Get Wellness: TIME Magazine, prevention and 10,000 steps a day.

TIME Magazine printed an important story in its January 10, 2011 issue. Get Wellness by Francine Russo. The story points out the Medicare change that will now pay for one wellness consultation a year. For the first time, physicians can get paid for not treating disease, but for actually trying to prevent it.  And the new health reform act provides other incentives and requirements for preventive wellness programs and counseling. The US health care (actually sick care) system would be wise to accelerate this new focus on prevention and wellness to balance its concentration on medical care and disease.

My main concern about last year’s health insurance reform act focused still on the sick care system, and gave too short shrift to behavioral preventive care. As the TIME article points out, about 3/4ths of the two and a half trillion dollar “health care costs stems from chronic disease, many of which may be prevented by lifestyle choices.” Indeed, a person’s own habits of exercise, eating and living are far more important, except for emergencies or accidents, to his or her health status than the entire medical care system. Little wonder that belatedly, insurance companies and health care providers are allocating resources to helping people help themselves live lifestyles that delay and prevent common infirmities. But as the TIME piece points out, most physicians are ill-equipped, by training and by incentive, to know anything about helping people adopt these positive health behaviors. The TIME article even included a graphic indicating the health wisdom of getting in 10,000 steps per day. How often do you see something like that at the doctor’s office?

Some good changes have taken place without much medical intervention. In the last generation, the USA has made substantial progress in one of the health care behaviors of its citizens. The rate of cigarette smoking has dropped in USA. This major cause of mortality and morbidity has waned, mainly though actions and social changes such as declaring no-smoking areas. Physicians have probably helped here some by advising patients to quit. In reality, though, a cigarette smoking habit should be seen as life-threatening by a doctor and an area for major concentration. Cigarettes still kill over 400,000 Americans each year, so there is a long way to go.

In other health behaviors, the news is less good. Distressingly, the past generation has seen a huge increase in Americans (and many of those in other lands) becoming obese. This trend is predisposing millions of people towards increased illness, disability and death by Type II Diabetes and other obesity-related maladies. The medical care industries can do little to cure these behavior-related diseases. These are essentially caused by poor health habits and can be cured only by healthy lifestyles. Once a year Medicare wellness consultations may help, but really obesity is now a pediatric disease, with victims as young as two years old. Fat babies usually become fat children and fat children usually become fat adults.

Blissful brains depend on strong bodies to support them. Bliss out your brain, improve your health and extend your life by taking 10,0000 steps per day, getting aerobic activity, doing weight training and eating right. A health-promoting lifestyle is your open-source health care. It is something you choose and do yourself. Perhaps now, though, some of you can even get a little preventive help with Medicare.

Cannabis dispensaries can be true wellness clinics.

Cannabis dispensaries and clinics are multiplying as citizens of ever-more American states vote to decriminalize medical marijuana. Many use the term “wellness” to describe their wider range of services. In fact, as medical cannabis becomes evermore accepted for the variety of conditions for which the herb provides benefit, dispensaries and clinics really can provide a mechanism for providing true wellness services.

The term “wellness” relates to a high level of health status, not simply the absence of disease, but the presence of behaviors that help prevent disease and cause the body to thrive. This behavioral perspective emphasizes the health practices that provide prevention effects from today’s causes of death and disability. High level wellness indicates a body not just disease-free, but strong, toned, nutritionally well fed, and free of excess tension. Wellness also refers to a relaxed but purposeful mental set, engaged with the world.

Several health behaviors are key determinants of our health status and our health future. A few of the physical activity behavioral goals may be beyond the capabilities of those with serious physical ailments, but serve as important guidelines to all. As a wellness center, the dispensary can communicate these basic practices and their importance to all patients in a variety of unobtrusive and complementary ways.

Virtually every person should:

  • Get sufficient exercise, especially walking.
  • Maintain good body composition with considerable muscle and little to moderate fat.
  • Practice good nutrition, focused on nutrient-dense, calorie-lean foods.
  • Avoid exposure to cigarette smoke.
  • Cultivate a supportive social life.
  • Manage and reduce stress.

Open Source Health Care

Two huge problems, besides the obscene cost, beset the current state of health care in the USA. One is the general non-availability of cannabinoid medications for most Americans. The other is the lack of prevention perspective; in fact, current “health care” is mainly medical care, focusing on relieving and curing established diseases.   Despite the fact that most of the ailments and diseases afflicting Americans are related to health behaviors, there is very little true prevention effort. The open source health care alternative for the 21st Century will enable people to harness cannabis for pain relief, anti-inflammation, glaucoma prevention and a dozen other conditions for which medical marijuana provides results superior to the mainstream medical/pharmaceutical approach. It will also provide a harm reduction, health promotion, preventive alternative to the current curative medical approach. Both these two problems could be addressed by dispensaries providing cannabinoid-based medications and true wellness services. Such services would address the health behaviors above:

Get sufficient exercise, especially walking. Most Americans walk far to little, depriving themselves of muscle and burdening themselves with fat. Taking at least 10,000 steps each day is a key health behavior of huge value to your health, and a crucial foundation for a preventive, wellness lifestyle. Even better is when some of these steps, or additional steps, are taken a faster pace, such as jogging a mile a day. Dispensaries could encourage patients to aspire to such basic fitness guidelines in a variety of ways:

  • Pedometers retail for $5. Providing each patient with one for no cost as part of the wellness services would send a profound message a hugely useful tool. The pedometer would of course bear the clinic’s logo.
  • Posters at the dispensary could impart more awareness of the 10,000 steps per day guideline.
  • If the clinic does the medical evaluations for eligibility for medical cannabis, this presents a perfect opportunity to encourage physical fitness goals such as 10,000 steps per day.

Maintain good body composition with considerable muscle and little to moderate fat.

America, and much of the world is suffering a crisis in body composition. Our bodies are composed evermore of excess fat. Plus we tend to carry too little muscle. Sufficient walking, see above, is key to building muscle tone and preventing fat, but additional muscle building is a healthy practice. A more muscular body composition helps burn calories, but more importantly provides a basic framework of physical strength that provides preventive and fitness dividends. Dispensaries could help patients gain the benefits of strength training with the same method as above, including posters and other messaging. The question of the obesity of its clients is important to a dispensary. Wanting to, “first, do no harm,” the clinic should confirm that its cannabis medication does not contribute to such problems. Cannabis is very effective at ending the wasting syndrome by helping people eat; its effect on people that are overweight may be less helpful. Obesity might even be seen as a contraindication in the prescription or recommendation of cannabis.

Practice good nutrition, especially nutrient-dense, calorie-lean foods.

  • The clinic or dispensary could educate on the quite incredible nutritional value of cannabis itself, in the form of hemp seed and hemp oil. Hemp seed is perhaps the most nutritious single food source, filled with essential fatty acids and proteins. The omega-3 profile of hemp seed is nearly optimal.
  • Good nutrition sets focus on nutrient-dense, calorie-lean foods, nearly the opposite of an American fast food meal.

Avoid exposure to cigarette smoke. The smoke from cigarettes, inhaled directly or as second-hand smoke, is a deadly toxin that kills over 400,000 Americans each year. Avoiding such exposure is a key preventive behavior. The reduction of cigarette smoking and proliferation of non-smoking areas providing freedom from this toxin have been a major public health victory in the last generation (and it was accomplished with zero SWAT raids and no one going to jail.

Although cannabis smoke appears far safer than cigarette smoke (marijuana smoking is not associated with lung cancer nor emphysema, two of the great risks of cigarette smoking, it is still smoke and contains toxins such as carbon monoxide (CO). Vaporizers provide a safe way to gain the medical benefits of cannabinoids with no exposure to smoke, and should be encouraged, and sold in dispensaries. With vaporizers, medical users can titrate dosages nearly as well as with smoking. In California, clinics, dispensaries and collectives have helped pioneer other ways of medicating with cannabis in a smoke-free manner. Tinctures with alcohol and edibles offer yet other alternatives. Invention, or rather reinvention of these medications (tinctures of cannabis were available to Americans 100 years ago) has been a major contribution of dispensaries in California.

Cultivate a supportive social life. Isolation is detrimental to physical and especially, mental, health. Although most important social interactions occur with family and friends, the dispensaries themselves could help provide some of this social glue so important to health.

Manage and reduce stress. Cannabis itself, especially types rich with a variety of cannabinoids, is a natural stress reducer. Indeed, much of the so called “recreational” use of cannabis helps users maintain a relaxed and happy state of mind. Stress reduction is of course a huge topic and the steps a clinic or dispensary might take are virtually limitless, from yoga classes, to progressive relaxation to massage.

Wellness and open source health care are giant topics that will be revisited.

A Cannabis Productivity Revolution

The liberation of cannabis from repressive laws around the globe will unleash a fountain of true human productivity. New foods, new fuels, new fibers and new medicines will issue forth when people are finally free to explore and expand the gifts of this plant. Americans in particular will be quick to exploit the multiple ways cannabis can serve to amplify human productivity when prohibition ends.

The most basic human needs are air, water and food. Regarding air, most of the physical structure of cannabis and other plants is made up of carbon atoms from carbon dioxide pulled out of the surrounding air. While the plant is consuming carbon from the atmosphere, it is also producing oxygen, each human’s most immediate need. The plant also transpires clean water vapor into the air, moisture that will return to earth as rain.

At its most elemental level, human productivity is about creating or gaining food to feed the family. The cannabis plant makes a stellar addition to humankind’s ability to produce nutritional plant foods. The seeds and oil of Cannabis Sativa are arguably nature’s most perfect foods. Cannabis hemp seeds and oil are filled with precious nutritional gems, including omega-3s, essential fatty acids and essential proteins. Silly regulations bluntly enforced by the DEA prevent fellow citizens from growing these powerhouse foodstuffs on American soil.

Shelled Hemp seed

Shelled Hemp seed

Currently, hemp seed and oil must be imported from China, where it is an ancient food, yet currently consumed each day. More hemp products come from Canada. None are grown in the USA, thanks to the DEA and cannabis’ Schedule I status.

So, let’s get this right, the so-called communist Chinese people have the personal liberty to grow and consume hemp, and to sell it to Americans. But the so-called free Americans are bludgeoned by our own government with long-prison terms and social and financial ruin if we plant this same crop?

Another basic aspect of human productivity is in providing clothing and shelter; people need clothes and they need places to live and to work. Again, hemp fibers from the cannabis plant offer bountiful resources. Hemp textiles are exploding in popularity. Part of their attraction is that cloth from hemp offers great environmental benefits, as compared to cotton.

Hemp textiles and clothing.

Hemp textiles and clothing.

In terms of working and building materials, hemp, of course, amplified the productivity of early Americans by providing them rope, canvass and a host of other materials. Deemed such an important contributor to colonial productivity and prosperity, some colonies required the growing of hemp. Its use declined with the availability of endless forests for wood building materials and with the introduction of oil-base synthetic fibers. With end of exploitative forestry and the passing of cheap oil, hemp fiber again has a great future as a source of construction material, building material and fiber for fabrication.

  • Many building materials incorporating organic material from cannabis sativa are gaining favor.
  • Hemp can be incorporated into fiber board, insulation, and hempcrete, a more natural form of concrete.
  • Productivity with these materials is multiplied. First, they are carbon negative, a crucial consideration in a warming world. Cannabis plant material comprising hempcrete and similar products sequesters carbon away, out of the atmosphere. Such materials may be locally sourced, as hemp can grow nearly anywhere, saving transportation and carbon costs.
  • Paper has been integral to mankind’s productivity ascent, as books and publications allowed idea sharing. But paper, when rendered from the wood of trees, exerts huge environmental costs. Hemp based paper, made from one year-old plants instead of centuries old trees could revolutionize, and clean up, the paper industry. Better paper products for less inputs equals true productivity.

Another aspect of the American economy in vast need of productivity improvements is health care. Huge cost increases in the American system have not resulted in superior health status. Other countries do far more for far less.

Cannabis, again, offers the American health care system a quantum leap from its pharmaceutical-based doldrums. The drug so outlawed by its Schedule I status as having no medical value now demonstrates its overwhelming medical, preventative and palliative benefits. As Americans demand their medical liberty in the coming years, the non-elected bureaucrats in the federal government will not much longer keep from its citizens this medication they demand.

True health care productivity is demonstrated when a patient can dispense with an entire array of debilitating pharmaceutical drugs after finding relief with medical cannabis. This is the actual case for many victims of disease, injury and pain. Relief is attained with far fewer narcotizing opioid drugs when supplemented (or even replaced) by phyto-cannabinoids, pain-relieving, inflammation-reducing, antioxidant molecules from the cannabis plant.

Even now in California, where voters have demanded cannabis medical liberty, health care innovation exploiting the plant is underway. New cannabis strains are being developed to best address the vast array of medical problems treatable with cannabis. Genetic mixtures of phyto-cannabinoids mix cannabinoid molecules such as THC, CBD, and THCV, to better treat different medical conditions. Novel harm-reducing ways of taking cannabis medicine have developed. Smoking has been replaced or supplemented with vaporization along with tinctures, teas, and edibles. The open-source nature of medical cannabis makes its economics exactly the opposite of pharmaceutical drugs it will, in many cases, replace.

Arguably, in a state in desperate need of jobs, innovation and prosperity, the most thriving new industry in California is the cannabis medicine sector.

Harm reduction is a term often associated with drug prohibition and enforcement.  This approach is diametrically opposite the American drug war harm maximization model that uses militarized police, private property forfeiture and decade’s long incarcerations for “crimes” involving nothing but a plant.

Harm minimization can also refer to productivity. Productivity gains made as a result of exploitative activities that cause environmental damage are false. A true productivity gain does not occur if the process of creating the product creates other, larger problems. Productivity is not true if it squanders resources and despoils surroundings. A mine that produces minerals for a few years, then despoils a stream for a century is not a productive resource.

Cannabis and hemp-based foods, fuels, fibers and medications do create opportunities for innovation, propel productivity increase, and gain prosperity in a way that minimizes harm. Every cannabis plant grown sequesters carbon dioxide. It is a local resource, open-source, available to everyone to grow, to innovate, to increase prosperity and to improve health.

The major impediment to these real world solutions are bureaucratic. Cannabis and hemp need to be freed from their dishonest and draconian Schedule I status. The jack-boot of the DEA needs to be removed from the necks of American citizens. Onerous international treaties, those that mandate prohibition of cannabis and its products, need be repudiated.

The planet and its people are in need of productivity and prosperity gains that don’t harm the biosphere. Americans, in this time of economic flux, need be able to explore and to use the huge productive resources of cannabis hemp. Much of this freedom could be attained from the rescheduling, by the President or Attorney General, of cannabis, hemp and cannabinoids from Schedule I to Schedule V.

Medicine Grown by Hand: Medical Cannabis as an open-source model.

In his near-future dystopian novel, World Made by Hand, James Howard Kunstler presents a bleak portrayal of a small upstate New York town a couple of decades hence. The federal government had collapsed, Washington DC was nuked and the availability of gasoline and electricity ended. Ex-motor cycle toughs run the community’s central resource, the old town dump, now the source of riches such as nails. In this new world, owning a horse makes one wealthy.

In the novel, the system no longer provides medication nor medical care. The town’s doctor is the protagonist. He faces the frustrations and tragedies of having to practice medicine with no modern supplies, tools or services. With pharmaceuticals unavailable, the good doctor grows medicinal herbs. A key medication for pain relief and succor from various ailments is one not freely available before the collapse, cannabis. Treatment with cannabis is part of open-source health care in this new world. Seeds are the open source. Such self-treatment will become an ever more important part of our own health care future.

In health care, the term open-source includes self-care, with the individual taking more responsibility for his or her health and treatment. In some cases, the person (the term patient not quite right) becomes the source of treatment. Self-care itself is part of a larger wellness model that focuses upon a preventive lifestyle, especially with sufficient exercise and mindful nutrition, as key aspects of health.

Without doubt, more open-source medication, especially with cannabis, will be part of America’s health care future. For many people, including the 45 million uninsured Americans, the current health care system does not work. It has many problems:

  • The current medical care colossus sucks up one dollar out of 5 in the American economy.
  • The American system is by far the most expensive, and offers far less care for the dollar than in other countries.
  • Much of what passes for medical care is in reality too late and inefficient. It does not do well treating the huge class of auto-immune inflammatory disorders that most afflict the health of Americans with chronic degenerative diseases.
  • Medicine is (over)used to try to stave off injury of primarily a behavioral nature. Medical technology is used to try to fix damage caused by behaviors such as cigarette smoking and sedentary lifestyle.
  • Pharmaceutical drugs are prescribed for most ailments. Mortality from these drugs alone is a major cause of death.

The choices and actions of Americans, especially regarding physical (in)activity and (over)eating behaviors underlie much of what ails us. In most of the degenerative, inflammatory diseases that bedevil modern Americans, much medical care is merely palliative, relieving just the symptoms, symptoms of behavior-caused damage. Obesity, flaccid body composition and sickly organs damaged from cigarette smoking and alcohol poisoning are examples.

Type II diabetes is essentially a self-chosen disease; walking 10,000 steps a day is a robust preventative, even cure for Type II diabetes. Personal health actions such as increasing physical exercise, if universally adopted, could abolish many of the inflammatory ails that now pass for disease.

  • To ignore these preventatives and to proceed as before with a late intervention, medical and pharmaceutical approach to life-style-based health problems is folly.
  • Just as the pre-diabetic can literally walk away from diabetes, so too our general health practices determine how healthy we really are. The 10,000 steps-a-day prescription is not just for those threatened by diabetes or obesity, but serve as a good goal for nearly everyone. Such activity is open-source self-care at its best.
  • Eating daily 5 to 9 fruits and vegetables is the core of healthy nutrition. Rich in nutrients and sparse in calories, this plant based foundation provides much fiber. High fiber helps us stay full and tune the digestive system.

Aspirin-taking is open-source self-medication. Because aspirin is a legal and available drug that provides relief for a wide variety of ailments, we are free to use it for self-medication. Aspirin is very useful, but not without some dangers, such as attacking the stomach. Like most drugs, it has a lethal dose and several hundred people die from aspirin poisoning each year. Still, its ability to reduce pain and inflammation and to provide protective cardio-vascular effects make it a key open source medication.

Another substance to relieve a wide variety of symptoms such as pain and inflammation is cannabis. Unlike aspirin, no deaths are associated with its use. Like aspirin, cannabis is medically useful not just for a small array of discrete problems. Although it does provide fairly specific prevention and therapy of maladies such as glaucoma, and works wonderfully for reducing the worse symptoms of chemotherapy, its applications are broad. It is useful in treating a dozen major diseases. Other benefits are less specific. The cannabinoids in cannabis are antioxidant, anti-inflammatory, neuroprotective and analgesic. The latter, pain relief, points to the more generalized medical benefits of cannabinoids.

Pain is one of the chief reasons people seek medical care at all. What percentage of the humankind, what single person, does not experience pain at sometime in life? To quell pain is the reason most people take an aspirin. To quell pain is the main reason tens of millions of Californians in the future may take a tincture of cannabis.

  • A century hence, and hopefully far sooner, Americans will regain the pain-relieving, self-health remedies available to their ancestors. They already have in California and a dozen other states.

In a country supposedly searching for national health care answers, the open-source, self-care benefits of medical cannabis must not be ignored. Medical cannabis will not be ignored by those without insurance, nor those increasing millions who become aware of the superiority of pain relief and other medical benefits available to them with cannabis. Bizarrely, conservatives who worry that a national health care system would deny medical choices are the first to deny totally American citizens the right to choose cannabis-based medications.

Americans will make these choices anyway, using the cannabis seed as the open-source basis for their medication. Hopefully they will have state laws in place to provide them some safety from the dangers inflicted upon them by their government, as they again produce their medicine grown by hand.