Category Archives: drugs

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Don’t try this at home

https://news.ohsu.edu/2022/03/17/little-evidence-on-how-psilocybin-therapy-interacts-with-existing-psychiatric-treatments-review-finds?linkId=156952130

People are busily hopping on the psilocybin bandwagon. DON’T. Why not, you say, it’s NATURAL. Well, the death angel mushroom is also natural but it will kill you. So are red tides, poisonous snakes and sharks.

You wouldn’t take your buddy’s appendix out in your kitchen, would you? Don’t mess with your buddy’s brain either. Especially if there is already a behavioral health diagnosis and/or an addiction already on board. Either or both might get WORSE rather than better. Wait for the research.

And remember: one in four people meets diagnostic criteria for a behavioral health diagnosis at least once in their life. When there is also an addiction, we call it dual diagnosis.

And for pity’s sake, be careful with pot products, ok? It’s a total myth that they are not addictive. Yeah, people have told me for my entire career, over 30 years, “I am not addicted to (pot, heroin, alcohol, gambling, cocaine, meth, crack, whatever)”. ALL ALCOHOLICS say this the first time they are admitted for crashing a car or alcohol poisoning or vomiting blood or liver failure. “Not me. I am stopping today. I am NOT addicted. I do not need to talk to the substance abuse person.” We roll our eyes and send in the substance abuse person anyhow, because HEY, THE PERSON IS TOO ADDICTED AND IN DENIAL.

If you are going to use pot products, use them one or two times a week. Max three. Because a study of teens that paid them (with parental permission, consent, etc) to stop for a month found that almost none of the teens who used pot daily could stop. They relapsed. And they complained of anxiety and insomnia. And I have worked with adults trying to quit: again, anxiety and insomnia. The teens in the study who only used 2-3 days a week COULD stop for the month. The study monitored urine drug screens quite strictly.

And if you say, well, I can’t sleep without it. Um, yeah, that is addiction. I would wean. Reduce amounts and then start with one night a week without it. Good luck. Get help if you need it.

And don’t jump on the psilocybin bandwagon!!! Holy moly, humans are amazing, the ways they think up to hurt themselves and each other. If you want to be in a clinical trial, go find one. Don’t fool with Mother Nature, she can be a killer.

Happy solstice and blessings.

Here is the scientific paper for the science geeks like me:

https://link.springer.com/article/10.1007/s00213-022-06083-y

The picture is just a picture. No worries.

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Avoid death by fentanyl

Some of the West Point Cadets overdosed on March 12, 2022 are still on ventilators. They took what they thought was cocaine. It was laced with fentanyl and they all nearly died.

Not only that, but two of the bystanders who did not use the drug, but did cardiopulmonary resuscitation, CPR, also succumbed. They stopped breathing because they got a heavy dose of fentanyl giving CPR.

Fentanyl is being laced into ANY illegal drug, and being 50 times stronger than morphine, it can kill you by making you stop breathing. Also, fake pills are made. Do not buy pills on the street. And I don’t care if it is your friend. Remember that when someone is really addicted, the addiction is running the show. They need the drug more than your friendship. People will lie, steal and sell drugs. Protect yourself:

Please read the website at

https://www.cdc.gov/stopoverdose/

If you or a family member uses illegal drugs, please get naloxone to have at home. If the shot is given in time, very soon after the person stops breathing, it can save their life.

Here: https://www.cdc.gov/stopoverdose/naloxone/index.html

If you give someone a dose of naloxone CALL AN AMBULANCE. Because it is short acting and the opioid may take back over. The person may need to be on naloxone iv! You must get them to an emergency room as fast as possible.

Our local Health Department was giving out naloxone shot kits in the last few years for free. Our local police carry naloxone. If you are on prescription opioids, you should be offered a prescription for naloxone and your family should be instructed on how to use it.

And teach your children well. I interviewed my patients for years on the age they started smoking. Most of my patients started at age nine. One woman said age seven. We have to start talking to children about drugs and risk and not smoking anything by third grade. That is the horrific reality.

And Bless the punk band The Offspring for reaching out to opioid overuse people and saying, “Get help. You can do it. Please do not die.”

The Opioid diaries live by the Offspring.

And they too are inimitable.

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don’t kill your clients

I wrote this in 2016, when at least nine people died of overdoses in Vancouver, BC at Christmas, from fentanyl. I knew fentanyl was hitting my corner of the Washington State too. Warning, this contains a lot of swearing (edited so this does not become a “mature” site). I was in a very bad mood when I wrote it. It is meant to be black humor, to help me deal with grief.

http://www.cbc.ca/news/canada/british-columbia/fentanyl-crisis-up-to-9-drug-overdose-deaths-in-vancouver-last-night-1.3900437

But the news today is STILL talking about fentanyl and overdose: https://www.cnn.com/2022/03/12/us/west-point-cadets-overdose-fentanyl/index.html. When will we ever learn? And also, drug dealers are not actually trustworthy…. your cocaine might contain fentanyl. Don’t do it.

don’t kill your clients

oh, you think I’m talking to physicians….

….no, I’m talking to my fellow dealers.

See, heroin is rather labor intensive to produce, being from the opium poppy and all that. (When people say “I only take natural supplements.” I want to say, “You mean like opium and heroin? You know, plant based.”) Also, Afganistan, those fungkers shoot you as soon as look at you. It turns out that fentanyl is cheaper to make and you can source the ingredients from China.

And then, you can make fake oxycodone tabs and fake hydrocondone pills and sell them for bitcoin on the silk road. But you know, ya gotta mix the sheet right. If you mix it wrong and a buncha people overdose and die, there are complaints. Ya might get some scared clients, like, junkie friends of junkies. And then there are also those chronic pain people who aren’t junkies but been forced onto the streets to treat they habit, I mean, pain. We got a good thing going, the pill thing, because the junkies think that pills is safer than heroin. You might scare the fungkers and then how the fungk will I be able to buy that island with my bitcoin?

So dealers, ya’ll fungkheads, ya messing it up if you don’t get the goddarn mix right. See, fentanyl is not routinely tested for on the blood and urine drug screens. So the person gets labelled as an oxycodone overdose and no one knows that it’s fake pills. But when there are too many deaths, the goddarn feds and doctors get suspicious and start testing the pills.

Same with heroin. Cheapens things to cut it with fentenyl. But you gotta calculate right, because if you kill a whole bunch of clients at once, 1. you cut into profits 2. you make the cops and docs suspicious. You gonna ruin it for everyone, you goddarn morons.

And now I hear we got a new mix. Carfentanil, an elephant tranquilizer. Read the recipes carefully, morons, it’s 10,000 times as strong as morphine, you gotta dilute the sheet 10,000 times. Don’t you know math? Take a goddarn chemistry course.

Don’t fungk things up for the responsible drug dealers. A live client keeps on paying.

Be careful out there.

https://www.theguardian.com/global/2016/dec/11/pills-that-kill-why-are-thousands-dying-from-fentanyl-abuse-http://www.cnn.com/2016/08/24/health/elephant-tranquilizer-carfentanil-heroin/

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The AntiDating Patch II

Gosh, again? Once again I am giving up on dating, because, well…. I just cannot even IMAGINE beginning to share my past life. Heh. I suppose I could do one of those “We never talk about the past” relationships, but BLEAGH. Sorry, boring.

So, I quit. As I wrote in The AntiDating Patch, people are contrary beasts and nothing makes them more interested then being engaged/and/or/quitting dating. How do I get around this? Wearing the PATCH(Tm) is not enough. (I chose itsy bitsy country of origin of my choice, just FYI, not the boxers and ick, not the speedo).

Quitting won’t work. I will be hounded. My microbiome will start howling and send out pheromones to the other microbiomes and people will gather round. No! I say, No!

Better to date. Hmmm. I think I will date the birds in my yard. The male deer are a bit spiky for my taste, a little scary to get close to. I like the raccoons, they are VERY good at growling and protect their young. The coyotes are shy but I’ve seen them within a block and by my former clinic. Also one on three legs by the hospital. I wonder if he was considering the ER? I find great blue herons fascinating and wish that I could fly and land in trees. I could date a tree, right? Be anything you want to be? At one point I was so fed up with people that I decided to be a tree.

There. I will peel the AntiDating Patch off in a week and date the local flora and fauna. A week of the patch will reinforce my resolve and then I can go moon at trees, or a blue heron, or a coyote.

Phew, problem solved and plan laid. I won’t have to explain my life at all, at least not in English. I have had a blue heron circle back to land in a tree when I was trying to talk blue heron. The heron looked pretty fierce, I am afraid that what I am saying is probably an insult. It’s easy to pick up the nasty slang in another language. Maybe they will teach me if they sense my deep and positive intentions. I hope so, don’t you?

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first impressions

I am taking a writing class and our next book is on cultural appropriation.

This interests me. I tend to be a little gender blind and race blind when I meet people. I am using my super skill instead. My skill is developed from a really scary childhood: I read the stuffed emotions. The stuff people are hiding.

No way, you say. Oh, yes, I say.

My sister described coming home from high school and stopping when she walked into the house. She was trying to sense what was going on. Were our parents fighting? Was our father drunk? Yes, he was drunk, but which stage?

We talked about the stages and which we hated most.

Stage goofy/silly was annoying but not toxic. We said we had homework.

Stage asleep in a fetal ball in the upstairs hallway. My sister said she would step over him to get to her room.

Stage maudlin. We both agreed this was the worst. He would cry and say, “You can tell me anything.” Once he caught me in that stage and I was in tears by the time my mother got home. I left the room. The next morning mother said, “He said you two were discussing the cat’s disappearance.” I didn’t answer. We never said a word about the cat. I didn’t know if he was lying or was too drunk to remember it the next day, so made it up. Don’t care. Avoid.

He was never physically abusive. He and my mother would scream at each other at 1 or 2 am through most of high school. Reading her diaries, she writes that she drinks too much. I think they were both alcoholics, thought the family story is that he was the bad one. But I can’t imagine yelling with a drunk at 1 or 2 am for an hour. What is the point? They are drunk. So either she was drunk too or needed to fight.

Emotionally abusive, yes, both parents. My mother would take any show of fear or grief and tell it as a very very funny story to every person she ran into. Is it any surprise that I had to go into therapy after she died to learn to feel fear or grief? My sister would say, “She’s got her stone face on,” about me. Um, yeah, I am NOT going to let my family see my emotions…

Anyhow, that is what I read in people when I first meet them. It’s not the suit, the clothes, the make up, the race, the gender. I pretty much ignore those. I was fashion blind in junior high, a girl geek, could not read the code and did not care. I had given up on socializing with my fellow students. I was hopelessly bad at it. I did a lot better with the adults around my parents. I could have actual conversations with them.

I had one patient who was transgender where I couldn’t remember which direction. I didn’t care, either. That was a really angry person. Anger is always covering other emotions, so I avoided pronouns and tried to be as gentle as possible.

I complained to a counselor once that I can’t turn this “off”. And that it’s fine in clinic with patients, but it screws with my relationships with my peer doctors. They do not like it if I “read” them.

It took me years, but I finally realized that I have to use my clinic skills with everyone. I can’t turn off “reading” any more than you turn off your eyes when you meet a new person. But I can be as gentle with everyone as I am in clinic. I realized that as I started on a trip and the trip was amazing, everyone was so nice.

This reading is a product of a high ACE Score: Adverse Childhood Experiences. I score about a 5. One of my patients set off my ACE alarms on the first visit. I asked if he had had a rough childhood and gave a very short explanation of ACE scores. “Oh, I am a ten out of ten,” he said. He was, too. Ran away from home at age 6 or 8.

The ACE scores of all the children are rising from the last two years. The war will raise them even more, worse for the children there and the kids trying not to starve in Afganistan and Syria and world wide.

It will be interesting to read about cultural appropriation. But I don’t care much: I don’t “see” those things when I meet someone.

Hugs and blessings.

The photograph is me and my sister Chris in 1987, before my wedding. We were dancing before the wedding. She died in 2012 after 7 years of breast cancer.

Doctors and nurses and hospital staff are the last caregivers for the elderly alcoholics and addicts who are alone, whose families have finally cut them off. I think this song illustrates their pain. We try to take care of them.

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Update on Addiction 2022: Mouse Cocaine Addict Studies

Recent experiments on mice are giving us interesting information on addiction, and suggesting that l-dopa may be able to control/mitigate addiction. This lecture about how dopamine works in addiction using a mouse model (poor mice) blew me away. The mice fell into two categories: maintenance users and vulnerable addict rats. The study of the dopamine postulates a reason for the difference.

20th Annual Drug Conference Washington State from 2019

Notes from lecture 3: Paul Phillips PhD
Dopamine Neurotransmission in Substance Use Disorders: from Preclinical studies

For a long time there were no agreed upon animal models: rats don’t steal money from other rats to buy drugs. However, rats do get addicted and this can be studied.

There are features in rats, rat behavior and rat brains that might translate to humans.

1. Basic discoveries about dopamine neurotransmission in substance use disorders is discussed.
A neurotransmitter study checking every ten minutes in brain examines two areas: dorsal and ventral striatum. Dopamine is increased in the area between cells from the administration of substances “first time use” in animal models: cocaine, alcohol, methadone, cannabinoids, nicotine, amphetamine, morphine. This is the first clue re addictive drugs, whether there is an increase in dopamine intraneuronally. The endpoint is that direct effect on dopamine receptors, which has a different brain mechanism for each drug. Cocaine blocks the receptor that reuptakes the drug into the neuron. Methamphetamines and amphetamines reverse the reuptake pump, makes the receptor spit it out. Gaba neurons act to inhibit dopamine neurons, normally mu receptors on the gaba interneurons and the opioids block those. Ethanol has another mechanism of action. It changes inhibitory activity, lowering the inhibition of the gaba interneurons. Nicotine REALLY messes with multiple receptors and multiple cells, but main effect is increase of dopamine in the striatum.
Increased dopamine in human brain relates to the feeling of being high: brain PET scans show amphetamine and dopamine bound less, reduction in the binding. Subjects were substance abusers. Subjective questioning of how high they felt correlated with the amount of dopamine released on the PET scan. Methylphenidate was used in that study. Canada study: cocaine increases dopamine in human brain by PET scan.
Addiction does lead to changes in the brain, on both PET scans and functional MRIs.
PET scans measuring dopamine binding in the brain show that the baseline in brains of substance abusers differs from non-abusers. The levels of dopamine receptors is lower in the substance overuses and there is lower binding than controls: heroin, alcohol, meth, cocaine (and obesity and ADHD…..). (This has been known for opioid overuse and chronic use for a while: the brain cells withdraw receptors, so the same dose does not reduce pain because there are less receptors. The change in receptors appears to vary in different subjects. Recovery is very slow.)
The role of dopamine has been confusing. It is known that it is involved in the cue evoking cocaine “craving”, but is also involved with — satiety. This has been confusing and contradictory — what does dopamine do but also the dynamic structural signaling.

2. The animal studies demonstrate that the dopamine signals are phasic.
Rat studies measure changes in dopamine minute to minute electrochemistry for sub-second dopamine detection in vivo, which means we can measure changes in dopamine in real time. There is an identified output signature for dopamine levels, measure in 8.5 millisecond, ten measures per second.
The rats were voluntarily taking cocaine. The cocaine was available in a liquid with a light that would come on when it was available, for two hours daily. The animal presses a lever when the light cue is on and gets an infusion of drug. With the ten measures per second, the first and smaller dopamine response in the brain is before the lever is pressed. That is, there is a rise in dopamine BEFORE the rat presses the lever. If stimulated dopamine, the animal would go press the lever. Then there is a larger reward dopamine signal when the drug hits.
Dopamine is the chicken and the egg: signal to USE and signal that has ARRIVED.

3. Changes that take place with drug use
There is a signal change over time that correlation with features of addiction.
The mice had an implanted brain electrode, tinier than human hair, 7 microns, biocompatability — don’t make the brain attack it as a foreign object so rat brain keeps working. The study involves tyrosine hydroxylase, a precursor of dopamine. A food pellet response of the tyrosine remains the same at 1, 2, 6 months so can monitor substance abuse brain changes. These are cocaine addicted rats. They get cocaine via a nose poke of a button when it lights up. Pellets, not iv (they learn that faster). There are 2 ports to nose poke: active and inactive. The signal that cocaine is available and the pellet is active: a light comes on for 20s and then drug arrives. Can take again after 20sec. The rats titrate cocaine use: not continuous. They pace cocaine use, wait for it to wear off. Over time, drug use 1 hour access daily… slow increase, relatively stable.
When the access is bumped up to 6 hours access daily… rats do increase use — first of 6 hours, escalation of drug use faster — in humans development of tolerance.
With 1 hour cocaine availability, the dopamine response to the cocaine in the rat brain is lower by the 2nd and 3rd week, slowly decreases, then with 6 hours of access the loss of dopamine is very robust, happens faster, dopamine signal gets smaller every time.
Rats long access: were there individual differences? Yes, metric, nonescalated vs escalated groups so like humans. 60 escalated 40 didn’t and stayed stable. So essentially I named these “Vulnerable addict rats” and “Maintenance rats”.
Which group most motivated to take cocaine? The study ups the price of cocaine for rats, how many times are you willing to receive the drug? The escalating animals made more responses, “worked harder” for the drug. The escalator brains, Vulnerable Addict Rats, had just about a complete loss of dopamine signal by three weeks.
The nonescalators had more stable dopamine responses, retained some dopamine brain function.
The greater the loss of dopamine, the more the animal escalates the drug use.
The Vulnerable Addict rats would use cocaine to the exclusion of food, water, sex and sleep and died early.
This is a feedback loop. The rats get a success signal when the drug is taken — but over time don’t get the success signal because dopamine receptors are gone — so take more. In the Vulnerable Addict escalators, the dopamine signal of anticipation goes down in response to the cue, the drug effect takes a little longer but the pharmacological response to drug actually remains.
They tried giving l-dopa, a parkinson’s drug and if treat, the rats get a restoration of the dopamine cue — pharmacological response didn’t change — how does this affect behavior? A daily shot of l-dopa and the animals on the l-dopa have less escalation. (wow!) The l-dopa didn’t affect the nonescalators/maintenance rats. When they remove the l-dopa in the vulnerable addict rats, the animals jump to higher use and so the brain changes are happening even when it is masked by the l-dopa but does not stop the brain changes.
They ask the question: can you reverse escalation? With the the l-dopa, they use less.
Dopamine signaling to take drugs (the anticipation cue when the light goes on) decreases in animals that escalate drug taking, but does not change in animals with stable drug taking.
Restoring dopamine signaling with l-dopa can prevent or reverse escalated drug taking.
This dopamine signaling….

4. Mechanisms — drug cue elicits dopamine.
So this is about triggers. This is a paired drug cue: the light signals that the drug is available. If a non-contingent drug given to animal, the light still elicits drug seeking. Using a naive animal: pair reward with cue, over time the cue will increase dopamine.
(hmm. Facebook. blogging. Instagram. “You have mail”. )
The initial addiction has a short access time. One hour out of 24. When this is changed to long access, some animals escalate vs non escalation — as take more and more drug, the response to the drug taking cue gets larger in the escalators/Vulnerable Addicts. Presentation of cue — by investigator vs animal:
If elicits drug seeking than the dopamine response gets larger to the cue over time.
If the cue is given but other choices of liquid, then the dopamine response gets smaller in some rats — so terminating drug seeking. The Vulnerable Addict Rats had a larger and larger dopamine craving cue spike, the longer they were off the drug. The the increase in the cue drives craving and decrease drives seeking — so both bad.
The conclusion in the rats is that craving for drug, related to cues, is dependent to length of time off drug. The longer the rats were off the drug, the larger the dopamine spike when the cue light comes on. The measure of cue behavior gets worse …. 60 day study in rats, this is not physiological withdrawal, is prolonged way beyond the withdrawal.
1. noncontingent
wait a day or wait a month
work harder to get drug, harder a month out
reaction to drug cue presentation, enhanced over time
at start of drug small signal to drug cue
long access then cue gets bigger
same a day after stop drug
but huge in a month after no drug — huge dopamine response

(my thought was then swearing. how do we treat this?)
In chronic drug use the cue signal shrinks which reinforces drug use AND stopping increases the cue response which ALSO reinforces.

5. Implications for treatment
treating rats
They discuss a virus with promotor that affects dopamine cells, light activated ion channel, cells release dopamine when light stimulated
only activates release of dopamine, to understand mechanisms.
For the self administered nose cue …. In the nonescalator maintenence rats, dopamine cue response stays fairly robust, stimulate those cells and no change.
In the escalator/vulnerable addict rats… if do a virus stimulation of dopamine in the brain, more dopamine to cue boosted, so they use less cocaine and look like the non-escalators.
5th cue less dopamine than 1st cue: if put dopamine back then maintains the drug seeking.

What underlies the decrease in dopamine release?
When the animals use cocaine, dynorphin goes up (kappa antagonist).
They injected a kappa receptor blocker — animal no longer escalate (not in humans at this time, don’t understand well enough) treating animals that are escalating, so the bad addict/vulnerable rats.
Most animals don’t escalate — but pretty serious amounts of drug cocaine so not abstinent.

For future
Dopamine diametric changes: dopamine may reduce consumption but might increase craving, so it is difficult to treat.
l-dopa — treatment — some studies, looking for abstinence, does NOT produce abstinence. Does not make abstinence worse. Says that promise seen relates to the status of the subject — helps with people who are still using (some) but doesn’t help increase or prolong abstinence. So could reduce harm but not abstinent….politically unpopular. Happier with turning alcoholic into a social alcohol user, but that idea is less popular/politically ok with cocaine/opioids (and especially meth).

They are studying mouse nosepokes for alcohol — reduced intake when the rats are on l-dopa.

There is a functional agonist for kappa receptors == buprenorphine, might have effects on drug consumption, speculation across different drugs.

Dynorphin is a stress related peptide, so does that signaling produce escalation of drug taking? So other stress drugs — like corisol, CRF, plan for more studies.

Question: Stress related hormones– babies in stress in utero and in stressful childhood have less dopamine receptors and need more dopamine for pleasure, susceptibility to drug addiction (ACE scores) so is still really early studying neurotransmitters.

Dr. Question: why do people do better with agonist therapy than abstinence in opioids vs other drugs? Answer: we don’t know….. yet.

further information:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1920543/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC80880/
https://archives.drugabuse.gov/news-events/nida-notes/2017/03/impacts-drugs-neurotransmission
https://nida.nih.gov/

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Covid-19: A tiny bit of good news

This: https://www.healio.com/news/primary-care/20211216/teen-drug-use-decreased-during-pandemic-survey-finds.

“Since 1975, the Monitoring the Future survey, funded by the National Institute on Drug Abuse (NIDA) and conducted by researchers at the University of Michigan Institute for Social Research, has been tracking substance use among adolescent students in the U.S.”

The numbers are interesting, aren’t they? “There was a sharp decrease in reported use (of alcohol) among 10th graders, from 40.7% in 2020 to 28.5% in 2021, and a mild decrease among 12th graders, from 55.3% in 2020 to 46.5%.”

What do YOU think the cause is? More parental supervision or less in person time with peers or something else or both? The news yammers about increased behavioral health issues and “crisis, crisis, crisis” but hello, it’s normal to be stressed during this. Learning to handle stress is important and useful. My elderly patients who lived alone came in to clinic after the first couple months of Covid-19, because they needed human contact. Since I had a one doctor clinic with me and a receptionist, my clinic was safer than the grocery store. We screened everyone for Covid-19 symptoms before they came in and diverted them to the testing site if they had symptoms. Only two of my people got Covid-19 by the time I closed, and both had traveled out of state. Neither one came in to clinic. They went and got tested because of symptoms.

Anyhow, I think it’s both parental supervision and less peer time in person. There is still a significant amount of alcohol consumed. A previous study of well off and very well off households showed increased risk of addiction by age 22 and 25 because 1. money 2. opportunity 3. parents more inclined to be in denial. Parents would turn a blind eye if grades were good. The biggest correlations for NOT being addicted were 1. family dinners and 2. parents who yapped about drugs/alcohol/addiction quite a lot. Caring, I think. Not giving up as the child enters their teens, but staying present and opinionated. Not to mention setting an example of moderation. The households where the parents use methamphetamines or heroin locally are higher risk for the teens.

More here: https://www.drugabuse.gov/drug-topics/trends-statistics/monitoring-future

This fits the Ragtag Daily Prompt: enigma.

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Email quack spam: try CBD oil for free!

Lovely email QUACK spam. TRY CBD OIL FOR FREE!

“The Miracle Molecule! Everything You Need To Know About the Health Benefits of CBD Oil“. The link implies that the article was in Reuters. I ain’t pressing no spam link. Internet search on Reuters Everything You Need to Know About the Health Benefits of CBD Oil does not bring up a Reuters article.

“All natural formula. All CBD products use proven, organic all natural ingredients that are toxin-free.”

Ok, now WAIT a minute. Proven? By what the hell method? We dropped some and got high so it’s good? And don’t get me started on toxin-free. Sure, and they’ll sell you a bridge too.

Let’s discuss all natural.

Is CBD oil “all natural”? Um. Well, it could be organically grown, I will give them that. There have been pesticide poisonings from illegal pot and the laws for growers vary state by state. Check your state laws re whether they have specified what the growers can use on the marijuana plants. Paraquat is very strongly implicated in Parkinson’s (https://pubmed.ncbi.nlm.nih.gov/20094060/) and you don’t want that, do you?

How do you define “all natural”? Innocent virgin farmer girls and boys, skipping through the pot plans and milking the oil out gently? Oh, ye innocent and foolish peoples. Here is a nice article about fires in CBD processing plants: https://www.sandiego.gov/sites/default/files/dsdfire-38-1.pdf. They burn real good, it turns out.

The National Fire Protection Agency (NFPA) has guidelines: https://www.firefighternation.com/prevention/nfpa-approves-420-standard-on-fire-protection-of-cannabis-growing-and-processing-facilities/. You do keep up with the NFPA, don’t you?

An older article illustrating the problem: https://www.politico.com/story/2019/02/18/marijuana-factories-explosions-safety-issues-1155850.

And the title of this seems pretty self explanatory: https://extraxx.com/the-top-five-safety-concerns-in-a-cannabis-extraction-facility/. “Let’s begin with the obvious. When dealing with flammable gasses or liquids in extract production, there is a risk of fire or explosion during the handling process. The easiest way to understand the risk of fire or explosion is to consider the fire triangle. Essentially, a fire needs three things to start: a fuel source, oxygen, and an ignition source. The basic philosophy here is that by removing legs from the fire triangle, we can make the process safer; by removing two legs, an operator can make their extraction process significantly less incident-prone.” Later in the article: “there are two tools that should be kept on site to make known the presence of unnoticed flammable vapors: a permanent LEL, or Lower Explosive Limit, monitor should be installed in the extraction room; and a handheld two or four gas portable monitor should be on site as well.”

I don’t have much experience with LFL monitors. Now I want to buy some of the gummies and try lighting them on fire. Does the smoke make one high? Well, I think it depends what it is suspended in. I thought vaping was insane when I read that some of the nicotine vapes suspended the product in antifreeze. Um, your dog may die if they drink it. Absorption in the lungs just does not seem wise. Also, some of the vapes get so hot that heavy metals get in the lungs. You know, lead and stuff. When I researched it last, China was turning out 500 different kinds of vape machines. Uh, ick, don’t do that. Sugar burns so the gummies might. I have some “Annie’s organic fruit gummies” so I can check whether they burn. Though they shouldn’t contain CBD oil. Now you know what I am doing while disabled. Home chemistry and on line research.

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The AntiDating Patch

I wrote this in 2009. I was in one of THOSE moods, where I had completely given up on ever dating anyone or anything again. There are some anatomical terms in here but I don’t think it qualifies for x-rating.

The Antidating Patch!
New from Astronomical-Zenith!

Tired of dating? No one interesting around you? In fact, are the single people around you creepy losers who make your skin crawl?

You are not alone! You need the patch. FDA approved and tested, the AntiDating Patch will repel people of either sex who normally would want to date you. People are contrary beasts, so this will make them want to date you all the more, but you will remain aloof, pure and free of sexually transmitted diseases, as if you were hermetically sealed in a plastic bag or old refrigerator.

Herbal remedies make the same claim but they have not paid the large sum of money to the FDA to fast track their product or even to evaluate it at all. Also, 35% of dating sufferers using the herbal remedy are actually unhappy about their privates turning blue. We are unsure about the rumor that parts have fallen off. The herbal company did change its’ formulation recently, but they don’t have to tell you that on the label, because it is a natural product, no FDA evaluation needed, and in fact, it is treated just like other natural foods including carrots even though we remain unconvinced that it fell off the tree in patch form!

The Antidating Patch is safer, more thoroughly tested, doesn’t turn your privates blue (except for one person) and we price it to reflect those facts! For men, choose Thong, Old Lady Full Coverage Underwear, or Bikini style patches.* Consider shaving off all that nasty hair before applying to skin. You may want to wear it on your arm, where the ladies (and gents) can see it. NO, YOU ARE NOT, REPEAT NOT, TO STICK IT ON YOUR PRIVATES. THIS MEANS PENIS, WANG, DOINK, TUBESNAKE, DORK, BALLS, TESTICLES AND WHATEVER ELSE YOU CALL YOUR PERSONAL EQUIPMENT. DON’T STICK IT THERE. WE WON’T BE RESPONSIBLE FOR ANYTHING FALLING OFF IF YOU DO. For ladies, choose Boxer, Itsy Bitsy Tight Well Hung (ethnicity of your choice here) or Speedo. Don’t put it on or in your privates, but we know you have more sense then that. This would include boobies, tits, yumyums, mams, breasts, ‘gina, down there, silver beaver, box, cunt, slit, vagina, anus, hole and anything else you learned to call it.

Side effects are rare but include and are not limited to hearing alien voices, high blood sugar, we swear that your privates don’t turn blue or really mostly not. That’s just a faint tinge. Fainting, homicidal behavior, acting like George Bush the Younger, delusions of grandeur (oh, we just said that, didn’t we?), jumping off of buildings, hating sex, loving sex, becoming pregnant (only one man so far and some ladies) and irritation of the privates. Also they can get cranky from lack of use.


*Little Girl style will not be marketed since even though many gents loved it in premarketing testing, those damn strident militant feminists** were up in arms again. We just don’t get it. Those whacko women also didn’t like the Little Boy style for women.

**I qualify for all but the militant bit.

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Top ten causes of death: US 2020

Top ten causes of death US 2020, according to JAMA, here.

Total deaths: 3,358.814
Contrast total deaths in 2019, at 2,854,838. That number had been on a very slow rise since 2015 (2,712,630) to 2019 (2,854,838). That increase over four years is 142,208 people. Then the death rate suddenly jumps 503,976 people in one year. Ouch. I cannot say that I understand vaccine refusal.

1. Coronary artery disease: 690,882
Heart disease still wins. And it went up 4.8%. It is suspected that people were afraid to go to doctors and hospitals. I saw one man early on in the pandemic for “constipation”. He had acute appendicitis. I sent him to the ER and his appendix was removed that day. He thanked me for seeing him in person. Might have missed that one over zoom.

2. Cancer deaths: 598,932
This is cancer deaths, not all of the cancers.

3. Covid-19: 345,342
I have had various people complain that covid-19 is listed as the cause of death when the person has a lot of other problems: heart disease, cancer, heart failure. The death certificate allows for more than one cause but we are supposed to list the final straw first. I cannot list old age, for example. I have to list: renal failure (kidneys stopped working) due to anorexia (stopped eating) due to dementia. That patient was 104 and had had dementia for years. But dementia is not listed as the final cause. So if the person is 92, in a nursing home for dementia and congestive heart failure, gets covid-19 and dies, covid-19 is listed first, and then the others.

4. Unintentional injuries: 192,176
Accidents went up, not down, which is interesting since lots of people were not in their cars. However, remember that the top of the list for unintentional injuries is overdose death, more by legal than illicit drugs. If there is no note, it’s considered unintentional. Well, unless there is a really high blood level of opioids and benzos and alcohol. Then it becomes intentional. They do not always check, especially if the person is elderly. The number rose 11.1%, which seems like a lot of people.

5. Stroke: 159,050
This rose too.

6. Chronic lower respiratory diseases: 151,637
This went down a little. This is mostly COPD and emphysema. So why would it go down? Well, I think bad lung disease people were dying of covid-19, right?

7. Alzheimer’s: 133,182
This seems to belie me putting renal failure due to anorexia due to Alzheimer’s. I think they actually read the forms and would put that as Alzheimer’s rather than renal failure, because it is not chronic renal disease.

8. Diabetes: 101,106
This rose too. 15.4%, again, probably partly because people avoided going to clinic visits. Also perhaps some stress eating. Carbohydrate comfort.

9. Influenza and pneumonia: 53,495
So this went up too in spite of a lot less influenza. Other pneumonias, presumably.

10. Kidney disease: 52,260
This went up.

And what fell out of the top ten, to be replaced by covid-19?

11. Suicide: 44,834
This actually went down a little. What will it do in 2021?

So what will 2021 look like? I don’t know. It depends what the variants of covid-19 do, depends on what sort of influenza year we have, depends on whether we are open or closed, depends if we bloody well help the rest of the world get vaccinated so that there is not a huge continuing wave of variants.

Today the Johns Hopkins covid-19 map says that deaths in the US stand at 608,818 from covid-19. If we subtract the 2020 covid-19 deaths, we stand at 263,495 deaths from covid-19 so far this year. Will we have more deaths in the US from covid-19 than in 2020? It is looking like yes, unless more people get immunized fast.

Take care.