Pass a Drug Screen

Dealing with a Urine Drug Screen

Drug screens are essential to detect ongoing drug use or relapse to drug use. It’s kind of like using X-rays to detect growth of cancer. The earlier it’s detected, the better.

Addiction is a disease that convinces its sufferers to lie so that the addiction can continue. In the end, drug screens help people recover from addiction, and are also important tools to measure the success of current treatment. When used in the right way, drug screening really does help patients.

Sometimes drug screens are wrong. The usual drug test is a quick and relatively cheap screen for the most commonly used drugs. If that screen is positive, but the patient denies drug use, a second test can be done that is very accurate, called a GC/MS (gas chromatograph/mass spectrophotometer) Because this second test is expensive, most clinics either ask the patient to pay for it, or run these tests only where the first test shows an unexpected result. Each lab hired to do a clinic’s drug screens has different screening tests, and use different reagents (chemicals) to do the test. False positives can occur, most often for benzodiazepines and amphetamines.Fortunately, cocaine and marijuana screens rarely turn out to be in error.

Working at an opioid treatment center, I get questions frequently from patients who are concerned about their positive urine drug tests. Overall, the tests are pretty good, but false positives can, and do, occur. Every different lab tests the urine samples with different reagents, or chemicals, so the doctor at your opioid treatment center should know what can cause a false positive at your particular lab.

Cocaine and Marijuana

First, a little about cocaine. The test for cocaine is very specific. The only thing that causes a positive for cocaine is cocaine. Despite similarities in the name, Novocain and lidocaine don’t cause a drug test to be positive for cocaine. No, it can’t be absorbed through the skin enough to give a positive, and if you are so close to cocaine that you’re handling it, I would say that counts as a positive anyway. Yes, it can be absorbed through mucosal lining – oral, vaginal, rectal – and again, that’s a true positive.

Benzodiazepines (Valium/Xanax)

Benzodiazepines are a different story. I’ve worked at clinics where diphenhydramine (Benadryl) causes false positive results. That is, the patient didn’t take benzos, but the diphenhydramine made their test positive, so it looked like they are using benzos.

I tell patients to avoid diphenhydramine, which can be difficult, since it’s in most of the over the counter sleep aids. But diphenhydramine does interact with the metabolism of methadone, and needs to be avoided.

I had a patient test positive repeatedly for benzos, and she swore she wasn’t taking them. I believed her, and had her gather all the medications she had at home, prescription and over the counter. When we looked at them, she had a bottle of some kind of herbal stress-relief medication. On a hunch I asked her to stop this pill. Within two weeks her urine drug screen was negative.

So what should you do if you get a positive drug screen and you know you have not used the drug in question? First, talk with the doctor about all of your prescription and over the counter medications. Your doctor should already know which drugs may cause false positives for that particular lab’s test chemicals. You may want to ask your clinic to do a GC/MS on the urine drug test in question.

Also, consider herbal/health food pills as a source for the positive screen. Dietary supplements do not undergo FDA approval before being marketed, and can be sold without any evidence of effectiveness or safety, so there’s little oversight of these products. Some studies discovered that dietary supplements can have ingredients not listed on the label. (1) In the case of athletes who must take drug tests, some supplements have been shown to contain banned substances.

I have a patient who repeatedly tested positive on drug screens for benzodiazepines, and the GC/MS showed Valium. This mystified her, and she said she didn’t take any benzodiazepines. Only after stopping a dietary supplement advertised to help with anxiety did her drug screen turn negative. I’m convinced this herbal remedy either contained a benzo, or a substance that caused a positive for benzos. There’s no FDA oversight with these herbal remedies, so the contents may or may not actually be what’s listed on the label.

So if you are testing positive for benzos, and know you haven’t taken any, consider stopping any herbal medicines that you are taking.

Methadone and Suboxone

Many patients who are prescribed methadone or buprenorphine (better known to some as Suboxone) are concerned about their employment drug screens. Because of the stigma attached to opioid addiction and its treatment with methadone or buprenorphine, patients don’t want their employers to know about these medications, and thus about their history of addiction.

Most companies who do urine drug screening hire a Medical Review Officer (MRO), who is a doctor specifically trained to interpret drug screen results. This doctor is a middle man between the employer and the employee, and though this doctor may ask for medical information, and information about valid prescriptions, this doctor usually can’t tell the employer this personal information. The MRO reports the screen as positive or negative, depending on information given to her.

Most employment urine drug screens check for opiates, meaning naturally-occurring substances from the opium poppy, like codeine and morphine. Man-made opioids like methadone, buprenorphine, and fentanyl, to name a few, won’t show as opiates on these drug screens.

A few employers do drug screening that specifically checks for hydrocodone or oxycodone. This is infrequent. It’s rare for employers to screen for methadone, and they almost never screen for buprenorphine, unless the patient is a healthcare professional being monitored by a licensing agency. The screen for buprenorphine is pricey, so the only doctors who tend to screen for it regularly are the ones prescribing buprenorphine. These doctors want to make sure their patients are taking, not selling, their medication.

Does your Employer Need to Know?

Patients ask if they should tell their employer they are on methadone or buprenorphine. In general, that’s probably a bad idea, unless it’s a special situation. So long as you can do your job safely, your medical problems aren’t any of your boss’s business.

CDL’s and Other Special Circumstances

The only exceptions to this are if you work in a “safety sensitive” job. This includes medical professionals, transit workers, pilots, and the like. These jobs may require disclosure of medical issues to protect public safety. For example, to get a commercial driver’s license (CDL), you have to be free from illnesses which may cause a sudden loss of consciousness behind the wheel.

The Dept. of Transportation still says that if you are taking methadone for the treatment of addiction, you can’t be granted a CDL. However, most of the studies done on methadone-maintained patients shows their reflexes are the same as a person not on methadone, so there’s no real scientific reason for the DOT’s decision. (1, 3, 4)

Patients can be impaired, and unable to drive safely, if they have just started on methadone, haven’t become accustomed to it, or are on too high a dose. These patients shouldn’t be behind the wheel until they are stable, even in a car, let alone an 18-wheeler. Methadone patients are likely be impaired and unable to drive if they abuse benzodiazepines. They shouldn’t drive any kind of vehicle. Ditto for alcohol. (2, 5)

---

1. Baewert A, Gombas W, Schindler S, et.al., Influence of peak and trough levels of opioid maintenance therapy on driving aptitude, European Addiction Research 2007, 13(3),127-135. This study shows that methadone patients aren’t impaired at either peak or trough levels of methadone.

2. Bernard JP, Morland J et. al. Methadone and impairment in apprehended drivers. Addiction 2009; 104(3) 457-464. This is a study of 635 people who were apprehended for impaired driving who were found to have methadone in their system. Of the 635, only 10 had only methadone in their system. The degree of impairment didn’t correlate with methadone blood levels. Most people on methadone who had impaired driving were using more than just methadone.

3.Cheser G, Lemon J, Gomel M, Murphy G; Are the driving-related skills of clients in a methadone program affected by methadone? National Drug and Alcohol Research Centre, University of New South Wales, 30 Goodhope St., Paddington NSW 2010, Australia. This study compared results of skill performance tests and concluded that methadone clients aren’t impaired in their ability to perform complex tasks.

4.Dittert S, Naber D, Soyka M., Methadone substitution and ability to drive. Results of an experimental study. Nervenartz 1999; 70: 457-462. Patients on methadone substitution therapy did not show impaired driving ability.

5.Lenne MG, Dietze P, Rumbold GR, et.al. The effects of the opioid pharmacotherapies methadone, LAAM and buprenorphine, alone and in combination with alcohol on simulated driving. Drug Alcohol Dependence 2003; 72(3):271-278. This study found driving reaction times of patients on methadone and buprenorphine don’t differ significantly from non-medicated drivers; however, adding even a small amount of alcohol (.05%) did cause impairment.

Maughan RJ, Contamination of dietary supplements and positive drug tests in sports. Journal of Sports Science 2005; 23(9):883-9

https://janaburson.wordpress.com/2010/05/09/how-to-pass-a-urine-drug-screen/

https://janaburson.wordpress.com/2010/05/26/more-about-drug-screens/More About Drug Screens

https://janaburson.wordpress.com/2010/07/07/urine-drug-screens-for-methadone-and-suboxone-buprenorphine/

Please like & share:

Pass a Drug Screen

Chronic Pain Syndromes- Irritable Bowel Syndrome

What is Irritable bowel Syndrome?

Tens of millions of people suffer from irritable bowel syndrome (IBS), an enigmatic problem with no known cause and no effective remedy. Sometimes referred to as spastic colon, it affects 10% to 20% of otherwise healthy adults, most of them women. In the United States it accounts for as many as 3.5 million visits to physicians and 2.2 million prescriptions each year.

The symptoms include intermittent lower abdominal cramps and bloating accompanied by spells of diarrhea, sometimes alternating with constipation. The abdominal pain generally subsides after a bowel movement or after passing gas, but there is excessive mucus in the stool, and patients often feel that the rectum is not fully emptied.

Since IBS is easily confused with other diseases, including Crohn’s disease, ulcerative colitis, diverticula disease, and colorectal cancer, it is important for a person with these symptoms to consult a physician. The most common dietary recommendation is fiber to increase the stool’s bulk and speed it through the gastrointestinal tract. Drug therapy is often not very useful; the drugs most commonly used are anticholinergics and antispasmodics such as Bentyl (dicyclomine) and Imodium (loperamide).

What does the colon do?

The colon, which is about five feet long, connects the small intestine to the rectum and anus. The major function of the colon is to absorb water, nutrients, and salts from the partially digested food that enters from the small intestine. Two pints of liquid matter enter the colon from the small intestine each day. Stool volume is a third of a pint. The difference between the amount of fluid entering the colon from the small intestine and the amount of stool in the colon is what the colon absorbs each day.

Colon motility—the contraction of the colon muscles and the movement of its contents—is controlled by nerves, hormones, and impulses in the colon muscles. These contractions move the contents inside the colon toward the rectum. During this passage, water and nutrients are absorbed into the body, and what is left over is stool. A few times each day contractions push the stool down the colon, resulting in a bowel movement. However, if the muscles of the colon, sphincters, and pelvis do not contract in the right way, the contents inside the colon do not move correctly, resulting in abdominal pain, cramps, constipation, a sense of incomplete stool movement, or diarrhea.

As its name indicates, IBS is a syndrome—a combination of signs and symptoms. IBS has not been shown to lead to a serious disease, including cancer. Through the years, IBS has been called by many names, among them colitis, mucous colitis, spastic colon, or spastic bowel. However, no link has been established between IBS and inflammatory bowel diseases such as Crohn’s disease or ulcerative colitis.

The Causes of Irritable Bowel Syndrome:

There are many possible causes of IBS. For example, there may be a problem with muscles in the intestine, or the intestine may be more sensitive to stretching or movement. There is no problem with the structure of the intestine.

It is not clear why patients develop IBS, but in some instances, it occurs after an intestinal infection. It is called post-infectious IBS. There may also be other triggers.

Stress can worsen IBS. The colon is connected to the brain through nerves of the autonomic nervous system. These nerves become more active during times of stress, and can cause the intestines to squeeze or contract more. People with IBS may have a colon that is over-responsive to these nerves.

IBS can occur at any age, but it often begins in adolescence or early adulthood. It is more common in women. About one in six people in the U.S. have symptoms of IBS. It is the most common intestinal complaint for which patients are referred to a gastroenterologist.

Symptoms of Irritable Bowel Syndrome:

Symptoms range from mild to severe. Most people have mild symptoms. Symptoms vary from person to person.  Abdominal pain, fullness, gas, and bloating that have been present for at least six months are the main symptoms of IBS. The pain and other symptoms will often:

• Occur after meals

• Come and go

• Be reduced or go away after a bowel movement

People with IBS may switch between constipation and diarrhea, or mostly have one or the other.

• People with diarrhea will have frequent, loose, watery stools. They will often have an urgent need to have a bowel movement, which is difficult to control.

• Those with constipation will have difficulty passing stool, as well as less frequent bowel movements. They will often need to strain and will feel cramping with a bowel movement. Often, they do not eliminate any stool, or only a small amount.

For some people, the symptoms may get worse for a few weeks or a month, and then decrease for a while. For other people, symptoms are present most of the time and may even slowly increase.

Irritable bowel syndrome is most likely a lifelong condition. For some people, symptoms are disabling and reduce the ability to work, travel, and attend social events. Symptoms can often be improved or relieved through treatment.

Bleeding, fever, weight loss, and persistent severe pain are not symptoms of IBS and may indicate other problems such as inflammation or, rarely, cancer.

What can Aggravate Irritable Bowel Syndrome?

The following have been associated with a worsening of IBS symptoms:

• large meals

• bloating from gas in the colon

• medicines

• wheat, rye, barley, chocolate, milk products, or alcohol

• drinks with caffeine, such as coffee, tea, or colas

• stress, conflict, or emotional upsets

Researchers have found that women with IBS may have more symptoms during their menstrual periods, suggesting that reproductive hormones can worsen IBS problems. In addition, people with IBS frequently suffer from depression and anxiety, which can worsen symptoms. Similarly, the symptoms associated with IBS can cause a person to feel depressed and anxious. Symtoms range from mild to severe. Most people have mild symptoms. Symptoms vary from person to person. People with IBS may also lose their appetite.

Irritable bowel syndrome (IBS, or spastic colon) is a diagnosis of exclusion. It is a functional bowel disorder characterized by chronic abdominal pain, discomfort, bloating, and alteration of bowel habits in the absence of any detectable organic cause. In some cases, the symptoms are relieved by bowel movements. Diarrhea or constipation may predominate, or they may alternate (classified as IBS-D, IBS-C or IBS-A, respectively). IBS may begin after an infection (post-infectious, IBS-PI), a stressful life event, or onset of maturity without any other medical indicators.

What can be confused with Irritable Bowel Syndrome?

Several conditions may present as IBS including celiac disease, fructose malabsorption, mild infections, parasitic infections (like giardiasis), several inflammatory bowel diseases, bile acid malabsorption, functional chronic constipation, and chronic functional abdominal pain. In IBS, routine clinical tests yield no abnormalities, although the bowels may be more sensitive to certain stimuli, such as balloon insufflating testing. The exact cause of IBS is unknown. The most common theory is that IBS is a disorder of the interaction between the brain and the gastrointestinal tract (brain-gut), although there may also be abnormalities in the gut flora or the immune system.

IBS does not lead to more serious conditions in most patients. However, it is a source of chronic pain, fatigue, and other symptoms and contributes to work absenteeism. Researchers have reported that the high prevalence of IBS, in conjunction with increased costs, produces a disease with a high social cost. It is also regarded as a chronic illness and can dramatically affect the quality of a sufferer’s life.

Can changes in diet help IBS?

For many people, careful eating reduces IBS symptoms. Before changing the diet, keep a journal noting the foods that seem to cause distress. Then discuss these findings with the doctor. A registered dietitian can help a person make changes to the diet. For instance, if dairy products cause symptoms to flare up, try eating less of those foods. A person might be able to tolerate yogurt better than other dairy products because it contains bacteria that supply the enzyme needed to digest lactose, the sugar found in milk products. Dairy products are an important source of calcium and other nutrients. If a person needs to avoid dairy products, adequate nutrients should be added in foods or supplements should be taken.

In many cases, dietary fiber may lessen IBS symptoms, particularly constipation. However, it may not help with lowering pain or decreasing diarrhea. Whole grain breads and cereals, fruits, and vegetables are good sources of fiber. High–fiber diets keep the colon mildly distended, which may help prevent spasms. Some forms of fiber keep water in the stool, thereby preventing hard stools that are difficult to pass. Doctors usually recommend a diet with enough fiber to produce soft, painless bowel movements. High–fiber diets may cause gas and bloating, although some people report that these symptoms go away within a few weeks. Increasing fiber intake by two to three grams per day will help reduce the risk of increased gas and bloating.

Drinking six to eight glasses of plain water a day is important, especially if a person has diarrhea. Drinking carbonated beverages, such as sodas, may result in gas and cause discomfort. Chewing gum and eating too quickly can lead to swallowing air, which also leads to gas.

Large meals can cause cramping and diarrhea, so eating smaller meals more often, or eating smaller portions, may help IBS symptoms. Eating meals that are low in fat and high in carbohydrates such as pasta; rice; whole–grain breads and cereals, unless a person has celiac disease; fruits; and vegetables may help.

How does stress affect IBS?

Stress—feeling mentally or emotionally tense, troubled, angry, or overwhelmed—can stimulate colon spasms in people with IBS. The colon has many nerves that connect it to the brain. Like the heart and the lungs, the colon is partly controlled by the autonomic nervous system, which responds to stress. These nerves control the normal contractions of the colon and cause abdominal discomfort at stressful times. People often experience cramps or “butterflies” when they are nervous or upset. In people with IBS, the colon can be overly responsive to even slight conflict or stress. Stress makes the mind more aware of the sensations that arise in the colon, making the person perceive these sensations as unpleasant.

Some evidence suggests that IBS is affected by the immune system, which fights infection in the body. The immune system is affected by stress. For all these reasons, stress management is an important part of treatment for IBS. Stress management options include:

 “The Psychology of Pain”

• stress reduction training and relaxation therapies such as meditation

• counseling and support

• regular exercise such as walking or yoga

• changes to the stressful situations in a person’s life

• adequate sleep

What is the treatment for IBS?

Unfortunately, many people suffer from IBS for a long time before seeking medical treatment. Up to seventy percent of people suffering from IBS are not receiving medical care for their symptoms. No cure has been found for IBS, but many options are available to treat the symptoms. The doctor will prescribe the best treatments for a person’s particular symptoms and encourage the person to manage stress and make dietary changes.

Medications are an important part of relieving symptoms. The doctor may suggest fiber supplements or laxatives for constipation or medicines to decrease diarrhea, such as diphenoxylate and atropine (Lomotil) or loperamide (Imodium). An antispasmodic is commonly prescribed, which helps control colon muscle spasms and reduce abdominal pain. Antidepressants may relieve some symptoms. However, both antispasmodics and antidepressants can worsen constipation, so some doctors will also prescribe medications that relax muscles in the bladder and intestines, such as belladonna alkaloid combinations and phenobarbital (Donnatal) and chlordiazepoxide and clidinium bromide (Librax). These medications contain a mild sedative, which can be habit forming, so they need to be used under the guidance of a physician.

With any medication, even over–the–counter medications such as laxatives and fiber supplements, it is important to follow the doctor’s instructions. Some people report a worsening in abdominal bloating and gas from increased fiber intake, and laxatives can be habit forming if they are used too frequently.

Medications affect people differently, and no one medication or combination of medications will work for everyone with IBS. Working with the doctor to find the best combination of medicine, diet, counseling, and support to control symptoms may be helpful.

Medical Marijuana has significant anti-spasmodic and pain relieving qualities and may be of help with the symptoms of irritable bowel.

Chronic Pain Syndromes- Irritable Bowel Syndrome

Chronic Pain Syndromes- Fibromyalgia

What is Fibromyalgia?

Fibromyalgia is a chronic pain syndrome characterized by widespread musculoskeletal pain, multiple tender points, and fatigue. ―Tender points refers to tenderness that is found in precise areas, particularly in the neck, spine, shoulders, and hips.

The 18 Trigger Points of Fibromyalgia

A person is considered to have fibromyalgia if they have widespread pain in combination with tenderness in at least 11 of 18 specific tender point sites, with these symptoms persisting for more than 3 months. People with this disorder may also experience other symptoms including sleep disturbances, morning stiffness, irritable bowel syndrome, and anxiety. Most patients with fibromyalgia describe their pain as ―aching all over, as if their muscles have been pulled or overworked.  Sometimes their muscles twitch and at other times they burn.

The majority of sufferers (90%) are women, diagnosed in their twenties and thirties, but the disorder has been found in people of all ages. Changes in weather, cold drafts, hormonal fluctuations (premenstrual and menopausal states), stress, depression, anxiety and over-exertion can all aggravate the condition and cause symptom flare-ups. Diagnosis is made by history and physical exam with your doctor. There is no blood test to diagnose fibromyalgia, but blood tests can be expected to rule out other causes of diffuse musculoskeletal pain.

Marijuana Rated Most Effective for Treating Fibromyalgia

The National Institutes of Health estimates that 5 million Americans suffer from fibromyalgia, a poorly understood disorder characterized by deep tissue pain, fatigue, headaches, depression, and lack of sleep. There is no known cure and the disorder is difficult to treat.  Medical marijuana is far more effective at treating symptoms of fibromyalgia than any of the three prescription drugs approved by the Food and Drug Administration to treat the disorder. That is one of the surprise findings in an online survey of over 1,300 fibromyalgia patients conducted by the National Pain Foundation and National Pain Report.

The FDA has approved only three drugs – Cymbalta, Lyrica and Savella — for the treatment of fibromyalgia. Although they generate billions of dollars in annual sales for Pfizer, Eli Lilly, Forest Laboratories and other drug makers, most who have tried the medications say they don’t work.  “Fibromyalgia is devastating for those who must live in its grip. There is much we do not understand. We need innovative ‘out of the box’ solutions that change the face of this disease,” said Dan Bennett, MD, an interventional spine and pain surgical physician in Denver, Colorado, who is chairman of the National Pain Foundation.  Many who responded to the survey said they had tried all three FDA approved drugs.

“The prescriptions that are available for treatment have more negative side effects than positive aspects,” said one fibromyalgia sufferer.  “I haven’t found anything! Please find a cure or at least a medicine that will take our pain away,” said another.  Asked to rate the effectiveness of Eli Lilly’s Cymbalta (Duloxetine), 60% of those who tried the drug said it did not work for them. Only 8% said it was very effective and 32% said it helps a little.  Among those who tried Pfizer’s Lyrica (Pregabalin), 61% said it did not work at all. Only 10% said it was very effective and 29% said it helps a little.  Asked to rate the effectiveness of Forest Laboratories’ Savella (Milnacipran), 68% of those who said they tried the drug said it didn’t work. Only 10% said it was very effective and 22% said it helps a little.

About 70% of the people who responded to the survey said they had not tried medical marijuana – which is not surprising given that it is still illegal in most states and many countries. But those who have tried marijuana said it was far more effective than any of the FDA-approved drugs.

Sixty-two percent who have tried cannabis said it was very effective at treating their fibromyalgia symptoms. Another 33% said it helped a little and only 5% said it did not help at all.

“I’ve found nothing that has worked for me, apart from marijuana,” said one survey respondent.  “Nothing but medical marijuana has made the greatest dent in the pain and mental problems,” said another.“Marijuana does help a LOT it numbs the pain. But it doesn’t last long and it makes your brain foggy,” wrote another fibromyalgia sufferer.

Survey respondents said massage, swimming, acupuncture, muscle relaxers and other alternative treatments also helped relieve their symptoms. Many said they take opioids to relieve their pain – although narcotic painkillers are generally not prescribed to treat fibromyalgia.

Other survey findings:

• Four out of ten (43%) fibromyalgia sufferers feel their physician is not knowledgeable about the disorder.


• Over a third (35%) feel their physician does not take their fibromyalgia seriously.
  
  45% feel their family and friends do not take their fibromyalgia seriously.


• Nearly half (49%) said their fibromyalgia symptoms began at a relatively young age (18-34).


• Only 11% were diagnosed with fibromyalgia within the first year of symptoms.


• 44% said it took five or more years before they were diagnosed with fibromyalgia.


• Many survey respondents lamented that the disorder had taken over their lives, leaving them socially isolated, fatigued and in constant pain.

“I was once an active person and have now virtually become a hermit due to this disease,” said one.  “The worst thing about having fibromyalgia is disappointing loved ones when I can’t do things with them,” wrote one fibromyalgia sufferer.  “Having fibromyalgia is a life sentence. One simply cannot have a productive life living with this disease,” said another.

The 1,339 people who participated in the survey were self-selected as fibromyalgia sufferers. Ninety-six percent of them were female.

This was the second online survey of pain patients conducted by the National Pain Foundation and National Pain Report. The first survey found that over half of patients worry that they are perceived as “drug addicts” by pharmacists. Eight out of ten said they had stopped seeing a doctor because they felt they were treated poorly.

Call Denali Healthcare 989-339-4464

We can help you!

Chronic Pain Syndromes- Fibromyalgia

Denali Article- PTSD and Medical Marijuana

http://ift.tt/15aqMx0

Dare Propaganda and School Drug Education

This was written in response to an article in the St. Ignance News.

Dr. Bob Townsend Discusses Drug Education in Schools

The article on drug education promotes what amounts to little more than anti-drug propaganda being taught in our schools. I actually have a daughter that, laughing her 14 year old head off, brought home an ‘educational quiz’ she received in class. I reviewed it and the ‘if you use marijuana your head will explode’ nonsense brought a sad smile to my face as well.

Your article correctly points out the DARE program, a blatant piece of propaganda from the ‘Just Say NO’ era and created by the same Los Angeles police chief that brought us Rodney King is no longer used. But then you go on to promote a local version called TEAM from the state police. I have experience with this program. I got a call from a patient in Gaylord once, a father dying of pancreatic cancer. His 11 year old came home from school after such a Trooper lead class, and announced she could no longer live with him because he was a ‘drug addict’ for legally using medical marijuana.

You missed the major point of the story. Ask the students. You are correct, they are exposed to medical marijuana in the home (and nice job demonizing your band director by the way). They view the programs with ridicule, because they have first hand experience that marijuana is not the civilization ending ‘Assassin of Youth’ these programs portray.

Drug Warrior Propaganda Leads to Lack of Respect for Authority

The real problem is one of the lack of respect for the police and teachers these programs generate. To have a state trooper- a servant of the people we are all raised to respect, come in and spew drug warrior propaganda leads to a lack of respect for the institution of law enforcement. Teenagers are not stupid. They can use the internet, and they can read. They know better, and to have a teacher or a police officer come in and outright lie to them not only lowers their respect for those that are responsible for molding their educations, but leads them to question not only the other ‘truths’ they are presented in school, but it erodes their respect for these hard working mentors.

If my 14 year old daughter is any example, the reason DARE failed is the message is viewed with ridicule and amusement by the students. Is that really the message we want to send our children? We want them to respect their bodies. We want them to avoid dangerous drugs like meth, cocaine and narcotics. We need to take a serious look at the message we are sending our children, like that 11 year old in Gaylord. Telling obvious lies about marijuana dilutes the serious warnings about crack cocaine.

Dr. Bob Townsend

Dare Propaganda and School Drug Education

Denali Article- The Forgotten Patients

http://ift.tt/12uJ9u1

Meet Dr. Bob Townsend

Follow Dr. Bob Townsend on Twitter @DrBobTownsend http://ift.tt/1zmTu52 Call 989-339-4464 for questions and appointments

Muskegon Office

Our Muskegon Office is open from 12:00pm to 5:00pm http://ift.tt/1DNz62R Call 989-339-4464 for questions and appointments

Denali Article- Atty Michael Komorn on Followup with Your Doctor

http://ift.tt/1FSWdXt

Michigan Medical Marijuana Cards with Denali

Get your Michigan Medical Marijuana Card with Denali Healthcare http://ift.tt/1CrnEXU Call 989-339-4464 and set up an appointment TODAY!

Gaylord Office - Physician

Our Gaylord offices ours are 11:00am to 5:00pm http://ift.tt/1Cl3Io0 Call 989-339-4464 for questions and appointments

Denali Article- Atty Dan Hartman on Medical Marijuana

http://ift.tt/1yU2Hor

Suboxone Treatment With Denali Healthcare

End your Dependency on Narcotics the Denali Way! http://ift.tt/1GXL7CY Call 989-339-4464 for questions and availability

Mt. Pleasant Office - Physician

Our Mt. Pleasant Office is open from 11:00am to 5:00pm http://ift.tt/1KMkdhc Call 989-339-4464 for questions and appointments

Denali Article- Suboxone v Methadone

http://ift.tt/1viqNn5

Denali Pain Management

Denali Healthcare Offers Marijuana Friendly Pain Management http://ift.tt/14WzcHq Call 989-339-4464 for Questions and Appointments

Saginaw Office - Physician

Our Saginaw Office is open from 11:00am to 5:00pm http://ift.tt/1ILK0dY Call 989-339-4464 for questions and appointments

Denali Article- Combining NSAID's and Narcotics

http://ift.tt/1y8HjfH

update your records

Time to Check You Expiration Date http://ift.tt/1Cq2n3O Do Your On Line Follow up

Marquette Office

Our Marquette office is open from 11:00am to 5:00pm http://ift.tt/1rMKvg6 Call 906-203-8087 for questions and appointments

Denali Article- Understanding the MMMA by Dan Hartman

http://ift.tt/1BT6YKn

Iron Mountain Clinic - Physician

Denali Healthcare Iron Mountain is an outreach clinic of our Marquette Office http://ift.tt/1El0LJR Call 906-203-8087 for questions and appointments

Denali Article- Dr. Bob's Blog

http://ift.tt/1IenxCo

Denali Article- 6 Qualities of Marijuna

http://ift.tt/1C35U4K

Denali Article- Denali Locations

http://ift.tt/14Gq7CZ

Marquette Office

Our Marquette office is open from 11:00am to 5:00pm http://ift.tt/1D830hL Call 906-203-8087 for questions and appointments

Denali Article- Suboxone Treatment for Loved Ones

http://ift.tt/1DIOuM8

Marijuana enforcement is far more lucrative than Marijuana Certification

I am Dr. ‘Bob’ Townsend and I run Denali Healthcare, a regional pain management clinic. I’m an advocate of medical marijuana and was one of many involved in the drafting of the ‘Bonafide Dr/Pt Relationship’ law that set the standards for medical marijuana certification in Michigan. While I have offices in Marquette and Gaylord, I have no business or practice interests in St. Ignace. I was asked to review and comment on this article by members of the MMMA Community as an expert on the subject.

Sheriff Strait makes a sweeping condemnation of medical marijuana saying that certifications were about making money rather than patient care. Taking into account he probably isn’t a doctor and has no medical training, I can say he has never sat a day with me and seen my patients. Or read the hundreds of followups I review every week where people talk about how cannabis changed their lives, how their cancers are in remission, and how they were able to stop narcotics. I am sure his experiences with the Medical Marihuana Act involved handcuffs, not actually listening to their stories or reviewing their charts.

He also didn’t mention anything about the 22 MILLION dollars his and other agencies in Michigan seized in civil forfeitures in 2012. Most of which involved drug cases and nearly all of those cases were related to marijuana. Keeping marijuana illegal is big business to law enforcement. It also helps to support lawyers, the courts and jails. A typical Section 8 defense is about 2 years long, costs around $15,000 to defend, and nearly as much more in prosecution, court and jail costs at taxpayer/defendant expense.

The law was clarified in 2012, and Standards put in Place for Certification

There were bad doctors, that is why in 2012 we developed the bonafide dr/pt relationship law. We put it in place to stop the ‘transient doctors’ in head shops, the low standard, no record clinics that were a minority of the good quality clinics that stepped up to certify patients whose primary doctors would not. And that is also why they had to reach back to the Butler-Jackson Appliance store case from 2011. Yes, they lifted the money quotes right from her summary suspension apparently forgot to mention the year it occurred, which was the sentence prior to the fees.

I am sure the ‘oversight’ about the year was not a deliberate attempt to mislead the readers. The fact that the ‘Bonafide Dr/Pt Relationship’ Act was the response to this incident and others was also not mentioned either. I am sure the fact the standards were fixed in 2012 was just another journalistic oversight and not meant to mislead the readers into thinking it was still the ‘wild west’ when it came to certifications.

Who supports Medical Marijuana?

In California, approximately 4% of the population has a medical marijuana card, and in Michigan, that number is about 1.5%. Bringing in immediate family and a wide circle of friends, this ‘marijuana interest group’ is maybe 25% of the population. Yet the Michigan Medical Marihuana Act was passed by over 63% of the voters in 2008, and passed in EVERY County in Michigan. Many of these voters were like my 75 year old mother- who like me has never touched the stuff.

We are literate people. We read the law, and we had a clear understanding of what we voted for. We expected that if we had a qualifying condition, we could go to our own doctors and simply get certified. Once certified, we would have access to cannabis, and the police and courts would leave us alone. We thought it might be a good alternative to pain medicine, and might help those traditional medicine fails- intractable seizures, fibromyalgia, cancer, etc.

The Voters were DUPED

Boy were all us voters duped. The law, which was designed to be very broad and give extensive protections to all but those clearly going outside its borders, has been fought tooth and nail by those whose economic interests or personal beliefs depend on the continued criminal status of cannabis. They seem quite upset that the law was broad, vague and designed to protect patients, as opposed to being very black and white and designed to aid their prosecutions of patients. Or drug crazed criminals using the Act to try and justify their use of marijuana to get high- or so they would like us to believe.

We were further duped into thinking we could just go to our doctors and get certified for a medical marijuana card. We didn’t count on our doctors’ employers mandating they not write a certification no matter how qualified the patients because there was a perceived ‘conflict’ between federal and state law. We didn’t count on doctors having no training in cannabis medicine, or simply not wanting to get involved with it for fear of being called a ‘pot doctor’. We didn’t count on being cut off our pain medications by ‘practice policy’ if we got a card. ‘Cannabis is a dangerous, addictive, gateway drug and I don’t want it in my practice, but I’ll be happy to refill your oxycontin and xanax.’.

Marijuana Enforcement

While I am not a lawyer, either is Sheriff Strait. He got to put out a ‘legal opinion’ so I guess I do as well. The Michigan Medical Marihuana Act is NOT in conflict with federal law. It simply says we will not prosecute patients for growing and using cannabis under Michigan Law, if they have a card. And by the way, in case you didn’t get the memo, the Federal Government has made its position clear. So long as the states are regulating marijuana, they will not interfere. So your ‘Federal Law’ point is moot. Actually, your ‘Federal Law’ point is just an excuse you are trying to use to continue your prosecution of legitimate medical marijuana patients, because you don’t like the law and it threatens your forfeiture money. But that is just my opinion on the ‘drug warrior’ mentality.

Education is Needed

What is needed is better education. We need physicians educated in cannabis medicine (there are thousands of excellent studies right on google). We need law enforcement educated on the Act, and remind them they don’t get to put their own spin on the laws they are charged with enforcing. We need patients better educated to stay safe and within the law. And finally, we need to change the attitudes of the courts to get them to stop putting cannabis in the same category as alcohol- a recreation substance, and put it where it belongs- as a medicine recommended by a doctor.

But above all, we need to stop the reefer madness fear mongering by those with a financial interest in keeping cannabis illegal and marijuana enforcement. Despite what law enforcement, prosecutors and some sitting judges seem to think, the main danger to society is not from cannabis, it is from the criminal justice system response to cannabis. Society does not want to make criminals out of people over a plant. Start listening to those that put you into office.

Dr. Bob

PS-  Note on Drug Warriors.

I am sure that many of those that support the ‘War on Drugs’ truly believe drugs are evil.  People are a product of their times and their belief system.  In the eye of history, things that made perfect sense at the time they occurred seem completely outrageous when viewed years later.  Will our children look at the narcotic tasks forces of today as we look at Big Jim McLain?

Here is a classic example, staring the ultimate red blooded American man of justice himself- the Duke….

U.S. House Un-American Activities Committee investigators Jim McLain and Mal Baxter attempt to break up a ring of Communist Party troublemakers in Hawaii (ignoring somewhat, as do their superiors in the Congress, that membership in the Communist Party was, at the time, legal in the U.S.)

The film has developed something of a cult following due to a perceivedly now-campy red scare theme. In some European markets the film was retitled as Marijuana and dispensed with the communist angle, making the villains drug dealers instead. This was achieved entirely through script changes and dubbing.

 

Marijuana enforcement is far more lucrative than Marijuana Certification

Denali Article- Response to Decriminalization

http://ift.tt/1tRf0wS

Gaylord Office - Physician

Our Gaylord offices ours are 11:00am to 5:00pm http://ift.tt/1tSwec3 Call 989-339-4464 for questions and appointments

Denali Article- Legally Get a Medical Marijuana Card in MI

http://ift.tt/1BHFc3y

Denali Article- Drug Testing Public Assistance

http://ift.tt/1HVjF9q

Denali Article- Medical Studies/PTSD

http://ift.tt/1BCTwu9

Denali Article- Guns and Marijuana

http://ift.tt/1BzEWnc

Cadillac Office

Our Cadillac Office hours are 11:00 am to 5:00pm http://ift.tt/1Cvl5rf Call 231-468-2945 for questions and appointments

Denali Article- 5 Ways to Manage Pain

http://ift.tt/1HLKHzK

Denali- Bonafide Relationship Pitfalls to Avoid

http://ift.tt/17gb2cr

Denali Article- Is CBD Only the Answer?

http://ift.tt/14pU6PA

Portage Office - Physician

Our Portage Office is open from 11:00am to 5:00pm http://ift.tt/1EAA3gl Call 269-366-5878 for questions and appointments

Dowagiac Clinic

Denali Healthcare Dowagiac is an outreach clinic of our Kalamazoo Office http://ift.tt/1zS9VKr Call (269) 216-7544 for questions and appointments

Denali Article- Cannabis is Medicine and MORE!

http://ift.tt/14a6XVe

Denali Article- Marijuana Reduces Crime

http://ift.tt/1xnRQU5

Denali Article- Living with Chronic Pain

http://ift.tt/1xEcUYe

Denali Article- Marijuana and Pain Management

http://ift.tt/1DeKl25

Denali Article- Cloning for Continual Harvest

http://ift.tt/1zIULn7

Muskegon Office

Our Muskegon Office is open from 12:00pm to 5:00pm http://ift.tt/1DNz62R Call 989-339-4464 for questions and appointments

Denali Article- Marijuana and PTSD

http://ift.tt/1xddcU1

Denali Article- Spider Mites

http://ift.tt/1x9wXfb

Gaylord Office - Physician

Our Gaylord offices ours are 11:00am to 5:00pm http://ift.tt/1Cl3Io0 Call 989-339-4464 for questions and appointments

Denali Article- Dangers of Decriminalization

http://ift.tt/1EObVrJ

Denali Article- Pruning for Yield and Space

http://ift.tt/1rAiLuM

Mt. Pleasant Office - Physician

Our Mt. Pleasant Office is open from 11:00am to 5:00pm http://ift.tt/1KMkdhc Call 989-339-4464 for questions and appointments

Denali Article- Guns and Marijuana

http://ift.tt/1DhgeZn

Denali Article- Patient/Caregiver Matching

http://ift.tt/1CxbqN6

Saginaw Office - Physician

Our Saginaw Office is open from 11:00am to 5:00pm http://ift.tt/1ILK0dY Call 989-339-4464 for questions and appointments

Denali Article- On line Followup

http://ift.tt/1zFW8qF

Denali Article- Methadone for Pain Management

http://ift.tt/1zeHUdw

Denali Article- The Leafly Strain Guide

http://ift.tt/1CHBi9t

Marquette Office

Our Marquette office is open from 11:00am to 5:00pm http://ift.tt/1rMKvg6 Call 906-203-8087 for questions and appointments

Denali Article- Marijuana Myths

http://ift.tt/191xJBZ

Denali Article- Brewing Compost Tea

http://ift.tt/1IfqSPL

Ironwood Clinic - Physician

Denali Healthcare Houghton is an outreach clinic of our Marquette Office http://ift.tt/1yRfSrT Call 906-203-8087 for questions and appointments

Denali Article- Our DrBobCertifications.com Website

http://ift.tt/1yd9o5q This is our secondary website devoted to our Michigan Medical Marijuana Clinics. A great website for mobile phone, it offers a strain guide and caregiver/patient matching service.

Houghton/Hancock Clinic - Physician

Denali Healthcare Houghton is an outreach clinic of our Marquette Office http://ift.tt/1wrm5c3 Call 906-203-8087 for questions and appointments

Denali Article- Michigan Compassion Clubs

http://ift.tt/1KCBgm0

Denali Article- PTSD and Medical Marijuana

http://ift.tt/15aqMx0

Marquette Office

Our Marquette office is open from 11:00am to 5:00pm http://ift.tt/1D830hL Call 906-203-8087 for questions and appointments

Denali Article- Marijuana and Epilepsy

http://ift.tt/1zhU6YZ

Meet Dr. Bob Townsend

Follow Dr. Bob Townsend on Twitter @DrBobTownsend http://ift.tt/1zmTu52 Call 989-339-4464 for questions and appointments

Gaylord Office - Physician

Our Gaylord offices ours are 11:00am to 5:00pm http://ift.tt/1tSwec3 Call 989-339-4464 for questions and appointments

Denali Article- Marijuana and Glaucoma

http://ift.tt/1wqd6TJ

Michigan Medical Marijuana Cards with Denali

Get your Michigan Medical Marijuana Card with Denali Healthcare http://ift.tt/1CrnEXU Call 989-339-4464 and set up an appointment TODAY!

Denali Article- Marijuana for Nausea

http://ift.tt/1xfEabX

Suboxone Treatment With Denali Healthcare

End your Dependency on Narcotics the Denali Way! http://ift.tt/1GXL7CY Call 989-339-4464 for questions and availability

Cadillac Office

Our Cadillac Office hours are 11:00 am to 5:00pm http://ift.tt/1Cvl5rf Call 989-339-4464 for questions and appointments

Denali Article- Caregiver Responsibilites

http://ift.tt/1zhrdg1

Oscoda Clinic

Our Gaylord offices ours are 11:00am to 5:00pm http://ift.tt/1wamP54 Call 989-339-4464 for questions and appointments

Denali Pain Management

Denali Healthcare Offers Marijuana Friendly Pain Management http://ift.tt/14WzcHq Call 989-339-4464 for Questions and Appointments

Omer Clinic

Our Saginaw Office is open from 11:00am to 5:00pm http://ift.tt/1IuKAtG Call 989-339-4464 for questions and appointments

Denali Article- Marijuana and Muscle Spasm

http://ift.tt/1wZjsOM

update your records

Time to Check You Expiration Date http://ift.tt/1Cq2n3O Do Your On Line Follow up

Portage Office - Physician

Our Portage Office is open from 11:00am to 5:00pm http://ift.tt/1EAA3gl Call 269-366-5878 for questions and appointments

Denali Article- Eric Vandussen Videos

http://ift.tt/1AP45rG

Denali Article- Dr. Bob's Blog

http://ift.tt/1IenxCo

Denali Article- Reefer Madness (in Color!)

http://ift.tt/1DXRt7l

Denali Article- Denali Locations

http://ift.tt/14Gq7CZ

Denali Article- Marijuana and CPS

http://ift.tt/1sRMf8q

Denali Article- Response to Decriminalization

http://ift.tt/1tRf0wS

Muskegon Office

Our Muskegon Office is open from 12:00pm to 5:00pm http://ift.tt/1w5vY0G Call 989-339-4464 for questions and appointments

Denali Article- Medical Marijuana and Pain

http://ift.tt/1sNXSx0

Denali Article- Drug Testing Public Assistance

http://ift.tt/1HVjF9q

Gaylord Office - Physician

Our Gaylord offices ours are 11:00am to 5:00pm http://ift.tt/1tSwec3 Call 989-339-4464 for questions and appointments

Denali Article- Endocanabinoids Part 1

http://ift.tt/1zz9R0V

Denali Article- Guns and Marijuana

http://ift.tt/1BzEWnc

Mt. Pleasant Office - Physician

Our Mt. Pleasant Office is open from 11:00am to 5:00pm http://ift.tt/1pTKcin Call 989-339-4464 for questions and appointments

Denali Article- Medical Marijuana and Wasting Syndrome

http://ift.tt/1BXyE24

Denali- Bonafide Relationship Pitfalls to Avoid

http://ift.tt/17gb2cr

Saginaw Office - Physician

Our Saginaw Office is open from 11:00am to 5:00pm http://ift.tt/1yCYXqy Call 989-339-4464 for questions and appointments

Denali Article- Hemp for Victory

http://ift.tt/1A2NVwm

Denali Article- Is CBD Only the Answer?

http://ift.tt/14pU6PA

Marquette Office

Our Marquette office is open from 11:00am to 5:00pm http://ift.tt/1rMKvg6 Call 906-203-8087 for questions and appointments

Denali Article- Weed with Sanjay Gupta

http://ift.tt/1ISD4sN

Iron Mountain Clinic - Physician

Denali Healthcare Iron Mountain is an outreach clinic of our Marquette Office http://ift.tt/1El0LJR Call 906-203-8087 for questions and appointments

Denali Article- Cannabis is Medicine and MORE!

http://ift.tt/14a6XVe

Denali Article- The MMMA

http://ift.tt/1wPhLW3

Denali Article- Living with Chronic Pain

http://ift.tt/1xEcUYe

Marquette Office

Our Marquette office is open from 11:00am to 5:00pm http://ift.tt/1rMKvg6 Call 906-203-8087 for questions and appointments

Denali Article- Run from the Cure/Rick Simpson

http://ift.tt/16i9TRb

Denali Article- Cloning for Continual Harvest

http://ift.tt/1zIULn7

Gaylord Office - Physician

Our Gaylord offices ours are 11:00am to 5:00pm http://ift.tt/1tSwec3 Call 989-339-4464 for questions and appointments

Denali Article- The Botany of Desire

http://ift.tt/1zXTdHD

Denali Article- Spider Mites

http://ift.tt/1x9wXfb

Denali Article- MMMA Original Model Compassion Club

http://ift.tt/1yBV7Ai

Denali Article- Pruning for Yield and Space

http://ift.tt/1rAiLuM

Cadillac Office

Our Cadillac Office hours are 11:00 am to 5:00pm http://ift.tt/1z6Dd6p Call 989-339-4464 for questions and appointments

Denali Article- Suboxone Program

http://ift.tt/1wfIc3J

Denali Article- Patient/Caregiver Matching

http://ift.tt/1CxbqN6

Denali Article- Prescription Overdose Leading Cause of Accidental Death

http://ift.tt/1ItQ3AY

Denali Article- The Leafly Strain Guide

http://ift.tt/1CHBi9t

Portage Office - Physician

Our Portage Office is open from 11:00am to 5:00pm http://ift.tt/1wpsTbV Call 269-366-5878 for questions and appointments

Denali Article- How does Narcotic Addiction Start?

http://ift.tt/12hhGMO

Dowagiac Clinic

Denali Healthcare Dowagiac is an outreach clinic of our Kalamazoo Office http://ift.tt/1zS9VKr Call (269) 216-7544 for questions and appointments

Denali Article- Our DrBobCertifications.com Website

http://ift.tt/1yd9o5q This is our secondary website devoted to our Michigan Medical Marijuana Clinics. A great website for mobile phone, it offers a strain guide and caregiver/patient matching service.

Denali Article- The History of Narcotics

http://ift.tt/12R9eF1

Denali Article- PTSD and Medical Marijuana

http://ift.tt/15aqMx0

Denali Article- The Forgotten Patients

http://ift.tt/12uJ9u1

Meet Dr. Bob Townsend

Follow Dr. Bob Townsend on Twitter @DrBobTownsend http://ift.tt/1zmTu52 Call 989-339-4464 for questions and appointments

Muskegon Office

Our Muskegon Office is open from 12:00pm to 5:00pm http://ift.tt/1w5vY0G Call 989-339-4464 for questions and appointments

Denali Article- Atty Michael Komorn on Followup with Your Doctor

http://ift.tt/1FSWdXt

Michigan Medical Marijuana Cards with Denali

Get your Michigan Medical Marijuana Card with Denali Healthcare http://ift.tt/1CrnEXU Call 989-339-4464 and set up an appointment TODAY!

Gaylord Office - Physician

Our Gaylord offices ours are 11:00am to 5:00pm http://ift.tt/1tSwec3 Call 989-339-4464 for questions and appointments

Denali Article- Atty Dan Hartman on Medical Marijuana

http://ift.tt/1yU2Hor

Suboxone Treatment With Denali Healthcare

End your Dependency on Narcotics the Denali Way! http://ift.tt/1GXL7CY Call 989-339-4464 for questions and availability

Mt. Pleasant Office - Physician

Our Mt. Pleasant Office is open from 11:00am to 5:00pm http://ift.tt/1pTKcin Call 989-339-4464 for questions and appointments

Denali Article- Suboxone v Methadone

http://ift.tt/1viqNn5

Denali Pain Management

Denali Healthcare Offers Marijuana Friendly Pain Management http://ift.tt/14WzcHq Call 989-339-4464 for Questions and Appointments

Saginaw Office - Physician

Our Saginaw Office is open from 11:00am to 5:00pm http://ift.tt/1yCYXqy Call 989-339-4464 for questions and appointments

Denali Article- Combining NSAID's and Narcotics

http://ift.tt/1y8HjfH

update your records

Time to Check You Expiration Date http://ift.tt/1Cq2n3O Do Your On Line Follow up

Marquette Office

Our Marquette office is open from 11:00am to 5:00pm http://ift.tt/1rMKvg6 Call 906-203-8087 for questions and appointments

Denali Article- Understanding the MMMA by Dan Hartman

http://ift.tt/1BT6YKn

Ironwood Clinic - Physician

Denali Healthcare Houghton is an outreach clinic of our Marquette Office http://ift.tt/1yRfSrT Call 906-203-8087 for questions and appointments

Denali Article- Dr. Bob's Blog

http://ift.tt/1IenxCo

Houghton/Hancock Clinic - Physician

Denali Healthcare Houghton is an outreach clinic of our Marquette Office http://ift.tt/1wrm5c3 Call 906-203-8087 for questions and appointments

Denali Article- 6 Qualities of Marijuna

http://ift.tt/1C35U4K

Denali Article- Denali Locations

http://ift.tt/14Gq7CZ

Marquette Office

Our Marquette office is open from 11:00am to 5:00pm http://ift.tt/1rMKvg6 Call 906-203-8087 for questions and appointments

Denali Article- Suboxone Treatment for Loved Ones

http://ift.tt/1DIOuM8

Denali Article- Response to Decriminalization

http://ift.tt/1tRf0wS

Gaylord Office - Physician

Our Gaylord offices ours are 11:00am to 5:00pm http://ift.tt/1tSwec3 Call 989-339-4464 for questions and appointments

Denali Article- Legally Get a Medical Marijuana Card in MI

http://ift.tt/1BHFc3y

Denali Article- Drug Testing Public Assistance

http://ift.tt/1HVjF9q

Denali Article- Medical Studies/PTSD

http://ift.tt/1BCTwu9

Denali Article- Guns and Marijuana

http://ift.tt/1BzEWnc

Cadillac Office

Our Cadillac Office hours are 11:00 am to 5:00pm http://ift.tt/1z6Dd6p Call 989-339-4464 for questions and appointments

Denali Article- 5 Ways to Manage Pain

http://ift.tt/1HLKHzK

Oscoda Clinic

Our Gaylord offices ours are 11:00am to 5:00pm http://ift.tt/1wamP54 Call 989-339-4464 for questions and appointments

Denali- Bonafide Relationship Pitfalls to Avoid

http://ift.tt/17gb2cr

Omer Clinic

Our Saginaw Office is open from 11:00am to 5:00pm http://ift.tt/1IuKAtG Call 989-339-4464 for questions and appointments

Denali Article- Methadone for Pain Management

http://ift.tt/1zeHUdw

Denali Article- Is CBD Only the Answer?

http://ift.tt/14pU6PA

Portage Office - Physician

Our Portage Office is open from 11:00am to 5:00pm http://ift.tt/1wpsTbV Call 269-366-5878 for questions and appointments

Denali Article- Brewing Compost Tea

http://ift.tt/1IfqSPL

Three Rivers Clinic

Denali Healthcare Three Rivers is an outreach clinic of our Kalamazoo Office http://ift.tt/1u4ZCwE Call 1 (269) 216-75447 for questions and appointments

Denali Article- Cannabis is Medicine and MORE!

http://ift.tt/14a6XVe

Denali Article- Marijuana Reduces Crime

http://ift.tt/1xnRQU5

Denali Article- Living with Chronic Pain

http://ift.tt/1xEcUYe

Denali Article- Marijuana and Pain Management

http://ift.tt/1DeKl25

Denali Article- Cloning for Continual Harvest

http://ift.tt/1zIULn7

Muskegon Office

Our Muskegon Office is open from 12:00pm to 5:00pm http://ift.tt/1w5vY0G Call 989-339-4464 for questions and appointments

Denali Article- Marijuana and PTSD

http://ift.tt/1xddcU1

Denali Article- Spider Mites

http://ift.tt/1x9wXfb

Gaylord Office - Physician

Our Gaylord offices ours are 11:00am to 5:00pm http://ift.tt/1tSwec3 Call 989-339-4464 for questions and appointments

Denali Article- Dangers of Decriminalization

http://ift.tt/1EObVrJ