Getting out of the Weeds with Medicinal Cannabis

Medicinal cannabis (aka medical marijuana) is a growing topic in the United States. Today, there are 29 states (plus Washington DC) where cannabis is a legal medical option for patients. Cannabis is mostly prescribed for pain relief but can also be used to treat muscle spasms caused by multiple sclerosis, chemotherapy-induced nausea, lack of appetite from chronic illness, seizure disorders, Crohn’s disease, and more. However, cannabis exists in a legal gray area: while medicinally legal in a majority states, it is federally illegal and considered a Schedule I controlled substance by the Drug Enforcement Agency (DEA)—defined as having no acceptable medical use and high potential for abuse; the same categorization for heroin, LSD, and ecstacy.

 

Cannabis extract, commonly found in early 20th century pharmacies

Cannabis extract, commonly found in early 20th century pharmacies

The cannabis or hemp plant can be traced back to Central Asia before being introduced to Africa, Europe, and the Americas. Hemp fiber was used to make textiles used for clothing, rope, paper, and sails for hundreds of years before an Irish doctor found cannabis extracts could lessen the stomach pain and vomiting from patients suffering from cholera in the 1830s. By the late 19th century, cannabis extracts were commonly sold in pharmacies and doctors’ offices throughout Europe and the United States.

 

Cannabis also has a history of recreational use. Ancient Greek texts describe inhaling smoke of cannabis seeds and flowers, and Middle Eastern and Asian cultures refined the cannabis plant into hashish. Cannabis was not widely used recreationally in the United States until the early 20th century, commonly attributed to immigrants fleeing the Mexican Revolution. Unrest of the Great Depression along resentment of Mexican immigrants and black jazz musicians were contributing factors to the prohibition of cannabis in the U.S. by the 1930s.

 

The two most prominent compounds found in cannabis are cannabidiol (CBD) and tetrahydrocannabinol (THC). Both CBD and THC interact with the body’s endocannabinoid system—a signalling system regulating pain, appetite, mood, memory, and cellular life-death cycles. The main differences between CBD and THC is whether the cannabinoid will create a euphoric effect. THC is the compound that produces the “high” feeling, primarily interacting with cannabinoid receptors in the brain and nervous system. CBD on the other hand is non-psychoactive and does not produce a euphoria .

CBD is the therapeutic compound in cannabis and can be prescribed to patients with inflammation, pain, anxiety, psychosis, seizures, spasms, and other conditions without side effects. Clinical research has found benefits for those living with arthritis, diabetes, alcoholism, multiple sclerosis, chronic pain, schizophrenia, PTSD, depression, antibiotic-resistant infections, epilepsy, and other neurological disorders. CBD derived from hemp is legal in all 50 states, though CBD products derived from cannabis are only legal in the areas where medicinal marijuana has been legalized.

 

There are still many questions surrounding cannabis and its medical uses, as earnest research has been limited due to being considered a strongly controlled substance. Rates of cannabis abuse, the levels of physical addiction, and the rising potency of commercially available marijuana are the basis for concern from the National Institute of Drug Abuse (NIDA). States that have legalized medical marijuana have shown a drop in opioid abuse and Medicare prescription costs were seen to fall in states after legalization. Just yesterday, a panel of experts recommended FDA-approval of an epilepsy drug made from marijuana, marking a first time a medication derived from cannabis may receive full FDA approval.

 

NeedyMeds has limited resources to connect patients with medical cannabis, but one record from our Diagnosis-Based Assistance database is for Realm of Caring. They offer two assistance programs: Realm Cares provides financial assistance for those seeking prescribed and approved cannabinoid treatment when not covered by insurance; and the Joy Fund helps patients looking to move to Colorado for legal access to cannabinoid therapies with a half grant/half interest-free loan.

For others seeking help with prescription costs, the NeedyMeds Drug Discount Card can save users up to 80% off the cash price of prescription medications for those without insurance or choose to use the card instead of insurance for anything picked up from a pharmacy. In addition to the plastic card, the card is available in a printable form or on the NeedyMeds Storylines app for Apple and Android devices. For more help finding information, call our toll-free helpline at 1-800-503-6897 Monday through Friday 9am to 5pm Eastern Time.

 

National Volunteer Week

National Volunteer Week was established in 1974, and we at NeedyMeds want to recognize our amazing volunteers that help make our work possible.

 

Two of our volunteers, Max & Don

Two NeedyMeds volunteers, Max & Don

Our local volunteers are invaluable! They help us print and mail lists of medications for callers seeking help with several prescriptions (our call center helps with this information over the phone, but due to the volume of calls we receive we may mail you information for long lists of medications), update information in our databases, and help mail out the NeedyMeds Drug Discount Cards. Some of our earliest volunteers had been offered paid positions in the formative years of NeedyMeds, and our incoming volunteers are anyone from high school students seeking work experience to retired individuals looking for light office work. Our volunteers’ ages range from 16 years to 97 years old. All take their work seriously and help make NeedyMeds the success it is.

 

More recently, we have started our Volunteer Ambassador Program (VAP) that allows interested advocates around the United States to help spread the word in their communities about NeedyMeds’ resources. We have Volunteer Ambassadors all over the country—from Massachusetts to California; from Macon, Alabama to Homer, Alaska—who distribute NeedyMeds Drug Discount Cards, provide presentations of NeedyMeds resources for vulnerable populations and comprehensive trainings for organizations within their communities. Many are healthcare professionals or advocates, as well as students and members of other healthcare organizations. If you are interested in becoming a Volunteer Ambassador, contact us at outreach@needymeds.org.

 

We also have a board of directors comprised of volunteers with professional backgrounds in medicine, law, nonprofit management, and local government. Our board oversees the progress being made by NeedyMeds month-to-month as well as approving budgets, plans, and strategies.

 

National Volunteer Week is a time to celebrate the impact of volunteer service in our communities. With our network of volunteers, NeedyMeds is able to accomplish much more than we would as a small nonprofit. We applaud volunteers all over the country, and thank you all for your service.

Autism Awareness Month

April is Autism Awareness Month. Autism spectrum disorder (ASD) is a common but complex developmental disability, with 1 in 68 American children born somewhere on the autism spectrum. The signs of autism are usually apparent when a child is between 2 and 3 years old, although they may be seen in younger children. Symptoms are different for everyone, though some of the behaviors associated with autism include delayed learning of language; difficulty making eye contact or holding a conversation; difficulty with executive functioning (relating to reasoning and planning); narrow, intense interests; poor motor skills, and sensory sensitivities. A diagnosis of ASD is based on an analysis of all behaviors and their severity. The cause of autism is still being researched and debated, although doctors generally agree that the cause for autism spectrum disorder is unknown, but it is generally accepted that it is caused by abnormalities in brain structure or function.

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Autism awareness remains an important goal as early intervention has shown positive results for those on the spectrum, but also to relieve the stigma of those with special needs and the families that support them. Autism Eats is an organization that holds events at restaurants for families with children with autism. The events are able to provide a judgement-free environment for families that may often feel stressed or anxious at the thought of dining out. A stigma-free future is what awareness hopes to lead towards.

 

 

NeedyMeds has information on several resources available to children with autism and their families. Our Autism Diagnosis Information Page is designed to be the one-stop location to easily reach all the relevant information: we list commonly prescribed medications that link to any Patient Assistance Programs (PAPs) we have information on that may provide prescriptions at low or no cost. The Diagnosis Information Page links to our database of Diagnosis-Based Assistance (DBAs) programs that provide a variety of services from helping with living expenses, respite care, service animals, or durable medical equipment. We also link to our databases of recreational camps and academic scholarships that enable children and young adults on the autism spectrum to have fun experiences and continue their education. For more help finding information, call our toll-free helpline Monday-Friday 9am-5pm Eastern Time at 1-800-503-6897.AUTISM FB POST

Laws Proposed to Protect Patients from Artificially High Prescription Costs

In a previous blog post, we explored “clawback” and how it affects the prices of prescriptions. In short, Pharmacy Benefit Managers (PBMs) negotiate copay prices for insurers that are often higher than the cash price paid by uninsured patients all while instituting a “gag rule” for pharmacists to forbid them from revealing the price discrepancy to patients unless asked directly. A number of states have already passed laws banning clawback and gag rules, though a group of bipartisan U.S. senators have introduced a bill the ban gag clauses for PBM-negotiated contracts nationwide.

OLYMPUS DIGITAL CAMERAA recent study by Journal of the American Medical Association (JAMA) found that 23% of all prescriptions filled through insurance ended up costing more than patients who would pay out-of-pocket. Related to this, a national poll from West Health Institute/NORC at the University of Chicago found 32% of Americans didn’t buy a prescription or took less than the prescribed dosage due to cost. This all appears to be exacerbated by the continuing rise of prescription costs; in the past 14 months well known/high-use prescriptions rose an average of 20%, while less common prescriptions rose between 100% to 1,468%.

Pharmacists reportedly feel complicit in price gouging, and are often not allowed to offer information that could save patients money. However, if a customer specifically asks for a lower price option they are allowed to provide it. With this in mind, it is always a good idea to ask your pharmacist, “Is that the best price for my medication?” to ensure you are not becoming a victim of clawback or gag clauses.

No one should have to worry about being taken advantage of or sacrificing their health due to a lack in finances. For those without any prescription coverage or those who choose not to use it to avoid clawback, the NeedyMeds Drug Discount Card saves 0-80% on the cash price for prescribed medication. A plastic card can be ordered online or requested by calling our toll-free helpline at 800-503-6897, or a printable version can be found on our website as well as the NeedyMeds Storylines smartphone app on Apple and Android devices. For those still unable to afford their medications, NeedyMeds has an extensive database of Patient Assistance Programs (PAPs) that provide prescriptions for low or no cost. NeedyMeds also has information on Coupons and Rebates that can help lower the cost of necessary medications. For more help finding information, call our toll-free helpline Monday-Friday 9am-5pm Eastern Time at 1-800-503-6897.

LGBT Health Awareness Week 2018

The last week of March has been LGBT Health Awareness Week since 2003. We have gone over some of the barriers to health care for some of the transgender community in previous blog posts, but it remains important to bring awareness to the unique healthcare needs of lesbian, gay, bisexual, and transgender people and the health disparities that continue to beleaguer the lives of so many Americans.

rainbowcaduceusExperts report that LGBT people often avoid seeking out medical care or refrain from “coming out” to their healthcare provider. This compromises an entire community of lesbian, gay, bisexual, and transgender individuals who are at increased risk for several health threats when compared to heterosexual or cisgender peer groups: Gay men are at higher risk of HIV and other sexually transmitted infections; lesbians are less likely to get cancer screenings; transgender individuals are among the least likely to have health insurance along with risks from hormone replacement and atypical cancers. Even as youths, LGBT people are at higher risk of violence, depression, substance abuse, homelessness, and other suicide-related behaviors.

The Affordable Care Act (ACA) had helped over 10 million Americans gain insurance during the Obama administration. The ACA also prohibited health insurance marketplaces from discriminating on the basis of sexual orientation and gender identity. The 2015 Supreme Court ruling of Obergefell v. Hodges recognizing marriage between gay and lesbian couples throughout the United States led to more married couples to access their spouse’s health insurance.

 

The Trump administration has since dismantled many protections for equal access to care for LGBT people. Shortly after Trump took office, regulations to ban discrimination in Medicare and Medicaid were stopped and the White House declined to enforce the ACA’s anti-discrimination mandate, signalling they would roll back the rule. Throughout his first year, senior advisors for LGBT health were reassigned to less effective positions and questions regarding sexual orientation were removed from federal surveys. In late 2017, President Trump fired the Presidential Advisory Council on HIV/AIDS (PACHA) which concerned advocates believe is part of an “effort to erase LGBTQ people.” The mass dismissal followed six members resigning the previous summer, citing the Trump administration’s apparent disinterest in helping the HIV/AIDS community. In January 2018, it was announced the Department of Health and Human Services (HHS) would form a new Conscience and Religious Freedom Division that would functionally allow doctors to refuse treatment for those that go against their religious beliefs—further limiting access to care and undermining the civil rights, health, and well-being of LGBT people, women seeking reproductive health services, and others. Just this month, the HHS-operated Office for Women’s Health website removed the “lesbian and bisexual health” page and other related links.

The LGBT community continues to rank among the most underserved populations in terms of health care. Homophobia and stigma can negatively impact one’s ability to receive suitable care. Over 27% of transgender people in the U.S. report being denied health care. Mental health is a major concern for LGBT individuals often dealing with physical or emotional abuse, body dysmorphia, depression, or feeling unsafe at school or work, and there are still areas of the United States where finding sympathetic and appropriate help can be prohibitively difficult. If you are looking for a LGBT-friendly medical center, the Human Rights Campaign (HRC) has an interactive map with locations of over 1600 healthcare facilities in the United States. The HRC also has information on finding insurance for transgender-related healthcare, which can be a challenge for many transgender people even after the ACA.

To further help those in need, NeedyMeds has a growing list of programs in our Diagnosis-Based Assistance database for transgender/gender non-conforming people that offer various forms of assistance such as financial aid or legal services. NeedyMeds’ unique crowdfunding platform HEALfundr is also available for individuals trying to raise funds for their transition and other members of the LGBT community to receive appropriate health care. For more information, call our toll-free helpline at 1-800-503-6897 (open 9am to 5pm ET, Monday through Friday).

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