By Aari Ruben
December 20, 2018
As 2018 comes to a close we prepare for another ReLeafy Christmas here at DBRC and ReLeaf Brands, and true to form for 2018 the gifts are coming early (this year has just flown by). While we love and appreciate our lawyers, contractors, suppliers, and wholesale customers, the time spent on those tasks pales in comparison to the hours I spend with special patients.
Recently I met a young man by the name of Christopher who has a unique perspective about himself and the world, see Christopher has a severe case of Autism Spectrum Disorder (ASD). ASD has many faces and manifestations along its spectrum but it is characterized by differences in language, behavior and social interaction, it is also common for these special people have a comorbidity with epilepsy, irregular neurological activity and sometimes even seizures.
Christopher was infected with spinal meningitis as an infant and had subsequent seizures requiring anticonvulsant treatments like phenobarbital, he no longer has seizures or takes anticonvulsants but he still shows irregular neurological activity. His most recent allopathic treatment consisted of an anti anxiety benzodiazepine called Rispiridone.
Despite being non verbal Christopher lives a full life, he attends a day program and has clear ideas about what he wants and needs. He seems to understand speech but has to communicate his feelings and wishes in his own unique way, one of these ways is self harming behavior, in his case this appears when he is uncomfortable or wishes to express displeasure, Christopher hits himself on the chin and on one temple, another common form of self harm includes head banging which Christopher has outgrown.
This is all very distressing to his adopted mother who is a saint for loving and caring for Christopher with such patience and open mindedness. She heard of cannabis being effective for treating Autism and was referred to me through a healthcare provider we both know. Once we were connected we talked about the process of getting Christopher an AZ MMJ card, autism is not a qualifying condition in AZ, because he is nonverbal diagnosing Christopher is a challenge and it took a visit with a brave NMD who recognized that the bruises on Christopher’s chin and temple were painful results of his self injurious behavior. I did some research into autism and cannabis and found the literature to call for high cbd treatment, I prepared a one ounce bottle of 4:1 tincture and a few 15mg THC gelcaps for evening use and extreme pain.
Once he was certified I met Christopher for the first time at his family home in Tucson. I walked into the house and immediately the presence of a new person made Christopher uncomfortable and he began to strike the bright red spot on his chin firmly and repeatedly. Mom dispensed one ml of cannabis tincture containing 16mg of CBD and 4mg of THC into a spoonful of yogurt and Christopher gobbled it up and swallowed, he seemed restless rocking back and forth, his pupils were dilated, he kept an eye on me and looked often to mom for the reassurance she is to him.
As mom and I sat chatting about autism, the holidays, cannabis, and the weather for about 20 minutes a change came over Christopher, he began to calm, eventually he went to his room, all was quiet, mom and I went to check on him and he was laying on his bed peacefully, his pupils were normal size, he seemed to be benefiting from his first exposure to cannabinoids.
I left the family with instructions to dose with CBD tincture every 4-6 hours and to give one THC gelcap before bed each night and to call me with any questions or concerns.
The results thus far have been nothing short of miraculous, this is not a cure for Christopher but his mom texted me late that Sunday evening and said he hadn’t hit himself since I had arrived at his home that afternoon. He slept peacefully, the next day his treatment continued and he didn’t hit himself, his mother stopped giving him his anxiety meds and reports that he has only hit himself in extreme situations, when he didn’t want to go to an evening concert for example, and that he is in a loving, happy mood. The people at his day program report that Christopher is compliant and happy.
A week later I stopped by the house to deliver more tincture and see for myself the changes in this young man, I couldn’t be happier with what I saw, he didn’t hit his chin when I approached him, he let me touch his shoulder, the red spots on his chin and temple are fading, his eyes look clear, he has a beautiful smile and a mischievous twinkle in his eye when he laughs, he was content to sit and listen to his mother and I chat while he had his afternoon snack. I believe the cannabinoids balance Christopher out in mind body and spirit, the CBD turns down the music on his over active neurological system while the THC brings a sense of calm and wellbeing, he is also benefiting from the antioxidant and anti inflammatory properties of cannabis as well.
Christopher still needs a lot of care and will still have his moments. We don’t know where all this will go, I fully expect to run into obstacles and treatment barriers, when that time comes we have higher cbd meds, higher thc meds, more concentrated medicine to turn to, we will take the good with the bad but all in all it’s an amazing start to a new normal for him and his family and it’s been one of the years great blessings to know and help such a deserving soul. One love DBRC
MMJ Opinion: A Call to Action
Now’s the time to get involved in the cannabis social movement
By Aari Ruben
November 26, 2015
Many social movements have been taking hold in our nation recently. For example, same-sex marriage has moved from social acceptance to being fully legal. Cannabis law reform is a hot topic in politics and the media, as well as more and more states jumping onboard. Times are good, and there is much fulfilling work to be done on these and other humanitarian fronts. However, I am making a public call to action, asking for your participation in these movements. It isn’t hard, there are events happening all the time.
The 4th annual conference hosted by Marijuana Business Daily was recently held in Las Vegas, Nevada at the Rio Hotel and Conference Center. The event was attended by more than 5,500 people, representing all 50 states and 23 other countries. With a highly regarded group of exhibitors and speakers, such as Ralph Nader, Steve DeAngelo and Tripp Keber and two huge expo halls packed full of exhibits—the show was a must see for anyone with an interest in the cannabis industry.
“These attendance numbers far exceeded our expectations. It reinforces the investment, innovation and optimism in the legal cannabis industry moving forward,” says George Jage,Marijuana Business Daily president.
Nevada’s had medical marijuana laws in place for 15 years, but the market has suffered from a lack of retail stores. Only recently has Nevada written regulations permitting dispensaries to operate. Currently there are four dispensaries serving patients from around the country, Nevada’s law allows all state-certified cannabis patients to purchase and possess up to 2.5 ounces of medical marijuana. There are also dispensary tours, social clubs and other ancillary businesses in operation.
Go Nevada, and go Marijuana Business Daily for hosting your fall show here to showcase this new marketplace.
Marijuana Business Daily isn’t done yet either. In the spring, they will host another conference in Orlando, Florida. It will be a great time to get information and share ideas with the cannabis crowds, which will include the kindest, friendliest, most fun-loving, open-minded people in its ranks. You will want to get your tickets early as early bird discounts apply and the show is sure to be a sellout.
The Drug Policy Alliance got in on the act recently as well, with their biennial conference. This hybrid organization made up of many other groups focuses on harm reduction and drug policy issues. More than 1,500 people from 40 states and 70 countries around the world descended on Washington D.C. for four days of lobbying congress, inspirational seminars and displays of freedom and human rights included a protest on the National Mall near the Washington Monument. In October 2017, the conference will make an appearance in Atlanta, Georgia, home of some of the nation’s most restrictive drug laws.
So get involved however you can. Go to a local NORML meeting, a protest, or perhaps a more organized conference. I will see you there.
During Epilepsy awareness month, let’s remind ourselves why legalization is important
By Aari Ruben
November 19, 2015
November is epilepsy awareness month and that is cause for celebration in the cannabis world because cannabis has been shown to be a safe, effective and far less toxic treatment option when compared to the usual allopathic anticonvulsants. This is accomplished through the anti-inflammatory and antioxidant properties found in the cannabinoids and terpenoids that are the major active components.
These compounds help to turn down the music for many who suffer from epileptic conditions. With cannabis they are able to live fuller lives, without their development being interfered with by pills.
For some who are dependent on these treatments the Arizona Medical Marijuana Act provides a narrow exception to the Controlled Substances Act allowing them to possess the cannabis and cannabis infused products that give them a better life. There are barriers to entry into this legal market, which make participation difficult for some. Because of heavy handed taxation and regulation, cost of the products to the consumer is high, no pun intended. A patient must maintain their patient status year by year, with a renewal fee to the state and a visit to the doctor providing the recommendation. This can be too expensive or cumbersome a process for some patients in need.
The AMMA also has a very limited set of approved conditions for an Arizona marijuana recommendation. Many people who might benefit from cannabis are left out of the program. The Arizona Cannabis Nurses Association filed for eight new conditions to be added to the program but the Department of Health Services denied all eight without public hearing or comment. Surely the AZCNA will appeal as they did when PTSD was denied in the same abrupt way a few years ago.
Other patients languish in limbo as well, unable to participate for other reasons. The many who are here without papers or proper identification are also unable to get a medical marijuana card, regardless of how much they might be willing to pay for it. Aren’t those humans entitled to be able to safe legal access to high-quality, lab-tested cannabis if that is the treatment that works best for them?We need to legalize cannabis in Arizona, and eventually the U.S. to eliminate these barriers. There are multiple ballot initiatives being circulated and there is much infighting among the parties. The best-funded initiative is being promoted by the Marijuana Policy Project and it is largely criticized as being far too limiting a law by Arizonans for Mindful Regulation.
I am strongly in favor of the more permissive initiative promoted by the AZFMR. Many that represent the AZFMR feel that the MPP initiative does more harm than good, if the MPP bill sits alone on the ballot in November 2016 they will lobby against their own issue for fear that the MPP law gives the cannabis industry to big business and the industrial prison complex on a silver platter.
I do not support the idea that the MPP law does more harm than good. It is my hope that in the event the AZFMR initiative does not qualify for the ballot, that the MPP bill will prevail so that the people of Arizona, who do not already qualify for the AMMA, may care for themselves and their families, and that the market might mature to give widespread access to high quality products at a more reasonable price.
Opinion MMJ Part II
MMJ vs. Legalization
By Aari Ruben
July 3o, 2015
It is a sad but true fact in the world today that politics, lobbying, and action take money, lots and lots of money. This means that to enforce the will of popular opinion we must band together as a cohesive force and make our voices one. There has been a long history of infighting in the cannabis industry. If NORML and other groups of their day had worked together in the 1970s this conversation might be long over. This didn’t happen. Jealousy and greed gave the opposition the opening they needed to kindle the drug war. Cannabis is still prohibited under federal law, but in 27 states across our union there are experiments taking place that are proving cannabis to be a safer alternative to alcohol and opiate pain medicines.
One group in Arizona that gets it is Safer Arizona. They promoted their own voter initiative in the 2014 election, but failed to collect enough signatures to qualify for the ballot. In the end it came down to money—not having enough of it—that kept the measure from being seen by the voters. Safer has joined forces with Arizonans for Mindful Regulation led by Jason Medar. Not satisfied by the initiative filed by Marijuana Policy Project, Medar filed his own similar but more permissive measure.
MPP started out as a grassroots advocacy group focused on freedom, human rights and helping people gain safe, legal access to cannabis. They recently held an event in Phoenix to educate supporters about how to properly collect signatures to help get the proposed voter initiative on the November 2016 ballot. I reached out to J.P. Holyoak, MPP chairman of the Campaign to Regulate Marijuana Like Alcohol, in advance of the event and requested a few minutes to address the crowd about the importance of the upcoming Department of Health Services window to file petitions. Matt Schweich, MPP state campaigns director, responded by email and said I could address these urgent issues at the start of the event.
I made my way to Phoenix excited to help spread the word about our urgent mission to provide access to medical marijuana to another million Arizonans. I asked people I know to help me find Schweich, whom I’d never met. Much to my shock and dismay, when we met he said he couldn’t allow me to speak as MPP was lobbying for legalization and this work conflicted with our MMJ issue. He said the decision had come from on high and that there was nothing he could do. Unspoken was the issue that I wanted to raise money for the CNA to expand the medical program, while MPP is focused on raising the millions of dollars necessary to turn a voter initiative into law. I made him aware of my displeasure about my time being wasted and the important message going unheard.
It saddens me to say that I no longer have the confidence I used to that MPP is first on the side of the patients. They seem to be following the stream of cash they generate with their lobbying efforts to bigger and bigger markets. No longer are they focused on helping us regain our freedoms and our human rights, and our ability to care for ourselves. But lets not let them forget that medical marijuana opened these doors for acceptance of the many uses of cannabis. MMJ created the Industry that is emerging, and you haven’t seen anything yet. The science is coming, and big pharma is coming and they will do things with cannabinoids that we can only dream of. MPP is poised to be involved in all of this. They stand to raise tens of millions of dollars in lobbying money for political action. It is amazing to me that they could see me trying to raise money for a few sick people in Arizona as a threat to their high profile initiative. I will still support the MPP initiative. I will collect signatures. I will vote in favor of it. I probably won’t give them what they want most, money. I will also support the AZFMR initiative, I will support any initiative that expands Arizonans freedom, but the AZFMR initiative will have a special place in my heart. They truly want a more democratic system to be in place for Arizona’s cannabis industry. They don’t have the money, but they do have the human element on their side, and I am willing to chip in a few bucks. Lets hope some others will join me.
Opinion MMJ Part I
New Rules An update on MMJ petition process and DHS
By Aari Ruben
July 23, 2015
The Arizona Department of Health Services has announced that it will accept petitions from July 27-July 31 to add new debilitating conditions to those already approved by the Arizona Medical Marijuana Act. The AMMA itself calls for open application periods twice a year, but the rules surrounding the process and the specific standards by which these conditions are approved or denied are largely left up to the DHS administration and these rules can be changed.
DHS has fought hard against all the petitions filed in the history of the program. Only PTSD with the help of the Cannabis Nurses Association has been successfully added as a qualifying condition. CNA Attorney Ken Sobol appealed the DHS denial of PTSD and prevailed, in a huge victory for patient rights, this was special because is it is the first mental health condition to be approved for treatment under the AMMA.
The AZDHS responded by proposing to change the standard for approval of new conditions to “conclusive evidence based research” in their October 2014 proposed rules package. If you are aware of the history of cannabis prohibition, you know that studies about the usefulness of cannabis of this caliber are few and far between. Under these proposed rules and the higher standard they require it is possible that a new condition will never successfully be added to the AMMA again.
These new rules have not been implemented to date because of Gov. Doug Ducey’s moratorium on rulemaking. This hold on state administrative rulemaking could be lifted any day. The upcoming July 2015 window is the only time to file petitions and be sure to have them heard under the existing, slightly more patient-friendly rules. Sobol has agreed to do the legal paperwork to get 10 petitions filed next week, but he expects to be paid for his work this time around. One local dispensary that is patient focused has agreed to foot half the bill, but the CNA still needs to raise more money to see these lawsuits thru to the end if we are to help heal more sick Arizonans. Some of the conditions on our list of possibilities are:
• Sickle Cell Disease
• Huntington’s Disease
• Tourette’s Syndrome
• Broken Bones
These and a few others are the conditions in the running to get the attention of the CNA this time around. Some or all of these conditions will be discussed in a few months at public hearings in Phoenix. I invite your participation, if you or someone you know has one of these conditions and has benefited from the medical use of Cannabis please reach out to me or the CNA as soon as possible, your story may help us change minds and laws. If you support Medical Cannabis use and want more of your neighbors to have safe legal access to a non toxic remedy that could change their lives then send a donation to the CNA and earmark it “Conditions 2015”. I did and if we help one person to live a better life then I believe the sacrifice is worth it in the end.
Perhaps this is all irrelevant. There are multiple ballot initiatives being circulated that, if successful, would legalize limited amounts of Cannabis for all adults in Arizona. The best funded of these measures is sponsored by Marijuana Policy Project, the same group who helped pass Prop 203 and create the AMMA in 2010. In fact MPP has had a major role in shaping almost all Cannabis laws around the country. There are other initiatives, such as that sponsored by Safer Arizona, with less funding but with more good old fashioned grassroots support. My concern is that the support for Medical Marijuana far outweighs support of Cannabis Legalization. Looking back to 2010 we can see that Prop 203 barely passed, so legalization may not be as sure a bet as some think.
Next week we will take a look at some of these proposed laws, the motives of those who promote them and their chances of becoming law in Arizona in 2016.
MMJ is here to stay and is legal, but it depends on what public agency you talk to and that needs to change
By Aari Ruben
July 9, 2015
Friday, July 10 will go down in history but not for the same reasons I would have wished. There was a state of the art social event planned that had to be cancelled, well not entirely cancelled, just the state of the art part.
Counter Culture Events AZ planned and promoted the Fire and Ice 7/10 dab party. For those who don’t know July 10 is the new 4/20. The reason is if you turn 710 upsidedown and backwards it spells OIL. Hash oil is one name for some of the popular and potent cannabis extracts in the market these days. The event features three local bands including Alter Der Ruine who is about to embark on a nationwide tour opening for Haujobb, other local acts Mother’s Lament and Intertwine, who have a Native American radio station, will also play.
The portion of the event that has been cancelled had to do with medical marijuana, big surprise. This event is not, and never was, open to the public. Everyone who attends must purchase a ticket making it a “private event.” State certified medical marijuana patients were to be allowed to purchase VIP access to a “medicated area,” where they could sample and share cannabis and cannabis-infused products with other like-minded patients. This type of activity has happened in places around Arizona, such as Phoenix and other private events and clubs here in Tucson. In and of itself, consuming cannabis at a private event is legal. Sharing amongst those with the right to consume and possess cannabis is legal. Talking about and considering the merits of different cannabis with like-minded folks is legal. But the powers that be apply pressure wherever and however they can.
In this case, the pressure came from the Arizona Department of Liquor Licenses and Control. An agent visited our friends at Club XS and said that smoking inside was in violation of the rules surrounding the clubs liquor license. The liquor control agent tried to scare the owner of the club saying there would be a citation and fine forthcoming if he allowed the event to include a medicated area, and it worked. My contract to rent the space has been abruptly cancelled, without return of deposits, although we were able to re-negotiate and maintain the venue for the concert.
Sponsors and vendors have had to change their weekend plans after being told there will be no medicated area. The patients that have enjoyed similar events in the past are being denied their chance to socialize and share their freedoms. I feel like I have broken my word to all those above, but letting the patients down hurts me the most.
Counter Culture Events AZ won’t go away. There are parks, concert halls, ballrooms, and many other venues that don’t have liquor licenses, where we can host entertainment and socialize. Most medical cannabis patients don’t enjoy alcohol anyway, but we wanted to be inclusive and have the party in a place where non-patients would feel at home and have fun as well.
This sort of issues also happen in places like Denver, where cannabis is legal but public consumption is not. Private clubs, bars, hotels and bed and breakfasts are marketing their businesses as 420 friendly. Some, with liquor licenses, have had similar visits from Colorado liquor control.
These pressures are a form of intimidation and discrimination. It scares people into the shadows. We need an open honest conversation about laws and customs surrounding cannabis. Times are changing and it’s time to accept the differences between us.
The doctor is back to update us on an important MMJ legal case out of Pima County
By Dr. MJ
June 4, 2015
The landscape in the Arizona medical cannabis industry is rapidly changing, and after four and a half years the legal system in our great state is beginning to catch up to the Arizona Medical Marijuana Act. Brave citizens that have been charged with felonies have made the tough decision to take their cases to trial rather than try to plea bargain for a lesser sentence and the avoidance of a felony record.
One such Defendant is Jeremy Matlock whose case has been big news in Arizona. He was charged with sales of a controlled substance after he sold several cannabis plants to an undercover police officer who had presented him with an Arizona Medical Marijuana card. Matlock took his case to trial in Pima County and was found not guilty by Judge Richard Fields. This decision appeared to make clear the legal issues surrounding patient-to-patient sales of their medical cannabis products. It appeared that these transfers were legitimate, but not so fast in the conservative political environment of Arizona.
The prosecutors appealed this verdict to the State Supreme Court and in a decision released last week the case was overturned 3-0. This is a huge blow to the 60,000 plus MMJ patients in Arizona, and I am sure Matlock is reeling as well as he will face another trial during which he will be prohibited from using an affirmative defense. That is he will not be allowed to use the defense that his actions were covered under the AMMA. Needless to say it does not look good for Matlock.
All hope is not lost, the argument made by Matlock and his public defender may not have included all of the relevant issues. Amateur legal scholar Billy Hayes Jr. plans to raise the neglected issues in a Maricopa County courtroom sometime in the future for the charges he faces resulting from his role in the operation of a private vape lounge in Phoenix.
The science surrounding cannabis therapeutics continues to thrive. Cannabis is non-toxic, no one has ever died from cannabis use. The only harms cannabis causes to society and its users are due to its prohibition. Because cannabis is illegal there exists a black market, and similar to the prohibition of alcohol in the 1920s this creates a market opportunity filled by organized crime. We learned then and we are learning now that prohibition does not work.
An opinion on the latest MJ legalization petition draft from a MMJ dispensary operator
By Aari Ruben
March 5, 2015
I have been involved in the Pro-Cannabis movement for quite some time. I am actively involved with an alphabet soup of drug policy reform organizations. I voted to legalize medical marijuana in Arizona in 1996 and 1998. With my help those medical marijuana initiatives were passed by a majority of the voters but never enacted.
This was a frustrating event for a young man voting in his first two elections. The votes had been counted and we won. Why didn’t we get our program along with California, that also passed a medical marijuana law?
Arizonans eventually tired of this sort of treatment and in the very next election passed The Voter Protection Act of 2000 (VPA) preventing this sort of government interference. After al,l if government does not follow the will of the people why even vote to begin with?
This Voter Protection Act made this seldom-used type of citizen driven legislation an extremely powerful tool to change the laws in Arizona. One Arizona law created via this process is the Medical Marijuana Act of 2010, which was sponsored by The Marijuana Policy Project (MPP).
MPP has a history of doing this in fact, their slogan is “MPP—We Change Laws”. They have been the driving force behind nearly all successful change to state cannabis laws in the United States. Until recently all of this change was via voter initiative.
MPP is going to make a 10-state push via voter initiatives in November 2016 to legalize cannabis use for adults in Arizona and a number of other states. These measures have some common goals, to decriminalize use and possession of cannabis and create a regulated taxed system for its distribution. This move is being planned for the 2016 election cycle because we will be electing a new president and this event always drives liberal voters to the polls in greater numbers.
Wide spread success would likely signal the imminent end of cannabis prohibition to our federal government and begin to dramatically change the landscape in which the cannabis industry operates across the country. Because these 10 different states each have their own state constitution and state laws regarding how things are to be changed through each of their democratic processes, each of these measures enacted by MPP must be crafted in its own right.
There have been meetings between MPP, the industry group and cannabis activists that resulted in a recent publicly released draft of the MMP sponsored initiative dated Feb. 15, and purported to be the final draft that caused quite a stir among a group of current operators of medical marijuana dispensaries that we can refer to as the “industry group.” The devil is in the details, so lets go through some of the controversial parts line by line and consider what it all means. The excerpt of the draft initiative language itself is written in.
Sec. 2 Findings
3. The People of the State of Arizona proclaim that marijuana should be regulated in a manner similar to alcohol so that:
(a) Marijuana may only be purchased legally from a business that is licensed and regulated;
(b) Cultivation, manufacturing, testing, transporting, and selling marijuana will be controlled through licensing and regulation;
(c) Individuals will be allowed to produce a limited amount of marijuana for personal use;
(a) and (b) seem like good ideas as a regulated market will eventually eliminate the cartel’s hold on the coveted black market for cannabis, but who will be the regulators, how many licenses will be issued and how will they be distributed?
As initially written the draft initiative declares the Health Department will issue licensure, until the new Department of Marijuana Licenses and Control is created and staffed in 2018. The number of licenses issued will not be capped on the state level. However, each city, town or county will be allowed to impose a local limit or ban through their own political process. The licenses for cultivation and retail sale will initially be issued to existing state-licensed cannabis dispensaries, but after 17 months the application process for retail and cultivation licensure will be opened up to all interested parties that meet the requirements established through later rulemaking.
The “industry group” has taken issue with the proposed process of regulation and also with the proposed reliance on local jurisdictions to limit the number of operations permitted in the future. Instead they would like to impose a statewide cap on the number of licenses issued in the future and further they wish to be allowed to operate as a monopoly for an extended period of time so they might recoup investment they made in their medical cannabis operations.
The “industry group” also take issue with (c) in regard to an individual’s right to produce cannabis on a small scale for himself. The “industry group” would like to eliminate this privilege of individuals being allowed to produce cannabis for themselves or, at a minimum, require that individual cultivators register with the state. They fear that if people grow their own it will not be necessary for them to shop at dispensaries, and that their businesses will miss out on potential revenue.
In what can only be called a “Middle of the Night, Dirty, Back Room Deal” the the Night, Dirty, Back Room Deal” the “industry group” negotiated new language for this initiative, which was released to only a small group and was dated Feb. 25. Individual grow rights are mysteriously gone after being promised to the activists and those who care to grow their own medicine until this late date. The rules covering (a) and (b) and the distribution of permits have changed, benefiting no one but the current operators. The new idea is to cap licensure at 7 to 10 percent of the number of liquor licenses. This number is linked to population. Currently there are about 6,000 liquor licenses in Arizona. Seven percent of 6,000 happens to be 420, so at least someone has a sense of humor. This number might be adequate initially but will soon prove to be insufficient to handle the market.
The “industry group” wishes to create a monopoly surrounding cannabis production and distribution. They fear competition will drive the price down and affect their business. I beg to differ; most people will not have the time, talents or interest to produce their own cannabis. There will be plenty of users who are happy to purchase their products at the state-licensed stores. It is extremely important that those who do want to produce their own medicine have that right. They might need a certain varietal, or prefer organically grown product. Maybe they have limited financial resources and can’t afford to purchase from a dispensary, or perhaps they are a “live off the land” type who simply like to know where their food, medicine, and herbs come from. In addition, if the price remains high in the regulated market, the black market, which is unregulated and untaxed, will continue to thrive.
It should not be our concern to protect the industry group’s financial interests at the expense of millions of Arizona adult citizens who wish to take responsibility for their own destiny. A mother should be allowed to have a simple herb in a flower box to prevent her child from suffering through seizures. A person who finds relief of PTSD symptoms with cannabis should be allowed to grow a few plants to use as medicine. The simple act of caring for their own needs will be as cathartic as the medicine itself, and why should this right to care for oneself be limited to people who are sick? An adult in Arizona who prefers cannabis to alcohol for their relaxation and to unwind from the stresses of daily life should not face imprisonment for this choice.
I am a medical marijuana dispensary director and owner and while I know that competition from a new recreational market could negatively affect my business, state-legal dispensaries already face competition from the unregulated, untaxed black market. I am certain the recreational market will be many times larger and require far more retail and cultivation sites to satisfy the demand. We clearly will need to issue new licensure beyond the number suggested by the Feb. 25 draft. The 60,000 or so medical patients who are certified to use cannabis represent only a drop in the bucket of this new market’s potential.
I figure it this way,
An estimated 15 percent of Americans use cannabis. There are about 5 million adults in Arizona.
5,000,000 adults x .15 user rate= 750,000 recreational users compared to 60,000 medical users.
So the recreational market can be estimated at about 12 times the size of the medical market.
In addition, some accommodation is being made for the “industry group” in Arizona. Seventeen months is a long time in this rapidly growing industry. Here and in other states around the country, as the legal markets begin to mature, cannabis business volumes grow rapidly, sometimes at rates of 15 to 20 percent per month. Surely this is enough of a head start for these operators to establish infrastructure and market share.
We are learning more every day about Endocannabinoid Deficiency Syndrome, and about non-psychoactive cannabinoids people can use instead of pills to treat a wide variety of health care concerns. Prohibition of cannabis has caused great harm to our citizens and our society and none of the scientific information about cannabis was available when the laws prohibiting its cultivation and possession were enacted. It is irrational to enact policy that costs our society so dearly by imprisoning people for possessing or growing a plant.
These voter initiatives are useful but they also become a double-edged sword. The language of a voter initiative is extremely important because due to the VPA it is very difficult to modify parts that are impractical or become outdated. Once passed by the voters those words are law and they cannot be changed by the Legislature or courts. These initiatives are often written by individuals or small groups. In contrast, laws written and passed through the Legislature have many minds in the room while laws are drafted and much conversation happens before the vote.
No one is trying to make changes to the medical program created by Arizona voters with the help of MPP in 2010. This is a new market, an adult-use market, and it requires a new bit of legislation, that if successful, will provide a taste of freedom to millions of Arizonans.
Legalization of cannabis can come with many benefits for individuals and society as a whole, so it’s tempting to jump on board and vote for any legislation effort that gives citizens more freedoms. Voter initiatives are difficult to change once they become law. This initiative intends to create a framework, but there will be further rulemaking that is just as important to the success of the program. It is our civic duty to read the language of the initiative and understand the particulars, so we can make our best choice for Arizona. Critical thinkers should carefully cast their vote on these cannabis-related issues, but they must also think on a broader level and be wary of motives that would lead us astray.
If the MPP initiative does not satisfy Arizona citizens needs let us not pass the law. Instead we can ask our Legislature to craft a more sensible measure, and if they won’t we can elect those who will.
New MMJ Era
PTSD set to go forward as MMJ qualifying condition along with legal challenge
By Dr. MJ
January 8, 2015
This new year marks the beginning of a new era in Arizona’s medical marijuana community. Post-traumatic stress disorder (PTSD) became a qualifying condition for the state’s Medical Marijuana program as of Jan. 1 after more than two years of legal battles between the Arizona Department of Health Services and the Cannabis Nurses Association (CNA) led by Heather Manus. This momentous occasion represents the first time a condition has been added to the program narrowly passed by Arizona voters in 2010.
The PTSD medical marijuana research championed by former UA researcher Sue Sisley is now set to move forward in Colorado. However, here in Arizona, despite Sisley’s research to treat veterans with PTSD, the state is moving forward to allow medical marijuana for those diagnosed with the condition.
PTSD becomes the first mental health condition approved for medical cannabis in our state. Arizona Department of Health Services Director Will Humble added an unusual caveat to the approval of PTSD: he is requiring that a physician writing a recommendation also certify that the patient is receiving conventional treatment for their PTSD. This additional requirement of the patient and physician relationship is unique within the Arizona Medical Marijuana Act, because no other condition has such a stipulation and legal challenges to the requirement have been filed by Ken Sobol, pro bono attorney for the CNA. The conventional treatment required can be “talk therapy” but often is pharmaceuticals such as antidepressants, mood stabilizers and anti-anxiety products.
“Conventional” treatments have demonstrated limited success treating mental illness and often come with unwanted side effects. When a person suffers from PTSD they feel out of control of their behaviors; they sometimes hear voices; they suffer from hyper-arousal, have flashbacks, sweats, and panic attacks. It truly is a debilitating condition. Those that have found their way to cannabis report a quieting of the voices, an inner peace that allows them to function more normally.
The ease of titration and rapid onset of symptom relief that comes from inhaled methods of use leads most PTSD patients to smoking or vaporizing their cannabis treatments. Indicas have been shown to be most effective with this crowd, but with cannabis one size does not fit all; trial and error is the order of the day. Some PTSD patients find relief using edible products to aid with sleep. Some patients find sativas to be superior for their condition, although this should be tried after other strains have been shown to be ineffective or over sedating.
Israeli scientists are conducting research to determine exactly how cannabis works on PTSD. PTSD causes inhibition of neurons located in the brain, specifically the prefrontal cortex, the amygdala, and the hippocampus. These are the areas of the brain responsible for memory and decision making. One function of the endocannabinoid system is to mediate cellular memory. People who experience a traumatic or high stress event may have a hard time getting past certain triggering events due to suppressed memory cells. These memories are suppressed to block out unwanted information relating to the stressful event. Cannabinoids help to stimulate cellular signaling of neurons, allowing the stressful memories to be processed. With the help of cannabis, patients can begin to deal with the issues from a less guarded, vigilant position. As good experiences and memories begin to replace the triggering events and bad experiences in the patient’s consciousness the hippocampus can begin to safely process and store information without feeling threatened from a triggering event.
Dispensaries across the state will begin seeing the PTSD patient population in the coming weeks.
The treatment of PTSD with medical marijuana is effective for the patient and rewarding for the doctors and dispensary employees who serve them. Rarely has there been a patient population so deserving of our help.
Cannabis and cancer
Dr. MMJ offers an opinion on treatment claims and government research
By Dr. MJ
December 30, 2014
treatments are emerging and gaining acceptance across the globe, but with no FDA approval or large scale double blind studies done in the USA to fall back on where does one go for reliable information about these treatments? There is respected science about these issues coming from Israel, England and other parts of the world but very little from here at home.
This is because the United States government contends that cannabis is a substance with no accepted medical use. This assertion is made even though since 1974 the government has been in possession of scientific evidence that Cannabis can shrink cancerous tumors.
Below is an excerpt from a patent issued by the same U.S. Government to GW Pharma, an England-based pharmaceutical giant, for phytocannabinoids in the treatment of cancer. Phytocannabinoids are plant based cannabinoids as opposed to synthetic cannabinoids like marinol or the endogenous cannabinoids found naturally in all mammals.
Phytocannabinoids in the treatment of cancer
US 20130059018 A1
This invention relates to the use of phytocannabinoids, either in an isolated form or in the form of a botanical drug substance (BDS) in the treatment of cancer. Preferably the cancer to be treated is cancer of the prostate, cancer of the breast or cancer of the colon.
Cancer is a class of diseases which occurs because cells become immortalized; they fail to heed customary signals to turn off growth which is a normal function of remodelling in the body that requires cells to die on cue. Programmed cell death can become defective and when this happens malignant transformation can take place. The immortalized cells grow beyond their normal limits and invade adjacent tissues. The malignant cells may also metastasize and spread to other locations in the body via the bloodstream or lymphatic system. Cancer cells often form a mass known as a tumor.
Cannabinoids have been shown to play a fundamental role in the control of cell survival/cell death. It has been reported that cannabinoids may induce proliferation, growth arrest, or apoptosis in a number of cells, including neurons, lymphocytes, and various transformed neural and non-neural cells, and that cannabinoids induce apoptosis of glioma cells in culture and regression of malignant gliomas in vivo.
There is a long history of anecdotal evidence that points to cannabis having efficacy treating cancer. Programmed cell death this is the key, the author of this patent mentions it three times in less than a page and the application continues for hundreds of pages more and it is mentioned hundreds of times. So this pre-programmed cell death that cancer cells lack, can Phytocannabinoids fix it? How does it shrink tumors and cure cancer?
Cannabis Oil, often referred to as Rick Simpsons oil, is a highly potent concentration of the active parts of the cannabis plant, it is extremely intoxicating and taken at very high doses, like a gram of oil a day. Cannabis oil has been reported to reprogram cancer cells to die as described above. Those that have had success treating their cancer in this manner report shrinking tumors, and clear scans and sometimes continue on cannabis at much lower doses for maintenance.
The difficult parts about this process are developing a high enough tolerance to THC in the patient for them to reach and maintain a high enough dose to attain a therapeutic benefit and early detection.
Another challenge in using cannabis to treat cancer is the widespread use of chemotherapy and radiation in cancer patients. These treatments are extremely toxic and have had limited success in curing cancer. They shrink tumors but also kill undamaged cells causing nausea and loss of appetite. Cannabis focuses its energy on only the damaged cells and leaves the healthy ones alone.
Cannabis can be useful to a patient undergoing chemo or radiation treatment but the benefits are mostly supportive. Cannabis stimulates appetite and therefore can minimize loss of appetite and the resulting weight loss many cancer patients endure. Cannabis is a great pain reliever and can also relieve the discomfort caused by these treatments.
This leaves a cancer patient in a position of great uncertainty at a time when their life has already been disrupted greatly. In the end it is a difficult decision as to how to treat one’s cancer. These people deserve the best care and scientific information available and the freedom of choice to choose the best path for themselves.
All about the cannabinoids
We get back to where we left off on the world of cannabidiols and tetrahydrocannabinols
By Dr. MJ
December 18, 2014
Much has been made recently about a specific variety of cannabis known as Charlottes Web. There was a young epileptic girl in Colorado named Charlotte Figi who benefited from oil high in cannabidiol (CBD) and low in tetrahydrocannabinol (THC) produced from the minimally psychoactive cannabis strain.
There are other cannabinoids that have health benefits as well, cannabigerol (CBG) is a new favorite. CBG-rich cannabis has been found to help people with stomach and GI problems. CBG on its own has no psychoactive effect. Most of the 80-plus cannabinoids that have been identified don’t either. There is an astounding number of cannabis strains and each has its own chemotype or chemical composition. So how does a patient begin to chose from the offerings at their local dispensary?
First we need to highlight what is unique about cannabinoids and then we will address the role of the terpenes (essential oils) found in cannabis. On a molecular level, cannabinoids are colorless, odorless and full of hydrogen. Packed full of it. Every other psychoactive substance known is rich in nitrogen. To us hippies, nitrogen is plant food–poison, not medicine. The presence of Nitrogen is why other drugs are so toxic. The high comes from poisoning yourself and changes the function of your central nervous system (CNS)-the part of the brain that regulates breathing and heartbeat. If you do drugs over and over, your body’s functions slowly shut down.
The brain activity related to a cannabis high is peripheral. It does not affect the CNS regulation of breathing and heartbeat. That’s why no one dies from cannabis us — it just promotes creativity and free thinking. Too much is still a bad thing, through just like cheeseburgers will make you fat if you eat too many, but all in all we all need cannabinoids in our bodies and minds for optimum function. Remember all that hydrogen in cannabis? What else are we told to consume a lot of that is rich in hydrogen? Maybe … H2O? Yes water. Easy right? Simple stuff.
So our bodies apparently need a lot of hydrogen to function properly. It promotes the processes that regulate our bodies’ systems. Why does it do this? All mammals have an endocannabinoid system in their brains and bodies. We have receptors that the cannabinoids and some terpenoids bind to, starting a cascade of biological process. We need other nutrients, lots of them (some in tiny, tiny amounts), but we need a lot of hydrogen to maintain homeostasis.
I mentioned terpenes, (essential oils), note the word essential. So if cannabinoids are colorless and odorless, what accounts for all the variety of smell and flavors found in this useful plant? Terpenes. Oils. Each plant variety has it’s own unique profile of essential oils. These are found in cannabis and other healing plants.
Below are some common essential oils, their smell, and a list of their health effects:
• Myrcene: earthy, green, nutty. Potent pain reliever, anti-inflammatory and antibiotic it has antidepressant effects and it affects the permeability of cell membranes allowing optimum function.
• Limonen: -citrus. Anti-bacterial, anti fungal, anti cancer. Antidepressant effects.
• B-Caryophyllene: black pepper, clove. Binds to CB2 receptors and has anti inflammatory effect.
• Pinene: pine rosemary, sage, eucalyptus. Memory aid, antiseptic
• Terpineol: floral. Sedative
• Borneol: menthol, camphor. Sedative
• Linalool: floral, lavender, cancer treatment, calming
• Pugleone: minty. Aids memory
• Cineole: eucalyptus. Pain, aids circulation
When I help a patient choose the correct strain, we use a systematic method. We talk about their health condition and reaction to strains used in the past. We try to match the patient with the correct cannabinoid profile in regards to how much THC they desire. We consider other cannabinoid content and how it might benefit the patient. Then last, we have the patient smell the product options that make sense for them so they can make a personal choice.
Our bodies know what they need, our subconscious knows, and it is not always the same for each individual. What your body needs today could change over time. We need the full spectrum of oils and cannabinoids in small amounts for our bodies to function properly, so often the best results are achieved by changing strains on a regular basis using the same method outlined above during each visit to your local dispensary.
December 7, 2014
So I don’t know if anyone but me has noticed but I have had a bout of writers block since late this spring. I was on a roll this time last year writing about human rights and cannabis therapeutics almost daily. Well I am here to tell you that I am back! Life is good. I had a thanksgiving muy tranquilo. Means “super chill” to you hipsters. I can’t say for sure why I have had a writers block but I will attribute it to being busy and occupied running a growing business living my life and raising kids.
More importantly what snapped me out of it? This had been some time coming but today was special. My boy Bosco became a puppy daddy to seven baby boxers today, a beloved friend had his 37 birthday which was certainly reason to celebrate, I have a dedicated partner who I enjoy and who shares life with me, business is good, I am training new staff hoping to be ready to treat my share of the 500,000 people in az diagnosed w ptsd who become eligible for our program on January 1, 2015. We are fighting for our human rights on a state, local, and federal level which is always cause for amusement, my teenagers are tearing up the house and making their own mark on the world, my younger kids and step kids are sweet little loving beings and thirst for knowledge and experience……and given the state of the world at the moment I must accept all this as my reality, but all in all it is a charmed life…. So life is just so sweet that the dam broke and here comes the posts and the ideas and the love;)
There have been ups and downs over the last 7 1/2 months but the beat keeps on, I have a plan and it is working. We are going to keep helping people one by one until we have truly changed the world by touching every man woman and child that cares to join us in our quest for a natural, sustainable way of life. Stay tuned. One Love DBRC
<3 We owe it to the Kids <3
I was sitting holding my beautiful three week old niece the other evening after dinner. She is pink like a baby mouse, with delicate thin fingers and tiny hands, she is fragile, and focused inward on her own comfort and basic needs. She loves her parents and big sister in that special way but she is content to be held by her any of her family members and she tends to sleep in one of their arms most of the time. When she heard her parents voices or one of them laughed she would turn towards the sound and open her eyes. Watching her and thinking about the lifecycle for a long moment, I began to have thoughts of wonder at a creature so small, innocent, and helpless. I began to think of the great responsibility a parent bears, to care for their children, teach them to live, teach them skills, to make them self sufficient. Parenting is not just about the basic needs of food and shelter. Children develop their personalities and attitudes at an extremely young age. While their skill sets grow and develop throughout their lives these core components of how they view themselves and the world develop early.
In my own parenting I hope to instill a sense of “i can do it” in my children. This along with a strong desire to try new things creates a very human view of oneself. You learn to laugh at yourself, and the value of putting in time and effort to develop real skills at a variety of disciplines. In the end it results in what my mother calls “having stuffings”. In my mind “having stuffings” or being exposed to a variety of activities and cultural experiences gives us an appreciation for the differences or perhaps a glimpse at the similarities we all share. This results in a self awareness and perspective that cannot develop in an individual completely without this foundation in place.
In our modern world kids are exposed to the internet, and mainstream media at an extremely young age, when they are most impressionable and vulnerable to suggestion and developing the personalities that will shape their future lives and roles in the world. This overexposure and excessive stimulation at these critical stages is an incessant, constant, suggestion and reminder and re enforcement that they need to be stimulated and entertained by outside sources that it becomes an addiction. It is not my belief that we should raise children with an eye towards teaching them to continue to pass this type of lifestyle thru the generations and find ways to manage the ever increasing pace of the world and the stress and disillusions and false ideations that takes root.
Our dependence on refined sugar and processed food is another addiction that harms our children. The sugar molecule is a strong stable one and it it hard for our bodies to process and break down into its component parts. The amount of processed food that has these molecules present in the form of refined sugar or corn syrup, is staggering. Sugar is used as a flavoring agent or as a preservative in almost everything most of us eat and drink. It has been said that your health is inversely correlated to the amount of food you eat that has a label affixed to it. That is if you eat more foods in their natural form, that have been given a minimum amount of careful handling you will be healthier from that choice.
Instead of expecting our kids to adapt to these methods of entertainment and recreation, and this toxic diet and the countless chemical and environmental exposures present in the world today. Instead of teaching them to have all of that provided for them, let us teach them to do more of it for themselves. Let us raise children who would live differently and let us teach them to teach their children this lesson in self sufficiency. DBRC-One <3
Doctor agrees to take baby off dangerous drugs and try cannabis
Lady Harlequin has worked her charms for yet another patient, this time a 13-month-old baby girl. My deepest thanks go out to the grower who bred this plant five or so years ago in his basement in northern California. You, sir, are a genius. This plant is amazing. It produces a decent level of total cannabinoid content, has a wide variety of terpenes, a very useable 2:1 ratio of the major cannabinoids CBD and THC. But enough praise for the cannabis.
Baby T had her first visit with her neurologist today since beginning her cannabis treatments. Early in the process of treating her with cannabis the family was able to eliminate one of her more toxic anticonvulsant treatments. Despite that early success, no further reductions in pharmaceuticals were possible … until now. Baby T has many health conditions and is super fragile. This is delicate stuff, and her future is at stake.
The neuro and other healthcare professionals had already labeled this a hopeless case, a terminal patient. They said Baby T wouldn’t see her first birthday, but thankfully they were wrong. She has passed that milestone. Today, her neurologist reversed course in his plan and prognosis. He agreed to slowly eliminate another toxic anticonvulsant drug, and if things go well, to eliminate another. This will take some time and certainly entail some ups and downs, but Baby T is on the path to a life that doesn’t include seizures or anticonvulsants.
Why is the doctor changing course for this child? You can’t argue with something that works, and you definitely can’t argue with a mother that has seen it work and knows what’s best for her child. The family is determined to save their daughter, and Baby T wants to be here too. She has proven that by fighting through it all. Who could blame her? She is going to have a great life.
Baby T is here for a reason – so she can help change the quality of life here on Earth for every little person out there with special needs. Her story is yet another miracle in the works. The stage has been set, and now she just needs us to get out of her way and let her do her good works.
Aari Ruben, One Love
Desert Bloom Re-Leaf Center director
Cannabis keeps epilepsy patient seizure free
This post is part of a series of highlights of patient experiences at Desert Bloom Re-Leaf Center. These stories show how we learn and develop new methods. It’s his is a description of how we change things for the few, and their stories are how we inspire humanity and effect widespread change for the many.
It’s been quite awhile since we checked in with my little buddy, Madden, and his adventure battling epilepsy. I have had the privilege of working with him and his brave family for about six months now, and his cannabis treatments have had time to take hold.
There were many ups and downs over the first four months of treatment, while Madden got off of pharmaceuticals and adjusted to his plant-based medicine. He has been doing quite well for two months now, and these strides he has made so far in his effort to live as normal a life as possible are just the beginning.
Madden has had more medical care in six years of life than I hope most people have in their lifetime. He has tried a host of medications with some temporary success, but these treatments are toxic, not sustainable, and not conducive to good development and health. He has had surgeries. He has had tests and had to fast or be in uncomfortable situations over and over again. He has been poked and prodded to no end. He has fallen walking down the sidewalk and dancing with mom over the last few months, requiring trips to the hospital for stitches.
These are stressful experiences. They wear on a person and reduce natural protective hormones found in our bodies and brains, such as cortisol. Madden has survived it all. This kid is tough! He is a young boy growing into his new body and brain and living his new reality, and it seems to suit him well. He is mimicking words. He is enjoying his days without being forced into uncomfortable splints to keep his legs stable or into a helmet to keep his head safe, because madden isn’t having seizures anymore. He has been almost completely seizure free since he got over a bout of flu more than two months ago. The holidays were good to him.
He still is a fragile youngster, but he is getting stronger and asserting his independence more day by day. So if he is doing so well, why am I writing about Madden today? Didn’t Sanjay Gupta already tell this story about Charlotte Figi and cannabis and its effectiveness in treating epilepsy?
See the story isn’t over, there are countless Charlotte’s in our country, and they need our help, not just to find their way to cannabis as a treatment option, but to develop new treatment plans and breed newer and better plants to use as starting material. Madden’s success story and the good choices made for him by his family are helping others. Word has spread about him in our local community, and new patients and families are beginning to seek out these treatments.
See Madden is an inspiration. He is an inspiration to me, he is an inspiration to his peers that also have special needs. He brings hope to families left to rely only on faith that they will find an answer to their hopes and prayers. For someone who was so sick for so long and who was given so little hope of a normal life to have made such a dramatic, life changing recovery can only be the work of miracles.
The only possible explanation for how a humble plant can make these wonderful things happen for Madden is that it is natures way. It is being proven daily across the globe, and even in our own backyard at Desert Bloom Re-Leaf Center.
This is becoming undeniable, it is a human right, it is the essence of life and the human experience.
Aari Ruben, One Love
Desert Bloom Re-Leaf Center director
Cannabinoids knock childhood epilepsy to its knees
This post is part of a series of highlights of patient experiences of 2013. These stories show how we learn and develop new methods. It’s his is a description of how we change things for the few, and their stories are how we inspire humanity and effect widespread change for the many.
Imagine someone you love shaking uncontrollably, or simply being unable to move for a time, over and over again, day after day, for years. sounds terrible right? Imagine them sedated on many toxic drugs that inhibit their bodies natural functions and their development. Imagine a doctor telling you that they will never do this or never do that. How about a doctor telling you that brain surgery to inhibit the usual connections to certain areas of the brain is the answer? Makes one feel small and helpless, right?
Now imagine the loved one we describe is a fragile, innocent, beautiful, young boy or girl. That’s an even worse situation, how does one know what to do? Listen to the doctors? Listen to the stories of re-emerging treatments that were lost to science long ago? This is what treatment of childhood epilepsy looks like today. This is the challenge these families are faced with.
How do you know what to do for your kid if there is incomplete information and laws prevent some of these options in most states, and there’s no safe legal access to the best strains from one state to the next? Do you pack up and move like a refugee? Do you seek out alternatives that may or may not be legal? What would you do if a treatment was likely to work but was illegal? These are kids! People do what they have to for their kids! They do what works!
I know what works. I’ve seen it. Madden and his mom have proven the effectiveness of treating epilepsy with cannabis to me. This was proven to me in my own mind long before I met them, but the firsthand experience shows me that while cannabis is an effective treatment, helping these patients is not simple and easy.
It’s not one size fits all. It’s not just about CBD, we can’t just isolate CBD and pump it into people and have a miracle cure. It takes more than that. It takes being willing to get to know the patients and their situations in life and a willingness to always adapt and change their treatments to suit them. It takes knowing the plants just as intimately. You have to know which strains have which cannabanoid and terpene and what their effects are understood to be. This is hardcore clinical cannabis therapeutics and science. Kids’ well-being is at stake. It takes a serious commitment to the patients well-being and a willingness on all sides to be open minded and work together to solve the mystery.
For Madden, who suffers from childgood epilepsy, we have made a difference. Working with his parents, Desert Bloom has offered this child a drastic reduction in seizures. He is having a small fraction of the number of seizures he wasa having a few months ago.
And he has cannabis to thank.
Aari Ruben, One Love
Desert Bloom Re-Leaf Center
Vietnam vet turns to cannabis to treat Agent Orange exposure
This post is part of a series of highlights of patient experiences of 2013. These stories show how we learn and develop new methods. It’s his is a description of how we change things for the few, and their stories are how we inspire humanity and effect widespread change for the many.
Imagine living with cancer for 40 years.
Imagine painful sores and lungs that ooze constantly from nasty stuff working it’s way out of your body. Imagine waking every two hours at night to cough and clear your lungs, so you don’t drown on your own sputum. Imagine that these illness were inflicted on you by your fellow man. Welcome to the world of people exposed to Agent Orange and other chemicals used in war. They call them the ‘seasoned’ vets.
This particular seasoned vet, Sylvester, has lived and contributed to society beyond all expectations and odds. Born a week before Christmas in 1937, he was a unique child. He wouldn’t speak for most of his young childhood. Some said he was mentally disabled and wouldn’t do this and wouldn’t do that, but his family lived a natural existence with fear of nothing but their maker. They grew their own food and herbs, raised their kids to know just from unjust laws. There was much racism and repression for Sylvester’s black family in the 1940s, but this period represented a major shift in thought and in the way people lived their lives.
As a young man, Sylvester was a semi-professional athlete, and he eventually found his way to the armed services in Vietnam. He wasn’t just out of high school like most draftees; he was 30 and had a family to support. The military needed leaders. As a born leader,Sylvester had a long distinguished military career but he also, as a black man, had to fight for every promotion he ever got.
In Vietnam, he was exposed to Agent Orange, a chemical the U.S. military used to strip the jungle of vegetation that concealed the enemy. The exposure gave Sylvester cancer. He is able to care for himself through diet, exercise, plant medicine, and half a lifetime of know-how. Truly, this is a life lesson in self reliance. He learned this from others long ago and teaches it to all who cross his path.
Today, he is a bit round in the middle, but at 76, Sylvester still moves like an athlete. He is a gentle, jovial man. Kind-hearted and real. He laughs and jokes his way through life, and if you are having a bad day, an interaction with Sylvester will surely leave you smiling. You cant help but like the guy. Sylvester wouldn’t hurt a fly, unless it crossed his family or abused a child or woman. If that happened, we would see a side of him that he left in the jungle two generations ago.
Sylvester worked in supply for the U.S. Air Force. He rose to the highest rank an enlisted supply sergeant could. He was the conduit between the troops in the jungle and their supplies, and be damned the person who told him his troops out there in danger wouldn’t have their needs met. I am certain that Sylvester would have told such a person that regardless of the situation holding things up, his men would have their gear and rations and bullets.
So how was it going to happen? And when was it going to happen? And what couldSylvester do to make it happen? He got results. When things had to go into dangerous areas, he was the first in and last out. He didn’t move the goods from the safety of an administrator’s office, as he was entitled to do. If his men were going into harm’s way, he was going, too. He knows how to take care of himself. Faced with tough times, over and over again, he persevered. Kids to raise, work to do, a sick body to take care of, an active mind and soul to take care of – this man knows what life is about.
Some of these tricks he learned from his grandfather, who worked hard to support his family and dealt with severe pain and health conditions himself. He would hang cannabis to dry on a fence that ran along the road near his home. Cannabis was growing wild by the road, it was plentiful, and no one thought anything of it. His grandfather would take the leaves of the plant, the flowers, essential oils, and cannabanoids, a pound of block salt, and often mint or lavender, and put it in a tub of hot water, he would lay in the tub as long as he could while rubbing the plant material and salts around on his body. This is an effective way to remove toxins, relieve pain, promote healing and good health.
Sylvester grew into a young adult in a world that was changing, but he had many life lessons about the way people lived in the late 19th and early 20th centuries. He learned that often natural is better than the new synthetic products, and he learned that sharing the human experience is what’s important in life. He has written a book about his life, been asked to speak and share his life experiences with others.
He has taught me personally many life lessons.
He has taught me things about being an accepting parent and understanding a child’s unique needs. He has taught me about the government, as he has seen the depth of their deception. He has taught me more about the difference between sex and love than anyone I know. He paid me and my peers in the cannabis industry one of the nicest compliments I have ever received – that he was glad to see young people in the cannabis industry who have no fear, who are willing to speak unpopular truths, who stake their reputations and their freedoms on the knowledge that they are right and that they have found that fact to be self-evident.
This comes from a man who has faced real fear and real repression and real life and death. For him to validate that in his lifetime, the sum total of all his vast experiences, lead him to believe that I and my contemporaries are on the right path is such a boost that I wish to share that with the masses.
If cancer can’t take Sylvester from the world, then I don’t know what will someday. But life is not eternal. Someday he will be gone and his perspective gone with him. So let’s get to know this great man before he goes, and allow him to share those life experiences with all of us. It’s well worth the time, and Sylvester is happy to talk to anyone, anytime.
That’s just the kind of man he is.
Aari Ruben, One Love
Desert Bloom Re-Leaf Center director
This post is part of a series of highlights of patient experiences of 2013. These stories show how we learn and develop new methods. It’s his is a description of how we change things for the few, and their stories are how we inspire humanity and effect widespread change for the many.
Cannabis turns debilitating pain into a functional life
Imagine dealing with so much pain on a daily basis for so many days, months, and years that it drives you insane.
Neuropathic pain is often described as a burning, tingling, or pins-and-needles sensation. It can’t be rubbed away. It is an intense, constant, or sometimes intermittent discomfort. Pharmaceutical treatments are toxic and ineffective.
When this patient came into the store, she was completely insane. She wouldn’t shake my hand for fear that it would “burn her,” and she wouldn’t sit in the chair I offered for the same reason – she was afraid it would hurt. She chose to sit on the floor, which was fine, but not directly on the floor. She first put down a piece of plastic, and sat on that, so the cold tile floor wouldn’t burn her. This woman has been driven insane by her pain. She has no idea where it comes from or how to prevent it, and she makes some pretty wild associations with what might hurt.
We don’t judge people or try to change them to fit our ideals in my store. We listen and offer advice as to how they might better reach their goals and live their ideals, and this is different for each person. For Laura, the only goal was to stop this constant pain.
I sat with her and a talented cannabis clinician who works with me and asked Laura to describe her lifestyle and some of the sensations she felt regularly. It was hard to focus on her story, so we stayed very quiet, and when she would slow or stop I would nod or say quietly, “we are listening.” So she talked for an hour, maybe more. She told us about her burning sensations and how her painful pins-and-needles sensations were frequent and “way beyond pins and needles.”
She told us about her home and an issue with mold, and I advised her to move from that place if possible. She began to whine a bit about her life and how it had been hard and tragic, so I reminded her that, like everyone alive, she too, had enjoyed great magical experiences in her life. First loves and magic moments of all kinds with other people, sharing this thing called life. She lit up a bit at that and said that, yes, she had amazing fairy-tale things happen to her throughout her life.
I pressed on a bit and told her that my sidekick and I would make her some special pre-rolls that I hoped would help relieve her pain. We conferred a bit and made a special blend. We put it into pre-rolled cones for Laura and sent her on her way. We looked at each other, and with wide eyes just shook our heads in wonder, hoping that we had helped this poor woman in some small way. Laura became a bit of a legend that day, I made the Desert Bloom staff aware that I wanted to know when she came back to the store and that I wanted to follow this special woman’s care closely.
What a shock when she came back. This was a different person completely. She told me she loved the blend, she shook my hand, she held her head up and smiled, sat and chatted with me for a few minutes. It was unbelievable! We sent her on her way with more of her special blend.
She goes up and down with her pain levels since then, but I am proud to say that she is a much more functional human being than when we met. She credits our treatments and the special blend. I credit Laura, because she made good choices, even when her mind was so confused by the pain and pills. She never gave up. She found medical marijuana, and she found us, and she found herself.
Laura we are so proud of you! If you ever need us, you know where to find us.
Aari Ruben, One Love
Desert Bloom Re-Leaf Center director
A few predictions for 2014
Safer Arizona will valiantly fail to collect the necessary signatures for their legalization petition on the November 2014 ballot.
This will be despite Bob Clark, Patients4Patients, Dennis Bolkhe and many others’ collective efforts. Nice try guys, but this shit takes some money in 2014. It would have worked, if Marijuana Policy Project or NORMAL or some of the big, national pro-marijuana organizations had stepped up. I personally asked Mason Tvert, Rob Kampia, and Steve Fox more than once for backing for this very reasonable and prudent voter initiative. If they had responded to my many requests for a relatively small amount of money, it would be over.
Ruben Gallego will once again prove himself to be the brave man and leader of men that he was born to be by promoting reasonable and prudent legislative initiative to legalize cannabis in our great state. Even he hasn’t gotten his mind around what legalization means to Arizona in terms of taxes and earnings for residents. Despite his progressive stance, the Republicans that have ruled Arizona for generations will win and have their way one LAST time. Thanks for trying, bro!
Citizens of Arizona, by and large, will see very little change in their day to day life while more than 40,000 of their fellow citizens enjoy safe, legal, access to and benefits of medical cannabis. The people granted said permissions will be happier, healthier, and wealthier than they would have been if denied these liberties.
Cannabis as an industry will continue to change and grow, uses new and old will be implemented into our daily lives, and not just for those of us who enjoy the psychoactive effects of this blessed plant. There will be fuels and cloths and medicinal treatments that people will call miracles, and they will become mainstream.
The things I hope for most deeply are acceptance of diversity, the idea of embracing that which each one of us does best. And perhaps above all, I hope for the willingness to try new things and find that which one enjoys. The appreciation of the things others do well surely brings desire to do well in your own endeavors, and the experience of laughing at one’s own incompetence at things unfamiliar is good for the soul. But what of the idealization of a man with some skill at many things?
They talk of the age of the specialist and teaching yourself a skill or trade, and surely we need to know how to do certain things. But I see in my fellow man, in my kids, in myself, a desire to do things and learn skills and see the world and to do it ourselves, for ourselves. We don’t need an under class to pick up our trash and cook our food. Do it yourself. It gets cleaner or tastes better. People must take responsibility for themselves.
The skills I value most highly are those of growing food from the land, finding medicine in nature and being in touch enough to know what Mother Earth is up too. It takes simple awareness of yourself and your effect on the world, or if you are sick, the best healers in the business, before they give you an answer, after you have poured your story out to them, they ask “what do you think is wrong? What do you think caused this?” Well that’s insanity. You can’t plead stupidity! Why haven’t we been asking the person who knows the patient best, ie the patient, “what do you think is wrong?” all along?
In summary these are not original thoughts, many have recognized the power of people working together for the common good. I hope those who feel as I do will join in this fight, for our collective voice is the only way we will be heard.
Aari Ruben, One Love
Desert Bloom Re-Leaf Center director
An awesome year comes to a close
December 31, 2013 at 11:46am
So much can change in a year, as we get ready to close 2013, I hardly feel like the same person I did a year ago.
I’m still me. Nothing really changed. I knew then most of what I know now, and I had the same ideals, but my job and place in the world and how I am seen by others is quite different now. I used to feel like a bit of a drone, just going through the motions. Now I feel like I can shape the world to suit my will, and it brings a great excitement to life. This change seems to me to be a simple outcome of confidence, an empowering feeling that says it’s OK to be me, because I can do that better than anyone else alive, and I know where my talents and desires lie.
I was good at my previous jobs in life, but they weren’t my calling. They didn’t inspire me. I won awards as a bartender and made big advancements for the medical clinics I worked for, but I always had to ask permission to do big things and make big changes, and in those established industries, people were always very aware of the walls around them.
The people who owned those business were reluctant to go against the grain. They were conservative, almost paralyzed by the status quo. They didn’t dare to be different, not even a little. Ideas were dismissed as either too expensive or not profitable enough, or if they looked really good on paper, they were dismissed as unrealistic and as fantastic, pie in the sky craziness.
This past year was full of obstacles, small ones, big ones, personal ones, professional ones, socio-political ones. Many of these hurdles have been passed. Some are still on the horizon, but the new perspective I have shows these obstacles to be manageable and within my means and capabilities. The goals I had set for myself a year ago now seem easily within reach, so I plan to raise the bar.
I am not content to simply direct a well-run dispensary. I wish to contribute as fully as possible to the building of an industry. The best of my peers feel it as well. They aren’t just in this to make money or promote weed. Together, we will shape the world of the future. But even a contribution to this great endeavor will not satisfy me. I wish to use the sum of my life experience to be a leader, directing this social change. I wish to teach others how to run top-notch operations like mine, to develop systems to administer these new treatments to those who need them and to standardize the way the patients history and data about their anecdotal response to therapy are collected.
In the mean time, I help the few and train my staff and develop these methods, and it is so fun and of such potential benefit to humanity that I must seem a little manic. Sometimes my daily activities must seem like an act of sorts, but I assure you they are not. When I sit at my desk, writing or planning, and watch our patients flow through the store, the goal is to inspire. A year ago, I had no voice to change the world, and today that voice is only as strong as my last batch of cannabis or my judgment about the last patient’s needs.
My reputation is all I really have in life, and I’m not risking it.
I sit at my sisters house, Christmas Day 2013, and I marvel at the gifts I’ve received and had the opportunity to give this past six months.
These aren’t material things I’m talking about. I’m talking about gifts of sharing the human experience. For the past six months, I have had the opportunity to enrich many lives – patients and their families who benefit from our treatments and culture; staff who benefit from good jobs and hope for their futures. I have been asked to weigh in on cannabis legalization by state lawmakers. Doctors are sending hopeless cases to Desert Bloom Re-Leaf Center.
Our successes are being noticed and respected. I’m in Colorado for a much needed vacation, but there is always good work to be done. People I love and care about need some Xmas cheer and inspiration for what’s to come in 2014 and beyond. It gives me new vigor for life to help my fellow man in these ways, for if my dreams for others are realized then surely my own will follow, and the world will be a better place. That’s how the world works. No one owes you anything. If you want the world to be different, if you find it does not meet the standards you set for yourself, then actively change it to be as you see fit.
I learn about myself and the rest of humanity from my patients and staff every day, without fail, so I feel obligated to share this with others, so they may, in turn, also pay it forward. This is how you change the world – one mind at a time, starting with your own.
Truthfully, my life is like a dream lately. The world seems ripe with opportunity – to learn, to help others, and to prosper. If life is a zero-sum game and every good deed comes with some sacrifice, then what do I give up by doing these things for others? Money? Time? Privacy?
There is a time and dollar cost to being benevolent and helping others, but the time is well spent, because I am always aware of the human factor, and I always learn from those interactions, even if it’s not apparent to me at the moment. The entire experience goes into a data bank and is saved for future use.
Over and over again, until the picture starts to become clear.
So, what is a man to do in the world in 2014? Do you obey the status quo, which has a deeply vested interest in keeping things as they are? Do you quietly disobey and allow that to make you feel the shame that one who is discriminated against feels? Do you shout from the rooftops that which you believe to be just, and welcome the punishment that the man metes out for your just sins?
I will tell you one thing, if you don’t feel some anxiety about the state of our nation and universe, some unease that we may collectively be on the wrong path, then please sit quietly and enjoy this realm. Those of us with free minds and free will are going to right some wrongs. If those who are comfortable will simply stand by we will move forward without disturbing your bliss. We wish to cause no harm. Far from it, we wish to right the wrongs of four generations.
Care to join us?
Aari Ruben, One Love
Desert Bloom Re-Leaf Center director
A nod to some folks who make it happen 😉
December 27, 2013 at 8:52am
A big Desert Bloom Re-Leaf Center thanks to my patients, staff, family and friends for making this Xmas one to remember.
You have all been part of building something special, and the gifts we have seen are but a small slice of what’s to come. I could not be more proud and indebted to everyone of you, for this wouldn’t be nearly the same without each and every one of you. This industry isn’t about weed, although there seems to be quite a lot of that around. It’s about people and freedom and choice to live as we see fit. It’s about each of us feeling empowered to embrace that which we ourselves enjoy, empowered to never imitate others or waffle in your opinions, if you are uncertain, then be sure of that, and strive to understand specifically what you are uncertain about for surely there is much to be unsure of in the world today.
I have known Dr. Skinner all my adult life. At various times, I’ve been her front desk support, administrative support, business adviser, patient, colleague and friend at different times.
She has quit my employ or threatened to quit more times than I have had hot breakfasts. When these situations arose, I would typically tell Yvonne about the business, ethical and legal concerns that shaped my positions. Most times she understood and stayed; sometimes she chose to go. But even when she would leave we never allowed the relationship to be soured by our differences. Usually in the end she would say, “I really like your ideas about cannabis, and I would rather do this than not, so I will stay.” I am always grateful for her support.
When I need help taking care of a patient, Dr. Skinner is on the short list of those to call. Yvonne is a great doctor, a true healer. It’s unfortunate on many levels that her methods are not more in demand. She heals with oils and herbs and her hands. She assists the patients bodies natural healing process. And because she is a great doc, a great healer, she truly first does no harm.
We are blessed to have you at DB doc, and to try to keep the peace I am skipping all breakfasts. Thanks for your support.
Dr. Wonka, it’s a true testament that you made the rounds of dispensary operations and ended up choosing to hang your hat at DB. And perhaps even more of a testament to the potential in our group that you have begun to take the steps necessary to fully enjoy it with us.
You are the best in the business and have street cred second to none, thanks to Moses. You are a part of the clinical successes we have had, part of the way we come up with these treatments for seriously sick people. I’m proud of your products, and I am proud to call you my best friend. Thanks for all you do bro.
We have so many things in common, and a few distinct differences. Before you first came to Desert Bloom there was talk, mostly by me, of refusing you service. This was because we knew your alter ego and not the real you. In the end, Desert Bloom needed the publicity. I’m glad we did, for publicity is what we got along with a true supporter and friend.
We had an instant connection and understanding about our similar views. You have so many life experiences and have seen your industry changed by big business, technology and the Internet. In the cannabis industry, we play in a special new sandbox where old skills are still very useful, but we get to apply them in new creative ways for our customers. Our products are still part of a counter culture, that this counter culture will emerge as ahead of its time is the true secret to our success. So jump in bro, and let’s play.
This is gonna be really fun. We get to tell the story our way this time.
Some people come to this industry having had a long relationship with cannabis. They have specific knowledge that we need. Others come to us because they need our culture in their lives to thrive.
This second group typically consists of people who were not close to cannabis and later found a relationship there. Some of our industry’s most vocal, most effective advocates are critical thinkers from this group who saw and understood the disconnect between what they had been told growing up and what they experienced themselves.
George, thanks for being a great advocate, thanks for making Janna and I better managers, and thanks for making sure we all remember Sour Kooooosh!
This is another of that second group, the ones who find us. Justin is a great, talented guy, but he doesn’t feel permission yet to be himself. One of the things Justin will eventually bring to whatever endeavors he pursues is that he will forevermore be an advocate for each and every human to be himself.
Once be gets over the shock at how base human desires really are, he will see that diversity of thought is our greatest asset and that ones own experience and beliefs are the most powerful ones.
You are such a dedicated person – to your family, your friends, your careers past, present and future.
I’m so glad you came aboard and jumped in with both feet, both learning and teaching. You have a passion for people that serves you well in this industry. Your work history also lends well to what we plan to do, and your goals have a place in this as well. So all in all, I think you have a bright future at Desert Bloom, if it suits you. In any case thanks for the half-and-half, and for being yourself and sharing that with us at DB.
Vato, what can I say? I have never met someone so eager to learn, so happy to just be there, so humble and kind-hearted all rolled into one person.
You get it that the weed is fun and it’s why the people come and it’s why we have a voice, but that it’s not what really matters. You know first-hand of the injustice that we fight, and it is truly an example of the world gone right that you are here with us now. Never forget where you came from. Never forget who you are. Never forget that some of us are looked after and blessed, so we must share some of that with others.
Jason and Mindy, thanks for the professionalism you bring to our industry. We need your skills and the reputations that precede you to legitimize what we do.
As supporters of Desert Bloom, fans of our products and culture, and as people whose opinions we respect, we asked you into the shop and opened the kimono. We were so happy to hear that we don’t just shine on the surface, but that overall our business operations exceed the standards of our industry. That gives me hope that we have the foundation in place to reach our higher goals, and I hope you both will join me and the DB crew in taking this as far as we possibly can.
Thanks for being here, and thanks for your good work.
There are people in the world a man knows he can count on, and I know without asking that many people know that is true of you.
The day there was vandalism at the shop and customers were being harassed, I called you and asked you to be on the porch the next afternoon. As reliable as the sunrise, there you were, and regardless of your own needs you make certain we are covered, even when your peeps flake.
Thanks Budd, for keeping it real, and here’s to a long future looking out for DB staff customers and reputation, and let’s follow up on that bud-tending shift.
People expect me to be the teacher and mentor but there is nothing that I love more than crawling into that crazy head of yours.
You are a lucky young man to have an opportunity in this industry to set yourself up for some even bigger success. Perhaps that’s my role as a mentor with you, to help open your mind to the fact that anything is possible. For now we can learn from each other, from the plants, and from the patients, and one day I want to sit on a beach somewhere and watch you take the ball and run farther than any of us has ever dreamed.
We don’t know what that journey will be about, but it will be cool, and it will be useful to our fellow man. The skills we learn and the lessons we have found to be self-evident will still apply.
Love you, my Gemini twin. Keep on sharing the message.
I am so grateful for you and all you have done for Desert Bloom and myself. It would be far from the same without you.
One of the happiest moments of my life was when you told me you were using skills you learned at school to fix our menu boards. To me, this signifies that this really is your calling. I hope you find a home at DB for a long time to come. Your dedication as a student, as an employee, as a friend and as a human is second to none.
Your life experiences gave you wisdom and grace far beyond your years. There are precious few people one can count on and trust completely in this world, and I am so lucky to have found that in you. I trust you with my secrets, my innermost thoughts and fears, my money and my life.
Thanks for being the invisible smiling girl, and for knowing when to practice civil disobedience as well.
You are the best.
Aari Ruben, One Love
Desert Bloom Re-Leaf Center director
Baby T settling into cannabis therapy
December 18th, 2013
Baby T is an infant suffering from severe epilepsy. Her parents are trying cannabis therapy in the hope that it can accomplish what other drugs haven’t – a normal life for their daughter.
Day 4 Dad reports Baby T is doing well. She has responded to her cannabis treatment. There are legal and ethical concerns being raised by a home nurse. Consult with a local attorney suggests no preemptive action is possible. Parents advised to treat any encounter with Child Protective Services as one with law enforcement. We have clinical concerns about mom having pneumonia. Could be a big deal for Baby T. Seizure activity seems greatly reduced. Dosing with such a small quantity of oil is difficult. We will prepare Harlequin in a corn syrup suspension. Dad reports a rough night.
Day 5 Baby T is doing well, we have concerns about dosing with oil thru the feeding tube. We are not seeing the rise in heart rate that accompanied the early doses. This is due to a number of effects. Baby T is developing some tolerance. She also has been taken off of medicine that lowered her heart rate significantly, because of her heart rate being lowered to a lesser degree, the cannabis does not have the effect of raising it as significantly. Cannabis is an adjutant. Liquid suspension in corn syrup seems viable at a dose of 1-2.5 ml depending on viscosity and suspension capability. Dose for Baby T is to be 4 mg CBD, 2 mg THC, 1 mg unknown active per dose about 8 times per day.
Day 6 Parents report Baby T doing well. She is alert, her gaze is focused, she recognizes her mom and laughs and coos and smiles. Parents concerns about withdrawal dependance and addiction addressed. Parents report diarrhea and a bit of diaper rash, possibly due to grape seed oil. Delivered 20 Harlequin chews, 0.1 mg each, in 2 g chewable form, which yields one day’s medication when dissolved in 4 tablespoons of hot water. Parents are concerned about neurologist and his reaction to their choice to stop phenobarbital. Parents want information about strains and effects of medical cannabis. Parents report no identifiable seizures. Duty nurse reports four focal seizures today. Received video from mom showing a possible new type of seizure. To my untrained eye this does not look neurological, but may be a bit of trance-like fixation from the dose being slightly too high.
Day 7 Parents report that Baby T continues to have arm movements that could be seizures. My lay opinion is that these movements are more of a trance-like state from her cannabis treatments, but we will have to wait on the doctor’s opnion to be sure. Discussed meds separating with mom and suggested possible remedies. She will warm and agitate the solution, or when drawing up meds leave the units upside down or tip up.
Day 8 Mom reports Baby T being very squirmy, seems something is off. Nurse reports something is different. No word from her neurologist, but his nurse reports that he has the video of Baby T from evening of Dec. 11.
Day 9 I visited Baby T at home. She was off her monitors and feeding tubes, and the family was sitting in the afternoon sun in the backyard. One of Baby T’s biggest assets in her fight for good health is the positive vibes and energy given to her by her parents and her big sister. This intangible factor can never be overlooked. Dad is making ready a hot tub that was left in their backyard by a previous tenant. They plan to use it as a therapy pool for Baby T. We have made a plan to help Baby T and the whole family sleep through the night on a more consistent basis. Parents report that the baby wakes up often at 2:30-3 a.m. This seems in line with three 90-minute sleep cycles after bedtime. She wakes up rested and has trouble going back to sleep. We plan to use a small dose of THC rich chew when needed – a 3 or 4 mg dose to help her sleep.
Aari Ruben, One Love
Desert Bloom Re-Leaf Center
December 13th, 2013
I talk often about sharing the human experience, about how all of us are similar in our desires, and about how the diversity among us should be embraced and honored instead of ridiculed as strange or different. The work we do in the medical marijuana community showcases these ideals. We use plants and their various properties to care for our patients’ bodies and minds. The plants are diverse, and we need to continue breeding and selecting to encourage that diversity to flourish. The patients are diverse as well. They have a wide variety of health concerns and lifestyle factors to be evaluated. When patients need extra help in defining their treatment needs, our close relationship and product knowledge help us match the patient with the best medicine. The patient I have been thinking about most recently is a girl who suffers from epilepsy. She has focal seizures and petite mal seizures and about four other types of unwanted neurological activity, as well. She is on the typical anti-convulsant drugs and may or may not be having benefit from these pharmaceuticals. Doctors have told her family that she wouldn’t ever be able to do this and she wouldn’t ever do that, and even that she could die from her health conditions.
Day 1 Baby T is beautiful. She looks chubby and pink, like a baby should. She is alert and has a focused gaze. Her reflexes seem fine. She seems lethargic, likely sedated due to phenobarbital +20 other medications. She has a tube to her stomach and one to her intestine. She suffers from frequent seizures. There is no apparent change in respiration during her neurological episodes. Her heart rate drops when her neuro activity increases 10-15 percent. She has a history of increase in neuro activity when her immune system is compromised. Her parents wanted to try cannabis to control seizures, so I prepared 30 ml of oral suspension from two, 40 mg candies made from Harlequin, which gave a dose of 13 mg of active cannabinoid per teaspoon: 9 mg CBD and 4 mg THC. I suggested a dose of ½ teaspoon every two hours into her feeding tube. Mom administered half a teaspoon at 1730. Onset of symptom relief was 30 minutes after administration. Heart rate increased from 100 beats per minute to 140 bpm for 90 minutes after onset. Baby T had a lot of smiles and made nice cooing noises. Two hours after medication, her heart rate was 120. Mom gave the second dose as scheduled at 1930. I recommend light body work and mango body oil. We will use change in heart rate to determine dosing and schedule for administration.
Day 2 Dad reports a rough night. Baby T was overly sedated, her heart rate dropped to unsafe levels during sleep. Parents had to stimulate baby to maintain heart rate of 100+. Half a teaspoon of suspension administered by family at 2030 on Dec. 6. Half a teaspoon administered by family at 0400. The administration of liquid suspension raised her heartbeat to 120-140 bpm. Dad discussed reducing Phenobarbital with Baby T’s doctor, who suggested skipping the morning dose and reducing her p.m. dose by 50 percent. At the parents request, we will shift to Harlequin oil suspended in grape seed oil base, with the dose to remain the same. Parents administered a 4 drop dose of Harlequin at 1830. Baby T’s heart rate rose 20 percent by 1900, with some noticeable agitation. I recommended reducing the dose to 3 drops. Parents wish to discontinue Phenobarbitol.
Day 3 Dad reports a much better night than the previous two. The whole family was able to relax a bit. Baby T has been responding well to 2.5 ml liquid suspension. She is alert and happy. Parents are pleased with the course of treatments, and dad says they will try the oil again today. They’re concerned about how much reduction in neuro activity is being achieved. The family has been advised to consult with Baby T’s doctor in regard to med changes and reductions. Baby T seems to be overly sedated by her pharmaceutical medications, and the cannabis treatment seems to balance out some of these side effects. Mom reports her laughing a lot, alert and babbling like a baby should. I expect to see continued improvements in Baby T’s appetite, sleep, and neurological activity. My hope is that her doctors and family will work to eliminate as many other treatments as is safe, then we can most clearly see how the cannabis effects her. I would like to make as much progress as the cannabis therapeutics will allow for her, and at that point reevaluate her condition and determine the correct course. We can help this little girl, and I won’t ever tell her parents that she wont do this or cant do that.
These are brave beautiful people who deserve to be able to care for their daughter using the most effective treatment without fear of repercussion from their jobs, or CPS, or law enforcement. Baby T is going to be OK, whatever that means for her as an individual. We are going to support her development by using cannabis treatments to regulate sleep and appetite and to reduce her seizure activity and dependence on pharmaceuticals. This kid is a fighter. She has proven it with her will to survive thus far, given her difficult start in life. It pisses me off to no end that the experts, the doctors, want to place limits on the future abilities of a person who has so much life ahead. What a terrible thing to put in a parent’s mind. I don’t believe in giving false hope, but let’s let the patient’s outcome decide what her limits are. I have known just a few days, and I can tell you that nothing she does in life will surprise me. Already we have begun to reduce meds, and to dial in the dosing and make a plan to help this little girl.
Aari Ruben, One Love Desert Bloom Re-Leaf Center director
Much to be thankful for this holiday season
November 29th, 2013
I have to say that Thanksgiving 2013 will go down in Desert Bloom history as one of our finest hours. I am so proud of my staff for being accepting of all humans, of their moods, of their problems and of their individual needs. The human experience is a beautiful thing, and so much more so when it is shared. We had a great time in the store today spreading holiday cheer. Our patients came in looking cleaned up and sharp dressed on their way to holiday meals with families and friends. Everyone had a kind word and a smile and a wish for all to have a great Thanksgiving. There is a culture budding at Desert Bloom Re-Leaf Center, and I am proud of what it represents. For the patients … by the patients. It’s not just a catchy slogan. It’s the heartbeat of DB. It’s contagious. It makes people feel it’s OK to stop by and visit and makes them want to share their lives and stories. This helps us really know who our patients are as humans. By knowing them, their lifestyles and their health and social issues, we can more effectively suggest treatments we think will benefit them. We are also learning every day about the strains we carry in the store, our local lab recently doubled the number of cannabinoids we can test for, and they will soon have terpene profiles available. This will give us yet another piece of the puzzle to base our strain recommendations on. For now we rely on our prior experiences, our noses, our best judgement and faith in what works to help our patients. Madden is a good DB example. He has been doing quite well this holiday. He’s healthy and enjoying a trip with his parents to visit family. He has had his ups and downs, and we have had to make many adjustments to his treatments, but as we get to know him better things that are affecting his health become clearer and make more sense, and this makes it easier to take care of him. Surely this is much to be thankful for. So DB is getting ready to close the books on 2013 on a high note, with big plans for 2014. We will be starting in-house production of edibles, quality assurance testing of all products, beginning our own breeding program in our new cultivation facility and continuing to promote our ideals. At the same time we are faced with putting our best foot forward every time a patient visits our store, to be sure they feel heard and cared for, understood and appreciated as human beings, and that they leave us marveling at the wordless beauty and joy felt when we share the human experience.
Human nature will keep cannabis therapies moving ahead
November 13, 2013
My word, it is a wondrous world we live in.
I spent time recently in Denver with some truly visionary people who develop new treatments for PTSD and other mental health issues, and then enjoyed the beauty of downtown Seattle with some close friends. What amazed me was the incredible diversity of thought and free will expressed in these communities….. No small wonder that these are two of the first states to legalize marijuana. These people are out and about and live a 24/7, big-city life, but they get it for the most part. People often have a kind word or a smile, and Pikes Place Market in downtown Seattle is undoubtedly one of the planet’s great bounties.
So among this vibrant immersion of sights and sounds, of talented street performers and delicious smells and flavors we find acceptance for one another’s beliefs and wants and needs, and we see a slice of what life is really about. And my word, isn’t the human experience an amazing adventure …
My buddy Madden has been having a good time, as well.
He went through another bout of whatever boogery kids pass around these days. It’s very telling that these disturbances to his auto-immune system induce more seizure activity, but with cannabis therapeutics his bouts of illness aren’t followed by a drastic seizure increase. Instead we see a moderate increase to just under 20 seizures per day.
Now, I don’t know about you, but this isn’t good enough for me. The medicine Madden is using is the most effective for him that I can legally obtain in Arizona. It’s my old standby Harlequin at a lousy 2:1 CBD to THC ratio. This strain was bred by one of the best growers in the world four or five years ago. Cannabinoid therapeutics is like the next tech boom, every six months bigger and badder toys come along and Maddy’s Harlequin is a virtual dinosaur. I had big hopes for Cannatonic, which tested higher in CBD ratio, but for Madden and another child we help, Harlequin seems to be working best at this point.
We get requests for information about cards for children. Other patients of Madden’s neurologist are asking about CBD rich strains. Hey, I’m game. Send me the tough ones, and let’s try something else. We’ll see what happens. For a lot of these little guys, it’s by far the lesser of two evils. It’s called harm reduction.
So I keep searching and asking and networking and taking steps to open a cultivation facility of our own. I mean, if we can’t get permission to share the best meds market-to-market, and state to state, then Madden and many others go without safe legal access to the best and hottest technology. Which leaves me wondering if the world has truly gone mad.
But if you think back to the bounty from the land and sea at Pike’s Place, you realize that it’s all been brought to market by man, and people will always innovate and thrive. Even the wheel has evolved, improved. You don’t have to reinvent it. Maybe we can spur the next evolution. We could make the next better wheel. Or the next cancer cure or weight loss drug.
It’s just a matter of time, really. Human nature will take it’s course.
Aari Ruben, director
Desert Bloom Re-Leaf Center
October 21st, 2013
So it’s been a little while since I’ve seen my buddy madden and I wanted to give his fans an update as to the last two weeks adventure. In my last madden post we had eliminated the last of his pharmaceutical drugs and madden had shocked the heck out of me and others by breezing thru his detox. He was really on a roll for a solid week, with just a few small seizures the whole time. He was going on walks with mom every day after school, able to play sans helmet, kids and teachers at school enjoyed his increased participation and life seemed good. So mom began to eliminate some of the treatments, like his chew before meals, as his appetite was good, and the bedtime chew as his sleep was good. And at that point we considered and began to slowly reduce the CBD rich oil maddy takes daily.
Then madden caught this early bug that is so active in Tucson right now and this increased his neurological activity quite a bit, nothing like 75-100 seizures a day, like the three years before we began working together but, 12-20 a day range. This has been the norm in the past when madden is sick, it’s also not a far fetched thing knowing what we do about body systems and homeostasis. The neurological system and the immune system have a strong connection, so do many other body systems. Actually the interesting part is the ones which are NOT closely connected but we will talk about that another time. The basic lesson to understand is that if one body system is not homeostatic or in balance, in this example it’s maddys immune system fighting a virus, then the changes that take place have effect on other systems. Too cool! this means if you have health issues and you are willing to make as many of your bodies systems strong and at optimal function the better your systems will support and heal the unbalanced ones. Woo hoo, good stuff! So madden is still improving all the time, the setbacks are part of the process, his skin color looks healthy, his sleep and appetite are strong and he has gotten past his flu virus. We tried again to raise the ratio of CBD to THC in maddens oil using hemp extracted CBD during his illness in hopes of reducing the seizures but it isn’t where the magic lies in my opinion and experience. The oil that has helped madden comes from a plant known as harlequin which was bred in California several years ago. Since then the breeding programs for CBD rich strains have taken off and with each plant generation the non THC cannabinoid levels are greater. Charlottes Web is almost a 20:1 ratio. Harlequin approaches 2:1, you do the math. Harlequin was state of the art a few years ago and made its way to my door. There’s no reason to think that sooner or later charlottes web or some other high CBD strain will do the same. It’s the way of humans. Things get done one way or another but if more of our systems as a society worked better to support each other then our society as a whole would thrive, like madden. One DBRC
October 5th, 2013
I love little kids like my buddy madden, they showcase people at our best. They have few insecurities, hardly a care in the world. They don’t see skin color, they don’t deny their feelings, they take life as it comes, developing stage by stage as described by Ken Wilbur in “A brief history of everything”. The development of a single person”s being and the collective Evolution of man has to be my favorite topic of thought lately. We live in strange but interesting times, for several generations now our way of living has been shaped by corrupt political and financial policies. It has come to the point that few can remember it having been different. Most of the time things change one by one, and it takes along time. On rare but special occasion many important things change at once and it happens in rather short order. This is known to history as Revolution. It usually happens because one significant change prompts widespread change of thought about something conceptual. This conceptual change affects how many other things work and relate to each other. This is nothing to fear, in fact it’s in all our best interest to participate and shape the movement as we see fit. But why am I talking about Revolution? I’m talking about it because we are LIVING one as I write and it’s such a unique thing to experience in ones lifetime rather than just read about it in books. It means every man, woman, and child here today has a chance to be involved. Today’s revolution is being led by the cannabis movement, but along side we find all the civil rights activists, the gay marriage proponents, the green energy crowd, everyone who decided we should go back to a sustainable lifestyle. One in which if you weren’t hurting anyone you were mostly left alone with Taxes as minimal as possible and just law that makes sense. Let me tell you something about cannabis prohibition. In order to marginalize and demonize cannabis in 1936 our government passed the Harrison tax act. It imposed $100 tax per oz. on cannabis.
In the early 30’s our economy was in the toilet. Our federal government was nearly broke (sounds familiar), and $100 was a hell of a lot of money. At that time cannabis/ hemp was widely used for fuel, paper, medicine, rope, clothing, and many more. Synthetic materials were being created, pharmaceutical drugs were being created, ELECTRICITY use was becoming widespread. Oil and coal were being consumed faster than ever before, remember these products take millions of years for Mother Earth to produce so they are defined as non renewable. These innovations were meant to improve the world and they have, they are amazing things that moved the human race forward and allowed for other innovation to follow. However those new innovations were abused, by men who had influence and wanted to commoditize them. This isn’t inherently evil. We need people to run businesses and bring products to market. What was evil is because the new products couldn’t compete fairly (they still can’t) they demonized, then taxed, then outlawed the cheaper, superior, natural, renewable product, in order for their products to make a nice profit. This was a TREASONOUS set of actions with motivations more disgusting than greed alone. The scope the damage that is result of those acts has not yet been fully understood, but here are my own predictions.
I think they took away an essential component of human nutrition and gave people diabetes and cancer.
I think they took away a precious renewable clean fuel and wasted the oil and polluted our environment.
I think they took away a powerful well known safe effective medicine that can stop seizure and nausea and pain.
I think they took away a source of paper and building material that grows in four months and instead cut down millennium old, old growth forests. (actually I know those dumbasses did that, wtf?!. For a few $?!)
So they did all these things and called natures blessing to the human race marijuana and pushed the world to do the same.
The problem with that is that people are people, we innovate, create, and evolve even under a repressive regime. We push our limits and strive to improve our lives, and our families lives, and hopefully the whole human races lives.
That’s why the kids are so important! That’s why madden inspires me so much! Today is a day that madden will look back on for the rest of his life, today is the turning of the tide in his personal revolution, today madden was pill free for the first time in a long, long time. After trying many different pharma drugs. Many of which were toxic and had side effects provided no real seizure relief. He’s been using cannabis to treat his seizures for about two months now. His meds have been steadily reduced and his seizure activity has substantially reduced over the same period of time. He is sleeping better, eating better, and feeling better all the time. He is still healing, we haven’t seen anything yet!
When he goes back to the Arizona School for the Deaf and Blind Monday I think the staff and kids will be pleasantly surprised. We need to make cannabis a front-line treatment for kids with epilepsy and many other conditions: if it is not effective let the drs have at it with their meds. It pisses me off that the man took such a natural reliable anti convulsant away in favor of the pills.
Now I know that the people who made the herb that helps madden so much illegal didn’t mean to hurt madden or the rest of us so badly, they couldn’t see the consequences five generations to come….
But when in a matter of days we can help people with cancers and seizures to heal we see the result of their ignorance and greed. We have seen Charlottes story open hearts and minds but science demands that an experiment be repeatable to be relied upon for future reliability so kids like madden lead us into the future with their strength, heart and will to thrive. DBRC One
October 2nd, 2013
Madden just amazes me daily. This kid wants it, he wants to be alive and laugh and play, he wants to feel good and eat well and sleep. I don’t know what his goals will be but He is going to have his own adventure and no drs or healers or anyone else is going to decide where that leads, See madden is an American, a pioneer, he looks forward not back…..But I look back!!!! To long before madden, To 20 years before my grandfather flew airplanes in WWII, he was raised in Kansas City by immigrants from Eastern Europe. His parents were successful business people before coming to Americas new frontier. My grandfather was one of Four kids. They knew what was important. Stay fed, clean water, little roof over their heads. Hey even if there’s no roof at least no one was bombing them or their kids. Basic, basic needs. Life was tough but good. They were free. Americans! That meant something, Because they knew what it was to have freedom taken away from them, they raised their kids to live by a higher law than can be written by man in a book. they made this country great by their hard work, and fair enterprising spirit. An amazing return was generated from those four Americans they all helped develop our country. So in return the man said he would look after them and their kids, protect them, FEED them, make sure they had their basic needs met. Anyone remember Maslow or maslows hierarchy of needs?
The idea is that once we have food, water, and basic security then we flourish and create tell stories and dream of what could be and help others live well too. Naturally! But this promise to make sure that people would have the basics and be allowed to do what they do got perverted. It became about money and power and abused trust. The same higher laws still apply. They never went away. A man should still feed his children and do his best to help those less fortunate because it’s the human thing to do. It’s those things that makes one come outside of their own selfish existence and make judgement as to what’s right and wrong. There’s no greater responsibility than being a parent we worry and don’t sleep and feel our kids embarrassments and excitements as acutely as we did when we lived them. That’s the human experience, the life cycle, and so in the end it’s all up to the parents, the mothers, the fathers to decide where we go next. Maddens mom has been doing a great job dealing with some tough stuff here but there’s only so much a person can take. She just wants to have a “normal” quiet life with her family but she is a madden advocate thru and thru and this kid is going to have every opportunity he’s got coming.so she has to study laws and stats and modern medical science and ancient healing, and a bunch of other stuff and then try to make sense of it. and if you read all that for yourself and you realize it makes no sense then you get MAD! Now I don’t know where you come from but where I come from if mamas not happy then nobody is happy. And these guys that had the good sense to write all these clever rules down better look out! Because the MAD mom is gonna get you! What’s the biggest thing that will piss a mom off? a LIE, what’s worse than a Mad mom whose been lied too? Not much I tell you but try fifty million MadMoms who have been lied to…. And who know what’s fair….and just….and know their rights as Humans to care for themselves and their children. Whoa u boys picked the wrong fight, once the moms are on our side, even the moms of kids who are healthy, say, yea, if that was my kid I would do anything to help them. Anything! Then finally we can re add this wonderful clean source of energy and good health to our collective lives and see what it can really do for human health. Nature made it for us it will do what it’s supposed to, that’s natures way. We have just got to get out of the way. DBRC ONE
September 29th, 2013
So maddens mom took him to his neurologist appointment today….I am a bit chaffed as usual but overall it was a home run! Let me start with the good part for a change, the room was packed with future neurologists and pediatricians, along with madden, his mom and one of the best neurologists in the world. That is like my dream com…e true because we didn’t help one kid today, we helped millions because I guarantee those young future docs remember this day forever! When mom told them that Maddens seizure activity has reduced by 90%, …During a slow long wean of the 2nd to last of 20+ anti-convulsant wonder drug! Everyone in the room, except madden, was shocked, and when maddys doc said he wanted to turn maddens VNS down?????f usually we turn that thing up??? AND when he agreed to immediately start a super duper slow, month long, taper on the last of the pharmies at least five bodies hit the floor?! Now I don’t know much about VNS or pacemakers, I’m not a cardiologist, or a neurologist or even an md but I have never, ever, heard of a VNS being slowed…. So anyway we are ELIMINATING the last pharmie.!,!,!, no matter how quickly or slowly,!,!,! This means soon maddy will be pill free for the first time in several years! Free of the mans meds, woo hoo!!! Now, this does not mean he is without support to control his seizure activity, remember he still has his VNS and he still has his various cannabis treatments, which we hope to be able to reduce or eliminate at some future time. Remember we are not big pharma, we don’t give a fuck about $, or making drugs that people will have to take forever so we can be rich. We care about making people well, we are healers not DR’s. Thank yaweh for that!! Now this all sounds like a picnic…. It’s all sunshine and roses. So where’s the nasty? this is life, real life, so let’s see some guts……! The Tsunami is coming, but it’s cool, we got this, we have maddens toughness, a never say die set of parents and a little bit of weed on our side and if they need I will come hold up the dam for awhile, We’re good. Heck no one even wanted the weed madden needs to be well over the last 25/30 years. All us pot heads thought it was garbage. Because for fifty years cannabis has been an under-performing star. A one trick pony. The $$$ has all been in the thc! Shucks I love thc. It makes me happy after a long day, and hungry before a good meal and sleepy at bedtime, It will help me relax and enjoy a romantic moment with my girl, it does whatever I need it to do in a given moment, because Cannabis is a magic new type of drug known as an adjustant. (Spell check doesn’t even have it as a choice) Lol! It means it brings one up or down as needed. It means if you are sick like madden it may help you fight off what’s wrong with you….. Naturally! Now forgive me for reaching a bit here, I’m a cannabis activist to the bone, and I don’t give a fuck what people think! (as long as they think for themselves), but my lay opinion, and a number of respected studies are confirming this, is that cannabis, cannabinoids, and their CONSUMPTION, is as critical to human health and well being as any micro-nutrient we know of, and we know of many, and they are hard to get into your brain from food alone, so people take supplements, much like the cannabinoids, (isn’t feeling good and healthy a form of “high”? don’t people who workout feel a runners “high”?) good health feels good! There are about 100 cannabinoids and most of them are not psychoactive, Mammals have endocannabinoid receptors and pathways that require these receptors to be bound in order for body systems to function optimally. The prohibition against cannabis has removed these from most peoples diets and lives, this may be the direct cause of much modern illness. Alzheimer’s, Cancer, Diabetes, Celiacs, So back to maddys daily life, his VNS, his fight coming up. Madden is like Rocky, he’s training and getting stronger everyday, he’s got DRAGO next so he’s pushing hard, eating, sleeping making himself strong, because he is gonna win! This is one kid that can do it!!!! He WANTS it, and those future doctors madden shocked the stuffing out of today? They can do it too, for a million more kids who need them to open their minds and want it too! They can change the world, go to work kids…. Thanks Maddy! DBRC
September 24th, 2013
For the patients…. By the patients….. I asked what it means to you some time ago and got no response, some of you are so couch locked you need some inspiration so here goes…….
I had some special guests in the store Saturday and we took time to talk about my buddy maddens recent progress, illness. and short term plans. He is such a beautiful boy. He smiles, rubs noses with his mom, looks around, he likes bright lights, he likes to explore his surroundings, touch things, add them to his brain. He waves, gives five, hugs, knows when he’s bored, he is alert, somewhat disoriented but he’s clear eyed and has no apparent hallucinations illusions or delusions. This six year old doesn’t talk but I promise you he is far far from stupid or “retarded” And I am sitting there thinking: I am watching the same “evolution” of intelligence in an individual that happened for mammalian life 580 million years ago (first organisms w endocannabinoid systems evolved). So anyway, enough daydreaming back to the present. We have madden and two great Americans here and we have to help them help themselves! So since my last update madden has started a different type of seizure. The first few of these scared the shit out everyone!!!!!!.( except the neurologist oddly enough) because they are of a different animal……, 15 minutes long at first! Then shorter 10! Then 6! He’s never had one more than 60 sec his whole life! Wtf is going on here? What have you given my kid? Crazy ass hippies!!!!! This isn’t “normal childhood” like a few stitches of a few pukes!!!! We can handle that stuff but a 15 min seizure UhhhhUhhhhh. So we talked about maddens brain and how it is so adapted to the meds he has been taking for half his life, some amount of dependence on these drugs is inevitable. With all the other changes to maddens meds over the last few years detox was a part of the deal, month “long slow” tapers to try to diminish the effects have been the norm. There are other ways to “detox” from all types of pharmaceuticals and all drugs for that matter, choices can include “cold turkey” or “a short fast taper” always consult your physician prior to starting or stopping any meds. If you want to get off pills and your doc doesn’t seem to have a logical explanation why he wants you to keep taking them go see another doctor like one of the great naturopaths in your community. If you need help to “detox” you can come see me. Detox is not just for changing meds, it’s the second half of the nutrition equation, we do it everyday and keeping bodies strong and healthy is basically an effort to keep our systems balanced, detoxed, and healthy.