of Michaela Jakubczyk-Eckert..
I knew a woman who went to a selective university at 16 and graduated EE. Decades later she was sole provider for a family of 4 with platinum plus medical insurance.
She had breast cancer, was treated conventionally, followed up, recurred, and got horrid news on life expectancy. So she went all out,
on modern medicine and to a limited extent, naturopathy. Caught late on a fast acting recur, she needed time, she needed functionality, and of course wanted NED and QoL. She had to be treated on weekends and keep working. Expecting perhaps months to 2 years, she got 3 yrs spending over $110,000 per month.
The chemo varieties were accompanied by many side effects. Looking at her journals, I would criticize the naturopath for being too timid. She gave substantial credit for functionality and durability to the naturopathic nutrition but was several steps short of "heavy duty" in my reading.
I would also question her blood monitoring program after the earlier tx. I know how inadequate CRC looks to me.
Since she was treated in a non-licensure state, perhaps the in-house naturopath for nutrition was too censored.
Representative Lisa Posthumus Lyons
Blessed with a name like that, a career as Speaker-for-the-Dead is inevitable.
@prn: nice vague testimonial. How do you know all this? Were you her quack ND?
For myself, I would never go to an ND, even if they were licensed in my state. What can they do for me that my wonderful PCP can't? They can't give me vaccines, they can't prescribe the medications I need to stay (or become, if I get ill) healthy. They can talk about diet, exercise, and health, but my PCP does that with me already, and gives recommendations based on her knowledge.
I just don't see any value in going to a quack making money off the supplements he/she sells.
O/T, but of interest to many: The Encyclopedia of American Loons has just published an entry on Jay Gordon.
Nice to see Gordon get the recognition he deserves.
Given the option of possibly spending every dollar I have, and leaving my family with nothing, I think I'd rather take my chances with alternative medicine even if it means that I will die but leave my family some money to live off of. The cost of chemo and radiation therapy is highway robbery, and oncologists essentially prey on desperate people who will spend their entire life savings to live 3 months longer. No thanks.
Now, if chemo and radiation were more reasonable, say, $200/month, I'd be receiving allopathic treatments as expected.
If oncologists REALLY cared about their patients, they'd fight harder to reduce the costs of cancer treatments.
Natural medicine certainly has the ability to create chaos and confusion in a treatment plan for a patient. Unfortunately, the reason the movement is becoming so powerful is the fact that "legit" doctors have canned treatment plans designed for them by the manufacturers of the drugs and treatment they prescribe. This streamlined approach to medicine surely provides the ability to track statistics and succes and failure rates. But it is a process that has no ability to take humanness into consideration. It would require so much effort and even more TIME for a doctor or surgeon to delve into the variables of a human body to provide the right (and vastly different) treatment plan that each individual patient requires. Science doesn't do "every specimen is unique" very well. In fact it precludes it. So the more people become personally educated, the less they are willing to step in a cancer conveyor belt. Sorry, scientists. It's your fault.
Let me get this straight. Naturopaths, a group known to be dismissive of "conventional" medical practitioners as "pharma shills" and often selling supplements themselves, are being backed by supplement makers in an effort to expand their practice and seek an imprimatur of legitimacy from the state. Has my collection of birthdays and cynicism caused me to miss something here? Does no one engaged in the lobbying efforts see any potential problems with this, at least in PR terms?
I'll now return to my continuing campaign against the local population of rodentia.
What can they do for me that my wonderful PCP can’t?
The answer was in the video - NDs are trained to listen, and will for as long as you are willing to pay.
Michele goes into this in her response above - note how 'time' is in all caps. She wants someone to treat her like the special snowflake she is, and learn all the many things that make her oh so different than every other special snowflake.
She says that science can't handle unique, and that isn't true. It is well understood that every specimen is different, especially in the biological sciences. But when you are dealing with large numbers of specimens, they are more similar than different, and probability comes into play. That offends her and all other marks victims of NDs.
Can a brother get a preview button to avoid hamlet fails?
D'oh! Stupid autocorrect.
"Alternative" treatments aren't covered by insurance....you are much more likely to piss away all of your funds going down the road of alt med, than going with conventional treatments which are covered by insurance.
In countries where universal access to health care is available, no one goes bankrupt getting treated by real doctors.
Sooo, soon to occur in your state, I can become a doctor.
Call me Who.
Christ, but at 3.75 liters a week, I'm not drinking enough.
Worse, my liver function, despite serious anti-hyperthyroid medication, is quite fine.
I'm stuck watching modern medicine collapse.
Hey, doc, want to borrow one of my firearms? I'll gladly loan you one, along with advanced SOCOM training.
Otherwise, I'm out of altitude, speed and ideas.
I'm pretty sure they'll add Laudanum to the natural prescription book to get into the lucrative controlled substance business. After all, it's just alcohol extract of poppy seed pods, doesn't get much more natural.
I'm going to go into business and sell my all natural herbs and plants! I mean, I can sell belladonna, apricot pits, aminita mushrooms, and all sorts of things. They *can't* be dangerous, they're ALL NATURAL!!!!
Depends on what alternative route you want to go, but I suspect it will be very hard to find one that only costs you $200 a month. Especially since it is all out-of-pocket with no insurance to help cover costs.
And be prepared by whoever is treating you to blame you fro trying to do it on the cheap so it is 100% your fault when it fails as the treatment would have worked if only you'd been willing to commit enough finances to it.
Some will require you to quit work to do the treatment full time and require at least one friend or family member to be at least a 1/2 time care giver if not full time as well. And that is after the tens of thousands in equipment and travel to their clinic in another country for initial treatment and training you will need to do it "right". Some also need thousands a month to buy the allowed foods in the amounts required as well as additional supplements.
I rarely see a $200 a month or less price tag from most of the big cancer cure places. But I supposed you can consult Dr. Google and find cheap and easy cures from common household items and make your own program.
Johnny - the snarky narcissist who has no concern for human beings is exactly the reason the Natural Medicine movement will grow stronger. Your sarcasm doesn't deflect from the #truth. Yes, every human being who pays $50,000 per month for treatments deserves a real plan for recovery. Just like you wouldn't hand over $1,000,000 to someone with a permit and tell them "just build whatever you think I need."
Natural medicine will only grow to the limits of education. Once people can work out the risk assessment, the lack of evidence, the outright lies for themselves, the growth will stop. Natural medicine offers hope where none is in evidence. I'd rather throw money at a cure with even a shred of evidence over the lied told by NDs.
I am a bit bemused by some of the comments. I know that the NHS, which doesn't have the best statistics for it's cancer patients despite it's excellence in other areas, always tailors treatment for each patient. Unfortunately I know three women who have been diagnosed with breast cancer recently, all getting individualised treatment that has been adjusted as the results of biopsies etc have come in. Are you telling me that the much vaunted American private system is worse than the NHS?
Oh and the treatment is of course free at point of use having been paid for by the taxpayer
Michele: "It would require so much effort and even more TIME for a doctor or surgeon to delve into the variables of a human body to provide the right (and vastly different) treatment plan that each individual patient requires. Science doesn’t do “every specimen is unique” very well. In fact it precludes it."
The reality is quite different.
Naturopaths and other quacks talk a good game about "personalized" therapy.
Evidence-based physicians on the other hand actually accomplish it.
Don't worry, there's a use for this as a meme at some point.
Has my collection of birthdays and cynicism caused me to miss something here? Does no one engaged in the lobbying efforts see any potential problems with this, at least in PR terms?
You're not missing anything. I realized a while back that the "pharma shill" gambit is pure projection: alt-med practitioners often earn a substantial income from selling their supplements, so they assume that legitimate doctors must get a cut from the makers of SBM prescription drugs. Never mind the lack of evidence to back up this accusation.
As for whether they'll be called on it, I am not optimistic. It would require journalists to actually examine the facts rather than report what each side claims and call the story "balanced". The former is so rare these days that it's notable when a journalist goes so far as to look at the facts. To paraphrase Stephen Colbert, facts have a well-known pro-SBM bias.
Aminita muscaria is supposed to be pretty tasty in small quantities, MI Dawn #16.
Here is psylocibin for depression. Small trial, yes, but long-term depression is not likely to spontaneously remiss:
Demonstrating the safety of psilocybin is no small task. Magic mushrooms are categorized as a Class A illegal drug in the United Kingdom—the most serious category, which also includes heroin and cocaine.
“Every interaction — applying for licenses, waiting for licenses, receiving the licenses, applying for contracts for drug manufacture, on and on — involved a delay of up to two months. It was enormously frustrating, and most of it was unnecessary,” says Nutt. “The study result isn’t the remarkable part — it’s the fact that we did it at all.”
Laudanum to; I hear it is great for a toothache. And Kratom for the opiate withdrawal -- Cannabis for so many things.
These things ought not to be banned nor even behind a prescription wall. Folk medicine, with unfettered access to all the traditional herbs, may just filter down to fare as well as allopathy for the conditions it may treat. Same ol' same ol', drug companies don't do the studies because it is a natural plant... easier to just ban it for everyone. I'm just waiting for the jackboot to fall upon Passion Flower.
a bill that would allow a pharmacist to refuse to dispense a prescription for a controlled substance if there is reason to believe the prescription was not written in good faith or would not be used for legitimate medical purposes.
I don't know how to feel about that^^. If these herbs are shown to be efficatious yet still prohibited then will the pharmacist be just another stumbling block to herbal remedies (such as cannabis) even if there are 'studies to show', even if there is a prescription written? They don't seem to deny Sudafed to even the most ardent of meth heads now though putting it behind the counter did raise the price from a couple dollars a box to twenty.
Orac makes a good point against 'naturopaths' and I agree. But this conflation of sanctioned naturopathy with desires to use folk medicine and herbs may just serve to futher damn the latter even though there are now 'studies to show'.
Yes, every human being who pays $50,000 per month for treatments deserves a real plan for recovery. Just like you wouldn’t hand over $1,000,000 to someone with a permit and tell them “just build whatever you think I need.”
So Michele, what "real plans for recovery" can your "natural medicine" scheme provide?
" The cost of chemo and radiation altmed cancer therapy is highway robbery, and oncologists naturopaths essentially prey on desperate people who will spend their entire life savings to live 3 months longer"
The biggest problem with licensing altmed practitioners is that gives them a spurious legitimacy in the eyes of the unknowing, and an argument for the true believers.
I don't know if rosross ever shows up here, but she is a diehard homeopathy supporter. When asked to provide proof that it works, she says that hospitals, medical schools and governments endorse it, therefore it must be effective.
That's all the proof she needs.
@Gilbert: then I'll have you over for some belladonna and arsenic tea. Yes, I'm aware that professional beauties used to use them in very small doses. But we don't know how many of those who died young died from the toxic herbs. And yes, foxglove is a great help for the heart. And if you're willing, I'll make you a salad of the leaves. I'd still have it as digitalis so I KNOW the dose I'm getting.
The problems with most herbals is you don't KNOW what dose you're getting, how pure it is, and how safe it is. Like buying heroin on the street, or your favorite marijuana. If I'm going to take a drug, I'm going to take one where I know the dose is the same every day, every dose, every time.
Alt med types keep going on and on about how each person is so different from every other person. I think a Lois McMaster Bujold line in her last book is appropriate: A database of one does not provide infinite wisdom.
Truth Seeker @7: The thing is, chemo, radiation and surgery to treat cancer, as well as some newer therapies that don't fall into one of those categories, are covered by insurance. And Medicare. And Medicaid. And many of the "big pharma" companies also support foundations to help people pay for their therapies. So even if a treatment regime has a price tag that says $90,000, the patient doesn't pay that.
But herbs, vitamin IVs, hyberbaric oxygen and coffee enemas? Yeah, that's all directly out of pocket.
Rich Bly @30: "Gentleman Jole and the Red Queen" was great! (I think I missed that line, though.)
The problems with most herbals is you don’t KNOW what dose you’re getting, how pure it is, and how safe it is. Like buying heroin on the street, or your favorite marijuana.
Well, MI Dawn #29, cannabis is pretty much Pro re nata and with a short time period for feedback of 'how much'.
In fact, I'd say it is way more suited to the individual than the quantum 1pill, 2pill, 3pill, a OD.
A way to know the purity is to allow people to grow their own; It is artifice due to prohibition that 'purity' comes into question. The spectra of CBD, THC et al. may vary with the weather but there is not an overdose criterea for any variety... use until you get there; In no way do I mean to imply that all herbs can be used in this manner, it just seems that the most effective ones can ignore potency whereby people just laissez faire fall into using the right amount.
Oops, pro re nata should read Ad libitum as there is no maximum dose to exceed as it can not be exceeded.
The spectra of CBD, THC et al. may vary with the weather
But that's the point: you don't know in advance how potent it is. Contrast beer, which depending on what variety you buy can have anywhere from 3.2% to 12% or more alcohol by volume. At least with beer the alcohol content is listed, but if you're used to 3.2 beer and you start chugging microbrews with a 12% ABV content, you're going to be in trouble. I don't have personal experience with marijuana, but I expect similar issues if somebody accustomed to low grade ditch weed tries some high-THC stuff. And other herbs which are taken internally don't have the self-limiting dosage that you claim exists for marijuana. People have died from taking herbs that turned out to be much more powerful than what they were used to. That's one of many reasons reproducibility is important.
Gilbert @33: There is also the issue that in some states pot is not held to the same pesticide standards as food, although at least in Washington the grower must provide information about pesticides used on a specific batch to the processors/retailers that must be available to customers upon request.
As for "grow your own"; I've known people who could kill mint. I don't think it's a viable alternative for everyone.
I don’t think it’s a viable alternative for everyone.
But it could be if not for the only viable(??) education being 'just say no'.
The most accented impediment is likely to be lawns and lawn poison crap the neighbors have their place drenched with.
Over the counter laudanum? Oh...sure, let's go back to those days when high numbers of the population were addicted to morphine. Sounds great. While we're at it, perhaps Bayer would like to go back to selling OTC heroin. I'll have mine with a nice Foxglove salad.
" Just like you wouldn’t hand over $1,000,000 to someone with a permit and tell them “just build whatever you think I need.”
In essence, that's what you're doing with a naturopath. Look at the track record of "alternative" oncologists like Gerson and Bollinger.
if you’re used to 3.2 beer
I've pointed this out before, but "3.2 beer" is ABW, not ABV, dammit.
You know, I feel kind of awkward defending the NDs because I have my own reservations about superfluous modalities. Despite their thinly documented evidence bases, often with clinical series and empirical methods, their often lesser undergraduate academic performances, they often slaughter MSM on nutrition and GI digestive performance issues.
Poor performance, over half a century late in many cases on nutrition, and then hobbled with a halting, slow, narrow approach to EBM looks like a fine way to economic disaster. Despite starting with so many advantages and monopolies...
#4 MI Dawn
@prn: ...How do you know all this? ....
she and her family left copious notes. One of the more useful note sets I've seen.
...What can they do for me that my wonderful PCP can’t?
If they are careful about human biochemistry and nutrition, lots.
They can’t give me vaccines
No big deal. The pharmacies in the groceries and discount warehouses may be more convenient and have a better price anyway.
... they can’t prescribe the medications I need to stay (or become, if I get ill) healthy.
they won’t prescribe the same old/new medications that you need to stay (or become) chronically ill
They can talk about diet, exercise, and health, but my PCP does that with me already, and gives recommendations based on her knowledge.
When people go to NDs, I suspect that often they're already worn out or unhappy with their treatment and results after seeing a number of MDs. With chronic illness or chemo, this becomes more likely. If they get substantially better quickly, they'll likely return again.
I just don’t see any value in going to a quack making money off the supplements he/she sells.
In my example @1, the supplements represented under 1/3% of outlays, where staying on the job was essential. MSM and dietetics have screwed the pooch so many times, so many ways , on biologically based nutrition, it is the theater of the absurd. CAM and the naturopaths have been probably 10-20 yrs ahead of MSM PCPs on vitamin D issues alone.
MikeMa@19: Michele, Natural medicine will only grow to the limits of education. Once people can work out the risk assessment, the lack of evidence, the outright lies for themselves, the growth will stop. Natural medicine offers hope where none is in evidence. I’d rather throw money at a cure with even a shred of evidence over the lied told by NDs.
Your view is a little one sided. Probably they'll do better if they work together, rather than undercut the other.
#31 JustaTech: Truth Seeker @7: The thing is, chemo, radiation and surgery to treat cancer, as well as some newer therapies that don’t fall into one of those categories, are covered by insurance. And Medicare. And Medicaid. And many of the “big pharma” companies also support foundations to help people pay for their therapies. So even if a treatment regime has a price tag that says $90,000, the patient doesn’t pay that.
Oh, great. So the whole system goes broke. "Covered" cancer pts do often wind up with an annual spend of $6,000 - $25,000 for deductibles, copay and uncovered expenses, plus their large premiums for tx at second class cancer sites. Outside of surgery and CT/PET/MRI, we've mostly found it better to just stay home. Skype helps occasionally.
Your nutshell riposte to the "we're all unique" gambit is much appreciated.
You've completely changed my thinking on alternative medicine over the years, but I will always believe in qi, if not its medical relevance.
you don’t know in advance how potent it is
That's what the label is for, silly #35:
Dark & Milk Chocolate Peanut Butter Cups
……………………. 200mg …………………
That’s what the label is for..
What labeling? They're still working all that out.
The copy cat packaging you linked to was pretty funny though.
Yea Not a Troll #45, they are 'working all that out'. I hope it doesn't lead to imposed monoculture standardization; That would be a travesty.
Speaking of cannabis,
While a person may appear healthy and lead a normal life, the unseen damage to their DNA could also be passed on to their children, and cause illness for several generations to come.
'Even if a mother has never used cannabis in her life, the mutations passed on by a father's sperm can cause serious and fatal illnesses in their children,' Dr Reece said...
Dr Reece said that when the chemicals in cannabis altered a user's DNA structure it could lead to slow cell growth and have serious implications for the fetal development of babies, potentially causing limbs or vital organs not to develop properly or cause cancers.
He said: 'The worst cancers are reported in the first few years of life in children exposed in utero to cannabis effects.
Sounds pretty dire, I wonder why the video is of an an individual whom perportedly suffered from 'cannabis psychosis'?
'Some people may say that previous data collected doesn't show there are serious effects from using cannabis, but many authorities acknowledge that there is now a much larger consumption of cannabis use compared to previous years,' he added.
what is wrong with this ^^ sentence other than *some people say*?
The study carries implications for researchers, medical health professionals and governments in regulating drug use and protecting those who are most vulnerable.
Lovely, Daily Fail, just lovely. Could somebody here find that study and give it a little John Oliverin', please?
I wonder if pesticides, dioxin, ..., BPA cause mutations that can pass down through generations to.
The only one speaking of pot around here is you, stoner boy.
We get it. You like pot, you want pot, and you want easily available pot. Just say so, and move on.
You don't have to convince anyone that it will cure anything and everything, because you never will.
Yes, pot has some complex chemistry that has an effect on people, and maybe that can be used to help people, and yes, it should be studied to find out.
But you don't really care about that, do you? You just want to get high, and that ain't no sin, so stop trying to convince us otherwise.
Or are you trying to convince yourself?
I don't live in a legal state, Johnny #48. So when such tripe as the above is trotted out as a foregone conclusion it tends to dash all hopes.
The medical community remained silent for far too long; And if they weren't silent they were amplifying the stigma of the party line. There have been far too many lives irreperably harmed over the immutable wrongness that is prohibition. So, Johnny -- Side, meet Thorn.
All that is necessary for the triumph of evil is that good men do nothing.
-- Edmond Burk
Gilbert @49" Oh, you poor wee thing, have you only just now noticed America's tendency towards the Puritanical? Like, this ain't news. Why don't you go watch Ken Burns' excellent documentary "Prohibition" (last I checked it's available for free on the PBS website).
And you know what? It's a free country. Either move to a pot state or start campaigning to make your own state pot friendly. But please stop whining about it here.
Gil: I don’t live in a legal state.
A couple of things: First of all, a lot of pot farms need workers, and will happily accept out-of-state workers. Also, they pay well, so, once the harvesting is done, you can move to where it is legal. Why have you never thought of that, dimbulb? Or do you just like the South? I suppose you'd feel out of place in an area near a university, or anywhere where the phones were smarter than you.
I suppose you’d feel out of place in an area near a university, or anywhere where the phones were smarter than you.
"OK Siri, Politicalguineapig"
A home girl with home-training preparing to slay culture, class, charity and academia.
"OK Cortana, Politicalguineapig"
A home girl with home-training preparing to slay culture, class, charity and academia.
"OK Google, Politicalguineapig"
(1.) One who finds intelligence the most sexually attractive feature.
(2.) A person that is so douchey, said douchey-ness travels cross bodies of water.
(3.) An older woman who is past her prime & who is attracted to younger men, often as an act of desperation or as a last resort.
(4.) A home girl with home-training preparing to slay culture, class, charity and academia.
I don't think I have anything to fear; I yeild back the balance of my time.
2 describes you more than me, Trump pig.
Ok, PgP #53. I'm a douche canoe but I don't like Trump.
Why do you fucking go there, Gilbert? Says way more about you than it does about PGP. Like, you're a bottom-dwelling misogynist stoner whose chief talent is a one-hand roll. Clap clap, you're so edgy.
Lovely, Daily Fail, just lovely. Could somebody here find that study and give it a little John Oliverin’, please?
Total mendacity spewed from the Daily Mail is not really newsworthy enough.
It's the Daily Heil, people.
Here I sit in a medical marijuana friendly state, in the deep south and simply ask, keep the smoke away from myself and my wife.
We have a rather severe reaction to the smoke, as in severe allergy to it.
Obviously, it's not an option for either of us, needing that epinephrine and all would kind of undermine any feel good present.
Erm, Gilbert, please grow up. The rest of we adults like having conversations that don't sound like kindergarten exercise yard trash talking. Frankly, such behavior seriously undermines your cause, as none respect you after reading that nonsense.
Delphine: Says way more about you than it does about PGP. Like, you’re a bottom-dwelling misogynist stoner whose chief talent is a one-hand roll. Clap clap, you’re so edgy.
Eh, I figure he's been stoned since he was 16. Addicts are permanently stuck at the age they became addicted at, but I do wish he'd go to Reddit and live with his own kind. Teen boys, ya know.
Wzrd1: I'm with you on the smoke. Ever since my state went cigarette smoke free (thanks, indoor air act) I simply can't tolerate cigarette smoke. I don't really want to be around marijauna smoke either, simply because I don't know how my lungs would react. (Growing up around two asthmatics makes you really aware of how important the pulmonary system is.) I'm sure there are marijauna advocates who aren't sexist pigs or stone stupid, but I haven't ever met them.
@PGP, I still smoke cigarettes, hard to kick an addiction like that when one toys with v-tach while trying.
That said, I loathe my own secondhand smoke, I do my level best to not inflict that upon others.
Wzrd1: Nicotine is a hard addiction to quit. And thank you for keeping your smoke to yourself.
Pgp, my bad.
Here I sit in a medical marijuana friendly state, in the deep south
I'm not seeing any such animal, Wzrd1 #58. I see Mississipi and North Carolina are CBD oil only states though as Alabama just became to a limited extent.
I still smoke cigarettes, hard to kick an addiction like that when one toys with v-tach while trying.
That said, I loathe my own secondhand smoke
You may wish to consider a vaporizer with e-juice, Wzrd1. There is the 'harm reduction' of doing away with the other 9600 chemicals in cigarette smoke. It appears that it may be the ritual of smoking, synergy with nicotine, and the pattern of the rush which greatly contribute to the addiction. One can slowly reduce the level of nicotin in the e-juice if one so wishes.
The federal government has just recently cracked down on e-cigs. To be fair, some of the e-juices do contain questionable ingredients (such as diacetyl). I'm currently puffing on a Kanger protank2 with some nice menthol juice.
Over the years, I have grown averse to cigarette smoke -- It stinks and clings (marijuana smoke does not taint one's clothes or linger like cigs do).
I have a friend with stints in his heart; Not only has he not quit but he keeps the place shut up tight. I'd swear he'd cut his smoking by 3/4 if only he'd air the place out every now and again. A visit over there is all it takes for my clothes to be trashed -- They can lay around for a week and still reek like that place.
Believe it or not, he's asked me to keep the vapor pen away from him as his doctor advised him that the e-cigs are way worse than cigarettes, the derp. I don't know if he misunderstood him or if the doctor really believes that. I know the American Heart Association is against them because of the conflicting message they send.
As for cannabis/asthma: I've heard tell that nothing stops an asthma attack flat like a hit of the good stuff -- It is an effective bronchiodilator with mediation of immune response, after all.
p.s. I don't 'do' joints. I can manage to roll one but it must be doctored like it has Polio after the fact.
Anyone caught smoking on the premisis will be hung upside down by their toenails and pummeled into subconsciousness with a wet carp
-- My aunt.
What is with the Reddit hating? I was around for the migration of refugees from Digg -- I didn't see it as a hangout for adolescents unless you're burned by the invocation that women in gaming ought to hang back in the barracks and make sandwiches...
Gil:Over the years, I have grown averse to cigarette smoke — It stinks and clings (marijuana smoke does not taint one’s clothes or linger like cigs do).
LOL. Do you make a hobby of being wrong about everything, or have you just lost your sense of smell? Marijauna smoke does linger for hours. It's not as bad as cigarette smoke, but I don't like the smell either- it's like someone mixed over-ripe fruit and fresh weasel glands together.
As for reddit, where do I start? It's not so much a hangout for adolescents as it is a haven for sexist nitwits, which is probably why you like it so much. Aside from gamer gate, (which I have really no opinion on aside from it confirming why online gaming really ought to be a solitary pursuit)there are numerous threads devoted to upskirt photos (always taken without consent), rape denial, pick-up artists (who are stupid, depressing and dangerous in one awful package), men's whine activists, and etc.
Even more damning, the one attempt by the administration to take out the trash went down in flames, and no one will ever try again. Frankly, I hope it gets shuttered. Facebook's admin may be anti-vax, South Park libertarians, and a fair bit sexist, but they're not nearly as persistently bottom-of-the-barrel scum as Reddit's admins and forum users tend to be.