December 25, 2017 by
The Boomtown festival is continuing its campaign on drug awareness with the release of a new short documentary on the subject. The film looks at various drug issues, and the steps taken at this year’s festival to improve safety. As previously reported, Boomtown was one of a number of festivals this year to offer free drug testing, via not for profit organisation The Loop, so that festival-goers could find out what drugs they had specifically acquired. The event agreed to increased security on site in order to be allowed to have the drug testing service in place, and also dedicated a section of its website to raising awareness of current dangerous drug trends at festivals. Among those to appear in the new documentary are director of The Loop Fiona Measham, Chill Welfare’s Katy MacLeod, Ed Morrow from Royal Society Of Public Health, musician Beans On Toast, and the family of Ellie Rowe, who died after taking ketamine at the 2013 edition of Boomtown. Activities such as this to raise awareness are extremely important right now, says Measham: “In the UK drug related deaths are at their highest rates on record, ever. This isn’t just a problem for Boomtown or just for festivals, this is the situation right across the country”. Meanwhile Boomtown Creative Director Lak Mitchell says of initiatives like those implemented at the festival this year: “It feels like a huge evolution in the festival world, all of a sudden things are stepping up and we’re progressing. We’d like to use the festival platform to introduce these new harm reduction services and ways of bringing public safety and education towards drugs [to the forefront]”. Services provided by The Loop and Chill Welfare contributed to a 25% reduction of drug-related cases at Boomtown medical facilities this year. Watch the film here: By Andy Malt

December 26, 2017 by
Claire's is pulling makeup that tested positive for asbestos.  Makeup was pulled from jewelry and accessory retailer Claire's after some brands tested positive for asbestos. The company tweeted on Dec. 23 it was pulling the suspected toxic products off its shelves, and said it was beginning an "immediate investigation into the alleged issues." The reports came out of Rhode Island's WJAR after a mom who was concerned about what was being used in her daughter's makeup sent several makeup items to an independent lab.  Test results from the lab found tremolite asbestos in at least 17 makeup products purchased from different states. According to the U.S. Department of Labor's Occupational Safety and Health Administration, asbestos is a health hazard that has been linked to asbestosis, which produces a scar-like tissue in the lungs that can cause disability and death, and mesothelioma, a cancer that occurs in the lining of the lungs, abdomen and heart.  Claire's is a global brand that operates 3,400 stores in 47 countries, selling jewelry and accessories for children, teens and young women. It's been in business since 1974. By Annalise Knudson    

December 27, 2017 by
For a decade, Arizona-based Biological Resource Center persuaded dying Americans to donate their bodies to science. More than 5,000 did. Here’s what happened to thousands of them. Sam Kazemi stood over the old man’s corpse. Nearby lay pliers, a scalpel and a motorized saw designed to cut drywall and pipe. On a busy day, Kazemi might harvest body parts from five or six people who had donated their bodies to science. On this day in November 2013, the corpse before Kazemi typified the donors who gave their remains to his employer, Biological Resource Center. The man was a retired factory worker with a ninth-grade education. He had lived with his wife in a mobile home in Mohave Valley, Arizona, and had died six days earlier, aged 75. His name was Conrad Patrick. But after he died and his body was donated, Patrick became a commodity, known by the company’s initials and a number: BRC13112103. Reuters reviewed thousands of internal BRC records and confidential law enforcement documents containing profiles of Patrick and 2,280 other donors. The documents include invoices and inventories for thousands of body parts harvested from those people. They show how their bodies were dissected, which body parts were sent where, and why buyers obtained them. Kazemi helped cut up and package Patrick into seven pieces. BRC shipped Patrick’s left foot to a Chicago-area orthopedic lab. His left shoulder was sent to a Las Vegas company that holds surgical seminars. His head and his spine went to a project run by the U.S. Army. And Patrick’s “external reproductive organs” were sent to a local university. His right foot and left knee were placed in the company’s freezers, where they became part of BRC’s million-dollar inventory of flesh and bone. For more than a year, Reuters has examined America’s body trade, a little-known and virtually unregulated industry. These businesses, which call themselves non-transplant tissue banks, are also known as body brokers. The operations can resemble meat-packing plants. At BRC, body parts from heads to fingernails were harvested and sold. On Saturday mornings, Kazemi taught college students how to dismember cadavers in the company lab. He also starred in a grisly training video, demonstrating how to carve out a man’s spine using a motorized saw. The documents obtained by Reuters – along with dozens of interviews with investigators, former BRC workers and families of donors – offer an unparalleled look at how one of America’s major body brokers operated. The records, never before made public, also reveal how little the government or the donors themselves understood what was happening at the company, and show in graphic detail how a cadaver becomes a commodity. Sales invoices detail many of those transactions. For $607, BRC sold the liver of a public school janitor to a medical-device company. The torso of a retired bank manager, bought by a Swiss research institute, fetched $3,191. A large Midwestern healthcare system paid $65 for two femoral arteries, one from a church minister. And the lower legs of a union activist were purchased by a Minnesota product-development company for $350 each. For raw material, the industry relies in large part on people too poor to afford a funeral, offering to cremate a portion of each donated body for free. A Reuters analysis of BRC donor files from May 3, 2011 through January 20, 2014 confirmed how important the disadvantaged were to business. The vast majority of BRC donors came from neighborhoods where the median household income fell below the state average. Four out of five donors didn’t graduate from college, about twice the ratio of the country as a whole. Before brokers accept a body, they typically present the donor or next of kin with a consent form. These agreements are often written in technical language that many donors and relatives say they find hard to understand. The documents give brokers the right to dismember the dead, then sell or rent body parts to medical researchers and educators, often for hundreds or thousands of dollars. At BRC, a whole body sold for $5,893, records show. Since 2004, when a federal health panel unsuccessfully called on the U.S. government to regulate the industry, Reuters found that more than 2,357 body parts obtained by brokers from at least 1,638 people have ended up misused, abused or desecrated. Documents reviewed for this article indicate that those figures are vastly understated. The extent of BRC’s operation surprised even investigators who raided the Phoenix-based company in 2014. There, agents discovered 10 tons of frozen human remains – 1,755 total body parts that included 281 heads, 241 shoulders, 337 legs and 97 spines. Applying a state forfeiture law, authorities hauled away the contents of BRC’s freezers, filling 142 body bags. One bag held parts from at least 36 different people. The seizure was so large that officials struggled to properly handle the body parts. When plans to cremate the remains stalled, officials brought three walk-in freezers to a military base and stacked the body bags inside, one atop another. Parts from 851 different people remained in those freezers for almost three years before they were cremated. The raid on BRC was part of a broader federal probe into the suspected practices of one of its clients, Arthur Rathburn. A Detroit body broker, Rathburn has pleaded not guilty to charges of defrauding customers. During a 2013 search of Rathburn’s warehouse, federal agents found rotting body parts along with four preserved fetuses, confidential photographs reviewed by Reuters show. It is not clear how Rathburn acquired the fetuses or what he planned to do with them. He was indicted for allegedly selling diseased body parts without warning buyers. His trial is set for January. After the BRC raid, the company went out of business. Its founder and former owner, Stephen Gore, later pleaded guilty to fraud – not for selling body parts but for misleading customers by shipping them contaminated specimens. His punishment: probation. He is expected to testify at the Rathburn trial. Gore’s attorney, Clark Derrick, said Gore always tried to act in the best interests of his donors. “At some point the business grew exponentially, we became shorthanded, we cut some corners, and for that I apologize and make amends,” Derrick said on Gore’s behalf. PROFITING OFF THE POOR Gore housed his business in a 9,000-square-foot building once occupied by an insurance agency – a one-story facility near two interstate highways and the Phoenix airport. From 2005 until early 2014, court records show, BRC received about 5,000 human bodies and distributed more than 20,000 body parts. As Reuters reported last year, BRC also sold body parts to U.S. Army contractors for military experiments. A Pentagon spokeswoman said BRC provided the body parts “under false pretenses,” misleading the Army that consent had been secured for donors  to be used in destructive tests. Among the parts BRC sold for the Army experiments were the heads and spines of Conrad Patrick and Leon Small, a 71-year-old retiree who had once managed a furniture factory. On the consent forms Patrick and Small signed, each man checked a box stating that he did not wish to be used in military or destructive tests, records show. But just days after Patrick and Small died, a BRC employee called their widows and persuaded them to amend the forms so their husbands could be used by the military, according to recordings of the calls reviewed by Reuters. The widows said the calls came during a traumatic time. “I didn’t understand what they were talking about,” Dona Patrick said. “But I said ‘OK.’” Bodies or parts from at least 20 BRC donors were used without their consent in Army experiments, Reuters found. Parts from Small and Patrick, however, were not. The military halted testing when it learned of the raid at BRC. The shoulders of both men were sent to a for-profit surgical training company in Nevada. The widows, Karen Small and Dona Patrick, are among two dozen next of kin who said they were surprised to learn that BRC profited from a relative’s donated body. “They prey on people that have no money, that are poor, that have no insurance – like us,” Patrick said. Family members of some donors said BRC employees led them to believe body donation was regulated by federal and state authorities, and that selling body parts is illegal. Based on those pitches, the relatives said they believed the remains wouldn’t be sold. In truth, there are virtually no regulations on the body trade. “It’s a horrible thing,” Small said. “Sick.” In a statement to Reuters last year, Gore said his employees took “great care to ensure that donors and their families were well-informed about the processes.” Gore acknowledged at his sentencing that he relied on books and the Internet for instruction on how to handle the bodies he sold. “HOMEMADE HORROR MOVIE” In 2012, BRC hired lab technician Kazemi. He earned $21 an hour. Before joining the company, his resume shows, he spent the previous decade working as a real estate agent, a waiter at a Morton’s steakhouse and a manager for an Olive Garden restaurant. When he arrived at BRC, he was 35 and had just graduated from Arizona State University with a degree in kinesiology, the study of body movement. At ASU, he was a teaching assistant in an anatomy lab. In 2013, Kazemi starred in a BRC instructional video. It opens with a jarring title, punctuated for emphasis: “Stripped Cervical Spine!” The video begins with a close-up of Kazemi wearing a mask, gloves, goggles and a surgical gown. Then it pulls back to reveal a body face down on a table. The man’s shoulders and arms have already been sheared off. The head lolls from side to side until Kazemi holds it still. With a scalpel, he makes incisions along the neck and back, then peels away the man’s skin and scalp. About seven minutes into the video, Kazemi picks up a construction saw. “On this one,” he says of the cadaver, “we are using a sturdy, thicker 9-inch blade. You want to make sure that the blade is long enough to reach from ear to ear across the back.” In his interview with Reuters, Kazemi described the video as clinical and “not disrespectful to donors” in any way. It was meant for internal use only, he said. Kazemi also said he did not know how BRC acquired donors or where body parts were shipped. In hindsight, Kazemi said using a motorized saw was wrong because it cannot be cleaned well enough to avoid spreading diseases. “Would I do something like that now that I know better? No,” Kazemi said. “But at the time, that’s what was provided to me.” Two retired investigators for the Arizona attorney general said even veteran prosecutors recoiled when they viewed the 24-minute video. “It was like a homemade horror movie,” said Charles Loftus, the former assistant chief agent. ‘CHOP SHOP’: Matthew Parker, a former agent for the Arizona Attorney General’s Office, stands in front of the former headquarters of BRC. “It looked like a junkyard chop shop where they are just ripping things apart,” he said of a company-made video that shows a body being dismembered. “I couldn’t sleep at night after seeing that,” said Matthew Parker, another former agent who says he retired with a disability – post-traumatic stress disorder – related to his work on the case. “It looked like a junkyard chop shop where they are just ripping things apart.” INTERNING AT BRC Kazemi also spent Saturdays in BRC’s lab teaching college students about dissection. On one Saturday in late 2013, ASU junior Emily Glynn said she showed up for her first day at the lab. She was majoring in nutrition. “I was really surprised when I got the internship because I didn’t have any experience,” said Glynn, then 20. “Just went in the first day and learned things on the job.” That first day, under Kazemi’s direction, interns used pliers to remove fingernails from donors, Glynn recalled. “I don’t want to say it was barbaric, but it was weird,” she said. “One day, I found myself holding the hand of a 70-year-old woman and felt like I needed to apologize to her, to say, ‘I’m sorry.’” FINGERNAIL ORDER: A BRC document shows a company’s request for four fingernails from eight different donors. Neither Glynn nor Kazemi knew how the fingernails were used, they said, and Reuters could not locate invoices for that order. But the news agency did identify fingernails from 22 other donors that were sold by BRC. They went to a North Carolina bioengineering research company, SciKon Innovation. SciKon CEO Randy McClelland said he was unaware that BRC was raided by the FBI. He said his business helps companies study how products enter the bloodstream through fingernails. “Like new cosmetics that go on your skin,” he said. On another Saturday, Glynn said, Kazemi gathered the interns around the body of another elderly woman. “He says, ‘Emily, you’ve never cut off a head before, and everyone else has, so do you want to try?’” Glynn recalled. “And I’m, like, ‘OK.’” As she held the reciprocating saw, Glynn said, Kazemi steadied her grip. “It wasn’t a full-on chainsaw like you would see in a horror movie, but it was a smaller version,” Glynn said. “And then I just went for it. I was expecting lots of blood but there wasn’t much to it. It came right off,” she said of the woman’s head. Kazemi said he doesn’t remember helping an intern cut off a head or any other body parts. The Saturday sessions, he said, were more akin to lectures during which he showed interns various organs and other body parts. In her senior thesis, Glynn described her time at BRC differently. INTERN’S STORY: During an internship at Biological Resource Center, college student Emily Glynn wrote in her thesis that she “sutured dismembered legs using an oversized needle and twine, and decapitated an elderly woman with what looked and sounded like a chainsaw from Home Depot.”  “Over the course of the internship, I stripped subcutaneous fat from the vertebrae of a cervical spine, practiced performing cricothyrotomies (incisions to the throat), sutured dismembered legs using an oversized needle and twine, and decapitated an elderly woman with what looked and sounded like a chainsaw from Home Depot,” Glynn wrote in her thesis. “Not once did I receive formal training or instruction.” BODY PARTS TO MIDDLEMEN BRC’s customers were not always directly acquiring body parts from the broker for their own medical education, research or training programs. According to invoices, some customers were middlemen – brokers who resold or leased body parts originally donated to BRC. The consent forms gave BRC the discretion to choose its customers, but the forms did not state that body parts could be resold by third parties. In 2012 and 2013, BRC sold at least 961 body parts, including at least 224 human heads, to three such middlemen. One was Innoved Institute LLC, a Chicago-area medical lab provider that also supplies human body parts. Innoved was among BRC’s best customers. It received at least 32 shipments with 277 body parts. Innoved executives did not respond to requests for comment. Another was Rathburn, the Detroit-area broker facing trial next month. He received at least 26 heads from BRC. Rathburn’s lawyers did not respond to a request for comment. A third middleman was Biological Resource Center of Illinois, another Chicago-area broker. Better known as BRC-IL, it received at least 658 body parts from BRC. BRC-IL operated independently from BRC. But it was also raided by FBI agents as part of the federal probe into suspected fraud against donors and customers. No one has been charged with a crime in the BRC-IL matter, and executives there did not respond to requests for comment. One of the shoulders shipped to BRC-IL came from the body of Robert Louis DeRosier, a casino security employee. He died at age 64 after a long battle with diabetes. His widow, Tama DeRosier, lives in a mobile home park in Mohave Valley, Arizona. She said her husband donated his body hoping it might contribute to diabetes research. She did not expect anyone to make money selling his remains. FIGHTING DIABETES: Tama DeRosier holds a photo of her husband Robert. He donated his body to BRC in hopes that it might contribute to diabetes research. Instead, his remains were sold. “That’s morbid,” the widow said. “Greed is a terrible thing.” Russell Parker Jr, who helped care for his dying brother Todd, said he was surprised to learn from a reporter that BRC sold Todd’s right knee and offered to sell Todd’s head. Friends had recommended BRC, he said. And when the company returned his brother’s ashes, everything seemed “all on the up and up, very professional.” “Shame on BRC for showing such disrespect,” Parker said. “That’s so wrong. It’s like trafficking.” CONFUSED CONSENT The companion of one donor cited another area of confusion: BRC’s use of the term “tissue.” In sales pitches and on consent forms, body brokers commonly talk about retrieving tissue from donors. To the medical community, “tissue” means any part of the body – from an organ to a torso. But in interviews with Reuters, family members of some donors said they believed “tissue” meant only skin samples. Though BRC did sell skin, those sales represented just 2 percent of its business, invoices show. Maureen Krueger said her partner of 42 years, Fidel Silva, told a female hospice worker in his final days that he wished to be cremated. “And that’s when she brought it up: ‘Would you be interested in donating tissues?’” Krueger recalled. The way she understood it, Krueger said, a few skin samples would be removed for research purposes. In return, BRC would cremate Silva for free. Silva, a 69-year-old construction worker with a high school degree, peppered the hospice worker with questions. “He asked, ‘Well, are you sure? What are they going to do?’” Krueger said. “He wanted to know. And that’s when she assured him it was only body tissues, they only took samples, they didn’t remove any organs or parts or anything. It was just tissues. And that’s when Fidel agreed.” The conversation took place at the Hospice of Havasu in Arizona. Its executive director, Dan Mathews, said he could not discuss the matter due to patient-privacy laws. But he said the hospice, which offers its clients options to donate their bodies to science, “removed that company BRC from our list of providers” upon hearing it was under investigation. Internal BRC records show the body broker removed Silva’s head, and his right and left arms from shoulder to hand. Each was tagged with a tracking number and prepped for sale. “Wow,” Krueger said. “I didn’t really realize they could do all that. I mean, I didn’t understand that’s what would happen with Fidel at all.” BODY PARTS IN LIMBO After the raid of BRC by federal and state agents, the body parts seized by authorities remained in limbo for almost three years. Their fate, detailed in confidential state logs, sworn statements and photographs, has never been made public. Logistical problems began the day of the raid, said former agents Parker and Loftus. Authorities were stunned to find so much human flesh inside BRC, they said. “We expected two freezers and a few hundred pounds of body parts,” said Loftus, who’s now running for state representative. “Instead, we found 40 freezers with 10 tons of bodies and parts.” Agents entered in hazmat gear and took biopsies from each body part to preserve as evidence. Records show the agents then placed the 1,755 parts into 142 body bags. The bags were sent to 10 local funeral homes so the remains could be cremated. But records and interviews show that BRC and others for whom it was storing body parts objected to their destruction. They argued that the parts had a value of more than $1 million. The cremation plans were put on hold, but authorities soon faced a pressing problem, according to former agents Loftus and Parker. Funeral homes could refrigerate but not freeze the body parts, and the mortuaries began to complain that some of the parts were starting to thaw. As a solution, authorities obtained three walk-in industrial freezers and installed them at a military base used by the Arizona National Guard. Then, body bag by body bag, the mortuaries delivered the parts, and Loftus and Parker helped carry them into the freezers. In an interview, Parker recalled feeling body parts sloshing around inside the bags as he moved them. Some bags leaked blood that stained his pants and shoes. The experience led to his PTSD diagnosis, he said. “It’s not how you treat human beings, human remains,” Parker testified in a deposition as part of his PTSD claim. “You don’t throw them in a bunch of body bags and then throw them into a freezer like a pile of garbage.” The spokeswoman for the Arizona Attorney General’s Office said the body parts were kept for federal authorities “as evidence in ongoing criminal investigations and prosecutions across the country.” An FBI spokesman declined to comment. In February, after almost three years in the containers, the remains were cremated and returned to families that requested them, the state spokeswoman said. In response to the Gore case, the Arizona governor signed into law a bill that requires body brokers like BRC to be licensed and regularly inspected. The new law calls for brokers to follow a set of standards and to hire a medical doctor to supervise company practices. Although the law was adopted a year and a half ago, it has yet to be enforced: The state health department still must create specific rules for brokers. It isn’t clear when it will. Health department officials, said a spokeswoman, “do not have an anticipated date of completion at this time.” By John Shiffman, Reade Levinson and Brian Grow Read More: The Body Trade: Cashing in on the donated dead

December 27, 2017 by
Cuomo’s decision to legalize only cannabis extract, not the plant, leaves medical users in a gray zone More than twenty years after I first attempted to quell a migraine headache with a bong hit, I have become a card-carrying medical-marijuana user. Well, not exactly. This is New York State. You can’t get actual marijuana, only extracts. This makes it impossible to access what could be my best medical option, and significantly increases my costs — but at least it’s legal. I’ve suffered frequent, sometimes near-daily, migraines for almost forty years — virtually all of my adult life. I’ve learned to manage them fairly well with a combination of triptan migraine-abortion drugs, marijuana, prescription-opioid painkillers, and rest when I can get it. I’m pretty stoic about my migraines, and I can function when I have one, as long as people give me a little leeway for being spacey. But about once a month I get an incapacitating attack that sends me to bed with an ice pack and hydrocodone. Like the migraineur protagonist of the Nineties film π, I’ve tried myriad would-be remedies, with more side effects than success. So when the state added chronic pain to the list of qualifying conditions for medical marijuana at the end of last year, my doctor was quick to give me a recommendation. Once my doctor files her paperwork — under federal law, she can’t write a formal prescription — and I sign up on the New York State Department of Health website, a purple-striped ID card arrives in the mail. The dispensary I go to, one of four in the city, is on what was once a fairly notorious drug block, the “dubious business enterprise touches Skid Row” place where William Burroughs copped heroin in the late 1940s, and a flea market for Valium, Placidyl, and other repurposed psych meds in the Seventies and Eighties. It’s gentrified now. When I ring the bell at the dispensary, a security guard lets me into the small vestibule, then makes sure the outside door is locked behind me before opening the one that leads inside. The handful of patients are middle-aged to younger elderly, with a couple using canes or walkers. The dominant decorations are house-ad posters with slogans about “excellence” and “leadership,” giving the space a corporate New Age atmosphere. The cannabis culture has always been prone to self-aggrandizing mysticism, and now that marijuana is semi-legal and potentially quite profitable, this tendency has cross-fertilized with corporate mysticism, in which businesses do not merely purvey goods or sell services, they’re about “passion” and “empowerment.” On the other hand, the background music on a recent visit is Mazzy Star’s So Tonight That I Might See, one of my main migraine-soothing albums since the Nineties. As state law currently limits the permitted cannabis products to vaporizable extracts, tinctures, and capsules, there are only nine medications available, and they’re seriously expensive. A bottle of tincture with a 20:1 ratio of THC (the intoxicating ingredient in marijuana) to CBD (cannabidiol, nonintoxicating but widely believed to help with chronic pain and anxiety) costs $53 for about fifteen five-milligram doses. A bottle of high-CBD tincture costs the same. That’s a worse deal, because I’d use CBD more as a preventative than an acute pain reliever — taken once a day, it would cost $106 a month. A steel vaporizer pen for cannabis-oil extract is $110 — $10 for the device, $100 for each oil cartridge — or about $2 a toke. No health insurance policy in the state will pay for this. (The most that insurance companies are legally allowed to reimburse for is doctor’s visits that aren’t solely for a medical-marijuana recommendation.) It’s cash or debit card only, to avoid running afoul of federal money-laundering laws. In contrast, my $216 would get me close to twenty grams of high-quality U.S.-grown pot on the black market, and California’s largest dispensary advertises vaporizer cartridges for $25 to $50. California’s and Michigan’s medical-marijuana programs each offer patients many more options for medication, from myriad strains of cannabis to ganja-infused “edibles” to oil extracts advertised as containing more than 60 percent THC. Still, being on the program seems to have helped me. The frequency of my migraines has come down to one or two a week, and my painkiller consumption has declined proportionately, although there could be other reasons for that. The vaporized oil is potent and instantaneous. The THC tincture doesn’t feel as benevolently psychoactive as a home-baked pot cookie, but it’s not as harsh as Marinol, the synthetic THC that was for decades the only legal cannabinoid medication in the U.S. And it’s good to be legal, after having to be furtive about my marijuana use ever since I copped my first nickel bag on MacDougal Street as a teenager. I could even openly show my vaporizer pen to a fellow nascent geezer on the subway in Queens. The reason the New York program allows only extracts is that Governor Andrew Cuomo feared the optics of having the state authorize selling pot. But marijuana is not a pharmaceutical drug where doses can be measured in milligrams; it’s an herb, by nature more nebulous, and there are some theories that the constellation of different chemicals in it — cannabinoids, terpenes, and more — enhances its therapeutic effect. Cuomo, then, opted for a pseudo-scientific approach in which doses can be quantified, but the medicine may be less efficacious. He feared blurring the lines between medical and recreational use, so New York, like Minnesota and Pennsylvania, prohibits actual marijuana. California is the example those states are trying not to emulate. Its law, the first in the nation to allow the distribution of medical marijuana, treated the herb like a standard medicine, letting doctors recommend it for any condition they thought it would help treat. The problem was that a lot of dispensaries stretched that to “If you’ve got anything wrong with you, we’ll sell you weed,” marketing themselves with ads like “Home of the Five-Gram Eighth.” To be fair, until Barack Obama’s second term, the federal government treated any state or local efforts at regulation as a prospective conspiracy to traffic in a controlled substance. And while California is generally viewed as having the laxest law in the country, its ban on letting nonresidents get medical herb meant that when I got a screaming migraine in Oakland in 2010, I got tossed out of a dispensary the minute they saw my New York driver’s license. For what other medication are you not allowed to cross state lines? When I popped a nasty migraine on a previous trip to the Bay Area, I went to the emergency room and left with a prescription for codeine. The line between medical and recreational use can blur, however. If I have a migraine and, after my painkillers and herbs kick in, feel good enough to play bass along with slow, pain-exorcising 1960s soul tunes, is that because playing music is therapeutic, or because I’m just another weedhead/dopefiend musician? Some pot evangelists argue that “all marijuana use is medical.” As someone who’s both a medical and recreational user, I find that to be self-serving nonsense. There is a difference. If I’m not sick, I don’t want to have to put crutches under my ass to have the pleasure of getting high. The best way to handle marijuana as a genuine herbal medicine would be to do serious research on how to use it. Plenty of scientific and historical evidence has shown that it’s medically useful, but very little research has been done into which varieties and cultivars, what cannabinoid profiles, work best for specific ailments. What’s best for seizures? What’s best for pain? There has been a bit of research in Spain, Germany, and Israel, but next to none in the United States, where anecdotal feedback from patients is usually buried under marketing and folklore, and the commodity fetishism about strains of pot. There are also major legal and economic obstacles: Federal law says marijuana has “no valid medical use,” and the government maintains a near-total lock on the supply available for research. The Food and Drug Administration’s drug-approval process is expensive, its three-phase testing protocols costing millions of dollars. No pharmaceutical company is going to put that kind of money into research on a plant they can’t patent. The result: When I asked the pharmacist at the dispensary which formulation would be best for migraines, he said, “I really don’t know.” It would be nice to live in a society that treated medical marijuana like an actual medicine instead of as a grudgingly tolerated toxic taboo. by NICHOLAS MAVRAKI  

December 30, 2017 by
The move aims at making ambience of six government hospitals specialised on treating gas-tragedy victims more colourful and positive to fight depression among patients who have been suffering for last 33 years. Bhopal gas disaster survivors hold a protest rally in Bhopal. Over 150 artists, sculptors and potters came together to contribute their creations to hospitals that treat victims of 1984 Bhopal gas tragedy, in what is viewed as a real-life adaptation of O Henry’s short story, The Last Leaf. An initiative of Bhopal gas tragedy relief and rehabilitation department, the move aims at making the ambience of the hospitals more colourful and positive to fight depression among patients who have been suffering for last 33 years. Paintings of rising sun, blooming flowers, green trees, smiling faces and other modern arts will now adorn the six government hospitals that specialised in treating victims of the gas tragedy, one of the world’s biggest industrial disasters. These hospitals attend on an average 800 to 1000 patients of gas tragedy every day, department sources said. Already over 250 artistic creations have been put up in the hospitals. A deadly gas leak at the Union Carbide’s Bhopal plant killed over 3,000 people and maimed thousands of others more than three decades ago. “Whenever we think about Bhopal gas victims, black and white pictures of bodies, carcasses and debris come to our minds. We talked to the victims and found that the depression is one of the major causes behind their illness. They are still living under the shadow of trauma. So by improving facilities and ambience in the hospitals, we hope to make them feel better,” said Vishwas Sarang, gas relief and rehabilitation minister. Since the government did not have enough funds for the beautification of the hospitals, the department approached the artists for help, who enthusiastically donated their creations, the minister added. The artists are happy to be a part of the noble initiative. “We are feeling proud to be a part of this initiative. Nothing is better than healing a wound. Every artists try their best to bring a smile on the face of gas affected people,” said Devilal Patidar, a renowned artist from the city. Patients expectedly were delighted. “In the hospital, we have nothing to do except thinking about our incurable disease. But installation of paintings on the wall is soothing for our eyes,” said Salma Khan, 42, a patient admitted at Bhopal’s Kamla Nehru Hospital. “The Last Leaf”, published in 1907, is the story of an old artist who saves the life of a young artist, dying of pneumonia, by giving her the will to live though a painting. By Shruti Tomar   

December 30, 2017 by
The tax bill that passed last week made good on a host of Republican campaign promises. But it doesn’t even come close on one that almost every agrees is way overdue: Reducing the complexity of the tax code. Worse, the fact that the changes to personal income taxes expire in less than a decade, adds long-term uncertainty to all the complexity for millions of American taxpayers. Complexity and uncertainty, as you can guess, add friction to the economy (that’s been the GOP—and everyone else’s—argument for simplifying the tax code for decades). And ample research from the fields of cognitive psychology and behavioral economics shows, financial complexity, is literally taxing. It depletes our focus, especially our ability to comprehend and identify the best choices for our own personal situation. This occurs whether you’re talking about taxes or investing or mortgage paperwork and has nothing to do with intelligence. Recent research from neuroscientist Sam Barnett provides a glimpse inside the brain under strain, and demonstrates how increasing complexity degrades our ability to make sound decisions. When we struggle to understand financial issues, we actually suffer from cognitive fatigue. Then there’s the additional uncertainty and stress the tax bill add to the long-term, hard-to-alter financial decisions many people have already made. Big stuff, like what will my house be worth now that I can’t deduct the whole mortgage interest? Or how will I be able to afford my retirement community if the deductions I factored into my decision years ago disappear? I have no doubt tax lawyers will do what they always to, and find ways to make all of this work for the people who can afford top-notch advice. Heck, this may prompt millions of us to reorganize as a C-Corp. But that’s the point. Of all the promises the GOP Congress made, the one that may have had the largest, long-term impact on the country would have been finding a way to reduce complexity and uncertainty, not add to it. By Elizabeth Harris 

December 30, 2017 by
Erica Garner, daughter of Eric Garner, leads a march of people protesting the Staten Island, New York, grand jury’s decision not to indict a police officer involved in the July 2014 death of Eric Garner, in December 2014. Activist Erica Garner, the eldest daughter Eric Garner who died at the hands police in New York City, died Saturday after a major heart attack. Garner was 27. A representative of the family announced via Garner’s Twitter account that the heart attack over Christmas weekend left her with major brain damage, and later confirmed the activist death. The mother of two has become a prominent, fiery voice of the Black Lives Matter movement as well as in national and local politics, largely for her tireless pursuit of accountability and justice for police violence victims. Following the death of her father, Eric Garner, who was held in a fatal chokehold by a plainclothes NYPD officer on July 17, 2014, a grand jury declined to indict any of the officers involved in the encounter. Video footage captured on a bystander’s smartphone showed Garner’s father saying “I can’t breathe” several times as officers attempted to arrest him for allegedly selling loose cigarettes in Staten Island. His final words went on to become a rallying cry of the BLM movement. Erica Garner asks a question during a presidential election town hall at the University of South Carolina, in February 2016.  As of late December, it had been roughly 1,261 days since Eric Garner’s death — and no disciplinary action had been taken against Daniel Pantaleo, who remains employed with the New York Police Department. Under the Obama administration, the Justice Department opened a civil rights investigation into the officer’s conduct — but has yet to announce whether it will file criminal charges against Pantaleo. In June, the Garner family, their attorneys and veteran civil rights leader Rev. Al Sharpton met with Trump administration DOJ officials at a Brooklyn hotel to discuss progress in the case. When they emerged from the meeting, the family revealed that investigators could only relay that the case was still ongoing. True to her reputation, Erica Garner blasted politicians and law enforcement on Twitter over the years-long wait for resolution of her father’s case. The experience changed her outlook on equality in the U.S. justice system, Garner explained in a 2015 essay published by HuffPost. “I have opened my eyes. I have studied this snapshot in time and learned that my father will never get justice,” she wrote. “I only see blood. If we’re going to move forward, we need transparency. Police and elected officials cannot seriously hope to repair relationships with the community without it.” Garner’s near-constant advocacy efforts have not been in vain. In 2015, at the behest a coalition of New York families who lost a loved one to police violence, Gov. Andrew Cuomo signed an executive order that directs the state attorney general’s office to act as a special prosecutor to investigate officer-involved homicides. The order addresses activists’ concerns of whether local district attorneys, who routinely work with officers, can fairly prosecutor officers accused of misconduct. The Rev. Al Sharpton addresses the media alongside members of Eric Garner’s family after they met with Department of Justice on June 21. Even casual observers would be hard-pressed to find a day or week over the last three years when Erica Garner wasn’t pressing local and national politicians for accountability among law enforcement. For a while, Garner organized weekly rallies outside of the convenience store where her father encountered the officers. She has famously sparred with New York City Mayor Bill de Blasio, saying he had broken promises made to the family about transparency in her father’s case. In July 2016, she criticized ABC News producers over a town hall event on police violence and race relations that featured former President Barack Obama, after she was not allowed to pose “real and hard questions” to him for the TV broadcast. Patrisse Cullors, co-founder of the Black Lives Matter Global Network and founder of the Los Angeles-based social justice group Dignity and Power Now, recalled first meeting Garner at that event in Washington, D.C. “Many of us in the Movement for Black Lives were pretty pissed about how Obama let the police slide — and Erica Garner, pretty much in the last two minutes of the town hall, got up [and] left. She was yelling and was super courageous about how she confronted the president,” Cullors said in an interview with Mic. “I think Erica Garner is one of our heroes in this movement, and I’m so honored to be a part of this movement with her.” Garner was also among a handful of prominent BLM voices to endorse presidential candidates in 2016. She backed Vermont Sen. Bernie Sanders and recorded endorsement videos for the candidate. Garner often lent her support to other communities touched by police violence. The activist had recorded video messages to protesters in Baton Rouge, Louisiana, following the 2016 police shooting death of Alton Sterling and to youth in Baltimore, after the 2015 in-custody death of Freddie Gray. “While our friendship and camaraderie largely consisted of a mutual sharing of our online platforms, Erica never hesitated to use hers to magnify and bring awareness to systemic racism, structural inequalities and injustices wherever they may be,” Steve “B.I.K.O.” Thomas, a Virginia-based writer and organizer, who has followed Garner’s work since 2014, said in an interview. Erica leaves behind two children, including a three-month-old son; her mother, Esaw Snipes-Garner; her grandmother, Gwen Carr; and a host of other relatives. By Aaron Morrison

December 31, 2017 by
The White House honored World AIDS Day this month. The remaining members of the Presidential Advisory Council on H.I.V. and AIDS were dismissed this week.  The Trump administration this week dismissed the remaining members of a federal advisory council on H.I.V. and AIDS. The group’s executive director said the move was a common occurrence in new administrations, but others questioned that. Six members of the body, the Presidential Advisory Council on H.I.V. and AIDS, resigned this year in protest of President Trump. Kaye Hayes, the council’s executive director, confirmed in a statement on Friday that the remaining members had received a letter saying the administration was ending their appointments. “Changing the makeup of federal advisory committee members is a common occurrence during administration changes,” she said. She added that the Obama administration ended the appointments of members appointed by President George W. Bush “in order to bring in new voices,” noting that the dismissed members could apply to serve on a new council to be convened in 2018. Established by President Bill Clinton in 1995, the council can have up to 25 members who are appointed to four-year terms by the secretary of health and human services in consultation with the White House. Continue reading the main story RELATED COVERAGE FEATURE America’s Hidden H.I.V. EpidemicJUNE 6, 2017 Opinion Opinion My Struggle to Take Anti-H.I.V. MedicineSEPT. 21, 2017 Gabriel Maldonado, the chief executive of TruEvolution, an advocacy group for lesbian, gay, bisexual and transgender people and an H.I.V. and AIDS services organization, who was among those dismissed, said federal officials could have removed him and his colleagues when Mr. Trump was inaugurated or at one of the two meetings the council held this year. During those meetings, he said the council had voiced concerns over the Trump administration’s position on the Affordable Care Act, among other issues. Six members announced their departure in June. Writing in Newsweek, one of the former members, Scott A. Schoettes, who is counsel and H.I.V. project director at Lambda Legal, said that “the Trump administration has no strategy to address the ongoing H.I.V./AIDS epidemic, seeks zero input from experts to formulate H.I.V. policy, and — most concerning — pushes legislation that will harm people living with H.I.V. and halt or reverse important gains made in the fight against this disease.” Mr. Maldonado said he also found it strange that Mr. Trump issued an executive order in September continuing 32 advisory committees — including the council on H.I.V. and AIDS — whose operating authorities had been set to expire. That would have been an appropriate time to relieve the remaining members of their appointments, he said.  David Kilmnick, the president of the LGBT Network, criticized the dismissals. “We have finally made significant progress in trying to end the epidemic once and for all and the irrational and immature moves by Trump will only set us back,” he said in a statement. Patrick Sullivan, a professor of epidemiology at Emory University in Atlanta who studies H.I.V. prevention and was among the council members terminated, said the move came as a surprise, but added that he thought it was a “positive sign” that Mr. Trump had signed the executive order continuing the council. He urged the administration to formally affirm the National H.I.V./AIDS Strategy drawn up during the Obama administration, which he said would help ensure “we’re all pulling in the same direction toward a common goal.” The strategy’s basic premise is that everyone old enough to be sexually active should be tested for H.I.V. regularly, either as part of routine care or through special efforts. Everyone who tests positive should be put on triple-therapy treatment immediately and kept on it for life. It also recommends that anyone at high risk — gay men with many sexual partners, people who inject drugs, people whose regular partner is infected, and so on — should be offered pre-exposure prophylaxis, a daily antiretroviral pill that, if taken faithfully, reduces the chances of infection almost to zero. The domestic strategy on the disease is overseen by the director of National AIDS Policy, a White House post created by Mr. Clinton in 1993. The advisory council helps with that strategy. But since 1993 — around the time that antiretroviral triple-therapy cocktails turned H.I.V. infection from a death sentence into a dangerous but manageable illness — the White House job has been fairly low profile. Eleven people have held the post since 1993, none for more than three years. Mr. Trump has left the job vacant since January. By Matt Stevens and Daniel Victor

January 11, 2018 by
The move marks a dramatic change to the 50-year-old program. President Donald Trump and CMS Administrator Seema Verma.   The Trump administration is paving the road for states to design new eligibility requirements for Medicaid, including forcing many recipients to work, look for work, or volunteer in order to qualify for government health coverage. It’s a dramatic shift for the 50-year-old program. Under current law, eligibility for Medicaid is based almost entirely on income. But the Trump administration, after months of promises, is now telling states how they can introduce a new requirement that certain Medicaid recipients also work in order to receive health coverage through the program — a move that experts say is a significant departure from the program’s purpose of providing a safety net to Americans in or near poverty. “Conditioning Medicaid eligibility and coverage on work is a fundamental change to the 50-plus-year history of the Medicaid program,” MaryBeth Musumeci, who studies Medicaid at the Kaiser Family Foundation, told me. Right now, 10 states have proposals pending with the Trump administration to impose some kind of work or community engagement requirement, almost all of them led by Republican legislatures and governors. The Trump administration could move quickly to institute this kind of requirement in a substantial part of the country. The new guidance from the Centers for Medicare and Medicaid Services offers some parameters for these requirements. Certain populations — the elderly and pregnant women, for example — are expected to be exempt. States are expected to consider various activities, including volunteering and caregiving, to comply with these work requirements. They are also asked to account for high unemployment in some areas and to accommodate, in the midst of the opioid crisis, people in drug treatment. But in spite of the administration’s nods to these various vulnerable populations, critics said the guidance released Thursday did not actually provide sturdy guardrails to protect them. “It’s like the Wild West. Who knows what will come in the door?” Sara Rosenbaum, a George Washington University professor who has followed Medicaid policy for decades, said. “Everything is couched as ‘you could,’ ‘you might,’ ‘you should think about.’ It’s like winking and nodding throughout the whole thing. They are not saying, ‘These are the limits on what we’ll approve.’” Republicans argue that requiring work for Medicaid eligibility will lead to better health outcomes, because employment can be linked to improved health and help move people off Medicaid as they make more money. But many Medicaid recipients are already working. If they are not, then they are likely elderly, disabled, retired, sick, or caring for a loved one. These new bureaucratic hurdles could impede some Americans’ ability to access health insurance and the care they need. The Trump administration’s Medicaid work requirements, explained Republicans have long criticized the Affordable Care Act for expanding Medicaid eligibility to non-disabled adults without children, a move that has covered more than 15 million Americans in or near poverty. Though Congress failed to repeal the expansion, CMS Administrator Seema Verma has pledged to use her administrative authority to rein the program back in. Requiring work for non-disabled adults, particularly the expansion population, is central to the Trump administration’s vision of reshaping the Medicaid program as long as Congress is unable to act. “This policy is about helping people achieve the American dream,” Verma told reporters on Thursday. “People moving off of Medicaid is a good outcome because we hope that means they don’t need the program anymore.” States and the federal government jointly fund Medicaid, but states are responsible for running it. Work requirements cannot be imposed at a national level without congressional action, but states can propose a work requirement in a waiver, and the Trump administration can approve it. Most fundamentally, CMS urges states to target any work requirements for non-disabled working adults; pregnant women, the disabled, and the medically frail are expected to be exempt. However, experts questioned how ironclad that guardrail is, given that parts of the guidance released Thursday appear to only suggest, not mandate, that those populations should be excluded from any work requirements. “There is a breathtaking lack of guardrails. Basically almost anything goes,” Rosenbaum said. “There’s really nobody who’s exempt.” The Trump administration says that states should try to align any Medicaid work requirements with existing mandates for federal food stamps and cash welfare programs, which generally require 20 to 30 hours of work or related activity every week. Those programs also exclude pregnant women and the disabled. States are advised to consider a range of activities to fulfill the work requirements, including actual employment, job training, volunteering, or caregiving. CMS officials said states would have broad authority to decide what will actually be considered in compliance with their work requirements. The agency singled out the need to continue providing Medicaid coverage for people with opioid addictions, in the midst of a crisis killing 60,000 Americans every year, and urged states to consider drug treatment to be counted toward a work requirement. However, several experts noted that CMS will not be providing federal resources for states to administer their work requirements. The administration may be constrained by federal law, which requires Medicaid dollars to pay for actual health care, but the result nevertheless is that states could struggle to effectively implement their work requirements and any bureaucratic snafus could result in people who need and should qualify for Medicaid coverage losing it. “For a state to do this, it would take enormous resources, and they’re not going to put those in,” Judy Solomon, who follows Medicaid at the left-leaning Center on Budget and Policy Priorities, told me. “We know enough to know this can’t be implemented in a way that protects people. At the end of the day, it’s going to have people who need health care lose coverage.” Rosenbaum also warned about “the potential for enormous discrimination, really racial redlining.” She noted that CMS would allow states to account for local conditions, such as high unemployment in certain areas or other factors, to provide exemptions from a work requirement. Rural areas, more likely to be white, could have fewer job opportunities, less robust transportation, and fewer social support services, all things that might lead a state to provide an exemption from the work requirement. The result, intentional or not, is that black people on Medicaid — because they are more likely to live in urban areas, where those grounds for exemption are less likely to be found — could face a higher burden under these waivers. “All of these things are potentially much harder to come by in rural areas,” Rosenbaum said. “Because of the demographics, you could have situations where the populations required to work are disproportionately African-American.” Most Medicaid recipients already work or have good reason not to There is strong evidence that there is not a vast number of Medicaid enrollees who are avoiding work to stay on the program’s rolls. Research conducted by the University of Michigan and published last month in JAMA looks at the work status of people who enrolled in Medicaid after Michigan expanded the program under Obamacare. It stands out from other research because it’s based on interviews with enrollees, rather than on administrative data or other information. The big-picture takeaway is: Most Medicaid enrollees in Michigan were working already, unable to work, or at a point in their lives where they would not work (retired or a student). Almost three-fourths of the people in the study fell into those categories. Nearly half of the Michigan Medicaid enrollees were working. Another quarter were either unable to work or were retired, in school, or acting as a homemaker. State proposals to institute such a mandate usually make allowances for the Medicaid enrollees who are in school or have a disability that stops them from working. Only 27.6 percent were “out of work” — not working but would work. Those are the people who might be affected by a work requirement. Even within the “out of work” population, based on the Michigan survey, are people with real barriers to working — and who might benefit from having health insurance: Two-thirds said they had a chronic physical illness. 35 percent said they had been diagnosed with a mental illness. One-quarter said they had a physical or mental condition that interfered with their ability to function at least half of the time. “The question raised by these data for states is — is it worth the cost to screen and track enrollees when only a small minority isn’t working who are potentially able to work,” Dr. Renuka Tipirneni, lead author of the Michigan study, said in a statement. The findings in Michigan align with broader national surveys. The Kaiser Family Foundation found in 2015 that most Medicaid enrollees who might be expected to work were ill or disabled, retired, going to school, or taking care of their family. Not only do most Medicaid recipients who might be affected already work, but the new requirements could place an administrative burden on those people that could cause them to lose coverage, even if they are actually in compliance with the requirements. “Documenting compliance will often not be trivial, and even small hassle costs can discourage people from signing up for insurance coverage,” Matt Fiedler, who covers health care policy for the Brookings Institution, told me. “Higher hassle costs will likely cause meaningful reductions in Medicaid coverage even among people who are working.” Medicaid work requirements could soon be approved — and challenged CMS said that 10 states had submitted waivers requiring work or community engagement as a condition for Medicaid recipients. Some states, like Wisconsin and Kentucky, have proposed more robust changes, including drug-testing enrollees and requiring them to pay more out of pocket for their health care. The Washington Post reported, citing sources familiar with the process, that the first work requirement could be approved as soon as Friday, probably for Kentucky. Others could soon follow. But any approved waivers are expected to be swiftly met with legal challenges. The issue hinges on whether requiring Medicaid can be construed as furthering the goals of the Medicaid program, which contains no explicit reference to encouraging work. As the Post explained: “This is going to go to court the minute the first approval comes out,” predicted Matt Salo, executive director of the National Association of State Medicaid Directors, whose members reflect a spectrum of views about requiring work. The association Once CMS gives one state permission, “we would be looking very, very closely to the legal options,” said Leonardo Cuello, health policy director at the National Health Law Program. “It’s not a good idea, and it’s illegal.” Cuello said the argument that work promotes health is “totally contorted. . . . It’s a little like saying that rain causes clouds. It’s more that people [with Medicaid] get care, which helps them be healthy and makes them able to work.” In the call with reporters on Thursday, Verma defended work requirements as in compliance with the goals of the Medicaid program, asserting that CMS considered the proposals to be well within the administration’s discretion to approve. “As we know, there’s countless studies out there that show the link between having a job and positive health outcomes,” she said. Any legal challenge will focus on the particulars of a state’s proposal and the administration’s explanation for approving the waiver, Nicholas Bagley, a health law professor at the University of Michigan, told me. “The real devil will be in the details; it will be in the details of the plans that are submitted and in particular in the details of what CMS says in approving the waivers,” he said. “It’s a pretty flexible standard, and the courts are in general disinclined to second-guess an agency’s determination that a particular waiver will advance the program’s objectives or it’s a genuine test.” So the matter is not yet resolved. But the Trump administration has opened a major new front in the battle over Medicaid. By Dylan Scott

December 11, 2017 by
Under the banner of welfare reform, the administration is eyeing changes to health care, food stamps, housing and veterans programs. President Donald Trump is expected to sign the welfare executive order as soon as January, according to multiple administration officials. The Trump administration and Republicans in Congress are hoping to make the most sweeping changes to federal safety net programs in a generation, using legislation and executive actions to target recipients of food stamps, Medicaid and housing benefits. The White House is quietly preparing a sweeping executive order that would mandate a top-to-bottom review of the federal programs on which millions of poor Americans rely. And GOP lawmakers are in the early stages of crafting legislation that could make it more difficult to qualify for those programs. In the meantime, the Trump administration has already begun making policy shifts that could have major ramifications. Federal health officials are encouraging states to impose work requirements on able-bodied adults on Medicaid — a major philosophical shift that would treat the program as welfare, rather than health insurance. The Agriculture Department said last week that it would soon give states greater control over the food stamp program, potentially opening the door to drug testing or stricter work requirements on recipients of the $70 billion program long targeted by fiscal conservatives. Another initial move has already backfired — the Veterans Affairs Department announced it would redirect hundreds of millions of dollars from a program for homeless veterans to local VA centers, but it reversed course after fierce blowback from advocates. While candidate Donald Trump pledged to protect some safety net programs, conservatives have long wanted to devolve control of social programs to the states and impose stricter work and drug testing rules. Now that they control both ends of Pennsylvania Avenue, Republicans believe they have a once-in-a-generation opportunity to overhaul those programs, which they have long argued are wasteful, are too easily exploited and promote dependency. “People are taking advantage of the system and then other people aren't receiving what they really need to live, and we think it is very unfair to them,” Trump said in October. The president is expected to sign the welfare executive order as soon as January, according to multiple administration officials, with an eye toward making changes to health care, food stamps, housing and veterans programs, not just traditional welfare payments. To be sure, many of the changes are still in the talking stages, and it remains to be seen when and how they are actually implemented and at what political cost. And there remains internal debate in the administration over how to balance other priorities like an infrastructure bill. The White House's leading advocate for a welfare overhaul, Domestic Policy Council Deputy Director Paul Winfree, is slated to leave the administration on Friday, according to a person familiar with the move. But two administration officials said Winfree's departure won't hobble the welfare push, as the White House has already completed much of the groundwork on the issue. Defenders of the safety net programs, meanwhile, fear the effort could rob Americans — including many Trump voters — of a vital lifeline. “It would be a recipe for massively exacerbating poverty and inequality in America in violation of all of Trump’s campaign promises,” said Rebecca Vallas, managing director of the Center for American Progress’ poverty program. “The poor are under attack,” said National Community Reinvestment Coalition President John Taylor, who accused Republicans of “rigging the system” for the top 1 or 2 percent at the expense of the middle class and poor. “Most Americans, if they really understood what was going on, would not support it,” he said. Although the effort to reshape the country's welfare system is all but guaranteed to produce powerful political backlash, it appears to have broad backing from conservative congressional Republicans, who are already coordinating with the White House on a legislative agenda to complement expected executive actions. White House Domestic Policy Council staff, who are working closely with congressional Republicans on legislation, are slated to meet this week with House Ways and Means Committee and Senate Finance Committee staff. The exact provisions of the pending bill are unknown, but a conservative group closely aligned with lawmakers said Republicans intend to pass broadly focused legislation. “They’re thinking about welfare reform in a large, all-encompassing way, not a program way,” said Jason Turner, executive director of the Secretaries’ Innovation Group, a group of conservative officials who run state-level social programs and met with Ways and Means Committee Republicans on the Hill last week. Turner said he expects Republican leaders will seek to combine their ideas with House Speaker Paul Ryan’s vision in his “A Better Way” plan to create a “mega-idea” for reform with a focus on work. “In terms of scope, that is part of the discussions that we are having with the committees,” White House spokesman Raj Shah said. “We are still running options through the interagency process and consultations with Congress.” Ryan spokesman Doug Andres declined to offer more details, adding that Republicans would discuss the issue at their January retreat. In recent days, Ryan said he hopes to embark on entitlement and welfare reform next year. He has said entitlement reform — an overhaul of programs like Medicare and Medicaid that has been his priority since his days as Budget chairman — is essential for tackling the debt, which is set to surge by $1 trillion under the Republican tax reform bill, according to the Joint Committee on Taxation. “We have a welfare system that’s basically trapping people in poverty and effectively paying people not to work, and we’ve got to work on that,” he said in a recent radio interview. Democrats immediately pounced on Ryan’s comments. “Paul Ryan just admitted that after providing $1 trillion in tax breaks to the top 1% and large corporations, Republicans will try to cut Social Security, Medicare, Medicaid and help for the most vulnerable Americans,” Sen. Bernie Sanders (I-Vt.) wrote on Twitter. It is unclear whether Republicans will take aim at Medicare given Trump’s campaign promise not to touch it. Trump also promised not to cut Medicaid or Social Security, the latter of which is trickier for lawmakers to change because of procedural rules designed to protect the program. If Republicans steer clear of Medicare, they say they will need to cut deeper into programs like food stamps and Medicaid. Despite Trump’s campaign vow on Medicaid, the GOP already placed the health insurance program for the poor on the chopping block earlier this year as part of its failed push to repeal Obamacare, proposing to siphon nearly $800 billion from the program over a decade. With strong Democratic opposition a certainty, GOP leaders will need to rely on a budget tool that allows them to jam bills past their Democratic counterparts. That tactic, known as budget reconciliation, allowed Republicans to pursue their successful push on tax reform this year, as well as an unsuccessful one on health care. But unlocking reconciliation will require Republicans to almost unanimously agree to a budget blueprint — unity that took months of wrangling by GOP leaders this year even on their longtime priority of tax reform. That unity may be even more difficult to achieve in an election year. Ways and Means Chairman Kevin Brady (R-Texas) recently confirmed to a small group of D.C. conservatives that welfare reform would be the focus of the 2019 budget. But the reception wasn’t what he expected. Several people in attendance were shocked, according to one person familiar with the conversation — because they read it as Republicans abandoning their push for Obamacare repeal. “Not that we don't need welfare reform,” the person said. “But if you're looking to get something accomplished through 2018 and through the Senate, even on reconciliation, it’s hard to see how welfare is that policy.” But Rep. Rob Woodall (R-Ga.), a longtime Budget Committee member, told POLITICO last week that he’s leaning toward using the reconciliation process for welfare reform. “When we're using reconciliation instructions, we should deal with the hard stuff,” Woodall added. “The easy things, people have done already. What's left is hard, and it's hard when you're dealing with food stamp programs, for example.” On the executive side, the Trump administration is moving ahead on its own even before Republicans work out the details of their legislative push. Food stamp changes One of the biggest programs that could be in the administration’s cross hairs is food stamps, or the Supplemental Nutrition Assistance Program, a $70 billion program that helps one in eight Americans buy groceries each month. The Department of Agriculture has said it’s developing a policy that could make it easier for states to impose stricter work requirements or drug testing on recipients — things that states like Wisconsin and Florida have long tried to do, but have been blocked by either courts or USDA. On Tuesday, USDA issued a vague announcement highlighting the principles around encouraging self-sufficiency, pledging to give more flexibility and “local control” to states administering SNAP in the coming weeks. “SNAP was created to provide people with the help they need to feed themselves and their families, but it was not intended to be a permanent lifestyle,” said Agriculture Secretary Sonny Perdue. Many states already limit SNAP benefits to three months for able-bodied adults who don’t care for young children or an elderly parent, and who aren’t working or enrolled in a job training or volunteer program. Nearly half of all SNAP recipients are children. Handing over more control to states is loathed by Democrats and anti-hunger advocates who fear that Republicans will eventually try to block-grant SNAP, much like they did with the Temporary Assistance for Needy Families program during welfare reform in the 1990s — a change that led to a big drop in the rolls but, critics argue, didn’t actually reduce poverty. SNAP serves a vastly larger population than TANF and has been shown to reduce hunger and improve health outcomes. There’s also now renewed concern that more states could try to follow Wisconsin Gov. Scott Walker’s push to impose drug screening on all able-bodied adults who apply for SNAP, which critics argue stigmatizes the program and costs many times more than it will save taxpayers. Medicaid work requirements Work requirements are just one of several new coverage restrictions federal health officials are expected to grant to red states trying to reduce enrollment in a program that now covers one in five Americans. Other proposals include imposing higher costs on enrollees, and strict disenrollment penalties for not following certain rules. But work requirements have generated the most ire from Democrats and advocates for low-income people, who argue that they do nothing to advance Medicaid's core purpose of providing health coverage to the poor. Ten Republican-led states are seeking the Trump administration’s permission to require certain enrollees to work or participate in other job-related activities as a condition of receiving health coverage. The restrictions, which were repeatedly rejected by the Obama administration, are primarily targeted at low-income adults who gained coverage under Obamacare's expansion of Medicaid. Yet other red states that never implemented that expansion — including Kansas, Maine and Mississippi — are also interested. Top health officials have actively encouraged states to enact work rules, saying the proposals are designed to reduce government dependency as Medicaid has grown to cover able-bodied adults rather than primarily serving the disabled, pregnant women and children. "The thought that a program designed for our most vulnerable citizens should be used as a vehicle to serve working-age, able-bodied adults does not make sense," Centers for Medicare and Medicaid Services Administrator Seema Verma said in a November speech to state officials. Housing At the Department of Housing and Urban Development, Secretary Ben Carson has made clear his philosophy that welfare fosters dependency and has said government should be focused on the business of getting people out of public housing. HUD will be “significantly involved” in Trump’s welfare reform efforts, Carson told POLITICO. “Our objective is to empower people, to give people opportunity. “Housing and affordable housing is supposed to be something we provide for the elderly, the disabled and for work-able people. It should be a steppingstone toward self-sufficiency,” Carson said. “Obviously, that has not been the case for decades. We need to change that. But to change it, we need to be able to provide opportunities.” On Thursday, he launched his EnVision Center project, a multi-agency effort to create job training and educational opportunity hubs near public-assisted housing with the goal of self-sufficiency. HUD will track people using the center to see how many find long-term jobs, attain education and start a business. By ANDREW RESTUCCIA, SARAH FERRIS and HELENA BOTTEMILLER EVICH

December 13, 2017 by
Syndros is a Synthetic Version of Tetrahydrocannabinol (THC). Syndros is made by the same pharmaceutical company that opposed legalizing marijuana. The U.S. Drug Enforcement Administration has approved the synthetic drug dronabinol. The brand name for the drug is Syndros and is a synthetic version of tetrahydrocannabinol (THC) that comes in liquid form. The drug will be classified as a Schedule II controlled substance along with hydrocodone. Actual, natural THC, is still classified as a Schedule I drug, along with heroin and Fentanyl. Syndros is made by the same pharmaceutical company that opposed legalizing marijuana, Insys Therapeutics. Incidentally, the pharmaceutical company also makes Fentanyl. Dronabinol helps cancer patients going through chemotherapy by helping to reduce nausea and vomiting. It has also been prescribed to patients suffering from AIDS to increase appetites in people that can’t eat. The announcement was made public when it was quietly published on Nov. 22 in the government daily journal Federal Register. The DEA said in the announcement that the oral liquid Syndros would be in the Schedule II drug class, raising eyebrows because natural marijuana is still classified with heroin. Questions were immediately raised about why natural cannabis is illegal federally and classified as a Schedule I drug when there has never been an overdose of marijuana, while synthetic marijuana, which is responsible for rapid increases of overdoses, is now considered safer by the DEA. Medical marijuana is legal in Washington D.C. and 29 states, but it is still illegal on the federal level. The DEA response to questions raised was to blame the FDA, saying that “two commenters expressed concern that pharmaceutical companies are making a profit from approved drugs containing marijuana constituents. The DEA notes that FDA-approved products of oral solutions containing dronabinol (THC) have an approved medical use, whereas marijuana does not have an approved medical use and therefore remains in Schedule I.” The Food and Drug Administration granted approval for the drug’s application last summer. By