• Default
  • Foliage
  • Clouds

Ebola Virus Disease — Current Knowledge

Ebola is in the news and has landed on our shores. A current epidemic in West Africa very likely could result in sporadic cases appearing across the U.S.  Everyone should know the basics about this threat.

Ebola presents as many other viral infections with fever and body aches.  The highly variable incubation period averages about 11.4 days (time from exposure to first symptoms). It develops into a severe gastrointestinal illness with vomiting and diarrhea. Volume depletion and hypovolemic shock will occur with inadequate treatment.  A hemorrhagic terminal phase occurs with internal bleeding and vomiting blood.  Bodily fluids are highly infectious. The case fatality rate is as high as 90%.

The NEJM has an very informative graphic entitled Ebola Virus Disease—Current KnowledgeIt details what known about the virus and its transmission.

ebolass

Amendment 2: The opinions of the former Florida Supreme Court Justices are wrong.

This reviews the opinions of seven former Florida Supreme Court Justices about Amendment 2. Their statements appear below in italics.

“First, the amendment is so broadly cast and vague, it will open the door to the general use of marijuana, not the carefully regulated medical use of a drug for those truly suffering.”

Suffering is subjective.  The justices’ imply some peoples suffering is more worthy than others. Who’s to say your back spasms is worse that my lung cancer? Or, your migraine is worse than my kidney stones? Every patient is deserving of relief. If people can get relief from marijuana for their debilitating condition– they have a right to it. These decisions should NOT be made law enforcement officers, or judges, or bureaucrats. The amendment makes clear a “Qualifying patient” means a person who has been diagnosed to have a debilitating medical condition, who has a physician certification and a valid qualifying patient identification card.

“Amendment 2 endangers Floridians by granting broad immunity from criminal and civil liability to virtually everyone involved in the chain of custody of marijuana.”

The harsh laws concerning cannabis use in Florida have been used to arrest and jail minorities disproportionately, deprive patients of civil liberties, confiscate property, and put patent’s children in foster care– because they have sought legitimate relief from cannabis. Immunity insures a patient’s basic right to access cannabis for debilitating conditions will not be infringed.

(1) The medical use of marijuana by a qualifying patient or personal caregiver is not subject to criminal or civil liability or sanctions under Florida law except as provided in this section. (2) A physician licensed in Florida shall not be subject to criminal or civil liability or sanctions under Florida law for issuing a physician certification to a person diagnosed with a debilitating medical condition in a manner consistent with this section. (3) Actions and conduct by a medical marijuana treatment center registered with the Department, or its employees, as permitted by this section and in compliance with Department regulations, shall not be subject to criminal or civil liability or sanctions under Florida law except as provided in this section.

“Amendment 2 creates a right to use marijuana, coupled with a right to privacy for medical marijuana users, without regard to age. This could be construed to allow minors to obtain marijuana for purported medical reasons without the knowledge or consent of their parents.”

As a practical matter, except for rare exceptions such as an emergency, Florida physicians will not treat minors without parental consent.

“Amendment 2 creates the role of medical marijuana “caregiver.” There is only one requirement to be a caregiver— be at least 21. Amendment 2 requires no medical expertise, training or background checks for caregivers, who would have the authority to provide marijuana to multiple individuals. This caregiver provision could be used as a legal shield to protect drug dealers from prosecution.”

This is nonsense. The amendment requires:

“The Department shall issue reasonable regulations necessary for the implementation and enforcement of this section. The purpose of the regulations is to ensure the availability and safe use of medical marijuana by qualifying patients. It is the duty of the Department to promulgate regulations in a timely fashion….b. Procedures for the issuance of personal caregiver identification cards to persons qualified to assist with a qualifying patient’s medical use of marijuana, and standards for the renewal of such identification cards.”

“If Amendment 2 is approved, it would be almost impossible to fix its many flaws because it would be enshrined in the Constitution, rather than being a general law that can be changed or improved as needed to respond to inevitable problems.”

Amendment 2 is needed to protect the innocent patients who have found relief in cannabis and limit the legislative powers which have inhumanly criminalized their diseases, pain and suffering.  To protect citizen’s rights in Florida the ballot initiative “Use of Marijuana for Certain Medical Conditions” needs to be “enshrined” as an amendment to the Constitution of Florida. Passage of Amendment 2 is more than an issue of “compassionate use.” It is about fear the legitimate use of cannabis to relieve medical suffering will result in jail or loss of property. Traditionally in American medicine a patient and their physician have a right to choose, without fear, their preferred treatment. It should be a choice, without government interference. Amendment 2 helps ensure these choices and rights.

“The Department shall issue reasonable regulations necessary for the implementation and enforcement of this section. The purpose of the regulations is to ensure the availability and safe use of medical marijuana by qualifying patients. It is the duty of the Department to promulgate regulations in a timely fashion.”

Medical Cannabis Laws and Opioid Analgesic Overdose Mortality in the United States, 1999-2010

This study has found a link between medical marijuana laws and lower morality rates from opioid overdose. (JAMA Intern Med. Published online August 25, 2014. doi:10.1001/jamainternmed. 2014.4005).

According to one of the authors, Marcus A. Bachhuber, MD:

“We controlled for time-invariant differences between states using fixed effects, as well as some other time-varying policies and the unemployment rate. In our regression models, we found the average overdose death rate in states after adopting medical cannabis laws relative to years prior to adoption, and trends in states with no cannabis law during the same period. To summarize, the raw number of deaths is higher (on average) for medical marijuana states, but after implementation of the medical marijuana law, rates were about 25% lower than would be expected (based on prior years’ trends and trends in non-law states).”

According the the accompanying commentary:

“The striking implication is that medical marijuana laws, when implemented, may represent a promising approach for stemming runaway rates of nonintentional opioid analgesic–related deaths. If true, this finding upsets the applecart of conventional wisdom regarding the public health implications of marijuana legalization and medicinal usefulness.”