North Carolina On The Band Wagon

North Carolina might follow the steps of the 13 other states that have already legalized the use of medical marijuana. A lawmaker has proposed its legalization, and as in other states also in the process of discussing the possibility of legalization, the proposal has been received with mixed reactions. The North Carolina Medical Marijuana Act was introduced by State Rep. Guilford Jones, who said that the bill will benefit the seriously ill. In the other states where the use of medical marijuana has been legalized, it is primarily applied as pain management therapy for those who are in advanced stages of pain-ridden diseases such as cancer and HIV/AIDS. In the proposed North Carolina bill, patients with chronic ailments will be allowed to do the same. The bill spells out several guidelines, some of which are currently being followed by the 13 states where medical marijuana has been legalized. Marijuana is to be distributed and sourced from licensed dispensaries, and will only be administered to those who have been given written certification stating the need for medical marijuana therapy. Patients who qualify will be provided with a registry identification card, which they will have to keep with them at all times.

Of course, the primary driver is medical cost escalation, which is driving states to regulate. The alternative is raising premiums. Premiums are like taxes, the higher they are the higher product and service prices will be. They are, in themselves arguably inflationary. As medical costs rise, there is increasing competition for access to limited resources. Thus states are turning to control mechanisms such as formularies, treatment guides, and impairment guides. The application of these standards will lead to increased litigation in some jurisdictions as injured workers resist the spirit of constraint. An individual naturally has more interest in their personal well-being than in the "greater good" of any system. Pain will continue to vex and challenge. Pain is real. And people will continue to experience pain. Certainly, pain is personal and subjective. It cannot be measured or tested. In 2016, we think the final numbers will demonstrate 64,000 dead of overdose. America, it seems, has a problem. In the entire history of American involvement in Vietnam we lost 58,220 lives.

We mourn them, honor them, thank them and put their names on a wall. But we lost more Americans to Opioids and overdose in just one year. And the numbers seem to be increasing. The same year, we lost 37,461 to motor vehicle accidents, another 10,000 or so to gun deaths (a mere 374 to rifles). Though we see activism and excitement to address the gun deaths, there seems less enthusiasm about the overdose. Only in 2017 and 2018 have we seen states begin to find the overdose issue critical. Certainly, the states went after pill mills earlier, supply was diminished. But overdose remained and increased with illicit drug deaths. Supply is only one part of this complex equation. Pain is real. I return to that again and again. That means that the solution to overdose and the solution to pain must remain co-joined. There must be alternatives for pain, whether in the form of alternative medications, yoga, bio-feedback, psychosocial conditioning, or otherwise. There must be compassion for the condition and perceptions of pain, even among acceptance of the inappropriateness of over-medicating with addictive and delitreious substances. There is a perception of the Pandora's Paradox here.

We have a population of people in pain, acute or chronic. And, as a system we must address dealing with that pain. Within this is the realization that pain is a perception of our brains. The human body experiences pain, but our brains interpret that bodily perception. Thus, there is arguably a psychological component to many or perhaps most traumatic injuries. Yet, as a system, workers' compensation has been reluctant to engage psychology. There has been resistance because of the subjective nature of mental health. There is no x-ray, conduction study, or similar for the diagnosis of either existence or extent of psychological condition. How we cope or perceive is personal and is subjective. Thus, there is a perception that disputes regarding psychological injury or condition devolve to wearing matches between hired experts. Thus, the Pandora reference. Some believe that the condition must be addressed psychologically or at least psycho-socially. Others fear that starting down that path leads to greater disability allegations and dysfunction. Without addressing the emotional aspect of pain and dysfunction it is possible we can never improve it, but there is also the potential that by addressing it practitioners would (seemingly) create dysfunction.