South Carolina’s Senate gave preliminary approval to a medical marijuana legalization bill on Wednesday.
If the legislation clears a forthcoming third reading vote for final passage, which is expected on Thursday, it will formally proceed to the House of Representatives.
Senators, who spent weeks debating the legislation and considering dozens of proposed amendments, voted 28-15 on second reading passage Wednesday evening.
Gov. Henry McMaster (R) said earlier this week that it was too early to comment on the proposal, as changes were still being made by lawmakers. “This is one that’s going to depend on a lot of things,” he told a local FOX station, adding that he’ll wait to see the final version before deciding whether he would potentially sign or veto the bill if if were to arrive on his desk.
The Compassionate Care Act was prefiled in late 2020 and passed out of the Senate Medical Affairs Committee last March, but a lone senator blocked it from reaching the chamber floor in 2021. Since then, the bill’s sponsor, Sen. Tom Davis (R), has redoubled his efforts to get the bill across the finish line, arguing that South Carolina voters are ready what he’s repeatedly called “the most conservative medical cannabis bill in the country.”.
Davis said last month that House Speaker Jay Lucas (R) has agreed to “allow the bill to go through the House process” if it advances through the Senate, but a spokesperson for Lucas later told the Charleston Post and Courier that “Sen. Davis doesn’t speak for Speaker Lucas.”
Medical Cannabis Bill passes second reading in the South Carolina Senate with a vote of 28-15. Major step to passing this legislation. Congrats to Sen. Tom Davis for leading this compassionate effort. Proud to join you. pic.twitter.com/w0cBx97K3R
The bill, S. 150, in its current form would allow patients with qualifying conditions to possess and purchase cannabis products from licensed dispensaries. Smokable products, as well as home cultivation of cannabis by patients or their caretakers, would be forbidden. Merely possessing the plant form of cannabis could be punished as a misdemeanor.
While more qualifying conditions could be added in the future, the bill specifies cancer, multiple sclerosis, epilepsy and other neurological disorders, glaucoma, Crohn’s disease, sickle cell anemia, ulcerative colitis, cachexia or wasting syndrome, autism, nausea in homebound or end-of-life patients, muscle spasms and post-traumatic stress disorder (PTSD) provided a patient can establish they experienced one or more traumatic events. Patients diagnosed with less than one year to live could also qualify.
— Marijuana Moment is already tracking more than 1,000 cannabis, psychedelics and drug policy bills in state legislatures and Congress this year. Patreon supporters pledging at least $25/month get access to our interactive maps, charts and hearing calendar so they don’t miss any developments. Learn more about our marijuana bill tracker and become a supporter on Patreon to get access. —
The bill would also allow access among patients with “any chronic or debilitating disease or medical condition for which an opioid is currently or could be prescribed by a physician based on generally accepted standards of care,” for example severe or persistent pain.
Medical marijuana would be subject to the state’s 6 percent sales tax. Local governments were initially prohibited from adding further taxes of their own, but an amendment from Sen. Sandy Senn (R) removed that restriction.
Senators spent most of Tuesday and Wednesday’s floor sessions discussing dozens of amendments to the legislation, taking action on some while tabling or carrying over others.
Davis successfully urged rejection of some of the more hostile proposals, though he embraced other restrictions in the name of getting the bill passed. Under one amendment approved Tuesday with the sponsor’s support, for example, the medical marijuana law would sunset entirely at the end 2028. Lawmakers would have to take affirmative action for the program to continue into the next year.
Among other new restrictions adopted in amendments, senators altered the bill’s language around medical marijuana and driving to clarify that DUI laws still apply and add a provision that patients who refuse to submit to a blood test if suspected of impaired driving would lose their license for six months. It would also be a misdemeanor for patients and caretakers to have an open container of cannabis in a vehicle unless it’s in the trunk, glove compartment or other sealed section.
Further changes did away with dispensaries under the bill’s language and instead creating so-called cannabis pharmacies. The facilities would need to have a pharmacist on site at all times, and the South Carolina Board of Pharmacy would promulgate business regulations.
That sweeping amendment, which Davis eventually backed, also revised the bill such that only physicians could recommend cannabis, rather than physician assistants and some nurses as allowed in previous versions of the legislation. A later amendment specified that retired law enforcement, former military or another qualified agency provide security to cannabis pharmacies.
Other new restrictions say that doctors who recommend cannabis would need to independently verify the qualifying diagnosis with the patient’s treating physician, and that cannabis cultivation centers could not be multi-level facilities. People with felony-level drug convictions would also be prevented from participating in the new industry for a period of 10 years.
Another change, dubbed the South Carolina First amendment, would give in-state businesses extra points in the state’s cannabis licensing process in an effort to prioritize them over larger, multi-state businesses that supporters said might otherwise dominate the market. Yet another amendment would clarify that state-licensed cannabis businesses could obtain cannabis only from other in-state businesses.
Just adopted. “South Carolina First” Amendment would prioritize South Carolina businesses and farms over out-of-state competitors, giving them a better shot at the limited number of licenses that could be made available for those interested in entering the cannabis industry. pic.twitter.com/UeXZew5Rqt
Lawmakers held a lengthy debate on an amendment that would have replaced the main patient access provisions of the bill with a limited program of clinical trials on medical cannabis’s effects, but it was tabled. A revised version of the amendment was reintroduced later to create a complementary system of clinical trials that would exist alongside the general program, a change senators approved.
Other adopted changes adjusted the makeup of the program advisory board, removed qualified immunity for doctors who recommend cannabis, restricted certain shapes of edibles in an effort to reduce their appeal to children, required cannabis businesses require liability coverage of at least $1 million and mandate that the state annually publish details on qualified patients by age group and type of debilitating condition. Another prohibits members of the General Assembly who vote on the cannabis bill, as well as their direct family members, from owning or benefiting financially from a medical marijuana business.
Amendments to the bill made last year in committee, meanwhile, were formally adopted on the Senate floor late last month. Those made a number of small changes to the proposal, for example allowing visiting patients with medical marijuana cards from other states to access South Carolina dispensaries. Another clarified that legalization would not require health plans to cover cannabis.
Revenue allocation would also change slightly as the result of recent amendments. Under the amended bill, 75 percent of tax revenue after expenditures would go to the state’s general fund, with another 10 percent going to drug use disorder treatment service providers, 5 percent going to state law enforcement, and the remainder going to cannabis research and drug education.
For the initial rollout, regulators would approve 15 cannabis cultivators, 30 processing facilities, a cannabis pharmacy for every 20 pharmacies in the state, five testing laboratories and four cannabis transporters. The bill initially allowed state regulators to add other license types, but an amendment adopted Wednesday made it so only elected lawmakers could do that.
The bill initially allowed state regulators to add other license types, but an amendment adopted Wednesday made it so only elected lawmakers could do that.
Local governments could ban medical cannabis businesses from operating in their jurisdictions under the amended bill, but otherwise the it says that local land use and zoning burdens “should be no greater for a cannabis-based business than for any other similar business.”
After yrs of hard work & perseverance, we’ve finally gotten 2nd reading on our bipartisan Compassionate Care Act (med marijuana) tonight in the Senate. Vote was 28-15…a significant 1st step. Appreciate @SenTomDavisSC & all who worked w/us to reach this milestone.#Progress 💪🏾 pic.twitter.com/2hx8vnsSzZ
The state Department of Health and Environmental Control would oversee licensing and other regulations of the new industry. A newly established Medical Cannabis Advisory Board would be in charge of adding or removing qualifying conditions. Under amendments adopted this week, it would meet at least once per year and be led by a governor-appointed chairperson.
Davis has championed medical marijuana in South Carolina since 2014 and at a rally last week brought out a binder that he said contained eight years of research into the issue. He said he would use the information to “take on every single argument that has been raised in opposition to this bill, and I’m going to show that they cannot stand in the way of facts and evidence.”
He’s also continued to push back against opposition to cannabis legalization from his own party, for example calling out an attack ad that was paid for by the state GOP.
The state Republican organization separately slammed a federal legalization bill from U.S. Rep. Nancy Mace, a Republican who represents South Carolina in Congress. And last month cannabis opponents sent a mailer accusing Davis of wanting to turn the state into “one big pot party.”
A former White House chief of staff under President Donald Trump also recently calling out his home state South Carolina Republican Party for opposing the medical marijuana bill medical marijuana. Mick Mulvaney, Trump’s top aide for more than a year and a former congressman, called the legislation “something that merits discussion and reasoned analysis,” even if it’s not a proposal that is conventionally considered a conservative priority.
Davis referred to the maneuvers by his own party as “the elephant in the room” on the Senate floor as debate on the floor kicked off last week, saying he was offended by the misinformation and planned to rebut every misleading claim the group made.
“I’m going to go through every single legal argument that’s been put up there—lack of medical evidence, unintended social consequences—and take them all up and discuss them and refute them,” the senator said.
A poll released last February found that South Carolina voters support legalizing medical marijuana by a five-to-one ratio. But the state does not have a citizen-led initiative process that has empowered voters in other states to get the policy change enacted.
Support for medical marijuana legalization among South Carolina residents has been notably stable, as a 2018 Benchmark Research poll similarly found 72 percent support for the reform, including nearly two-thirds (63 percent) of Republicans. Davis said last year that if the legislature didn’t advance the reform, he’d propose a bill to put the question of medical marijuana legalization to voters through a referendum.
Also in 2018, 82 percent of voters in the state’s Democratic primary election voted in favor of medical cannabis legalization in a nonbinding ballot advisory vote.
Lawmakers prefiled four marijuana measures for the 2019 session, but they did not advance.
As debate on the bill kicked off in the Senate this session, Davis said that after years of effort, even seeing his bill advance to the chamber floor was a victory.
“If you pound at the door long enough, if you make your case, if the public is asking for something, the state Senate owes a debate,” he told the Charleston Post and Courier. “The people of South Carolina deserve to know where their elected officials stand on this issue.”
Congress Briefed On Federal Courts’ Diverging Opinions On Medical Marijuana Protection Rider
Photo courtesy of Mike Latimer.
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Heart disease is the leading cause of death in the U.S., according to the Centers for Disease Control and Prevention’s mortality data from 2020. And, February is American Heart Month, where the U.S. highlights the implications of heart disease.
On a global scale, cardiac arrest kills more people than the collective deaths caused by colorectal, breast and prostate cancer, influenza, pneumonia, automobile accidents, HIV, firearm incidents, and house fires combined, according to the American Heart Association.
Due to the hecticness of college life in which Penn State students need to focus on homework assignments, internships and independent living, many students said they pay minimal attention to their heart health.
For Kylie George, she said she hardly focuses on preventative measures to help her future health.
“I don’t think it’s something a lot of people really think about,” George (senior-English) said. “So I don’t think there’s a big effort made by a lot of people our age.”
However, she said students should improve their heart health awareness — in terms of how their actions consequently impact their bodies — and attempt to improve their daily behaviors.
“It’s never a bad thing to be aware of what you’re doing and how that can impact your overall health, especially your heart health,” George said. “It’s good to be aware now and be preventative — if at all possible — at our age because a lot of people get to [a] point when they’re older and say, ‘Oh, I wish I had done this and that when I was younger.’”
George said the main way she maintains her health is through her daily walks around campus to get from class to class.
Maintaining an active lifestyle can improve one’s heart health due to lowered blood pressure, improved blood circulation throughout the body and reduced stress levels, according to the American Heart Association.
Research from the University of Michigan Health highlights the benefits of consistent walking, since it’s a form of aerobic exercise.
“A lot of people our age do a lot of walking,” George said. “But that’s not even really by choice or done in an effort to be healthy.”
Since George lives a decent distance away from campus, she said she walks approximately 30 minutes each day to get on campus alone — not including the time it takes to travel to the necessary buildings.
Although participating in daily exercise for approximately 30 minutes to an hour a day aids people’s physical and mental well-being, a Johns Hopkins Medicine article said people should not solely rely on periods of exercise and instead increase their overall hourly activity.
In fact, Johns Hopkins Medicine said people’s health would benefit from less sedentary behavior as a whole.
To do this, the article said people should aim for 10,000 steps a day, five minutes of movement or activity per hour and a minimum of 30 minutes of vigorous exercise throughout the week.
According to a study by the National Center for Biotechnology Information, college students typically experience changes in their lifestyle that increase their risk for heart health issues, including cardiovascular disease.
The main lifestyle changes include a decline in activity levels and an increase in sedentary behavior — along with worsened sleep, eating patterns and stress levels.
A 2019 NCBI study found that decreased or poor sleep schedules increase students’ risks of being stressed, overweight and having higher blood pressure.
High blood pressure, without interference by medical professionals and lifestyle changes, can lead to increased risk for “heart disease, stroke, heart failure, kidney disease, pregnancy complications and cognitive decline,” according to the CDC.
Although George has never taken a first-aid or CPR course in the past, she said she finds the skills to be “very helpful” to know and may look into certification processes in the future.
Immediately performed CPR, which is a lifesaving procedure performed in times of emergency when a person’s heart stops beating, can “double or triple” the likelihood of survival following an incident of cardiac arrest, according to the AHA.
“It’s obviously a good tool to have, especially since so many of us are living with others and out taking care of ourselves without our parents to help with everything,” George said.
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Kareena Pandya, who currently serves on the diversity and health care task force within Penn State’s pre-medicine honor society Alpha Epsilon Delta, said people should begin considering their heart health early and learning how to approach heart issues.
Beyond taking personal measures to prevent heart disease, Pandya (freshman-genetics and developmental biology) said early access and certification in CPR is “super duper” important today because individuals can be better prepared for any situation that develops.
Pandya said Campus Recreation is an American Red Cross Authorized Provider for safety courses like American Red Cross Adult CPR/AED and First Aid, which teaches participants how to appropriately respond to emergencies regarding cardiac issues, breathing or general first aid.
“Before I got started, I thought it would take months [to learn CPR] and would be a long windy process to get certified [and] understand all the different nuances to the actual technique,” Pandya said. “But in reality, it actually only takes a couple hours to learn and perform.”
She said students and community members have an array of CPR certification resources available to them across campus — even through programs offered through Penn State’s Kinesiology Department.
“A lot of different demographic groups and ethnicity groups have different risk factors for heart disease compared to others,” Pandya said. “I think if you couple that with [the] lack of proper health care access that they have, then that can also contribute to heart health [outcomes] overall.”
For instance, Pandya said Indians are “three to 20 times at higher risk of developing heart disease compared to other demographics,” and she said other minoritized groups are also disproportionately affected.
“I would say a healthy heart is central to overall good health,” Pandya said. “Embracing a healthy lifestyle at any age — no matter if you’re a college student or older — can really help you in taking the preventative steps toward heart disease and lowering your risk for both heart attack and stroke.”
Pandya said college students go through a period of adjusting when transitioning to college life due to their new environment and routine, and these adjustments can create risks for heart disease.
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For instance, Pandya said some college students may struggle with maintaining proper sleep schedules, physical fitness regimes or dietary decisions — all of which can increase one’s risk for heart disease.
“Some major lifestyle choices that college students can make toward improving their heart health for the future would be decreasing their use of tobacco, cannabis and alcohol consumption,” Pandya said.
Pandya said exposure to secondhand smoke acts as a significant contributor toward coronary artery disease, which she described as a “very, very significant heart disease within our society.”
Beyond these limitations, Pandya said students could take preventative measures by monitoring their blood pressure levels and educating themselves about their family medical history, especially heart history, so they can “make better and more appropriate lifestyle changes.”
In terms of her own personal health, Pandya said she tries to complete physical activity at the on-campus gym at least twice a week and simply increases her fitness by walking to class rather than taking the bus.
When selecting meals at Penn State’s dining halls, Pandya said she keeps in mind Michelle Obama’s “MyPlate” dietary guidelines that help people balance their carbohydrates, proteins, vegetable, fruit and dairy intakes.
To maintain one’s health, many doctors promote healthy diets composed of “fruits, vegetables, whole grains, lean meats and low-fat dairy products,” according to the CDC.
Foods containing high levels of omega-3 fatty acids — which is commonly found in fish like salmon and tuna — also aids heart health, according to research conducted by the AHA.
Consumption of nuts like almonds, walnuts and pecans is known to lower one’s risk for cardiovascular disease due to the high amounts of healthy fats, proteins and fibers within the products, according to the AHA.
Although the costs of healthy food can limit some students’ purchases, Pandya said she’s found many dining locations on and off campus that provide reasonable heart-healthy food options, such as Roots Natural Kitchen and Playa Bowls.
She said the a la carte food locations within on-campus dining locations, such as Bowls @ South and In a Pickle, allow students to choose exactly what they will eat for the day — unlike the buffets where food is already prepared in its entirety.
Pandya said she especially enjoys eating at In a Pickle because she can choose how many vegetables are in her meal and whether she wants to use wheat or white bread, which are decisions that “help make sure you’re getting proper nutrition.”
After finishing a workout at the gym, Pandya said Shake Smart is another dining location that consistently offers healthy food options for the student body.
Since stress is a contributor to heart disease as well, Pandya said she attempts to minimize her anxiety by listening to music and participating in yoga, which helps “bring [her] back to [her] center.”
Pandya said students should consult with their primary care doctor about methods to improve and monitor their heart health if they’re interested in undergoing a lifestyle change.
Kelsey Eckerd, a student involved in Penn State’s chapter of the American Medical Student Association, said many factors impact heart health — some controllable and some not.
“I don’t think college students really think about heart health unless they have some sort of medical condition,” Eckerd (senior-biology) said.
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Nevertheless, Eckerd said college students can begin monitoring and considering how their daily behaviors affect their current and future health.
Eckerd said college students have access to a wide range of health-related programs and resources that they’ll likely never have access to later in life — at least not in such breadth.
“For college students, this is probably the only time in [their] life that [they] have access to a free gym and free workout classes, so take advantage of that while you’re here,” Eckerd said.
While attending Penn State, Eckerd said she utilizes the free workout classes at the Intramural Building to achieve her recommended amount of exercise each week.
Penn State also has the Nutrition Clinic that provides free, individual nutrition counseling provided by a registered dietitian, according to the Nutrition Clinic website.
“It’s easier to start a [healthy lifestyle] now rather than after you graduate and are truly on your own,” Eckerd said. “It’s easier to start with the safety net of college, that way when you’ve [graduated], you know how to do it yourself.”
She said an easy modification college students can make is being more aware of their alcohol consumption.
“Obviously it’s pretty characteristic to be a heavy drinker in college, but if that continues throughout your life, it could increase your heart rate and blood pressure over time,” Eckerd said.
A study conducted by the Harvard T.H. Chan School of Public Health discovered individuals who engage in binge-drinking behaviors were 72{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c} more likely to have a heart attack than their counterparts who didn’t participate in the behavior.
Eckerd said college students could also work to make their daily meals more nutritious by considering different add-ins or substitutions that could be made.
To enhance her dinners from Trader Joe’s, Eckerd said she adds her own proteins and vegetables into the frozen food products to make them more healthy.
Eckerd said students should also be aware of the training programs available to them.
Beyond CPR certification, Eckerd said students should look into automated external defibrillator training because AEDs provide users with “verbal cues” on what to do for the victim, and they’re required in every building.
Mariella Dixson, who is also a member of AMSA, said learning CPR and AED is “smart” because “you never know if you could be in an [emergency] situation,” and by learning basic medical protocols “you could be able to help someone.”
Dixson (senior-biobehavioral health) said choosing heart-healthy lifestyle choices while in college can make it easier to continue those behaviors at an older age.
“A lot of people will at least eat fruits and vegetables semi-regularly, so that’s better than nothing,” Dixson said. “There’s no point in doing cold turkey [diets] or jumping right into new routines because you’re not going to be consistent [with major adjustments].”
If students hope to implement heart-healthy behaviors into their lives, Dixson said they should make “attainable goals” that could slowly be met — like adding a certain amount of fruits or vegetables to one’s diet each week.
“A lot of college students — I’m sure — love pasta because it’s a very easy meal to make,” Dixson said. “But what I started doing was adding a bunch of cooked vegetables into my pasta dinners, [which] was a [simple] way to start adding in various vegetables to [my diet].”
Dixon said making small changes during young adulthood is essential.
“Establishing those patterns while you’re younger will most likely make it easier to continue [making heart-healthy decisions] when you get older and are more at risk for disease.”
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In September 2018, the Eastern Band of Cherokee Indians (EBCI) made it onto a list they probably would have preferred to avoid. The Office of National Drug Control Policy identified the Qualla Boundary, the Eastern Band’s 56,000-acre homeland just south of Smoky Mountains National Park, as one of 10 “high intensity drug trafficking areas” in the country.
Following a two-year undercover investigation targeting drug traffickers, federal, state and local law enforcement authorities raided the Boundary, arrested 132 people and seized an array of illegal drugs valued at $1.8 million, including heroin, fentanyl, methamphetamine, oxycodone and marijuana. The operation was touted as a huge success and a possible turning point in the scourge that had plagued the community.
“The arrest of these drug dealers is a critical step towards ensuring that the Eastern Band of Cherokee Indians is able to provide the healthy environment our people deserve,” Principal Chief Richard Sneed said in a DOJ press release in 2018.
Instead of improving, the community’s drug problems only got worse. Drug-related crimes and addiction rates continued apace and, like everywhere else in the state, grew worse during the pandemic. Statewide, deaths from drug overdoses increased more than 25 percent in the first six months of the pandemic, according to CDC data. Almost immediately, the lockdown on the Boundary led to a dramatic increase in fatal and non-fatal drug overdoses.
In a May 3, 2020 Facebook video, Sneed issued a warning to the drug dealers: “We’re coming for you,” he said. “It’s a never-ending battle. Every time we take a dealer down, every time there’s interdiction, every time there’s a seizure, that supply chain seems to just continue to keep rolling. [Y]ou’re killing our people, and I’m done. I’ve had it.”
Meanwhile, state officials and experts have continued to say that a criminal justice approach to the opioid crisis won’t solve it. Gov. Roy Cooper has repeatedly said that “we cannot arrest our way out of this problem.”
There is a growing acknowledgement among treatment and drug policy experts that real solutions must center around prevention and treatment which include mental health counseling, medication-assisted treatment (MAT), as well as the time and support needed to recover.
Almost in recognition of that reality, Sneed later added a comment to the video. “I ask for prayers for our tribal citizens who are struggling with addiction as well as their families. Please encourage [those suffering] to seek treatment, remind them that there is help, and there are people that care about them.”
Racial disparities persist
More than a decade ago, an analysis from Seattle’s Urban Indian Health Institute revealed that substance use rates are higher among American Indians compared to other racial and ethnic groups. A recent analysis in the North Carolina Medical Journal found a similar disparity in overdose rates in the state, as well.
This graph depicts the drug overdose death rate per 100,000 by population in North Carolina. Graph courtesy of NCDHHS’ Opioid and Substance Use Action Plan Data Dashboard
North Carolina has the largest American Indian population east of the Mississippi River; they represent just 1.2 percent of the overall population, according to the latest available data. However, in 2020, the drug overdose death rate was 2.3 times higher for American Indians than white people in North Carolina (75.4 and 32.7 per 100,000, respectively), according to the state’s Opioid and Substance Use Action Plan Data Dashboard.
“We really don’t understand why that is very well,” said Ronny Bell, a health equity researcher at Wake Forest School of Medicine. “In general, populations in rural communities are more likely to be impacted by this issue because you have more people in jobs that can result in injuries that can lead to pain. The eight tribal homelands are all in rural communities where there is an increased likelihood of being injured in the occupational settings and a lack of access to quality pain treatment.”
A history of trauma, violence, poverty, high unemployment, lack of health insurance and racism also contribute to an increased risk of addiction.
The disproportionate impact of the opioid crisis
Ronny Bell, Director of the Office of Cancer Health Equity at Wake Forest Baptist Comprehensive Cancer Center. Credit: Ronny Bell.
Western North Carolina has been hit particularly hard by opioids. Data from the state’s Opioid Addiction Dashboard found the five western North Carolina counties that include the Qualla Boundary had an average of 43.6 unintentional overdose deaths per 100,000 in 2020, compared to 29.7 statewide.
On the other side of the state, the overdose death rate was even higher in 2020 for Robeson County, at 64.3 per 100,000. About 45 percent of the Lumbee Tribe’s 55,000 members reside here. Significant numbers also live in Hoke, Cumberland and Scotland counties.
Erika Locklear oversees the Lumbee Tribe’s Medication-Assisted Treatment (MAT) support program and has witnessed a disturbing trend in the Lumbee community.
“The problem is getting much worse,” Locklear said. “COVID has been the biggest factor. When COVID first started, I don’t know if it was a fear factor or what, but things were getting a bit better. Then, after the first couple of months, the overdose rates just skyrocketed.”
Providing solutions
A huge billboard stands at the Boundary’s main entrance in Cherokee in Jackson County –
“Opiate Dependent Addiction Treatment. Confidential. Life Changing. Help.”
Two decades ago, tribal leaders recognized the need for robust substance use and mental health treatment services for its tribal members. As the only federally recognized tribe in the state, the Eastern Band of Cherokee Indians receives significant financial support from the federal government, including free healthcare for its members through the Indian Health Service (IHS).
However, per capita spending on the health of Native Americans is significantly less than for the general population. According to data from the Indian Health Service, the national average for fiscal year 2019 was $4,078 for AIs, compared to $9,726 overall for calendar year 2017.
That imbalance carries over to treatment for opioid use disorder, as well. As more people of color struggle with and die from opioid use disorder, the funding is still targeted at white people almost exclusively. A $54 million federal grant allowed North Carolina to provide treatment to 12,000 people. Despite being the population with the highest overdose rate, fewer than 1 percent of those who received care were American Indian.
Meanwhile, the Eastern Band of Cherokee Indians oversees and operates its own public health care system and provides some of the most extensive substance use and mental health care of any tribe in the nation without copays or deductibles.
Significant investments in its health and treatment services include an $80 million hospital and a $16 million, 20-bed adult residential treatment facility. The old hospital building is now a crisis stabilization unit for patients with mental health issues or who require detox services. In addition, there are certified addiction counselors, psychiatric social workers, clinical psychologists and a variety of related community-based support groups.
Doing more with less
The Eastern Band’s initiative is viewed as a model for the treatment of substance use disorder but it is not easy to duplicate, particularly for lower-wealth tribes like the Lumbee. The Lumbee is the largest tribe in North Carolina and east of the Mississippi River, but they still lack federal recognition and the health care funding that goes with that. And, unlike the Eastern Band, they don’t operate a casino that might provide them with revenue.
“The Lumbee tribe does have quite a few tribal members who are practicing physicians, physician assistants, and nurse practitioners,” Bell noted. “That is a benefit to many of the people from the community.”
Lumbee’s MAT program is funded by a three-year $1.5 million grant from the state Department of Health and Human Services. It provides services for 65 Lumbee tribe members each year. Locklear doesn’t have an exact number but estimates that they have served hundreds and referred many more to their partnering agency, Lumberton Treatment Center.
Eighty percent of the MAT patient population is male although there is no gender divide in substance use in the American Indian population.
“Based on data from the Injury and Violence Prevention Branch (of NC DHHS), the proportion of females who die from overdoses seems to be higher in the American Indian population,” said Bell.
In addition to providing buprenorphine on-site, methadone is available at the Lumberton Treatment Center. The free services include support group sessions and individual and group counseling sessions.
In their North Carolina Medical Journal article, Community-driven Approaches to Preventing Overdoses Among American Indians, Bell and the co-authors recommend providing culturally appropriate, community-driven treatment and social support services. The tribal-run MAT program uses a talking circle approach in their counseling sessions and holds smudging ceremonies, a traditional spiritual cleansing ritual process Locklear describes as like going to church on Sunday. There is also a lot of education about the cultural traditions and history of the Lumbee people.
“A lot of people have kind of moved away from that so I think it helps and it’s great that they developed this program,” Bell said.
As addiction rates and overdose deaths increase, the MAT program becomes more vital but the funding runs out at the end of the month.
Locklear says the tribal administration is looking for resources to keep it going as long as needed, which seems to be for the foreseeable future.
This story is part of a reporting fellowship on health care performance sponsored by the Association of Health Care Journalists and supported by The Commonwealth Fund.
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by Melba Newsome, North Carolina Health News February 9, 2022
OMAHA, Neb. (WOWT) – The pandemic is not over, COVID is still making its round in our community. Omaha will hit its fourth week of the temporary mask mandate tomorrow.
“We still continue to have people hospitalized in fact now there are 342 people hospitalized in the metro with COVID, and 14 of those are pediatric patients,” Douglas County Health Director Dr. Lindsay Huse said.
Dr. Huse did have some good news for county commissioners, reporting the number of COVID-19 cases in the county is on the decline.
“361 is where we are currently sitting at per hundred thousand for a seven-day total so we’re making wonderful progress in the right direction.”
Those numbers do show progress but do not meet the benchmark set by Dr. Huse to call off the mask mandate. The health director set 200 cases per 100,000 population as the goal. Right now, we are 161 cases off the mark.
But the hospitals are feeling some relief. Local hospital capacity numbers are decreasing, taking some pressure off of doctors and nurses.
“I can feel it at the institution I work to the beds are still full but it feels like the patients are able to get some of the care they need in most cases.”
Dr. Huse says another stipulation for ending the mask mandate would be a local hospital capacity of 85{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c} or less for a week. She also says capacity has been below the mark for three days.
“Our overall hospitalizations are also decreasing, our hospital capacity has been below 85{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c} for three days now so last night with the report that came out we were at 83{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c}, day before that I think was 84 so that also is going in the right direction.”
The second stipulation for repealing the mandate would be a local hospital capacity of 85{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c} or less for a week. Right now we’re below the level but have not reached a week.
Even with some of our COVID numbers on the decline, Dr. Huse warns COVID continues to spread throughout our community.
“Certainly we’re still seeing some severe illness out there we need to continue to be vigilant and be careful but happily we are perhaps getting a little bit of breathing room soon.”
Dr. Huse says Omaha’s mask mandate is currently under review and she could make an announcement concerning the mandate tomorrow.
Dr. Huse tells 6 News those numbers give us a picture of how COVID is moving throughout our community. She says it’s not perfect and depends on how many people are actually testing for COVID.
Last month COVID-19 hit the Douglas County Correctional Center hard. In January, the county lockup experienced an unprecedented number of staff missing work because of COVID.
Douglas County Correction Director Michael Myers told the Board of Commissioners, 95 members of the staff including himself missed work due to positive COVID cases in January.
Myers also reported 44 inmates tested positive for COVID last month, however, they expect the actual total was much higher.
“We continue to test symptomatic individuals and those who are going to court there is simply not enough resources both staff or testing supplies to test everyone in custody, we assume that many of the individuals housed in units with confirmed positive cases were also infected,” said Myers.
Myers says the high number of COVID cases among staff sparked an increase in overtime hours.
Watch Dr. Huse’s report to commissioners
Copyright 2022 WOWT. All rights reserved.
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LIVE: Dr. Lindsay Huse is giving her weekly update to the Douglas County Board of Commissioners.
Posted by WOWT 6 News on Tuesday, February 8, 2022
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FLINT – Claressa Shields may well have a exclusive visitor at her world championship struggle Saturday in Wales.
Shields put in some time late final months in Las Vegas schooling at Floyd Mayweather’s fitness center and the former planet champion claimed he’s likely to try and make the excursion across the Atlantic Ocean to watch her fight Ema Kozin.
“Plans might adjust but he explained he’d make a substantial effort to arrive to the combat in the Uk,” Shields mentioned this 7 days in an job interview with MLive. “It would be neat. He told me he watched my fights in the Olympics and he was proud of me and he’s joyful to arrive to the British isles and view me grow.
“Him coming will give me excess commitment and I’ll set on an even improved show.”
Shields (11–, 2 KOs) will be placing her WBC, WBA, IBF and WBF middleweight championships on the line as part of a pay-per-see card in Cardiff, Wales. The struggle versus Kozin (21–1, 11KOs) is a required title defense for Shields.
Even though in Vegas, the two-time Olympic gold medalist acquired a opportunity to decide the mind of Mayweather, who retired with a 50– record and 27 knockouts.
A native of Grand Rapids, Mayweather received 15 world championship belts in five fat classes. He won his last 26 globe championship fights.
“Floyd welcomed me to his health club when he realized I was coming to Vegas, opened up his fitness center to me,” Shields reported. “We acquired video and photos and stuff. It was neat, just striving to suck up some awareness from him … and some information about boxing.
“I feel like Mayweather produced a blue print in boxing for adult males to make tens of millions of bucks and I’m building a blue print for girls in boxing to make tens of millions of bucks.”
Mayweather was a funds device, creating $285 million in 2018, in accordance to Forbes Magazine. He was the optimum-compensated athlete in the entire world at the time.
Shields is not in that stratosphere – who is? – but she mentioned she’ll be making “seven figure” for her future two fights in the United Kingdom just after signing a two-fight offer with BOXXER to combat on Sky Sporting activities.
She stated when they spoke, Mayweather gave Shields some tips and suggestions on her profession.
“He gave me a great deal of knowledge about my capabilities and every thing,” claimed Shields, 26. “He informed me some thing that I presently realized, that with my punching ability and my skills and all the things, he said I require to relaxed down and the knockouts will arrive.
“But the absence of knockouts is not simply because I’m not solid or rapidly or qualified. It’s since I’m always so nervous. He gave me some guidelines on how to be quiet and go out there and see the shots and all that.”
As a professional, Shields has previously produced heritage – or HERstory, as her workforce calls it.
When she scored a unanimous final decision past March around Marie Eve Dicaire in Flint, she turned the 1st fighter – male or woman – to keep undisputed championships in two fat divisions.
In her former struggle towards Ivana Habazin in January 2020, she unified the middleweight title in her 10th professional combat, turning into the quickest fighter – all over again, male or female – to acquire earth championships in three weight classes.
Additional:
When will Shields get a opportunity to avenge her only reduction?
Shields suggests she’ll make ‘seven figures’ for subsequent two bouts
Flint avenue named just after Claressa Shields
Shields hunting at super combat with Savannah Marshall
Shields wins undisputed tremendous welterweight title
/cloudfront-us-east-1.images.arcpublishing.com/gray/UCVHQWWUDVGI7FNK2PZUNY6ZCM.jpg "Douglas County Health Director gives update; Omaha mask mandate under review")
