November 28, 2014 Enigami Newsletter

Enigami Medical Cannabis, LLC (a subsidiary for Enigami Systems, Inc.)

Enigami continues to entertain “R & D” proposals for entities interested in developing condition specific medical cannabis medications.

Enigami is interested in partnering with a limited number of Dispensaries and Clinics who wish to be national treatment models for medical cannabis. As the medical cannabis field moves toward medical legitimacy we want to be in the mix.

For folks who are in the process of submitting clinic and dispensary applications for the various medical cannabis states Enigami will consider LOI’s to accompany the applications. In some cases Enigami can offer generous advertising allowances for new businesses establishing themselves as clinics and dispensaries seeking a significant difference in treatment resources – those that help patients determine the appropriate medications(s) for their treatment.

On some Enigami sites you will soon notice a “How to Register” video which also serves as a comprehensive FAQ resource. We’re always improving our products, generating meaningful patents, and trademarks.

Clif Croan spoke on the Dr. Diane Dike Radio Show, “Picking the Right Medical Cannabis For Your Medical Treatment”, joined the Board at the National Association of Cannabis Based Medicine , and was elected Chair (as a gubernatorial appointee) of the (Colorado) Disability Benefit Support Contract Committee . Most of the Enigami staff are heavily involved in community service as is the company itself. A nice lead in for our pro bono Veterans study…

“Do Veterans with PTSD Benefit from Medical Cannabis?” – an ongoing National Study

Kudos to Dr. Gary Miller, one of the study principals, for the Exclusive Ben Swann Video Interview: Dr. Gary Miller Says Veterans With PTSD Need Access To Cannabis Dr. Miller, always meaningfully contributing to the community, was elected to his local school board. Congratulations !

Bill Graf and Clif Croan manned a booth, for the study, at the November 8 Denver Veterans Day Festival at Denver’s Civic Center Park, near the State Capitol. It was a huge event and there were about 5-10,000 veterans. ttp://www.denverveteransday.com/ Bill Graf is constantly reaching out to various Vet advocacy organizations and is heavily committed to the worldwide community by his “hands on” philanthropic work in Haiti, several African nations, and southeast Asia.

Thank you ! to ML Mathre and Al Byrne, study members, for having made innumerable pitches for the study at more events than can be listed. What dedicated Vets they are ! Dr. Uma Dhanabalan, the study PI, continues her advocacy and has made numerous presentations at national conferences for the Vet study. She’s a Diamond !

Due to hosting problems on our website (2nd time) we were off line twice this month for a few hours. We no longer host our site with that organization. Problem solved.

A new informational brochure is available on the study website: http://www.vetptsdstudy.org/

Please contact the VA to support new legislation enabling them to look at medical cannabis treatment for PTSD. A call to Colorado’s Rep. Polis office wouldn’t hurt either. Ask for Stuart Feinhor.

As always please “spread the word” about the study…the VA and mainstream media sure won’t ! And for all the organizations disseminating information about the Vet study…Thank You !

Have a Happy, Safe, and Joyful Holiday Season !

September 22, 2014, Enigami Newsletter

Our development team at Crank211, LLC have evolved into close friends and co-workers. Despite their best efforts to avoid service disruption Microsoft ‘s “Azure” had a severe hiccup in service the past few weeks. If you encountered difficulties in your web services MIcrosoft may be the culprit.

The “Marijuana for Medical Professionals” conference on Sept. 9-11, 2014, in Denver, was a HUGE success. Many thanks to Ms. Montemayor, of Healthy Choices Unlimited for putting on the most professional medical cannabis conference to date. We can’t wait to attend next year.

Clif Croan, of Enigami, will be doing a radio interview with Dr. Diane Dike, Oct. 10, 2014, about the importance of patients being able to understand the medical cannabis products contents and how they relate to the conditions they’re treating: www.DianeDike.org.

Enigami Medical Cannabis, LLC (EMC) will be “tossing it’s hat into the ring” at the Marijuana Tech Start Up Competition, in Denver, the weekend of Sept. 26. EMC will only be accepting proposals on the future of the database which defines the relationships between the cannabinoid combinations and the qualifying conditions.

“EMC” has entered into a limited number of agreements to serve as R&D to large grow operations both domestically and abroad. EMC will furnish the information for product specifications to a very small number of growers/manufacturers.

“Brownie Points” – we all love ‘em, right ? A number of Dispensary and Evaluation clinics have signed LOI’s to provide EMC patient medication/symptom tracking (to determine the appropriate medications for treatment) in applications for state licenses to open. Good luck with the applications folks ! EMC looks forward to working with you !

Lastly, EMC has submitted two research applications to the State of Colorado Medical Marijuana Research Grant Program (RFA #1353). EMC and Healthy Choices (HCU Education LLC) teamed together for a study entitled: “Use of urine neurotransmitter markers in determining appropriateness of cannabis for chronic pain patients”. In the second instance EMC has teamed with the Colorado Cross Disability Coalition to research: “A Correlational Study of Medical Cannabis Cannabinoids Efficacy in the Treatment of the Colorado Qualifying Conditions”. Our advocacy position for the Colorado disability community is to assess the community’s needs in relation to the Colorado Department of Health and Environment’s Medical Marijuana Registry. Tragically the State has failed to allow representation of the Colorado disability community in the various Boards relating to the use of Medical Cannabis in Colorado. EMC is also exploring research needs in Uruguay and Europe.

“Veterans, PTSD, and Medical Cannabis” – the national study inviting 10,000 participants is cruising along and we would appreciate the advocacy of anyone involved in advancing Veterans treatment options through the findings of this valuable study.
Not a word in answer to our communications from the Veterans Health Administration.

Dr. Gary Miller, a senior account specialist with Enigami based in Arizona, will be doing a radio interview on Liberty Radio, catch up to Dr. Miller and his comments about the need for Veterans advocacy: http://benswann.com/

Medical Marijuana Is Becoming All About the Money …Less About the Care.

Let me share how I came to see the present medical marijuana business as “…all about the money”.

I’m a clinician and very interested in health information technology and how it may assist patients to improve care so I began to look at medical marijuana (MMJ) care with an eye to contributing to that care method. I also have to say I’m a sixties child and still full of that Love, Peace, and “people are basically good” approach to the world (thus my career as a caregiver).  I’m with a little IT company that helps patients track symptoms and the medical marijuana field seems to be an ideal place to help people in this regard. My company and I are unimportant to this article but where the field is going in respect to patients managing their treatment is important. My personal interests and background have helped me to frame an understanding of the cannabis care model. Here’s what we see…

In the medical marijuana field a patient has an evaluation (and if recommended) then purchases medication. In order to keep getting medication a person has to have an annual certification renewal. The docs get a buck, the dispensaries get a buck, and even the state gets a buck on the certification. So you got a condition and a medication – how is a patient supposed to manage treatment? Where’s that part of the care model fit in? Wasn’t someone supposed to have said something about that along the way?

In “mainstream medicine” an individual gets an evaluation (and if recommended) may get a medical intervention (like medication) but the patient will undergo some type of assessment of the interventions success later. If you’re in the medical field you would say, “that’s practicing real medicine”. That leaves it to reason that the cannabis care model is not considered legitimate medical practice by many. If you’ve been around medicine the last few decades you know that “evidence based medicine” (looking at the interventions results) is the norm and ethical practitioners ALWAYS assess their interventions. This makes MMJ look kind of, well funny.

In the medical marijuana care model there are three distinct, mutually exclusive, areas of involvement:

  • physicians manage evaluations
  • patients manage ongoing treatment or “follow up care”
  • dispensaries manage selling medication 

Why should patients needing help with multiple sclerosis, cancer, glaucoma,  pain management, or other illnesses be told, “we got ours…you’re on your own !”. Don’t the physicians and dispensaries feel any sense of partnership in the care model? Don’t the professionals owe it to the patient to get involved in the overall care model instead of concentrating solely on the profit side?

Should cannabis care be defined as more than the product, the physician, or the dispensary and more about the actual process of care? What sector is going to step up and help the sufferer find a way to manage treatment (right medication, right dose, right method of administration, strain, THC/CBD/CBN count, etc.). When you’re flopping around on a floor having a seizure or throwing your guts up these are a bit more important than just a recreational feature. You’re care is not a cookie cutter deal and you’re an individual with unique needs.

Why are these “mutually distinct groups” the care model for cannabis? Maybe it’s simply because the patients need for managing their care simply isn’t an area of interest to the other parties. Maybe it really is about the Almighty Dollar but maybe there’s more to it than that.

Physicians

Docs like to specialize – when they do they make more money. In MMJ this is very true. Is there anything wrong with wanting to operate in a specialty area of medicine? No. Is it a bad thing to be a diagnostician and not involved in subsequent care? No, again.  Do most cannabis physicians operate only in the MMJ field? Yes.

Regulatory authorities are struggling with the idea of treatment management and questioning whether it should be tied to the evaluating physician. This obligation hasn’t panned out because physicians in other areas of medicine are allowed to specialize in the same manner that cannabis physicians do. If physicians don’t help manage care are patients qualified to manage their own treatment? On a limited basis patients can manage their care but that’s not to say they don’t need meaningful consults from professionals like the cannabis physicians and “professionals” like the dispensary staffs are trying to be. Certainly no one expects a patient to travel too far into the “practicing medicine” area but to a limited degree patients can manage their well being reasonably well.

Is there a bit of trickery going on in the various state regulations when it comes to indicating the cannabis physicians should operate in a manner consistent with other areas of medicine and provide ongoing care? In my opinion I believe this may be the case because it takes us back to the “normal” way of practicing medicine “evidence based medical care” and I believe we’ll see a number of test cases where evaluating physicians are being prompted to provide ongoing care. (In some states follow up care is now mandated.) But this just takes us back to the “specializing in areas of medicine” paradigm and it’s really just an attempt to tie care to the evaluating physician. If a physician doesn’t really want to provide ongoing care he won’t.

If you want to know the answer to the question, “Does the doc really care about my well being?”…ask yourself this…did he REALLY steer you in the direction of specific, meaningful, and ongoing, care…or was it “try some acupuncture or yoga – and see you next year for the re-cert !”

But the docs aren’t the bad guys here. They’re just doing a job.

Dispensaries

Does your dispensary truly offer an array of ancillary services focused on your well being? Or, does the dispensary really just offer that one high dollar product? Check out Harborside Health Center in Oakland and see their commitment to their patients well being. They offer all kinds of ancillary services focused on patient’s well being. That’s a good model but it can be improved.

Dispensaries remind me of the plethora (yes, I actually used that word) of clothing boutiques which sprung up in the 1960’s (okay, I’m an old guy). Everyone just had to have a boutique, they were so cool, and so very hip. But most owners lost their businesses because they weren’t good business people – so perhaps we can forgive the dispensaries a bit because like the clothing boutiques they have a business to run and for many it’s new territory. For them the business is truly a bread and butter proposition and it’s not as if they took some kind of pledge to heal people or reduce people’s suffering.

A few months ago there were about 1285 dispensaries in Colorado now there are approximately 950. Do you think a few big money interests are getting together and forming chain dispensaries like in California? It’s just business folks.

And just trying to make a decent living doesn’t make you a bad guy either so the dispensaries are off the hook too.

Patients

Can consumers manage their care? Hasn’t that always been the bottom line reality anyway? Aren’t we forced to become our own advocates when we face our doctors in those 10-15 minute sessions? If you don’t speak up, you’re screwed. But where is the line for our competency as consumers?

Final rag, options for patients to manage their care will not appeal to businesses that are predominately concerned with helping people “score” legally. People who want to “get high” are NOT concerned about their well being or ongoing treatment. Businesses that wish to serve this type of customer will have no interest in legitimate treatment management options.  We all know the score on this issue.

So how do we create a workable cannabis care model?

Medical marijuana is a new, promising, and legitimate area of medicine. As a clinician I heartily believe it. As a human being I’m sold. It scared the pants off me to take a pipe and pot to my father in Texas when he was dying. Nauseated, and vomiting, the great man could have had some relief if only he could have gotten past the stigma and lit up. I was married to a wonderful woman who died of disabling asthma. I wish we’d known before the last year of her life that cannabis helped her breathe. She died when she was 44. They both deserved better medical options.

We need cannabis in the medical market and we need a decent model of care. We need the players to step up to the plate and do the right thing – get involved. Not because they have to, they don’t, but because it’s the right thing to do.

Ultimately it comes back to us, it’s our responsibility to look after ourselves. I hate to get all existential but you’re the one in charge – not just of your life but of your well being.

Now, go find the tools to take care of yourself. Look for good people to guide you. And along the way nag your doc and dispensary about helping you to manage your care. Try the guilt trip but remember to take your cash when you visit them.

Maybe Gordon Gecko was right, “It’s all about the money and the rest is conversation.”  

I hope not.

Enigami Blog 8-2-2012Copyright 2011 by Clifton D. Croan