Medical marijuana bill expected to pass House; Senate uncertain

By Melissa Patrick
Kentucky Health News

FRANKFORT, Ky. -- A medical-marijuana bill described by supporters as one of the tightest in the nation is out of committee and is expected to pass the state House. The Senate is another matter.

Reps. Jason Nemes and John Sims Jr. presented the medical
marijuana bill, HB 136, in the House Judiciary Committee.
(Photo from Legislative Public Information Office)

"This is a question for the Senate," Rep. Jason Nemes, R-Louisville, told reporters after the House Judiciary Committee approved the bill. "It's going to pass the House; I have no doubt about it."

House Bill 136 , with a committee substitute, passed Feb. 12 by a vote of 17-1-1, with Rep. Joseph Fisher, R-Fort Thomas, passing. Fisher had expressed concern about people driving under the influence of marijuana and how this would be effectively managed.

Rep. Kim Moser, R-Taylor Mill, was the lone no vote. Moser, who has consistently said she would like to see more evidence-based research on medical marijuana that includes guidelines for prescribing, called the medical-marijuana laws in other states a "popular national social experiment."

Senate President Robert Stivers, who has long been the key obstacle to the bill in the Senate, reiterated Feb. 12 that he thought there could be a "path forward" for this bill in the Senate, though he said they haven't talked about this bill yet. (Later in the day, Nemes said he had a long, encouraging conversation with Senate Majority Floor Leader Damon Thayer.)

Stivers said that while he recognized that there are some real medical benefits to it, he said he wished the federal government would conduct a three-tier, double-blind study so that people would know how it really needs to be used.

House Concurrent Resolution 5, sponsored by Rep. Danny Bentley, R-Russell, asks the federal government to expedite research on the safety and efficacy of medical marijuana. It has passed out of the House and has been assigned to the Senate Health and Welfare Committee.

"It's a balancing test of: Do the goods outweigh the bads?" Stivers said.

Kentucky would be the 34th state, plus the District of Columbia, with legalized medical marijuana. So far, only 11 states and D.C. have legalized it for recreational use. A recent poll shows that 90 percent of Kentucky adults favor legalizing medical marijuana, or cannabis.

The latest version of the bill removed a list of conditions that could be treated with cannabis or its psychoactive ingredient, THC, and says any list of conditions will be determined by a panel of doctors and advisers established under the state health department.

Dr. Jeffrey Block, an anesthesiologist with the University of Miami, offered a short list of conditions for which there is conclusive or substantial evidence that THC is an effective treatment, including intolerable nausea or vomiting, intractable epilepsy, intractable chronic pain and intolerable muscle spasm, particularly from multiple sclerosis.

The bill wouldn't allow patients to smoke marijuana. Nemes said this concession was necessary to get votes, even though smoking is usually the quickest and most efficient way to get the drug into the system. It also does not allow colorful packaging or formulations that would be attractive to children.

Nemes said 13.5 percent of the money that comes in from the program would be used to help those who can't afford it get medical marijuana, since insurance won't cover it. Another 13.5% would go to law enforcement. The bill also includes an opt-in or opt-out provision for local governments.

Eric Crawford, an advocate for medical marijuana, told the group that an automobile accident in 1994 had left him paralyzed, and he used marijuana instead of opioids for his constant pain and muscle spasms.

"Narcotics make me out of my mind. They make me high and unable to function at all," he said. "Cannabis allows me to get out of bed and make the most of my life."

Crawford said if HB 136 became law, "I would not be a criminal. I would not have to live in fear. I would not have to lay awake at night worrying about law enforcement coming to my home. I would not have to stress about going to jail, or losing my home, work or freedom."

Joe Trigg, a 30-year veteran with 15 deployments, said, "Thousands of other veterans and myself would benefit from this bill." But he also said, "House Bill 136 can do better and should do better."

First, he said because it is written so tightly, it will likely result in higher prices and a larger black market. He also suggested that the rules against smoking and limiting growing are a result of lobbying, and said that rules on how it can be grown do not benefit Kentucky farmers.

Kent Ostrander of the Family Foundation of Kentucky, urged caution and called for more evidence-based research, saying, "We cannot use anecdotal based assumptions" when it comes to medications.

The bill would make marijuana legal medicine in Kentucky on Jan. 1, 2021.

Senate President Stivers, long the key obstacle to medical marijuana in Kentucky, now says he sees 'a narrow path' for it

Senate President Robert Stivers

By Melissa Patrick
Kentucky Health News

The most important legislative opponent of legalizing medical marijuana in Kentucky said Friday that there is a "narrow path forward" for it. Senate President Robert Stivers said that the day after a medical-cannabis bill was filed in his chamber.

Senate Bill 107 has bipartisan sponsorship from 11 of the Senate's 38 members. It is a companion bill to House Bill 136, with 44 co-sponsors, including House Speaker David Osborne.

The House bill's prime sponsor, Rep. Jason Nemes, R-Louisville, told Tom Latek of Kentucky Today that most House Republicans support it and he is optimistic it will pass this year.

Stivers has said he wouldn't support a medical-marijuana bill without medical studies to back it up, but Friday he said it would be a balancing act to weigh the good and the bad of passing such a law.

"I know that Representative Nemes is trying hard and that he is modifying and amending, and I think there is a path, but it is a narrow path," he said.

Stivers said that in the 20-plus studies that have been delivered to him, he has found there are "statistically significant indicators" to use medical marijuana, such as nausea from chemotherapy, or spasticity in people with multiple sclerosis. But he cautioned that the studies were small and of short duration, and he said there are better medicines for glaucoma, an eye condition that many medical-cannabis supporters mention.

He also said that like all medicine, the good must outweigh the bad, noting "statistically significant indicators" in studies showing marijuana exposure to those under 25 hurts brain development; that prolonged exposure increases the likelihood of psychotic experiences; that it has 50 percent more carcinogens in it than tobacco; and can cause heart disease.

"So, it becomes a balancing test," he said. "And nobody has really come, in my opinion, to give us that good path forward."

He added, "Does anybody here in this chamber or the other chamber want to see individuals suffer? No, we don't. But we also don't want to exacerbate a drug problem or a problem with cancers, heart disease, anything like that."

The 160-page medical-marijuana bills offer a list of conditions for which cannabis can be prescribed, such as terminal illness and epilepsy, but don't limit prescribing to those conditions, and would allow physicians to prescribe marijuana to their patients as long as they have a "bona fide" relationship.

The 11 sponsors of SB 107 are Sens. C.B. Embry Jr., R-Morgantown; Perry Clark, D-Louisville; Denise Harper Angel, D-Louisville; Jimmy Higdon, R-Lebanon; Morgan McGarvey, D-Louisville; Gerald Neal, D-Louisville; Michael Nemes, R-Shepherdsville; Dennis Parrett; D-Elizabethtown; Reginald Thomas, D-Lexington; and Robin Webb, D-Grayson.

A medical-marijuana bill passed the House Judiciary Committee 16-1 last year, but with only five days left in the legislative session and opposition in the Senate, it did not get a vote in the full House.

This year's House bill awaits a hearing in the House Judiciary Committee. The Senate bill has not yet been placed in a committee.

Marijuana is legal medicine in 33 states and the District of Columbia. Recreational marijuana is legal in 10 states, most recently Illinois, the first bordering Kentucky.

If approved, the medical marijuana program would start Jan. 1, 2021.

Courier Journal has answers to many questions about CBD oil

CBD products for sale at Rainbow Blossom in Louisville
Photo by Michael Clevenger, Louisville Courier Journal

As cannabidiol, better known as CBD oil, becomes readily available in Kentucky and is touted as a cure-all for a host of medical problems, from arthritis to anxiety, Laurel Deppen of the Louisville Courier Journal reports on its safety and legality.

Much of the concern about the safety and legality of CBD oil comes from its association with marijuana, since both come from the cannabis plant, Deppen notes. Here is her guide to answer many of those concerns.

What is CBD oil? CBD oil is made by extracting CBD from the cannabis plant, then diluting it with a carrier oil, such as coconut or hempseed oil, according to healthline.com.

Is CBD oil legal in Kentucky? As long as CBD is derived from industrial hemp, it is legal. The 2018 Farm Bill allowed “the production and marketing of hemp” and other derivatives of cannabis with less than 0.3 percent THC, or tetrahydrocannabinol, the plant's psychoactive ingredient.

Can you get high off CBD oil? No, because it doesn't have enough THC.

Can you grow hemp in Kentucky? With a license. The Kentucky Department of Agriculture also requires anyone handling or processing plants, seeds, leaf or floral materials derived from hemp to be licensed. Without a license, growers could face the same penalties as those for growing marijuana.

Can you manufacture CBD oil in Kentucky? Yes, with a license, which is also issued by the Department of Agriculture.

Is CBD oil safe? Is it addictive? Deppen reports that it is not addictive, but adds that "a lot of facts remain unknown" about its safety. Medical experts recommend that you speak to a doctor before taking any medication or supplement, especially if you have a pre-existing condition.

Will CBD oil help or hurt my anxiety? Bottom line, more research is needed. Deppen reports that there haven't been any confirmed studies on whether it hurts or helps anxiety. However, she writes that "Some patients have reported less anxiety or depression after use, including more restful sleep."

How will CBD oil affect my heart? Will it affect my medications? In a previous Courier Journal article, James Patrick Murphy, former president of the Greater Louisville Medical Society, warned that CBD treatment may not be for everyone, including those with heart conditions or those who take blood thinners. Deppen explains that CBD can inhibit liver enzymes that metabolize drugs.

Does CBD oil show up on a drug test? "If a drug screening only tests 'positive or negative' for THC and not the amount, there's a chance your CBD oil intake could cause you to fail the drug test," Deppen reports.

Where can I find it? Most CBD oil has largely been sold in local, independent stores, "but as the demand for CBD products rises, you're more likely to find it on a store shelf where you'd least expect it," Deppen writes.

Walgreens started selling CBD products in almost 1,500 stores earlier this year, and CVS began selling them in in 800 stores. Both chains will sell the products in Kentucky. Deppen reports that Target and Walmart have started having "initial discussions" with CBD manufacturers, according to the New York Post.

Panel at health policy forum cites alternatives to opioids for pain, and the need for a culture shift on the topic

By Melissa Patrick
Kentucky Health News

Kentucky has a new law restricting painkiller prescriptions to three days for acute pain, but an anecdotal story from one of the state's leading doctors suggests that it has a ways to go: the child of a friend recently got wisdom teeth extracted and was given a 30-day supply of pain medicine.

"They don't need that many. They may only need -- zero!" said Dr. Philip Chang, chief medical officer at UK HealthCare. "I don't know how well that [law] is followed, to be honest with you."

Chang also discussed proven ways to reduce opioid use, and still relieve pain, during the "Alternatives to Opioids" panel at the Howard L. Bost Memorial Health Policy Forum held Sept. 24 in Lexington by the Foundation for a Healthy Kentucky. The meeting's theme was "Kentucky's Substance Use Epidemic: A Solutions Update."

Comprehensive EAP photo

The law, passed in 2017, limits painkillers to a three-day supply if prescribed for acute pain, but doesn't apply to chronic pain and has a long list of other exemptions -- and allows a prescriber to override the new rule by documenting a justification.

At the end of the session, Dr. Mel Pohl, chief medical officer of Las Vegas Recovery Center, noted that Nevada doesn't have this problem because its laws on opioid prescriptions are very strict.

"If people prescribe opioids for more than three days for a minor and seven days for a major surgical procedure, they will be brought before the medical board," he said. "It's too bad that we had to be punished and threatened into changing our behavior as prescribers, but we did. And now it's happening and I think that the paradigm shift is in place."

Chang said it was important for providers to get on board with the new law because opioids have adverse consequences. He pointed to research that shows a one-week prescription of opioids to patients who have never used pain pills before increases their risk of becoming addicted by 15 percent in one year, and a 30-day prescription increases that risk to 35 percent.

He also cited research that found a combination therapy of ibuprofen and acetaminophen is much more effective for treating pain than opioids. "This is the information we need to get out there, so they know that this doesn't come without a costs," he said. "The misconception that opioids are always better is not true."

Chang, a trauma surgeon, also noted a pilot study that he led, which basically didn't allow providers to prescribe any pain-medication prescriptions unless the patient had exhausted all other means of pain-control medications available to them, like ibuprofen, Tylenol and muscle relaxers.

He said that in just two years' time, they were able to drop the overall opioid-prescribing rates for trauma patients 50 percent, with the best results in the "opioid naive" patients.

The pilot was so promising that the policy has been implemented hospital-wide, with results over the last two years showing a steady decline in the amount of daily morphine prescribed, resulting in 250,000 fewer pills per year, and no changes in patient-described pain scores. "None at all!" he said.

"We can do this," Chang said. "We can get away from this trend of prescribing opioids and more opioids and more frequent and different kinds of opioids. We can get away from it."

Dr. Danesh Mazloomdoost, medical director at Wellward Regenerative Medicine in Lexington, told the group that we need a culture change when it comes to pain management and that the question shouldn't be how can we manage opioids more effectively, but to ask if they are even effective.

"That's really the key to understanding how we're going to fix this pain issue," he said. "We've got to stop thinking that we can cure everything or symptom-manage everything with a pill, and start getting an understanding of what the physiology of our bodies is, how our bodies function and how we're going to get healthy to feel better."

Mona Carper, a physical therapist and professor at UK, said it is long past time for her profession to have a seat at the table when it comes to discussing pain management.

She said access to physical therapy within the first 14 days of injury is critical for decreasing the need for opioids and for decreasing the long-term cost of care.

Pohl, an addiction specialist who treats co-occurring pain and addictions with the goal of getting patients off opioids, said, "When we take people off opioids, guess what happens to their pain? It goes down."

Pohl gave several suggestions for alternatives to opioids, including several specific types of therapy, including cognitive behavioral therapy, complementary alternative therapies like nutritional interventions and acupuncture, and mindfulness practices.

He spent much of his time talking about the benefits of practicing mindfulness daily, which he said is a type of meditation that involves focusing on an object, like breathing. He said the practice of mindfulness allows people to "detach from thoughts, feelings and physical sensations" and thus better tolerate or manage their pain.

Pohl noted two studies that spoke to the effectiveness of the practice, including a three-month study of adults 27 and older that found practicing mindfulness, or meditation, resulted in less pain, improved attention, enhanced well-being, and improved quality of life. The second one found that just four days of mindfulness training decreased pain and feelings of unpleasantness by half.

He added that results from his own clinic show a 20 percent reduction in pain scores among his patients who practice mindfulness. He said, "That is efficacious as most opioids."

"Kentucky Substance Use Epidemic: A Solutions Update" is title of Bost Health Policy Forum to be held in Lexington Sept. 24

As Kentucky continues to struggle with the health and economic impacts of the opioid epidemic, the Foundation for a Healthy Kentucky's 16th annual health policy forum will explore medical marijuana and other alternative pain therapies, as well as the rise in infectious disease associated with the crisis.

"We need to understand the truth behind the push for medical marijuana, hear the facts about whether it works to relieve pain, and learn the risks associated with its use," foundation president and CEO Ben Chandler said in a news release. "This year's speakers will give us the latest updates on the causes and impacts of Kentucky's substance use crisis, and will zero in on how we're doing in addressing what continues to feed the crisis and the resulting symptoms."

The 2018 Howard L. Bost Memorial Health Policy Forum is titled "Kentucky's Substance Use Epidemic: A Solutions Update." The forum is sponsored by the foundation with support from Centerstone and Bluegrass.org, organizations that care for patients with mental, developmental and behavioral issues. It is named for Dr. Howard L. Bost, who helped create Medicare and Medicaid, developed the Appalachian Regional Hospitals system, improved mental-health services in Kentucky, and created the vision for the foundation.

It will be held at the Griffin Gate Marriott Resort on Newtown Pike in Lexington on Monday, Sept. 24. Attendance is free, but registration is required. Click here to register.

This year's keynote speaker is Pulitzer-Prize-winning reporter Barry Meier, the author of Pain Killer: An Empire of Deceit and the Origin of America's Opioid Epidemic. Meier's book chronicles the aggressive marketing of the highly addictive drug OxyContin by Purdue Pharma, and the role it played in creating the nation's opioid crisis.

The forum will feature two morning panels, one titled "Kentucky's Addiction Burden," which will provide the latest updates on how substance addiction is impacting both the heath and economy of Kentucky, and the other "Agency Exchange: Views from the Front Lines," which will discuss various approaches being used by the state to deal with the crisis.

Attendees will be able to attend two of the three afternoon breakout sessions: "Infectious/Chronic Diseases Caused by Addiction," "Medical Marijuana: What is the Truth?," or "Treating Chronic Pain: Alternatives to Opioids. "

The full agenda and speaker biographies are available on the foundation's website. All speaker presentations will be made available on the website after the forum. Meier will also be available to sign copies of his book, which will be for sale at the forum.

New guidelines say sleep aids should only be used short-term; physicians recommends "cognitive behavioral therapy"

Photo illustration: medicalnewstoday.com

Sleep aids are readily available to the one-third of adults who suffer from insomnia, but health-care providers are beginning to steer patients away from them because of the risks the drugs pose, Laura Landro reports for The Wall Street Journal.

“Drugs don’t provide a natural sleep, and the side effects are significant,” Nitin Damle, an internist and president of the American College of Physicians, told Landro.“It’s true in all age groups, but even more problematic for older adults."

After reviewing more than 15 years of evidence, the physicians' group issued new guidelines in May for the management of chronic insomnia, recommending cognitive behavioral therapy as the first-line of treatment for adults. Cognitive behavioral therapy determines patient's actions that may be prohibiting sleep, and then develops a customized list of "do"s and "don’t"s for optimal sleeping.

The guidelines also say that drugs should only be used if therapy is unsuccessful, should only be used short-term, defined as four to five weeks, and only after the benefits and risks have been discussed with the patient. “The intent is for them to be on a short course, and then get off of it,” David Maness, a professor of family medicine at the University of Tennessee Health Science Center in Memphis, told Landro.

“But then the problem is perpetuated, and before you know it, it’s 10 years later, and it keeps getting refilled and no one has reviewed it.” In addition to their addictive properties, prescription sleep aids can cause fuzzy thinking, short-term memory loss, and diminished liver and kidney function, which can cause fatigue, weakness and impaired balance, in older patients. Longer term, sleep drugs may contribute to more serious mental-function issues, Landro reports.

Benzodiazepines, like Halcion, and non-benzodiazapenes, like Ambien, Lunesta and Sonata, are the most commonly prescribed sleeping pills. These drugs, called sedative hypnotics, slow activity in the brain to bring on sleep.

"The American Geriatrics Society recommends against using benzodiazepines or other sedative hypnotics in older adults as first choice for insomnia because large-scale studies consistently show that the risk or motor-vehicle accidents, falls and hip fractures leading to hospitalization and death can more than double in older adults taking the drugs," Landro writes.

There is a new class of sleeping pills that act differently than sedative hypnotics, but are not physically addictive and don't have withdrawal symptoms after stopping the drug. However, they do have some side-effects like drowsiness the next day, sleepwalking and performing activities while sleeping.

Landro reports that over-the-counter drugs can also be risky because many of them use the antihistamine diphenhydramine, which is a type of drugs known as anticholinergics. "A study last year in JAMA Internal Medicine suggested higher cumulative use of anticholinergics, which can impair memory and attention, is associated with an increased risk for dementia," she writes.

Patients who are dependent on sleeping pills should not stop them abruptly, but should taper off of them, Sean Jeffrey, director of clinical pharmacy services at Hartford Healthcare and a clinical professor at the University of Connecticut School of Pharmacy, told Landro.

Adults 62-85 are often taking combinations of drug or dietary supplements that could be deadly; risk nearly doubled in 5 years

Update: 4/4/16, This story has been updated to reflect that the study says the number of adults using at least five prescription drugs a day has increased and not the average older American is using at least five prescription drugs a day.

The number of older Americans at risk of potentially life-threatening drug interactions almost doubled between 2005 and 2011, according to a study from the University of Illinois at Chicago.

"One in six older adults now regularly use potentially deadly combinations of prescription and over-the-counter medications and dietary supplements, a two-fold increase over a five year period," says the release.

More than half the potentially deadly interactions involved a non-prescription medication or dietary supplement such as a vitamin. The study found that older adults have increased their use of vitamins and supplements, despite limited evidence of their clinical benefit.

The study, published in JAMA Internal Medicine, examined changes in medication use in more than 2,000 adults aged 62 to 85 between 2005 and 2011.

Fifteen potentially life-threatening drug combinations of the most commonly used medications and supplements were identified, and the study found nearly 15 percent of older adults in 2011 used at least one of these dangerous combinations, up from 8 percent in 2005.

The study found that older adults have grown more fond of non-prescription medications and supplements: 63.7 percent of older adults used them in 2011, up from 51.8 percent in 2005. Older adults using at least five prescription medications increased to 35.8 percent from 30.6 percent in the same time period.

The most common life-threatening interaction identified by the study was cholesterol-lowering drugs (statins), drugs used to prevent blood clots (anti-platelet drugs) and omega-3 fish oil supplements.

“Many older patients seeking to improve their cardiovascular health are also regularly using interacting drug combinations that may worsen cardiovascular risk,” one of the researchers said in a news release.

The researchers encourage health-care providers to carefully consider adverse effects of combining prescription and nonprescription medications when treating older adults, and to counsel patients about the risks. Older adults should also ask their pharmacists about potential drug interactions.

Oregon Medicaid will fund alternative treatments for pain in effort to cut opioid abuse; Ky. only pays for a few alternatives

Oregon's version of Medicaid is getting ready to pay for some alternative treatments to pain pills in hopes of reducing the number of people who become addicted to opioids or abuse them, Kristian Foden-Vencil reports for NPR.

The coordinator of the Oregon Pain Management Commission, Denise Taray, told NPR that Oregon wants more patients to try alternative approaches to treat pain,. "The only thing that might have been covered in the past was narcotics," Taray sayid. "But treatments such as acupuncture, chiropractic, massage therapy, physical therapy and rehab would never have been covered."

Payment for many of these alternative treatments will begin January 2016 for those who participate in the Oregon Health Plan.

The decision was driven by the over-prescription of opioids, which is a nationwide problem.

"Oregon leads the nation in the non-medical use of opioids,and about a third of the hospitalizations related to drug abuse in Oregon are because of opioids," NPR reports.

The Centers for Disease Control and Prevention says"health care providers wrote 259 million prescriptions for painkillers in 2012, enough for every American adult to have a bottle of pills."

NPR reports, "While the treatments may cost more than a course of pain pills, the hope is to save money by reducing the number of people who become addicted to opioids or abuse them."

Kentucky also struggles with the over-prescription of opioids, but only covers a few of these alternative pain treatment services.

According to the Department for Medicaid Services, "Medicaid covers medically necessary services," Beth Fisher, a spokeswoman for the Cabinet for Health and Family Services, said in an email. "Medicaid does cover some services mentioned in the article, such as chiropractic care and physical therapy. However, acupuncture is not a covered service. As with all treatment plans, the decision regarding specific treatment is made between the physician and individual."

In 2012, Kentucky was listed as one of the top five prescribers of painkillers in the nation, at 128 painkiller prescriptions per 100 people, according to the IMS, National Prescription Audit.

David Eisen, executive director of the Quest Center in Oregon and board-certified in traditional Chinese medicine and acupuncture, told NPR that doctors need to stop thinking of opioids as a first-line defense against pain.

"There should be an array of things for people to choose from," Eisen said, "whether it be chiropractic care, or naturopathic care, or acupuncture, nutrition, massage. Try those things — and if they don't work, you use opioids as a last resort."

Prince Charles to keynote Louisville health and food symposium

Prince Charles and Camilla Parker-Bowles

Prince Charles of the United Kingdom will keynote a health symposium in Louisville March 20.

The prince of Wales and his wife Camilla Parker-Bowles, duchess of Cornwall, "will highlight the work being done by members of the local community and charitable organizations to protect, preserve and promote the health and well-being of the people of Louisville through community cohesion, clean air and food literacy initiatives," says a release on his site.

The release says the prince will speak "to an audience of health practitioners, business, faith and community leaders about links between health and the natural environment. Highlighting the same theme, the duchess will visit a food literacy project for young people at a local farm. The project also offers young people an opportunity to experience life on a farm in order to help increase their knowledge of the connection between food and farming."

The speech could include some of the same points that Charles made in a speech at the Future for Food Conference at Georgetown University in Washington, D.C., in 2011, where he said, "We will have to develop much more sustainable, or durable forms of food production,  because the way we have done things up to now are no longer as viable as they once appeared to be."

Kirby Adams of The Courier-Journal reports that the symposium will be held by the Institute for Healthy Air, Water and Soil, chaired by Christina Lee "Christy" Brown of Louisville, who is one of four board members of the England-based Sustainable Food Trust. Her son, Owsley Brown III, is one of three board members of the Sustainable Food Alliance, the trust's U.S. partner.

Nico Hines of The Daily Beast reports that the Kentucky visit is being organized with the help of Gov. Steve Beshear, Louisville Mayor Greg Fischer (who has been active in food issues) and the Owsley Brown Charitable Foundation, named for Christy Brown's late husband, the former chairman of distiller Brown-Forman Corp. Her son-in-law, Matthew Barzun, "is the U.S. ambassador in London," Hines notes.

Hines's story is largely unfavorable. It begins, "Prince Charles is taking his unusual views on health, previously described as 'witchcraft' and 'quackery,' to the United States." Those descriptions came from a professor at the University of Exeter and the British Medical Association, which said in 2010, "Homeopathy is witchcraft."

When the prince became BMA president in 1982, Hines reports, "He advocated a radical overhaul of the medical system in favor of alternative therapies which he said had been successfully practiced for centuries by faith healers using the patient’s 'physical and social environment, as well as his relation to the cosmos.' Rather than laugh off the private views of their new figurehead, the doctors ordered a full inquiry into the efficacy of alternative medicine. After three years and 600 submissions, it concluded any support for the use of these therapies was purely 'unscientific'. . . . Prince Charles has remained resolute in his controversial beliefs." Some commenters on the story defend him.

The future king's Louisville stop will come on the fourth and last day of an American tour that will include "stops at the Armed Forces Retirement Home in Washington, site of the Lincoln Cottage, where it is believed Abraham Lincoln wrote the last draft of the Emancipation Proclamation. The royals will also visit Mount Vernon, home of George Washington, and the National Archives to mark the 800th anniversary of the Magna Carta," The Courier-Journal reports.

Acupuncture is actually a gentle way to treat, despite the needles

Cheryl Truman of the Lexington Herald-Leader takes a look at acupuncture, an alternative form of medicine with practitioners across the state. "It's a really gentle form of medicine, even though there's needles," said Kathleen Fluhart, a nurse who first heard about acupuncture in the 1970s. "It just made sense."

There are 362 places on the body "where an acupuncturist can insert a needle to balance the flow of xi, or body energy, which in Chinese medicine flows in meridians throughout the body," Truman reports. Acupuncture can help treat sinus infections, allergies, fatigue and other side effects from chemotherapy and radiation treatments, tendinitis and plantar fascilitis.

Treatment centers like Houston's University of Texas M.D. Anderson Cancer Center and Boston's Dana Farber Institute both offer acupuncture treatment to cancer patients. "It's not a cure-all, but it is so amazing for certain things," said Elizabeth Armstrong, who practiced internal medicine for 17 years before becoming trained, and opening a practice in, acupuncture. (Read more)

Alternative medicine can help patients manage chronic pain

Patients can turn to health practices like meditation, massage, yoga and acupuncture rather than pills to help manage their chronic pain, says Dr. Josephine Briggs, director of the National Center for Complementary and Alternative Medicine at the National Institutes of Health.

"Much of health care involves helping people find solutions for tough problems like pain," Briggs said in a release distributed by research-reporting news service Newswise. "I think all physicians are well aware of how difficult it is to manage chronic pain patients. For example, with back pain we see that large numbers of patients are turning to these approaches with the hope of decreasing discomfort, improving function and quality of life, and minimizing side effects of pharmacologic treatments."

A nationwide survey released in 2008 found about 38 percent of U.S. adults ages 18 and over and about 12 percent of children use some form of complementary and alternative medicine. Back pain is the most condition for which treatment is sought. These types of therapies are even being used in military health care. New military guidelines released by the Office of the Army Surgeon General include some alternative modalities for treating pain. (Read more)