Guest guest Posted February 12, 2003 Report Share Posted February 12, 2003 Yesterday, February 10, important legislation regarding the sale of ma huang in Suffolk County, New York, passed the local legislature. The bill bans the sale of ma huang in Suffolk County with one very important exception: Section 6 of the law states: " This law shall NOT apply to ma huang (Ephedra Sinensis) sold or dispensed by any practitioner of alternative medicine, whose qualification to use ma huang is explicitly established via evidence of an active certification issued to such individual from an agency accredited by the National Commission of Certifying Agencies (NCCA), as long as it is not prescribed as a dietary supplement for weight loss, is not prescribed for body building and is not prescribed as " energy food. " At this time, the only available certification is the NCCAOM herb exam. This means that at this time, only those individuals who hold active certification from the NCCAOM may legally sell or dispense ma huang in Suffolk County. This is landmark legislation. It marks the first time that the NCCAOM herb exam has been used legislatively to give diplomates access to substances that are otherwise banned. Initially the bill's language called for a total ban, but Kevin and Marnae Ergil, and to a lesser extent I, were able to persuade the bill's sponsor, legislator Jon Cooper, that we were a constituency worth protecting. There is a strong movement toward banning ma huang, driven by the growing number of reports of adverse reactions and some deaths in people using it for weight loss. Cooper's bill was in response to a constituent who's son died after ingesting ma huang as a recreational drug. On the other hand there have been no reports, to my knowledge, of adverse reactions due to ma huang prescribed by practitioners of Chinese medicine. Perhaps this will become a model for future legislation that controls access to ma huang, while acknowledging our expertise and authority in this area. Rory -- Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 12, 2003 Report Share Posted February 12, 2003 Yes, I think this is landmark legislation, and it should inspire us in this profession to make the point that there are herbal medicinals that should not be sold as food supplements in health food stores and as part of weight loss programs, but be used only by licensed health professionals who are trained in herbal medicine. On Wednesday, February 12, 2003, at 08:06 PM, Rory Kerr wrote: > Yesterday, February 10, important legislation regarding the sale of > ma huang in Suffolk County, New York, passed the local legislature. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 12, 2003 Report Share Posted February 12, 2003 , Rory Kerr wrote: > This is landmark legislation. It marks the first time that the > NCCAOM herb exam has been used legislatively to give diplomates > access to substances that are otherwise banned. Initially the bill's language called for a total ban, but Kevin and Marnae Ergil, and to a lesser extent I, were able to persuade the bill's sponsor, legislator Jon Cooper, that we were a constituency worth protecting. Rory: You three, together with Jon Cooper, deserve a lot of credit and the thanks of our entire profession for helping to make this legislation possible. I hope it sets a precedent. Jim Ramholz Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 13, 2003 Report Share Posted February 13, 2003 ....it should inspire us in this profession to make the point that there are herbal medicinals that should not be sold as food supplements in health food stores and as part of weight loss programs, but be used only by licensed health professionals who are trained in herbal medicine. I applaud Rory et al's efforts in protecting the materia medica for practitioners. I would be interested to know what other ingredients are being sold in health food stores that those in the profession think should not be offered directly to consumers. I think ma huang is a bit unique among " health " products in its safety profile. Although, others such as those with secondary abortifacient or purgative effects should perhaps be added to the list. I have been told that over 90% of the adverse event reports related to herbal products are due to ingestion of products containing ephedrine alkaloids, many of which are not manufactured as full spectrum extracts of ma huang. The National Plant Research Center at the U. of Mississippi has been doing government funded research on ma huang, for which my company has been providing the voucher samples. We have identified 23 species of ma huang growing in China, each with different phytochemical profiles, and consequently they are likely to have differing biological activities that have not been accurately differentiated by practitioners nor consumer product developers. One more task to add to the " to do " list. Stephen Chinese Herbal Medicine, a voluntary organization of licensed healthcare practitioners, matriculated students and postgraduate academics specializing in Chinese Herbal Medicine, provides a variety of professional services, including board approved online continuing education. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 13, 2003 Report Share Posted February 13, 2003 Dear Stephen and others, Kevin Ergil is a wonderful and hard working administrator and is to be applauded for his work regarding ma huang legislation. However, don't miss the point that he bravely threaded the needle in the actions that he took. All of the herbs and finished formulas available to Chinese medical practitioners in the U.S. are only legal at this time as food or as dietary supplements ... not as medicine. Once you go down the road of making these distinctions, you risk losing it all. According to Michael McGuffin of AHPA, the FDA is on a 10 to 15 year project regarding which herbs are appropriate for use in Chinese medicine as taught at accredited institutions. Distinctions may be made regarding use by a practitioner and availability in the general marketplace. Such things have not yet been addressed. Michael suggests that the academic community get out ahead of the FDA on this project to secure their own vision. The FDA will tend to adopt criteria that are already in place. The only academicians I saw at AHPA meetings regarding this issue were from the American Coll. of TCM in S.F. I did see AAOM there, too. If you truly want to influence legislation and the FDA on the issue of appropriate use of Chinese herbs, connect up with AHPA, AAOM and your own academic institution and address these issues. Emmanuel Segmen - Stephen Morrissey Thursday, February 13, 2003 10:59 AM RE: ma huang legislation ...it should inspire us in this profession to make the pointthat there are herbal medicinals that should not be sold as foodsupplements in health food stores and as part of weight lossprograms, but be used only by licensed health professionals who aretrained in herbal medicine.I applaud Rory et al's efforts in protecting the materia medica forpractitioners. I would be interested to know what other ingredients arebeing sold in health food stores that those in the profession thinkshould not be offered directly to consumers. I think ma huang is a bitunique among "health" products in its safety profile. Although, otherssuch as those with secondary abortifacient or purgative effects shouldperhaps be added to the list. I have been told that over 90% of theadverse event reports related to herbal products are due to ingestion ofproducts containing ephedrine alkaloids, many of which are notmanufactured as full spectrum extracts of ma huang. The National PlantResearch Center at the U. of Mississippi has been doing governmentfunded research on ma huang, for which my company has been providing thevoucher samples. We have identified 23 species of ma huang growing inChina, each with different phytochemical profiles, and consequently theyare likely to have differing biological activities that have not beenaccurately differentiated by practitioners nor consumer productdevelopers. One more task to add to the "to do" list. StephenChinese Herbal Medicine, a voluntary organization of licensedhealthcare practitioners, matriculated students and postgraduateacademics specializing in Chinese Herbal Medicine, provides a variety ofprofessional services, including board approved online continuingeducation. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 13, 2003 Report Share Posted February 13, 2003 , " Emmanuel Segmen " < susegmen@i...> wrote: All of the herbs and finished formulas available to Chinese medical practitioners in the U.S. are only legal at this time as food or as dietary supplements ... not as medicine. And I hope they remain that way. the only ones I want off the market and medicalized are ones like ma huang. Also, in california, our scope of practice DOES give us the right to prescribe herbs to restore health, not just prevent disease. We are the only alt. med. licensed providers in CA legally allowed to use herbs for treating illness. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 13, 2003 Report Share Posted February 13, 2003 At 9:52 PM +0000 2/13/03, < wrote: > , " Emmanuel Segmen " < >susegmen@i...> wrote: > All of the herbs and finished formulas available to Chinese medical >practitioners in the U.S. are only legal at this time as food or as dietary >supplements ... not as medicine. > >And I hope they remain that way. the only ones I want off the market and >medicalized are ones like ma huang. -- I must say I have misgivings about the legislation we contributed to. On the one hand we saved the situation locally that was otherwise lost, in that the alternative was a total ban; we also created a new model that can be used to protect our practice if this sort of legislation is taken up more broadly. On the other, I think Emmanuel makes an excellent point that in placing ma huang in a special controlled category, we may lose the right to use it. There is a strong campaign underway by the medical establishment and pharmaceutical interests that is using public safety as a cover for their gaining back their lost turf.Ma huang is an excellent wedge issue for them. We are going to have to be very astute in our politics as this becomes a more national issue. Rory -- Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 13, 2003 Report Share Posted February 13, 2003 Rory, > I must say I have misgivings about the legislation we contributed to. > On the one hand we saved the situation locally that was otherwise > lost, in that the alternative was a total ban; we also created a new > model that can be used to protect our practice if this sort of > legislation is taken up more broadly. On the other, I think Emmanuel > makes an excellent point that in placing ma huang in a special > controlled category, we may lose the right to use it. There is a > strong campaign underway by the medical establishment and > pharmaceutical interests that is using public safety as a cover for > their gaining back their lost turf.Ma huang is an excellent wedge > issue for them. We are going to have to be very astute in our > politics as this becomes a more national issue. > This is one of the key reasons why I believe that we must, as a community, become masters of the language that we speak and use in the study and practice of our profession. As the substance control issue, along with a host of other issues, continue to occupy a place of greater prominence on the national and international stage, the command of communication becomes an increasinly critical factor in winning or losing the kinds of political battles that you have been talking about. The " public " has an uncanny way of knowing who knows what they're talking about and who doesn't, and command of language and nomenclature is a critical factor in this kind of public perception. As Nigel has referred to it from another point of view, language is the neglected key. Ken Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 13, 2003 Report Share Posted February 13, 2003 , Rory Kerr <rorykerr@w...> wrote: in placing ma huang in a special > controlled category, we may lose the right to use it. I disagree. I think what you have done is the only possibility of protecting our materia medica. if you hadn't acted, than ma huang would most certainly have been banned for everyone under all circumstances. I also do not think that any conspiracy exists to regain lost ground in that I do not believe nay ground has been lost. the rise in the use of herbs has had no effect on the sale of drugs, nor has it decreased the use of western medical services. I believe the concern over ma huang is well justified given all the recent deaths from misuse. However, I believe very few herbs fit this bill. Of the commonly used herbs, my only concern would be fu zi, but who is going to self-medicate with fu zi in the US? Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 14, 2003 Report Share Posted February 14, 2003 At 7:05 AM +0000 2/14/03, < wrote: >I also do not think >that any conspiracy exists to regain lost ground in that I do not believe nay >ground has been lost. -- I wouldn't use the word conspiracy, but it's naive to think that commercial self interest isn't a motivating factor. It certainly is for us, no? >I believe the concern over ma huang is well justified given all the >recent deaths from misuse. -- I think I agree, but I'm not so certain as you seem to be. It's not really clear that ma huang was the agent responsible for the deaths. For example, in the case of the teenager who died who was the inspiration for the Suffolk County bill, there were several kids who had ingested the same quantity of ma huang at the same time. They had all been ingesting multiple other substances, including a lot of alcohol. None of the others suffered more than a hangover. Death due to ma huang was by no means proven. Given this, what was the justification for banning it? It certainly wasn't clear thinking (you had to be there!) Millions of people believe they receive benefit from ingesting ma huang for weight loss. Of these millions, fewer than ten have died under circumstances which suggest ma huang may have played a role, although the role was not proven, and there were other possible causes in all cases. Is the solution to this to ban ma huang? This is what many people are ready to do. Is that what they do with another herb, tobacco, which contributes to the deaths of not just a few, but millions of people? Wouldn't public education be a better solution than banning ma huang? We have found a clever solution that protects our interest, for the time being. What about the public interest in having free access to herbal remedies? >However, I believe very few herbs fit this bill. Of the commonly >used herbs, my only concern would be fu zi, but who is going to self-medicate >with fu zi in the US? -- There are others, for example ginko. There are also efforts to make the FDA reclassify all herbs, regardless of known safety issues, so that they would no longer be classified as foods. Think about the consequences of that. Rory -- Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 14, 2003 Report Share Posted February 14, 2003 Rory: Amen to all you say. I see in the absurd ma huang prohibition efforts (and the tone of the professional support for it) more evidence that the path of TCM in America is ultimate cooption by the govermental/professional regulatory impulse (the same one which keeps medicinal cannabis from cancer patients or puts them in the penitentiary for using it to relieve their iatrogenic nausea). The government cannot even effectively regulate the usage of such perilous drugs as heroin, which has soared many thousand fold since it was made illegal. In a truly free society, education provides the only effective means by which safety is achieved and freedom of choice to medicate (or knowingly poison) oneself is preserved as a right. Prof. Neal White. - Rory Kerr Friday, February 14, 2003 8:31 AM Re: ma huang legislation At 7:05 AM +0000 2/14/03, < wrote:>I also do not think>that any conspiracy exists to regain lost ground in that I do not believe nay>ground has been lost.--I wouldn't use the word conspiracy, but it's naive to think that commercial self interest isn't a motivating factor. It certainly is for us, no?>I believe the concern over ma huang is well justified given all the >recent deaths from misuse.--I think I agree, but I'm not so certain as you seem to be.It's not really clear that ma huang was the agent responsible for the deaths. For example, in the case of the teenager who died who was the inspiration for the Suffolk County bill, there were several kids who had ingested the same quantity of ma huang at the same time. They had all been ingesting multiple other substances, including a lot of alcohol. None of the others suffered more than a hangover. Death due to ma huang was by no means proven. Given this, what was the justification for banning it? It certainly wasn't clear thinking (you had to be there!)Millions of people believe they receive benefit from ingesting ma huang for weight loss. Of these millions, fewer than ten have died under circumstances which suggest ma huang may have played a role, although the role was not proven, and there were other possible causes in all cases. Is the solution to this to ban ma huang? This is what many people are ready to do. Is that what they do with another herb, tobacco, which contributes to the deaths of not just a few, but millions of people? Wouldn't public education be a better solution than banning ma huang?We have found a clever solution that protects our interest, for the time being. What about the public interest in having free access to herbal remedies?>However, I believe very few herbs fit this bill. Of the commonly>used herbs, my only concern would be fu zi, but who is going to self-medicate>with fu zi in the US?--There are others, for example ginko. There are also efforts to make the FDA reclassify all herbs, regardless of known safety issues, so that they would no longer be classified as foods. Think about the consequences of that.Rory-- Chinese Herbal Medicine, a voluntary organization of licensed healthcare practitioners, matriculated students and postgraduate academics specializing in Chinese Herbal Medicine, provides a variety of professional services, including board approved online continuing education. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 14, 2003 Report Share Posted February 14, 2003 , " renee white " < mamimami@t...> wrote: > Rory: Amen to all you say. I see in the absurd ma huang prohibition efforts (and the tone of the professional support for it) more evidence that the path of TCM in America is ultimate cooption by the govermental/professional regulatory impulse (the same one which keeps medicinal cannabis from cancer patients or puts them in the penitentiary for using it to relieve their iatrogenic nausea). Apples and oranges. Unlike cannabis, one of the safest substances nature has ever produced, ma huang kills when used by laypeople. Tobacco regulation has resulted in a dramatic decrease in youth smoking, a perfect example that government regulation of truly dangerous substances is effective. However, the comparison to illegal drugs is not accurate. Regulation is controlled legality. when something is completely illegal, a huge blackmarket springs up. while there are blackmarkets in tobacco and alcohol, access to these products is much more effectively controlled than with those that are completely illegal. the facts just do not support your position. The position that the government has no role to protect public safety is an argument that deserves no further rebuttal. It is this attitude that has gotten us where we are today. I truly hope your position is a minority one because if not we can pretty much kiss our materia medica goodbye. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 14, 2003 Report Share Posted February 14, 2003 , Rory Kerr <rorykerr@w...> wrote: There are also efforts to make > the FDA reclassify all herbs, regardless of known safety issues, so > that they would no longer be classified as foods. Think about the > consequences of that. that is propaganda put out by large supplement manufacturers who want to protect their ability to market medicine directly to the public, thus bypassing professional care from folks like us. that is the real conspiracy. when we support bogus product labeling and unrestricted access to herbs, we just basically send people to the healthfood store instead of our offices. if herbs are all safe and require no regulation, than they must also be safe for self- medication or prescription by a teenage healthfood store clerk. over 90% of supplements are sold directly to the public with no medical supervison at all. The two true sides of this battle are about government regulation versus corporate laissez faire. It is not at all about consumer choice. that is the scam. for those unfamiliar with history, the era of laissez faire economics in the US was called the robber baron era, when enron like ripoffs were the rule, not the exception. I trust government slightly more than I trust corporations if for no other reason that I can vote out my reps and have zero power over corporate boards. Just be clear that you are not putting any real control in the hands the public by this position, you are putting control in the hands of the elite with their propragandist media machines, the same way tobacco companies were able to seduce so many to smoke UNTIL the government got more involved. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 14, 2003 Report Share Posted February 14, 2003 Todd and All, Please note that the FDA which regulates us all was created by in the early 20th Century by the AMA and pharmaceutical interests. There are two categories: food and drugs. Currently that's our available choices. If you want medicinal regulation, it will cost you 1/4 to 1/2 billion dollars per item for FDA approval of efficacy and safety. Until a category is created by Congress for herbal medicine, those are the choices. I agree with Rory that legislation is ruled by lobbyists and economic interests that could overwhelm us in a day or even within the hour. We are unregulated because we fly under the radar of an industry that currently is "having it both ways": producing drugs for M.D.s and supplements to the public. Chinese medicine has no category in this structure. In the 1990s Sun Ten spent some $50,000 for lobbying to accomplish legislation under I think Title XXII (correct me if I'm mistaken) in CA. They briefly (1998) held a contract with Kaiser for 3rd party payment. I'm encouraged that because of this legislation Kaiser hires L.Ac.s to work in their hospital alt. med. clinics. I have mixed feelings that Sun Ten joined the marketing forces of industry to create legislation. They are so small a force in the marketplace. I live and breathe under the forces of FDA, USDA and Fish and Wildlife regulation. Most of Chinese medicine is unregulated regarding herbs which are regulated as food. A new category would be challenging to create. The FDA may create something anyway if Michael McGuffin is correct in his assessment. It's important to note that we are not "corporate America", the ISO 9000 group of companies. That represents less than half of our economy and less than half of the jobs in our economy. It's the elite portion of our economy. Chinese medicine from clinic to college to supplier exists in the other realm of the American economy that flies below the radar (mostly) of that which regulates corporate America. Corporate America in fact pays through their own lobbyists for their own self regulation which we call the FDA, USDA and so on. That's not Jefferson's Constitution ... rather it's a creation of the industry of interest. We also can push to create legislation, yet we are a profoundly small force on the American scene. It's wise to keep a clear vision of this while also maintaining your healthy optimism. Emmanuel Segmen - < Friday, February 14, 2003 10:27 AM Re: ma huang legislation , Rory Kerr <rorykerr@w...> wrote:There are also efforts to make > the FDA reclassify all herbs, regardless of known safety issues, so > that they would no longer be classified as foods. Think about the > consequences of that.that is propaganda put out by large supplement manufacturers who want to protect their ability to market medicine directly to the public, thus bypassing professional care from folks like us. that is the real conspiracy. when we support bogus product labeling and unrestricted access to herbs, we just basically send people to the healthfood store instead of our offices. if herbs are all safe and require no regulation, than they must also be safe for self-medication or prescription by a teenage healthfood store clerk. over 90% of supplements are sold directly to the public with no medical supervison at all.The two true sides of this battle are about government regulation versus corporate laissez faire. It is not at all about consumer choice. that is the scam. for those unfamiliar with history, the era of laissez faire economics in the US was called the robber baron era, when enron like ripoffs were the rule, not the exception. I trust government slightly more than I trust corporations if for no other reason that I can vote out my reps and have zero power over corporate boards. Just be clear that you are not putting any real control in the hands the public by this position, you are putting control in the hands of the elite with their propragandist media machines, the same way tobacco companies were able to seduce so many to smoke UNTIL the government got more involved.ToddChinese Herbal Medicine, a voluntary organization of licensed healthcare practitioners, matriculated students and postgraduate academics specializing in Chinese Herbal Medicine, provides a variety of professional services, including board approved online continuing education. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 14, 2003 Report Share Posted February 14, 2003 At 6:27 PM +0000 2/14/03, < wrote: > , Rory Kerr <rorykerr@w...> >wrote: > There are also efforts to make >> the FDA reclassify all herbs, regardless of known safety issues, so >> that they would no longer be classified as foods. Think about the >> consequences of that. > > >that is propaganda put out by large supplement manufacturers who want to >protect their ability to market medicine directly to the public, >thus bypassing professional care from folks like us. -- Actually it was from the NEJM, but I'll have to get the citation for you on Monday. Rory -- Quote Link to comment Share on other sites More sharing options...
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