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Prop 64: Legalization of Cannabis the effect on Voter Health and the Environment

Posted on November 7, 2016 at 4:01 PM Comments comments (3)
 
        The California ballot has prop 64 which is the legal recreational use of marijuana.  Voters will decide whether to make recreational cannabis use legal. There are positives and negatives of this initiative if enacted. If legalized it will compete with current initiatives to stop smoking and protect the public from second hand smoke, which is a negative aspect.  The legalization of cannabis in other states, has decreased the number of arrest for possession, which is a positive aspect (Boeker, 2016). The concern of voting yes on prop 64 is that it could deteriorate voter health and destroy our ecological system.

        The greatest threat to public health from marijuana comes from motor vehicle accidents. There is evidence that marijuana use is associated with approximately twice the number of both fatal and non-fatal motor vehicle accidents. Nationally, fatal collisions increased from 29% in 1993, to 37% in 2010. In Oregon, the percent of fatal crashes increased 49% after the legalization of medical marijuana (Sewell, Poling, & Sofuoglu, 2009). In 2014, Sonia Toor a 21-year-old female was so intoxicated on Marijuana, she ran over and killed a 84-year old elderly woman with a minivan in the parking lot of Walgreens in San Mateo, California (Journal Staff, 2014).

       Marijuana advocacy groups, and marijuana magazine promoting cannabis use; claim cannabis use is the cure for pain with no side effects and no addiction issues. Research discovered a mild pain reduction effect but with overwhelming side effects.  The psychological effects of cannabis usage are: lower IQ, disconnected personality, schizophrenic issues, inability to maintain gainful employment, fear, anxiety, lack of attention, poor impulse, reduction in memory and decision making. Heavy use of cannabis results in schizophrenia-like psychosis called substance induced psychosis. “It is estimated that 8–14% of schizophrenia cases are due to marijuana use” (Repp & Raich, 2014). The effect caused by marijuana use is depression and anxiety that is not fully restored with cessation of cannabis (Repp & Raich, 2014).

        The physical effects are” deficits in vision span, verbal fluency, hypertension, cardiac issues, strokes, increased heart rate, lethargy, lung congestion, asthma, bronchitis, phlegm production, and lung infections” (Cox,2014). The consensus that cannabis is not addictive is refuted by “research clearly demonstrating that approximately 9% of those who experiment with marijuana will become addicted. This percentage increases to 17% for those who start using marijuana as teenagers and up to 50% for those who smoke marijuana daily” (Volkow, Baier, Compton, & Weiss (2014).  Many cannabis users advocate that cannabis use is better than cigarettes but the research also noted “the use of cannabis is associated with cancer and cancer causing agents” (Repp & Raich, 2014).

         The Indoor/Outdoor Medical Grower's Bible states “Marijuana is a water- and nutrient-intensive crop, cultivation requires land clearing, ​ the diversion of surface water, agrochemical pollution, and the poaching of wildlife.” (Cervantes, 2006). California is in a constant flux of drought, so the toll of cultivation of Marijuana would further endanger our water supply and clearing land would reduce our forest. The pesticides used would increase the number of birth defects and cancer related illnesses and greatly diminish our wildlife. Cannabis grown in a greenhouse type setting requires about 20 TW/h/year nationally (including off-grid production) of electricity. This is equivalent to that of 2 million average U.S. homes, corresponding to approximately 1% of national electricity consumption or the output of 7 large electric power plants” that is a huge carbon foot print (Mills, 2012). 
            Legalization of cannabis will also lock out local individuals from growing cannabis since as seen in other states, only big business will be allowed to grow cannabis like tobacco companies since it will be a taxed controlled substance of the government. So while the lower income neighborhoods will benefit from a decrease number of arrests for possession of cannabis. The legalization will not increase the revenue in those neighborhoods, it will not decrease unemployment, and it will not improve or reduce neighborhood disorder. Instead of growing more cannabis locally it will be grown by big corporations which will increase the likelihood of a huge carbon foot print. Mostly likely the home grow variety will be gone and subject to prosecution. And as for the Cannabis enthusiast who have long for the day for it to be legal to smoke they will likely have to make more money to afford Cannabis.  In 2014, the National Association of School Nurses can out against legalization of marijuana, stating “there was not sufficient scientific evidence and legalization marijuana for adult recreational use, would give youth access” (Endsley & Embrey, 2014). Voting Yes on prop 64 may prove to be the Cannabis advocates worse nightmare. It could also be a degradation of the environment, an increase health cost to pay for the health issues and increase mortality.  Is it worth it?
             
 
 
 
 
 
References
            Boecker, K. (2016). On D.C.’s one-year anniversary with legalized marijuana, work remains. Washington Post 2016, Febuary 25. Retrieved on October 13,2016 from https://www.washingtonpost.com/blogs/all-opinions-are-local/wp/2016/02/25/on-d-c-s-one-year-anniversary-with-legalized-marijuana-work-remains/?utm_term=.67288f9099cc
Carah, J.K., Howard, J.K., Thompson, S.E., Short Gianotti, A.G., Bauer, S. D., Carlson, S. M., …(2015). High for conservation: adding the environment to the debate on marijuana liberalization. Bioscience, 65(8) (2015) 822-829. Retrieved from PubMed https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4776720/ - bib12
Cervantes, J. (2006) Marijuana horticulture: the indoor/outdoor medical grower’s bible. Van Patten Publishing Copyright 2006 pp 125-237.  Retrieved on October 23, 2016 from https://www.amazon.com/dp/187882323X/ref=rdr_ext_tmb - reader_187882323X
Cox, L. (2014). Marijuana: Effects of weed on brain and body. Live Science (31, March, 2014). Retrieved on October 7, 2016 from http://www.livescience.com/24558-marijuana-effects.html
Endsley, P. & Embrey, M.L.  (2014). Marijuana and children: position statement. National Association of School of Nurses (NASN). Retrieved on October 23, 2016 from http://eric.ed.gov/?q=marijuana&ft=on&id=ED558465
Journal Staff (2014). Woman, 84, dies after minivan runs her over: female driver, 21, charged with vehicular manslaughter and DUI. San Mateo Daily Journal. (2014, November 18). Retrieved on October 23, 2016 from http://www.smdailyjournal.com/articles/lnews/2014-11-18/woman-84-dies-after-minivan-runs-her-over-female-driver-21-charged-with-vehicular-manslaughter-and-dui/1776425133531.html
 
Mills, E. (2012). The carbon footprint of indoor cannabis production. Energy Policy 46 (2012) 58-67. Retrieved on October 10, 2016 from http://evanmills.lbl.gov/pubs/pdf/cannabis-carbon-footprint.pdf
Repp, K.K., Raich, A.L. (2014). Marijuana and health: A comprehensive review of 20 years of research. Washington County Oregon. Retrieved on October 16, 2016 from
Sewell, R. A., Poling, J., & Sofuoglu, M. (2009). THE EFFECT OF CANNABIS COMPARED WITH ALCOHOL ON DRIVING. The American Journal on Addictions / American Academy of Psychiatrists in Alcoholism and Addictions, 18(3), 185–193. `

Volkow, N.D., Baier, R.D., Compton, W.M., & Weiss, S. R. B. (2014). Adverse health effects of marijuana use. New England Journal of Medicine. 2014; 307:2219-2227. DOI: 10.1056/NEJMra1402309

Dry Needling Victory

Posted on July 28, 2016 at 9:16 PM Comments comments (0)









Corporate Medical Policy
Page
1
of
3
An Independent Licensee of the Blue Cross and Blue Shield Association
Dry
Needling of Myofascial Trigger Points
“Notification”
File Name:
dry_needling_of_myofascial_trigger_points
07/2016
N/A
02/2017
07/2016
Origination:
Last CAP Review:
Next CAP
Review:
Last Review:
Policy Effective August 30
, 2016
Description of Procedure or Service
Trigger points are discrete, focal, hyperirritable spots within a taut band of skeletal muscle fibers
that
produce local and/or referred pain when stimulated.
Dry needling refer
s to a procedure whereby
a fine
needle is inserted into the trigger point to induce a twitch response and relieve the pain
.
Dry needling refers to a procedure in which a fine needle is inserted into the skin and muscle at a
site of
myofascial pain. The needle may be moved in an up
-and
-down motion, rotated, and/or left in
place for as
long as 30 minutes. The intent is to stimulate underlying myofascial trigger points,
muscles, and
connective tissues to manage myofascial pain. Dry need
ling may be performed with
acupuncture needles
or standard hypodermic needles, but is performed without the injection of
medications (e.
g., anesthetics,
corticosteroids). Dry needling is proposed to treat dysfunctions in
skeletal muscle, fascia, and connec
tive
tissue; diminish persistent peripheral pain; and reduce
impairments of body structure and function.
The physiological basis for dry needling depends on the targeted tissu
e and treatment objectives.
The
most studied targets are trigger points. Trigger
points are discrete, focal, hyp
erirritable spots
within a taut band of skeletal muscle fibers that produce local and/or referred pain when
stimulated.
Trigger points are associated with local ischemia and hypoxia, a significantly lowered p
H, local and
ref
erred pain, and alter
ed muscle activation patterns. Trigger points can be visualized by
magnetic
resonance imaging and elastography. Reliability of manual identification of trigger points has not
been established.
Deep dry needling is believed to inactiv
ate trigger points by eliciting contraction and subsequent
relaxation of the taut band via a spinal cord reflex. This local twitch res
ponse is defined as a
transient
visible or palpable contraction or dimpling of the muscle, and has been
associated with
alleviation of
spontaneous electrical activity; reduction of numerous nociceptive, inflammatory, and
immune system related chemicals; and relaxation of the taut band. Deep dry needling of trigger
points is believe
d to reduce local and referred pain, improve range of motion, and decrease trigger
point irritability.
Superficial dry needling is thought to activate mechanoreceptors and have an indirect effect on pain
by
inhibiting C
-fiber pain impulses. The physiological basis for dry needling treatment of exces
sive
muscle
tension, scar tissue, fascia, and connective tissues is not as well described in the literature.
Alternative nonpharmacologic treatment modalities for tr
igger point pain include manual
techniques,
massage, acupressure, ultrasonography, application of heat or ice, diathermy,
transcutaneous electrical
nerve stimulation, and spray cooling with manual stretch.
Page
2
of
3
An Independent Licensee of the Blue Cross and Blue Shield Association
Dry
Needling of Myofascial Trigger Points
“Notification”
Dry needling is considered a procedure and, as such, is not subject to regulation by the U.S. Food
and
Drug Administration
.
***Note: This Medical Policy is complex and technical. For questions concerning the technica
l
language
and/or specific clinical indications for its use, please consult your physician.
Policy
Dry needling of trigger points for the treatment of myofascial pain is
considered
investigational
is considered investigational for all applications. BCBSNC does not provide
coverage for investigational services or procedures.
Benefits Applicatio
n
This medical policy relates only to the servic
es or supplies described
herein
. Please refer to the Member's
Benefit Booklet for availability of benefits. Member's benefits may vary according to benefit design;
therefore member benefit language should be reviewed before applying the terms of this medical policy.
When
Dry
Needling of Myofascial Trigger Points
is covered
Not applicable.
When
Dry Needling of Myofascial Trigger Points
is not covered
Dry needling of trigger points for the treatment of myofascial pain is considered investigational
.
Policy Guidelines
For individuals who have trigger points associated with myofascial p
ain who receive dry needling
of
trigger points, the evidence includes a number of randomized controlled
trials and systematic
reviews. Relevant outcomes are symptoms, functional outcomes, quality of life, a
nd treatment
-
related morbidity. Overall, dry needling of trigger points has not been shown to be clinicall
y
superior to sham treatment or
manual therapy. In addition, dry needling is associated with a high
incide
nce of mild adv
erse events. The evidence is insufficient to determine the effects of the
technology on health outcomes.
Billing
/Coding/Physician Documentation Information
This policy may apply to the following codes. Inclusion of a code in this section does not
guarantee that it
will be reimbursed. For further information on reimbursement guidelines, please see Administrative
Policies on the Blue Cross Blue Shield of North Carolina web site at www.bcbsnc.com. They are listed in
the Category Search on the Medical Policy search page.
Applicable codes
:
There is currently no specific CPT code for dry needling. The AMA CPT i
nstructs that
the unlisted code
20999 should be used for the dry needling procedure. Because dry needling is not
acupuncture, CPT codes
97810
-97814 are not appropriate.
BCBSNC may request medical records for determination of medical necessity. When medical records are
requested, letters of support and/or explanation are often useful, but are not sufficient documentation unless all
specific information needed to make a medical necessity determination is included.
Scientific Background and Reference Sources
BCBSA Medical Policy Reference Manual [Electronic Version].
2.01.100
,
5/19
/2016

Medi-Cal Acupuncture Restored

Posted on July 28, 2016 at 9:01 PM Comments comments (0)
Yesterday, the California Department of Health Care Services announced that acupuncture services will be restored as Medi-Cal benefits, effective for dates of service on or after July 1, 2016.
The announcement and likely rates were posted to the DHCS/Medi-Cal site

While reimbursement for acupuncture has been restored, rates remain low across the full spectrum of Medi-Cal benefits, including acupuncture. A recent report by the Bay Area Council Economic Institute ranked California as the 47th lowest state for fee-for-service reimbursement.  

Acupuncture was eliminated as an optional benefit under Medi-Cal during 2009 budget cutting. 

Medi-Cal Acupuncture Restored

Posted on July 28, 2016 at 8:56 PM Comments comments (0)
Yesterday, the California Department of Health Care Services announced that acupuncture services will be restored as Medi-Cal benefits, effective for dates of service on or after July 1, 2016.
The announcement and likely rates were posted to the DHCS/Medi-Cal site

While reimbursement for acupuncture has been restored, rates remain low across the full spectrum of Medi-Cal benefits, including acupuncture. A recent report by the Bay Area Council Economic Institute ranked California as the 47th lowest state for fee-for-service reimbursement.  

Acupuncture was eliminated as an optional benefit under Medi-Cal during 2009 budget cutting. 

Updated Correction of Date for Medi-Cal

Posted on July 28, 2016 at 8:50 PM Comments comments (0)


You recently received a Notice that Care1st Health Plan will administer acupuncture  services through ASH to their Medi-Cal (California’s medical assistance Medicaid program) and Cal Medi-Connect members beginning August 1, 2016.   

Care1st Health Plan is now effective July 1, 2016.

Please click on the Notifications link below to read about how this new plan is administered.
 
Go to the
Notifications section on ASHLink now.

Please note: Our online resources are in PDF file format and require Adobe Acrobat Reader software in order to view them.

To view resources on ASHLink for your different specialties, use the "Switch Clinic" link located in the top header area of the site to change your ASHLink specialty view.

Sincerely,

Practitioner Contract Services

Medi-Cal Patients covered for Acupuncture by ASH

Posted on July 28, 2016 at 8:48 PM Comments comments (0)


American Specialty Health Plans of California, Inc. (ASH Plans) is pleased to announce that effective August 1, 2016, Care1st Health Plan will offer acupuncture services through ASH Plans to their Medi-Cal (California’s medical assistance Medicaid program) and Cal Medi-Connect members in Los Angeles County and San Diego County, California. We are excited about the program as it will provide more opportunity to increase your patient base.


Sincerely,

Practitioner Contract Services

Relocated to San Mateo

Posted on April 14, 2014 at 1:53 AM Comments comments (0)
I had relocated to San Mateo from Boston, Massachusetts and was feeling disconnected from my body, having trouble sleeping, and frequent headaches. I was also having issues with my intestinal tract. I was in tough shape and exhausted.

I was looking for alternative health practitioners on an insurance website and I found Jame 'E. I did't know what to expect because I hadn't been to acupuncture before. Jame'E was welcoming and kind when I entered the office for my first appointment. He did a very thorough intake and provided a lot education about the work he does which made me feel quite comfortable. I felt like I can talk about whatever I need to in his office. I have so appreciated sense of humor and openness.

After a few sessions my symptoms have left and I feel incredibly better. I thought I would be plagued with poor sleep for the rest of my life - now I sleep deeply and well. The headaches have gone and my GI issues have eased. I am tremendously grateful that I 'found' Jame'E and I continue seeing him for maintenance.

Fire Cracker Shrimp Recipe

Posted on January 30, 2014 at 5:15 PM Comments comments (0)
Serves 4
Ingredients:
  • 12 large shrimp, in the shell
  • 1 teaspoon salt
  • 1/2 teaspoon garlic salt, divided
  • 4 sheets spring roll wrappers
  • 24 carrot strips (3x 1/4inch)
  • 1 egg, beaten
  • Dipping Sauce
  • 1/4 cup mayonnaise
  • 2 tablespoons Sriracha sauce
  • 3 cups vegetable oil for deep-frying
Instructions:
  1. Removing the shells and leaving the tail intact, make a deep cut lengthwise down the back of each shrimp; wash out the sand vein. Place warm water in a bowl and add the salt; stir to dissolve. Place the shrimp in the salt water and swirl. Leave the shrimp in the salt water for 5 minutes, then rinse with cold water, drain, and pat dry on paper towels. Sprinkle with 1/4 teaspoon garlic salt.
  2. Cut each spring roll wrapper into thirds, making 3 long narrow strips.
  3. Place the carrot strips in a small bowl, sprinkle with the remaining 1/4 teaspoon garlic salt, and set aside.
  4. Brush the egg at the top of the shrimp. Place 2 carrot strips in the slit of each shrimp. Brush each spring roll strip with egg and roll each shrimp up tightly in the spring roll strip, with the egg holding it together. The tail of the shrimp should be protruding from one end and the carrots from the other -- to resemble a firecracker! Continue process until all the wrappers are folded with the shrimp and carrots.
  5. To make the dipping sauce, in a small bowl, mix the mayonnaise and Srircha sauce. Set aside.
  6. In a wok or deep skillet, heat the vegetable oil to 350 degrees. Fry the shrimp rolls until golden brown, about 2 minutes, turning 2 to 3 times. Drain on paper towels. Serve with the dipping sauce.

Ginseng Chicken Soup

Posted on December 3, 2013 at 2:53 PM Comments comments (0)
 Tonifies Yuan Qi
. Tonifies Spleen Qi and harmonizes the Stomach.
Tonifies Lung Qi and strengthens the Wei (defensive) Qi. 
INGREDIENTS
·         1 whole chicken 
·         20 g (0.71 oz) ginseng (red) or American ginseng 
·         20 pieces jujube (red)
  ·         30 g (1.1 oz) lycium 
·         salt, to taste 
Makes 4 servings
  PREPARATION
  Remove giblets from cavity of chicken. Wash the chicken thoroughly. Place 10g ginseng, 10 pieces jujube, and 10g lycium inside the chicken.
  COOKING
  Place the chicken (breast-side up) in a stock pot. Add 1000cc of water, 10g ginseng, 10 pieces jujube and 20g lycium to the stock pot. Cover the lid and bring to a boil, then reduce to medium heat. Simmer for 30 minutes or until the chicken softens. Season with salt to taste. Serve  

Other Services

Posted on November 29, 2013 at 1:16 PM Comments comments (0)
A La carte services
Reiki $60
Reflexology $50.00
Cupping $75
Gua Sha $75

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