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For 2026, the California Cannabis Awards adds a new category for the backyard farmer. Here’s what you need to know.
Are you a Golden State ganja green thumb with a knack for growing backyard bud? If so, the California Cannabis Awards is giving you a chance to prove your pot prowess thanks to a newly added Home Grow – Flower competition.
According to the organization’s February 23 announcement, the new competition category is “designed to recognize cannabis flower cultivated by California residents for personal, non-commercial use,” and will be judged using the same methods and criteria as the professionally grown flower in the annual agricultural event that awards an assortment of gold, silver and bronze medals in the run up to the California State Fair in mid-July where best-of-the-best Golden Bear awards are handed out.
If you think your home harvest has what it takes, here’s what you need to know — and do — to officially enter the competition:
How much time do I have to grow my potentially award-winning weed?
The submission window for the home grow competition — and the rest of the 2026 California Cannabis Awards categories — is open through May 22, 2026. That means your magical plant needs to have been grown, harvested, dried and cured by then.
The reality of this deadline is that this year’s award-winning weed has almost certainly already been harvested.
How much does it cost?
Each submission requires a $250 entry fee, which covers laboratory testing, chemometric analysis and eligibility for medal awards.
What do I need to do?
Start by filling out the official California Cannabis Awards entry form completely (incomplete forms won’t be accepted). Then, create an SC Labs account either through the link in the registration portal or by going directly to www.sclabs.com.
Next, seal and label seven grams of cannabis flower per entry according to SC Labs’ submission requirements and schedule your sample(s) to be picked up by the lab folks.
What will SC Labs be testing for?
The lab’s analysis will look at potency, terpene concentration and cannabinoid concentration and generate a chemometric report (think of it as a kind of chemical fingerprint), which will be the basis for competition scoring. This is important because the competition medals will be awarded exclusively on those laboratory results.
What categories will medals be awarded in?
Gold, silver and bronze hardware will be handed out in the following categories:
The highest concentration of the following six specific terpenes: limonene, myrcene, beta-caryophyllene, pinene, ocimene and terpinolene
The co-dominant terpene profile MCL (Myrcene-Caryophyllene-Limonene)
Total terpene concentration
Primary cannabinoids CBG and CBD
Overall cannabinoid concentration
Is this the same criteria used for judging the professionally farmed flower categories?
Kind of. The chemotype-based sub-categories are the exact same ones used for judging commercial flower entries. The only difference is that the Home Grow entries won’t be separated by cultivation method; sun-grown, indoor and mixed-light submissions will compete together within each category.
Once I’ve submitted my entry, then what?
All gold medal winners in the Home Grow competition will be invited to participate in a live, on-site judging panel held on Saturday, July 25, at the California State Fair to compete for a Golden Bear trophy and the title of “Best Home Grow in California.”
This is crucial: Since the panel of expert judges — the same ones judging the commercial flower categories — will need to sample the gold-medal herb,it’s important that all entrants keep an additional 14 grams of product on hand until the medal winners are announced.
Where can I find out more information?
An extensive competition guide as well as additional information about the 2026 California Cannabis Awards can be found online at www.calcannabisawards.com/awards.
This article is from an external, unpaid contributor. It does not represent High Times’ reporting and has not been edited for content or accuracy.
The next time you walk into a glass door, trip over your own two feet, or pass gas during yoga class, laugh at yourself instead of turning beet-red in embarrassment. New research suggests finding the humor in the moment will make you more likeable—and people will see you as warmer, more competent, and more authentic than if you’re still cringing 5 minutes later.
“For harmless social mistakes, laughing at yourself often makes you look better than blushing or showing embarrassment,” says study co-author Övül Sezer, an assistant professor at the Cornell University SC Johnson School of Business. “Owning your mistake and laughing first can completely shift the room—you move from being judged to being relatable.”
The study—published Feb. 26 in the Journal of Personality and Social Psychology—was inspired in part by Sezer’s research interests: She studies impression management, or the small behaviors that shape how other people see us. Researchers have longknown that embarrassment is a socially useful phenomenon, because it signals remorse and respect for norms. Yet there’s a personal twist to her academic interests, too: Sezer’s experience performing stand-up comedy has shown her that sometimes the better move is to lean into the moment and let out a chuckle.
That dual perspective sparked a question: If you make a mistake, is embarrassment always the best move? Or might laughter be more effective?
When—and why—laughter works
In the study, Sezer and her colleagues ran six experiments involving more than 3,000 participants who read about other people’s embarrassing mishaps, like dramatically knocking over a glass in a restaurant or enthusiastically waving at the wrong person. They were then told or shown photos that gave them a sense of how the person who made the faux pas reacted. In some cases, the individual appeared flustered and self-conscious; in others, they reacted with humor and laughed at themselves. Participants then rated that person on traits such as warmth, competence, morality, and authenticity. Overall, those who laughed at their own minor blunders were judged more positively than those who appeared visibly embarrassed.
“Laughing at yourself signals self-acceptance, and we love people who accept themselves,” Sezer says. The ability to respond with humor is akin to a shoulder shrug—you’re not going to dwell on what other people might think of you. “These are classic, benign norm violations, meaning they’re a little awkward but they’re not harmful,” she adds. Plus, laughing at yourself sends a reassuring message to whoever’s nearby: “You don’t even have to comfort me anymore—it’s the best of both worlds.”
The findings match what Ildiko Tabori, a clinical psychologist in Los Angeles, observes and experiences in real life. She works with comedians at the Laugh Factory in Hollywood and says stand-up offers a kind of real-time laboratory for social dynamics. Comedians who laugh at themselves defuse tension and signal confidence, which makes it easier for audiences to join in. “It allows the audience to laugh at them, too,” Tabori says. “It gives them permission to have a human response.”
Interestingly, study participants frequently saw overt embarrassment as out of proportion to the offense—as if the person felt worse than the situation called for. In the experiments, observers consistently judged everyday blunders to be relatively harmless, even when the person committing them appeared mortified. That mismatch mattered. When someone seemed fixated on a small slip, it suggested heightened insecurity or an overfocus on how they were being judged. “Embarrassment signals heightened self-consciousness,” Sezer says. “It’s almost like you’re overly focused on how you’re being evaluated.”
Laughing, by contrast, conveyed that the person understood the mistake was trivial and didn’t require dramatic self-reproach. In other words, it wasn’t positivity that won people over—it was a reaction that felt proportional to the moment.
An important caveat
A key part of knowing when to laugh at yourself is being tuned in to when doing so isn’t appropriate. Sezer’s study found that people are only judged positively if their mistake is harmless. If someone trips and knocks over a colleague who breaks their arm, for example, it’s inappropriate for the person who caused the injury to laugh at themselves. The same is true if you congratulate a woman on being pregnant—only to learn she’s not.
“If someone else is hurt, laughter doesn’t look confident anymore—it actually looks insensitive, because it signals disregard,” Sezer says. “The key thing is to match your reaction to the seriousness of the moment.”
When someone is harmed, she adds, observers shift from evaluating likability to evaluating morality. In those situations, people expect visible signs of remorse. In the study’s final experiment, participants judged someone who laughed after injuring a colleague as significantly less competent and less moral than someone who showed embarrassment instead. Humor, in that context, wasn’t seen as self-assured—rather, it signaled that the person didn’t fully appreciate the consequences of their actions.
At the heart of it, Sezer says, is emotional calibration: “It’s this emotional awareness of the situation that you signal to others.”
Training yourself to laugh instead of blush
If you’re the type to light up like a fire engine when you say something awkward or get someone’s name wrong, that reaction can feel automatic. Yet there are ways to interrupt it and pivot toward humor instead.
The next time you accidentally hit “reply all” on an email to your entire company, remind yourself of the spotlight effect: We tend to vastly overestimate how much other people notice—and remember—our mistakes. “It’s not going to change your life, and other people don’t care about it as much as you do,” says Caleb Warren, a professor of marketing at the University of Arizona who studies what makes things funny. “People are far more conscious of their own identity than other people’s.”
That’s exactly what Sezer reminds herself before stand-up comedy performances: Other people judge our mistakes much less harshly than we expect they will. She suggests getting in the habit of saying to yourself: “OK, I made this mistake, but was anyone harmed?” The answer is probably no.
“Those types of reframing exercises may help us train ourselves—because I’m also a clumsy person who’s prone to embarrassment,” Sezer says. “This research inspired me to remind myself that I don’t need to be overly apologetic or excessively embarrassed. The best way to shift the dynamic is to laugh at myself, and that helps other people, too, because then they can join you in that laugh.”
Explore the hidden tricks grocery stores use to get you to spend more, driven by psychology and smart design.
Ever walked into a grocery store for “just milk and bread” and left with a cart full of snacks, flowers, and a rotisserie chicken you didn’t plan on buying? You’re not alone. Today’s stores are carefully designed to influence how you shop — and how much you spend. From store layout to sensory cues, retailers use subtle psychological tactics to encourage bigger baskets and impulse buys. Here are the hidden tricks grocery stores use to get you to spend more.
Most supermarkets place essential items like milk, eggs, and bread at the back of the store. This forces shoppers to walk past dozens of tempting displays before reaching their intended purchase. Along the way, you encounter seasonal promotions, end-cap deals, and eye-catching packaging designed to trigger impulse decisions.
Wide aisles near the entrance create a relaxed feeling, while narrower aisles deeper inside subtly slow your pace, increasing the time you spend browsing. The longer you linger, the more likely you are to add extra items to your cart.
Product placement on shelves follows a simple rule: eye-level equals sales. Brands pay premium fees to have their products placed at adult eye level, where shoppers are most likely to notice and grab them. Cheaper or store-brand alternatives are often placed on lower or higher shelves, requiring extra effort to find.
For children, sugary cereals and colorful snacks are placed at kid eye level, strategically positioned to spark “pester power” — when kids urge parents to buy what they see.
Grocery stores are sensory environments. Soft lighting and warm colors create a welcoming atmosphere, while background music is often slow-paced to encourage leisurely shopping. Studies have shown slower music can increase time spent in-store — and total spending.
Then there’s the smell of freshly baked bread or rotisserie chicken near the entrance. These aromas aren’t accidental; they stimulate appetite and create a sense of comfort, making shoppers more likely to buy ready-to-eat foods and treats.
Promotions like “Buy One, Get One Free” or bulk discounts create a sense of urgency and value — even when you didn’t need the extra item. Stores also use charm pricing (e.g., $4.99 instead of $5.00) to make products feel cheaper.
Large shopping carts are another subtle tactic. Bigger carts make purchases look smaller, encouraging shoppers to fill the space. Some stores have quietly increased cart sizes over the years for this very reason.
Understanding these tactics can help you stay in control of your grocery budget. Try shopping with a list, avoid shopping when hungry, and stick to the perimeter of the store where fresh staples are typically located. Taking a moment to compare unit prices can also prevent overspending on misleading “deals.”
Grocery stores aren’t trying to trick you — they’re using proven retail strategies to boost sales. But with awareness and a plan, you can outsmart the system and leave with exactly what you came for — milk, bread, and maybe just one treat.
The kids, work deadlines, what’s for dinner… these are the kinds of things that often occupy our thoughts. What’s going on inside our cells? Not so much. However, our cellular health is the key to a healthy body, and enzymes play an important role in the entire process.
This article is a deep dive into enzymes, what they really are, how I use them, and how they can help with energy, digestion, and more. While I don’t take lots of supplements or even take them every day, enzymes are one of the few exceptions. I used enzymes in my journey to recover from Hashimoto’s autoimmune disease and I still use them now for other reasons.
After 7 years of taking them and plenty of trial and error, I’m sharing what I’ve found!
What Are Enzymes?
Enzymes are like a precision tool our bodies use to break things down and build them back up. From a scientific perspective enzymes are protein catalysts that lower activation energy and speed up our reactions, all without being consumed in the body. Different ones serve different purposes, like a key only fitting a certain lock. For example lipase helps digest fats and only fats, while amylase only digests carbs.
They also work differently under different conditions which is why they can function differently depending on how they’re used. Things like pH, temperature, co-factors, and minerals all play a role in pulling the trigger for enzymes to do their job.
In theory we get them from food, especially produce. Our body also makes many enzymes, like amylase in our saliva to break down carbs, or gastric enzymes for proteins in our digestive tract. These enzymes break down most of the macronutrients in our body so we can actually use what we eat.
However with declining soil quality and nutrient density and disrupted gut microbiomes and absorption, many of us can use some extra help in this area. In hindsight I finally realized that my body wasn’t making and using enzymes well and I really wasn’t absorbing all the healthy food I was eating. Enzymes are just as important as minerals and light in my book when it comes to foundational health.
They’re especially helpful during times of stress, inflammation, and gut issues. Enzymes are also key when it comes to dealing with heavy metals, parasites, and general recovery.
The Best Way To Take Enzymes
If our bodies aren’t effectively making all the enzymes we need, then the next best thing is to take a quality enzyme supplement. How you take them though also makes a difference. When we take enzymes with food they work to help us digest, absorb, and break down the compounds of our food more efficiently. These are especially helpful for reducing bloating and gas after eating. Digestive enzymes also help with that heavy, overly full feeling when food is just sitting around and not being broken down well.
Taking enzymes on an empty stomach works entirely differently. Away from food enzymes work in a more systemic way, like proteolytic enzymes. So while they have multiple uses, the timing matters here. Research has explored enzymes like serrapeptase and nattokinase for circulation and inflammatory support. Nattokinase has been studied for breaking down blood clots, while serrapeptase has been researched for swelling after surgery.
You can find enzymes derived from plant and microbes that help the body fill in the gaps of what it’s already doing. I’ve learned the hard way that the best way to support the body is to work within the body’s natural systems. The idea isn’t to bypass or overload the body’s natural systems, which can lead to problems down the road.
Different Kinds of Enzymes
I mentioned that different enzymes do different things, so what are the different kinds of enzymes? First up there are the lipases that deal with breaking down fats, like glycerol and fatty acids. Next are amylases like glucoamylase and lactase. These deal with carbs, starches, lactose oligosaccharides, and other forms of carbohydrates. There are even some enzymes that target fiber to help make it more digestible, meaning less gas and bloating.
Specialty enzymes like serrapeptase and nattokinase perform other functions in the body.
Deciphering Enzyme Supplement Labels
Turn over an enzyme supplement bottle and you’re sure to see different abbreviations and lingo on the label. For example, protease may be labelled with HUT, PC, and SAPU, which are related to how much enzymes there are and their activity amounts.
These units matter more than milligrams, which don’t tell you much about what it’s actually going to do for you. There are a lot of different terms to consider here, but the main idea is to look beyond the grams and milligrams and look at the activity units.
Who Should Take Enzymes?
Not every supplement is the best option or necessary for every person. Those who can benefit the most from taking an enzyme supplement include anyone with compromised gut function or digestive issues. Research shows benefits for those with low stomach acid and pancreatic insufficiency, both of which can happen with age.
And if the problem isn’t addressed we tend to make less stomach acid and pancreatic enzymes as we get older. Anyone on a high protein or high fat diet can also see benefits, since we’re asking for more digestive power from our body and it could use the extra boost.
Another time I prioritize enzymes is when I’m traveling and eating out or during the holidays. Since I’m breaking my routine during these times I’ve found enzymes are helpful for keeping my digestion on track.
How to Make Enzymes More Effective
If there’s one theme you’ve probably heard me repeat over and over, it’s that supplements work best when they’re layered onto a strong foundation. Enzymes are no exception. Before adjusting doses or experimenting with timing, I focused on simple foundational habits that support the body’s own enzyme production and activity.
Chew More Than You Think You Need To
Carb digestion begins in the mouth thanks to salivary amylase. When we rush through meals, we skip that first important step. Digestion starts before we even swallow.
Slowing down also shifts us into a parasympathetic (“rest and digest”) state. When we eat stressed or distracted, digestive secretions can decrease. For me, something as simple as taking three slow breaths before eating noticeably improves how I feel afterward.
Support Stomach Acid (If Needed)
Low stomach acid becomes more common with age and can impair protein digestion and nutrient absorption. Having enough stomach acid is essential for breaking down proteins. Betaine HCl or bitters can be helpful for this, but check with your provider first. This is very individual, and anyone with ulcers, reflux, GI bleeding, or on certain medications should work with a professional before experimenting.
Don’t Water Things Down
Hydration matters, but large amounts of liquid during meals can dilute stomach acid and enzymes. I drink most of my fluids between meals rather than with them. For some people, that small shift alone reduces bloating and the overly full feeling after eating.
Move After Meals
Even light walking after meals has been shown to support digestion and blood sugar regulation. I’ll often go for a short walk after meals (especially in the sunshine!). Movement also supports lymphatic flow. A short walk, gentle stretching, or simply staying active can support both digestion and recovery without needing an intense workout.
Minerals Matter
Enzymes rely on cofactors like magnesium, zinc, and sodium. Zinc in particular plays a role in digestive enzyme production and stomach acid function. This is why I see minerals as foundational. When we have enough minerals, enzymes, both the ones we make and the ones we supplement, tend to work better.
Enzymes and Autoimmune Recovery: My Experience
During my recovery from Hashimoto’s, I often felt congested inside, like things weren’t moving well. Stiff joints in the morning, puffy fingers, and low energy were all too common for me. I started with the foundational basics like minerals, nervous system work, sunlight, sleep, and a focus on eating protein. I then layered in both digestive and systemic enzymes.
The changes were gradual, but over time I noticed:
My rings were looser in the morning
My joints felt less stiff
Digestion felt smooth instead of heavy
My sleep deepened
Enzymes aren’t a magic pill, but I’ve definitely noticed how using them helped my body have what it needed to reach my health goals. And the consistency helped more than doing something intensely.
Enzymes for Performance and Recovery
While this is discussed more in fitness circles, it’s worth mentioning. Especially since more people are realizing how much better they feel physically and mentally with a focus on healthy proteins.
Digestive enzymes can support higher protein intake by improving nutrient breakdown and reducing bloating. Proteolytic enzymes (taken away from food) have also been studied for supporting muscle recovery and reducing delayed-onset muscle soreness (DOMS).
While performance wasn’t my original reason for using enzymes, I’ve seen consistent anecdotal benefits here, especially among strength athletes. My older teen athletes now take enzymes without any prompting from me because they’ve noticed a difference too.
The Best Enzyme Options
As with any supplement, quality and context matter. Be sure to discuss with your healthcare provider if you take anticoagulants, have a bleeding disorder, are post-surgery, or have ulcers or active GI bleeding. Children may benefit from specific enzymes, but you can always check with their provider for targeted advice.
When choosing an enzyme look for something that has clearly labeled activity units (not just milligrams). Third-party safety testing when available is also something I reach for. I also want formulations that are designed to remain active at appropriate pH levels so my body can actually use the enzymes.
My favorite enzymes that check all the boxes for me are these:
Practical Tips If You Want to Experiment
If you’re considering enzymes, here’s the approach that worked for me:
Start low (one capsule)
Track how you feel (digestion, energy, stiffness, sleep, etc.)
Increase gradually if needed
Be intentional about timing (with meals vs. away from meals)
I found that timing and consistency mattered far more for me than high doses.
Final Thoughts on Enzymes
Enzymes may not be flashy or trendy, but they’re the quiet catalysts working hard behind the scenes. For me, they were a needle mover when layered onto sleep, minerals, sunlight, nervous system safety, and nutrient density.
I don’t take many supplements daily. Enzymes are one of the few I rotate in regularly because I’ve seen enough benefit to keep them in my toolkit. Our bodies are incredibly intelligent, but sometimes they just need the right support to function how they were designed.
Have you ever experimented with enzymes before? I’d love to hear about it in the comments!
Over the course of 2025, Jayant Mishra of Mission Viejo, California, progressively developed scaly, itchy red patches on his skin. Then came the pain and swelling in the joints of his hands, making it difficult to do his work at a bank.
His primary care doctor referred him to a rheumatologist, who diagnosed psoriatic arthritis. She advised Mishra that while there’s no cure, there were many new medicines that could keep the autoimmune disease in check, and she recommended one, Otezla.
At first, Mishra balked. He knew the medicines were expensive. He worried about side effects. He thought he could manage with over-the-counter drugs.
But by September he was in so much pain that he agreed to try a starter pack provided by Otezla’s manufacturer, Amgen. It worked: The skin lesions disappeared, and the joint pain that kept him up at night dissipated. He was sold.
His rheumatologist got approval for the drug from his insurer, UnitedHealthcare, and signed him up for Amgen’s copayment assistance program. Having enrolled other patients, she told Mishra the copay card, similar to a credit card, should last a year, he said, shielding him from the drug’s high list price: around $5,000 for a 30-day supply, according to GoodRx.
He said the doctor explained that, in her patients’ experience, insurers and their pharmacy benefit managers negotiated a deeply discounted price with Amgen — she estimated $1,400 to $2,200 a month. Patients paid a percentage of that amount, their “patient responsibility,” using the copay card.
Mishra said he was approved for a copay card covering $9,450 a year. “I was happy when I got the message,” he said.
He added that the doctor reassured him about the cost. “She said: ‘You shouldn’t have to pay anything out-of-pocket. Your copay card will cover this.’”
He started the medicine and, at first, paid nothing.
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The Medical Service
Otezla, which comes in a pill, is approved to treat some autoimmune disorders, including psoriatic arthritis.
The Bill
$441.02, for the second month’s fill of the drug — before Mishra chose to ration rather than refill his prescription, because his copay card was empty.
The insurance statement from UnitedHealthcare’s pharmacy benefit manager, Optum Rx — another subsidiary of the same parent company, UnitedHealth Group — showed it did not provide a negotiated discount and covered just $308.34 of the full $5,253.85 charge for a 30-day supply. The charges for the second month depleted the copay card and left Mishra owing the balance.
The Billing Problem: Copay Card ‘Tug-of-War’
Copay assistance programs are part of a “tug-of-war between drug manufacturers and insurers,” said Aaron Kesselheim, a professor of medicine at Harvard Medical School who studies the pharmaceutical industry.
The value of drugmakers’ copay cards has become more unpredictable as insurers try to restrict their use. Many insurance plans, for instance, do not count the money from a copay program toward a patient’s deductible.
And patients who use a copay card can wind up paying full or nearly full price rather than the discounted rate negotiated by their insurer’s pharmacy benefit manager.
“When you purchased your medication a Manufacturer Coupon was used,” Mishra’s explanation of benefits statements read, in tiny letters. The amount the copay card covered “was not applied towards your Deductible and Out of Pocket Maximum.”
Caroline Landree, a spokesperson for UnitedHealthcare, said that “the copay card is an arrangement between the patient and the pharmacy. It is used outside of insurance.”
In an emailed statement, Elissa Snook, a spokesperson for Amgen, expressed a different view of who was responsible for Mishra’s dilemma: “Copay assistance programs are designed to help patients start and stay on prescribed therapy, but the value of that assistance can be exhausted more quickly when a health plan requires patients to pay the full list price of a medicine.”
Few patients can afford the list prices that pharmaceutical manufacturers charge in the United States for brand-name drugs.
Insurers insulate themselves and their customers from those higher prices through pharmacy benefit managers’ negotiated discounts. They might, for example, designate certain drugs as preferred medications for plan members in exchange for the manufacturer agreeing to a significant price reduction.
Manufacturers’ copay assistance programs offer another way for patients to avoid paying full price. The assistance is intended to encourage patients to choose an expensive, brand-name drug — not one that “treats the same condition that the insurer has gotten for a cheaper price,” said Fiona Scott Morton, an economist at the Yale School of Management who studies drug pricing.
The assistance also discourages patients from discussing with their doctor whether a cheaper, generic drug would do, drug industry researchers said.
While the Food and Drug Administration first approved a generic version of Otezla in 2021, Amgen has sued to block U.S. sales of its generic competitors, ensuring the brand-name drug has patent protection until 2028. Generic versions are available overseas and in Canada, where patients can purchase it in some cases for less than $100 a month.
Mishra said one of his children joked he could cover a trip to visit relatives in India simply by purchasing his medicine while he was there.
The Resolution
Mishra has a health plan with a $5,000 deductible and contributes to a tax-free health savings account.
In September, he paid for the first month’s supply of Otezla with the copay card. But paying for October’s supply emptied the card — which he originally expected to last a year — and he said he used his HSA to pay for the roughly $400 that remained.
But wary of what the drug would cost in November and December, Mishra said, he tried to spread out the pills he had left from the starter pack and the first two months’ supply. He skipped some days and took only half of the prescribed dose to stretch the supply for two more months, knowing he would get a new copay card with the new year. Many of his symptoms returned, he said.
In January, he got another copay card, good for $9,450, which again wasn’t sufficient to pay for two months’ supply. He again paid the remaining balance in February from his HSA to count toward his $5,000 annual deductible. This time he owed $550, he said.
Mishra said his symptoms have resolved. With no clue what he’d be charged for March’s supply, he called UnitedHealthcare in late February and was told he would need to pay $4,450 for the month to meet his out-of-pocket maximum, he said.
But he said he pressed the representative further, asking why UnitedHealthcare doesn’t have a negotiated price. It does, they told him. “Actual price is $6,995.36.”
Mishra says his doctor reassured him that a copay card would cover his out-of-pocket costs for an expensive drug to treat psoriatic arthritis. But the assistance ran out much sooner than he’d expected.(Ariana Drehsler for KFF Health News)
The Takeaway
Copay cards and drugmaker programs that promise patients “you could pay $0” work in mysterious ways.
On the one hand, they encourage patients to use brand-name or expensive drugs that are off insurers’ formularies, or lists of preferred, covered drugs. On the other, many patients couldn’t afford prescribed medicines without them.
Patients with public insurance, such as Medicare and Medicaid, are not permitted to use the cards, because the government considers them an end run around its attempts to bring down drug spending.
Using a copay card has gotten trickier as insurers push back. First, patients need to understand whether there is an annual dollar or time limit on the card and how it works with their insurance. Otherwise, they risk ending up reliant on a drug they can’t afford.
Less expensive drugs often can suffice. For example, there are a number of medicines to treat psoriatic arthritis, some of which may be cheaper or have better coverage from a particular insurer. Patients should ask their doctors whether cheaper medicines will work.
It also can help patients to consider their prescriptions when they select a health plan. Landree, of UnitedHealthcare, said Mishra could have selected a plan for 2026 that would have covered Otezla for a $100 copay each month, though that would have meant a higher premium.
“Personally I’m not in financial distress — I can afford it,” Mishra said. “But it was sticker shock, and it just doesn’t seem right.”
Bill of the Month is a crowdsourced investigation by KFF Health News and The Washington Post’s Well+Being that dissects and explains medical bills. Since 2018, this series has helped many patients and readers get their medical bills reduced, and it has been cited in statehouses, at the U.S. Capitol, and at the White House. Do you have a confusing or outrageous medical bill you want to share? Tell us about it!
A woman with multiple sclerosis wanted to be able to walk up the stairs at home without losing her balance. Her doctor prescribed medicine that helped, but then approval from her insurance plan for the drug expired.
“Why do I need a prior authorization for something that I am already prior-authorized to take? If my doctor says that they want me on a medication, why does my insurance have another say in that?”
— Jaclyn Mayo, Lunenburg, Massachusetts
Jaclyn Mayo has multiple sclerosis, an autoimmune disease that damages the nervous system and can mess with coordination and balance. To get steadier on her feet, Mayo had been trying to lose weight: A lighter body puts less stress on the joints and leads to greater flexibility.
After Mayo didn’t have much luck with diet and exercise, her physician prescribed Zepbound, a GLP-1 weight loss medication that suppresses appetite.
“It was really helping me,” she said. “I could go up and down stairs and not feel like I was going to fall.”
As a happy bonus, the GLP-1 seemed to ease other MS symptoms for Mayo: She started sleeping through the night, and the frequent numbness in her hands went away.
After being on Zepbound for seven months, she fell into an insurance pitfall: prior authorization.
In August, her pharmacy wouldn’t refill her prescription, and it wasn’t clear why.
She called her pharmacist, then her doctor’s office, the pharmacist again, then her insurance company. After speaking with the insurance company’s pharmacy benefit manager — a third-party company that oversees prescription drug plans for insurers — Mayo figured out that the advance approval her insurer had granted for the drug, known as prior authorization, had expired.
Insurers require prior authorizations for certain treatments or tests, especially costly ones. When they do, your doctor has to make the preauthorization request to your insurance company, explaining why you need the treatment. Next, the insurer decides if it agrees that the care is medically necessary and if it will pay for it.
Mayo had been taking the weight loss medicine for less than a year and didn’t understand why a new prior authorization was needed so soon. She said she never got a letter or email notifying her that the clock had run out on her first prior authorization. As someone with a chronic illness, Mayo said, she keeps close track of her medical paperwork. She feels like she did everything right, which, she said, made the situation especially infuriating.
Her doctor submitted the necessary paperwork then found out the new approval would take seven to 10 business days.
At this point, Mayo had been off her medication for two weeks. Her sleep was getting worse, and the tingling numbness in her hands returned. So she asked that her prior authorization be expedited, only to learn that her doctor, not Mayo, would need to make the request for an urgent review.
“That red tape was completely avoidable,” she said. “And all that they needed to do was communicate clearly to me. And then I could have continued my medication without delays. But they didn’t.”
Why Insurers Want Prior Authorization
Doctors are often frustrated by the prior authorization process, but insurers argue it helps keep costs down.
AHIP, the insurer trade group formerly known as America’s Health Insurance Plans, declined an interview request. But in an emailed statement, it said that prior authorizations are an important safeguard that helps ensure patients receive safe, evidence-based care and keeps coverage affordable.
In a 2024 letter, the American Medical Association, which represents physicians, said the way health plans use prior authorizations is “opaque and overly complex,” creating delays in care and greater administrative burden.
Patients are also frustrated. A recent poll found that 1 in 3 insured adults call prior authorizations a “major burden” to accessing health care.
Mayo hit preauthorization hurdles likely because her physician prescribed a GLP-1, an expensive class of medication. The more costly the treatment, the greater the scrutiny, said Miranda Yaver of the University of Pittsburgh, who studies health politics and administrative burdens within the insurance system.
Issues with prior authorizations are common. Policymakers could standardize how insurance companies evaluate prior authorization requests to prevent more Americans from experiencing medical disruptions, Yaver said.
“It’s a solvable problem, if we have the will and the political conditions are ripe. I don’t think that they are at this particular moment,” she said.
Here’s what to know about getting prior authorization requests approved in a timely manner.
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1. Find Out When Your Prior Authorization Expires
Individual insurance companies, and even the individual plans within those companies, often have different policies for prior authorizations.
“As you can imagine, that becomes an absolute nightmare,” said physician David Aizuss, chair of the AMA’s board of trustees.
While expensive treatments are more likely to be targeted for prior authorization review, Aizuss said it also happens for low-cost generic drugs.
To figure out how long your prior authorization lasts, reach out to customer service at your insurance company or pharmacy benefit manager, whichever handles your plan’s prior authorizations.
2. Don’t Procrastinate
Getting a prior authorization isn’t always quick, so build in time for things to go wrong.
It took Mayo nearly three weeks to sort out the prior authorization issue for her GLP-1 prescription. She made the initial refill request about a week before her medication was set to run out and ended up without the drug for over two weeks.
3. Ask Your Doctor To Request an Expedited Review
As you wait for your prior authorization to go through, your doctor might not know how much medication you have left, or that your health may be declining. You can have your doctor request an expedited review. Though, as Mayo found, insurance companies and PBMs won’t always volunteer that as an option.
When an expedited review is appropriate is up for interpretation, said Kaye Pestaina, director of the Program on Patient and Consumer Protections at KFF, a health information nonprofit that includes KFF Health News.
“No one knows the specifics of what urgent means,” she said.
Federal regulations require that urgent requests made by people with employer-based plans be decided within 72 hours. And, on Jan. 1, a federal rule took effect that creates a similar requirement for all Medicare Advantage, Medicaid, and Children’s Health Insurance Program plans. However, this rule doesn’t apply to medications.
4. Consider Other Treatment Options
When Mayo’s doctor first suggested that she try a GLP-1, approval for the specific medication was taking a long time. When it became clear the request would probably be denied, the doctor canceled that initial request and put in a prior authorization request for a different brand of GLP-1, Zepbound. It was approved.
Ask your doctor about treatment alternatives. Health plans have different formularies — lists of medicines that are routinely approved. It might be easier to switch medications than to fight to get your health plan to approve coverage.
But be aware that your insurance company might change your health plan’s drug formulary anytime and require you to get a new prior authorization.
5. Don’t Be Afraid To Appeal
Submit an appeal, even if you’re worried you’ll lose. Yaver said that, based on the research set to be published in her book, Coverage Denied: How Health Insurers Drive Inequality in the United States, people who appeal a prior authorization or claims denial win about half the time.
First figure out where to send your appeal. Usually, it’s an insurance company, but if the treatment you need is medication, it may be a PBM.
Include detailed records in your appeal.
If you’re trying to get approval for a specific medication, Yaver said, send documentation showing that you tried other medications or treatments that didn’t work. This helps make your case and can speed up the process.
“I actually just went through a prior authorization for my migraine drug,” Yaver said. “It actually went through very quickly.”
Health Care Helpline helps you navigate the health system hurdles between you and good care. Send us your tricky question and we may tap a policy sleuth to puzzle it out. Share your story. The crowdsourced project is a joint production of NPR and KFF Health News.
Cannabis is most popular psychoactive substance among those prohibited by the international drug control regime. Yet, at least partly driven by the increased recognition that prohibitionist approaches to cannabis control cause more problems than they solve, cracks are appearing in the historic global consensus of prohibiting cannabis. Recent years have seen an increase in both the number of countries deviating from strict prohibition and the variety of policy approaches underpinning this deviation. As such, cannabis arguably has more variation in legality than any other controlled drug. The aim of this chapter is to explore this variation by outlining some of the key legal and policy deviations from prohibition and reflecting on the implications these have for the future of cannabis as a controlled substance.
Analysis: Many Unregulated Hemp-Derived Intoxicants Contain THC, Synthetic Cannabinoids
Milwaukee, WI: Many commercially marketed hemp products contain THC levels exceeding federal limits as well as synthetically produced novel cannabinoids, according to an analysis published in the Milwaukee Journal Sentinel.
Reporters purchased 30 unregulated hemp products from area retailers and had them independently tested for purity and potency.
Consistent with the results of prior analyses of commercially available intoxicating hemp products, most products contained THC percentages exceeding legal limits (above 0.03 percent). Half of the products tested positive for the presence of lab-produced cannabinoids, including HHC (hexahydrocannabinol) and THCP (tetrahydrocannabiphorol). Over one-third of the products contained mold and pesticides, while one product tested positive for the presence of the chemical solvent methylene chloride, which is commonly used in paint stripper. At least one product contained a forged COA (certificate of analysis).
In November, federal lawmakers approved legislation recriminalizing the sale of certain hemp-derived intoxicating products. Specifically, the bill redefines federally legal hemp products as only those containing no more than either 0.3 percent or 0.4 milligrams of THC or other cannabinoids that produce similar effects, including THCA. In addition, it criminalizes “any intermediate hemp-derived cannabinoid products which are marketed or sold as a final product or directly to an end consumer for personal or household use” as well as products that are produced following chemical synthesis, such as those high in delta-8 THC content.
In 2021, NORML issued a report on delta-8-THC and other novel synthetically derived cannabinoids, cautioning consumers to avoid these unregulated products because they are often mislabeled and may contain impurities. NORML has urged the FDA to establish regulatory guidelines governing the production, testing, labeling, and marketing of hemp-derived intoxicating cannabinoid products, but has argued against recriminalizing them.
This half day workshop covers the legal foundations and recent developments affecting psychedelic churches and sacramental practices. It focuses on religious freedom protections under RFRA, recent DEA exemptions, and ongoing enforcement risks under the Controlled Substances Act.
Participants will examine practical risks faced by churches and leaders, including criminal enforcement, ethical harms, professional licensing exposure, and threats to tax status, payment processing, and online platforms. The session reflects the growing visibility and spiritual importance of psychedelic sacramental practice.
The workshop maps real world legal pathways and common traps. Topics include the RFRA strict scrutiny framework, lessons from recent federal and state cases, DEA exemption decisions, and the need for clear ethical standards and accountability systems.
This workshop is for church leaders, facilitators, participants, licensed professionals, and attorneys. Participants will leave with a clear, practical understanding of how psychedelic churches can structure practices and prepare for legal challenges.
From early reform efforts to modern legalization fights, these Black leaders helped reshape cannabis law and justice.
Written by Parabola Center for Law and Policy
Today, support for cannabis legalization is widespread. A majority of Black Americans favor reform, politicians now campaign on outdated drug laws, and celebrities speak openly about racial disparities while building careers in the legal cannabis industry. That visibility, however, is the result of decades of work by Black leaders who challenged prohibition at moments when public opinion, policy, and personal risk were far less predictable.
In earlier decades, speaking publicly in favor of legalization carried far greater personal and professional risk. Before public support began to increase, advocates could jeopardize their careers and reputations. Consumers faced criminal prosecution and incarceration. These risks were not borne equally: because the War on Drugs disproportionately targeted Black communities, Black advocates and consumers faced significantly higher legal and social consequences.
Since the 1990s, High Times has celebrated both unsung heroes and well-known activists for bravely standing up for what they believe in. This Black History Month, we continue that tradition by recognizing some of the Black leaders whose early courage and truthfulness were critical to the legalization movement. Without their courage, we might never have secured the rights we often take for granted today.
Parabola Center for Law and Policy, a POC-led cannabis nonprofit that puts people over profits, curated this list to honor the individuals who have done just that–fought for people’s rights without regard for personal risk or gain. From the thousands whose hard work and dedication have led to better marijuana laws, we selected 10 Black champions to honor for their contributions to legalization.
1. Professor Michelle Alexander
In 2010, Michelle Alexander changed the conversation with her bestselling book, The New Jim Crow: Mass Incarceration in the Age of Colorblindness. While reshaping the national dialogue in favor of criminal justice reform, she also made a major impact on cannabis policy.
In a memorable address to the International Drug Policy Reform Conference, she criticized the hypocrisy of white men profiting from newly legal cannabis while thousands of Black and brown people remained locked up for the same activity.
In 2015, she inspired a new generation of cannabis leaders when she declined to endorse Ohio’s legalization effort, writing, “Granting an oligopoly for ten wealthy investors is not justice.” The measure failed 65-35.
2. Dr. Joycelyn Elders
An outspoken advocate for public health, Dr. Joycelyn Elders is best known for her steadfast support for comprehensive sex education in public schools. In 1993, she became the first Black person to serve as Surgeon General, nominated by Bill Clinton, and she achieved extraordinary results for underserved communities. Although widely recognized for her moral clarity and candor on many public health issues, it is less well known that she was also an early supporter of marijuana legalization.
In 2010, she supported California’s Prop 19, tellingthe New York Times, “I think we consume far more dangerous drugs that are legal: cigarette smoking, nicotine and alcohol. I feel they cause much more devastating effects physically. We need to lift the prohibition on marijuana.”
3. Major Neill Franklin
After 34 years in law enforcement, Major Neill Franklin began reexamining his role in prohibition and in repairing the harm it had caused. In 2010, well before legalization entered the mainstream, he joined the Law Enforcement Action Partnership, and testified in support of marijuana legalization across the country. Over the next decade, using his professional credibility and reputation, he helped broaden the movement by making the case that regulated cannabis was better for public safety.
His groundbreaking leadership didn’t stop at legal cannabis; he also joined United Nations advocacy efforts to end the prohibition of all drugs globally. Dubbed “the cop who broke with the drug war,” Major Franklin was recognized as a High Times Freedom Fighter last year.
4. Dr. Carl Hart
Dr. Carl Hart is a neuroscientist and psychologist at Columbia University who has spent decades challenging myths about drug use through both his research and his acclaimed books. When trace amounts of cannabis in Trayvon Martin’s blood were cited to justify his killing, Dr. Hart publicly dismantled the claim, comparing it to the alarmist narratives of Reefer Madness.
He has also served as an expert witness in family court to protect mothers from having their children removed based solely on a positive cannabis test during pregnancy. By consistently confronting fear-based policymaking and advancing evidence-based research, he has reshaped the legalization debate.
5. Linda Jackson, LVN
A cannabis nurse who was evaluating patients for cannabis approvals as early as 2003, Linda Jackson has been described as “way ahead of the curve.” While nurses’ contributions in the early era of medical cannabis in California received less attention than those of physicians, they were equally essential. In aninterview with the cannabis journal O’Shaughnessy’s, she detailed the process she used for patient intake.
Because medical cannabis regulations had not yet been clearly defined, she and her team developed a framework from scratch to interview patients, assess their history, and obtain their consent–all using telemedicine. Through this approach, she estimated that between 300 and 400 patients received approval to medicate with cannabis.
6. Dr. Renee Johnson
A scientist and professor at Johns Hopkins Bloomberg School of Public Health, Dr. Renee Johnson would not describe herself as an “advocate.” But as a researcher who looks at substance use in marginalized groups including people of color, immigrants, and LGBTQ+ youth, her work to discover and publicize the true impacts of legalization has been vitally important.
When many of her counterparts were quick to declare that medical cannabis laws increased use, she led astudy showing the opposite: three years after medical marijuana was first approved, rates of use declined. At the same time, she warned that use could rise or fall depending on context, emphasizing that public education would be key. Her commitment to truth over rhetoric has had a meaningful, positive impact on the legalization debate.
7. Professor Beverly Moran, Esq.
The first Black woman to serve on the national board of NORML, Professor Beverly Moran has a wealth of credibility as a professor of law and sociology. A longtime academic affiliated with institutions such as Vanderbilt Law School, she consistently focused on protecting consumers within emerging legal markets.
In aninterview, she explained the distinction that drives her work: “We have to understand that there’s a difference between consumers and the industry. . . [T]obacco consumers do not want tobacco to be more addictive, and yet tobacco companies worked for decades to make it more addictive. Alcohol producers and casinos would be more than happy if everyone was addicted to their products. These are the issues we deal with. . . how to keep it safe, how to keep it legal, how to keep research going, how to keep people out of jail.”
8. Dorsey Nunn
With a three-word question – “What about Pookie?” – Dorsey Nunn challenged the national legalization movement to call for the transition of those in the legacy market into the legal market. Sentenced to life in prison at age 19, he began advocating for the rights of incarcerated people while still behind bars. After his release, he co-founded All of Us or None and became executive director of Legal Services for Prisoners with Children, helping build a nationwide movement to restore the civil rights of formerly incarcerated people.
Featured in 13th by Ava DuVernay, Dorsey Nunn has changed the conversation by insisting that those most affected by the War on Drugs lead the fight to end it.
9. Deborah Peterson Small
The academic article The War on Drugs is a War on Racial Justice was written by attorney, community organizer, and Harvard Law School graduate Deborah Peterson Small in 2001. When she wrote How We Can Reap Reparations from Marijuana Reform in The Root in 2016, she had been inspiring organizations and activists for over 15 years with her organization Break the Chains, and it was still far ahead of the curve.
As one of the first people to argue that marijuana legalization should serve as a way to compensate the Black communities that the War on Drugs had harmed, Deborah Small has had a profound impact on the way that legalization laws were written and implemented.
10. Clifford W. Thornton, Jr.
Clifford Thornton retired in 1997 to work on drug policy issues. By 2001, he had spoken to over 60,000 people about drug policy reform, focusing on race relations, economics, and public health. In his talks, he shared his own tragic story of drug criminalization, when his mother died from a heroin overdose.
In 2006, he became the first African-American candidate to appear on the general election ballot for Governor of Connecticut. Over the following decades, he continued to appear in the media hundreds of times, serving on the NORML board and helping to remove the DARE program from various districts. Almost 25 years after Clifford began full-time advocacy, his home state of Connecticut finally legalized cannabis.
Honorable Mention: Representative Barbara Lee
No list of this kind would be complete without mentioning Congresswoman Barbara Lee, an iconic marijuana law reform advocate whose outspoken support for change dates back to the 1970s. Rather than holding a static position or claiming vindication as public opinion shifted, Rep. Lee kept innovating and introducing more bills, culminating with the Marijuana Opportunity Reinvestment and Expungement (MORE) Act.
When the MORE Act passed the U.S. House in 2020, it marked a symbolic but significant milestone: the first federal legalization bill approved by a chamber of Congress explicitly centered on racial justice. Without her decades of strategic and pioneering leadership, cannabis legalization in the US might look very different today.
Authors’ Note: To prevent any conflicts of interest, Parabola Center staff, board members, and advisors were not considered for this list.
All images courtesy of Parabola Center.
This article is from an external, unpaid contributor. It does not represent High Times’ reporting and has not been edited for content or accuracy.
In a dark room, in the middle of the night, a woman lies dreaming. Suddenly, her eyes beneath their lids dart crisply left-right, left-right. The eye signal means she knows she’s dreaming.
Lucid dreamers are people who can recognize that they are dreaming and, in some cases, control the content of their dreams. For scientists, they have proven a crucial link to this nightly hallucinatory state. In a new paper in the journal Neuroscience of Consciousness, researchers asked dreamers, both lucid and otherwise, to dream about solving a specific puzzle they’d failed to solve before falling asleep. While the study was small, the team saw signs that dreaming about a puzzle was linked to being able to solve it the following morning–although, intriguingly, normal dreamers were more successful than lucid ones.
A mysterious landscape
For many years, dreaming was seen as more or less impossible to study scientifically, says Robert Stickgold, a professor at MIT who studies dreaming and memory. The verbal reports of people who’ve just woken up are not strictly speaking an unbiased source of information—you’re just going on their say-so that they dreamt, and what they dreamt about.
Still, scientists have devised clever ways to investigate how sleep and dreams can affect us. Studies have looked at whether playing sounds or providing other prompts during different stages of sleep can influence what people are capable of when they wake up. One recent study found that providing cues to remind people during Rapid Eye Movement (REM) sleep, when most dreams are thought to happen, about a process they had been learning led to better performance later.
As well, in recent years, researchers have found ways to influence dreams by communicating with people while they are in a lucid state. In 2021, Ken Paller and Karen Konkoly of Northwestern University and their colleagues reported that they had established two-way communication with lucid dreamers, tapping their hands in a specific pattern and having them signal back with eye movements. The sleeping subjects received math questions and dreamed about the solutions, relaying them to the experimenter. This work opened the door to someday, perhaps, asking people in real time what they are dreaming about.
It is still unclear however, whether dreams might have some benefit for us, such as helping us work through issues we encounter during the day. It certainly feels that way—but proving it is far more difficult.
“How do dreams contribute to our creativity and problem solving abilities in the waking state?” asks Paller. “You could ask that by giving people problems before they go to sleep, and see if they come up with the answers when they wake up. But then, you’ll never know if it was because of what they were thinking about before they went to sleep, or as they were going to sleep, or any other time period–not their dreams.”
Dreaming of solutions
In this new study, to explore whether explicitly dreaming about a problem can help people find solutions to it, Paller, Konkoly, and their colleagues had 20 subjects work on a set of logic puzzles. Each puzzle had a separate soundtrack that played while they worked on it. Then, as the subjects got ready to sleep in the lab, researchers explained that the soundtrack for a randomly selected puzzle they hadn’t been able to solve would play once they reached REM sleep. This was their cue to keep working on the puzzle in a dream.
No one knew ahead of time which puzzle they’d be asked to solve. That meant the researchers could see whether dreaming of the specific puzzle was linked to solving it later. If dreamers found themselves lucid, the researchers asked them to announce the fact with an eye signal. In the morning, subjects reported their dreams to the researchers and had another chance to work on the puzzles.
Some people dreamed of puzzles, some didn’t, some were lucid, some were not. Interpreting the data proved tricky, but one thing did come clear, says Konkoly. People who dreamed of the puzzles did tend to be more successful at solving them in the morning.
Contrary to what Konkoly expected to see, “we had a lower solving rate for puzzles incorporated into lucid dreams,” she says. You’d think that being aware of dreaming and being able to control events would lead to better problem solving. But that doesn’t seem to be the case.
“One theory of creative problem solving is that during wake, you become fixated on an incorrect solution path, and then you forget that during sleep,” Konkoly says. That allows your mind to find the right answer, without interference. Asking people to bring deliberate focus to solving a puzzle during a lucid dream might prevent that forgetting, she speculates.
Another theory is that lucid dreams might be too much like waking consciousness to help with solving problems. “Your unconscious mind has all this plurality of simultaneously thinking about 10 things at once…It’s not limited by a single track,” Paller muses. “And maybe that’s more creative, in a sense. Maybe lucidity is therefore antagonistic, because you want to not just focus on one thing, but focus on a whole bunch of things.”
The results tally with findings from other work on dreaming and creativity, says MIT’s Stickgold, who was not involved in the study. He points to a 2023 study from his group, led by Adam Horowitz, in which subjects were asked before sleeping to dream of trees. Upon waking, they were presented with tests of creativity around the theme of trees. While the study couldn’t control for what people were thinking about before they went to sleep, the way Paller and Konkoly’s study does, “the more references they had to trees in their dreams, the more creative they were,” Stickgold says. That suggests that priming people to dream about a subject can change how they think about it later.
The way forward
Regardless, Konkoly points out that the goal of this research is to understand what dreams might be doing for us. It’s not to enable us to manipulate dreams for our benefit, at least not yet.
“I think this idea of dream engineering, where you can work with dreams and interact with them, is really important for moving dream science forward,” she says. But “it’s good to keep in mind…that without understanding exactly what dreams are for, we shouldn’t try to co-opt all of them for our waking life goals.”
Indeed, dreams have an odd staying power. Stickgold recalls that after the tree study, “Adam got notes and text messages from people a week later saying, ‘I’m still dreaming about trees.’” Stickgold wonders whether the effects might last longer than one might think.
“I would like to look at that–that dream induction leading to creativity–and really make clear whether this is a creativity that lasts for half an hour or a day or a week,” he says. “It might have a long-term effect.”
After urging Republicans earlier this year to make health care a central issue in their midterm campaigns, President Donald Trump gave the issue only passing mention in his record-long State of the Union address this week.
Meanwhile, Trump’s nominee to become U.S. surgeon general, Casey Means, a favorite of the “Make America Healthy Again” movement, got her long-delayed hearing before a Senate committee this week. Means’ nomination has been controversial not only because of her outside-the-mainstream medical views but also because she would be the first surgeon general without an active medical license.
This week’s panelists are Julie Rovner of KFF Health News, Alice Miranda Ollstein of Politico, Sheryl Gay Stolberg of The New York Times, and Lauren Weber of The Washington Post.
Among the takeaways from this week’s episode:
Trump devoted little of the State of the Union to health care, even though affordability is top of mind for voters. The topics he did address, briefly, included lowering drug prices — an effort that has yielded some benefit for some people — and, notably, fraud. The next day, the administration announced it would withhold Medicaid funding for Minnesota over fraud allegations. While fraud is a serious, persistent problem for Medicaid, which covers those who are low-income and disabled, withholding federal funds from a single, Democratic-led state is a major step that puts other states on edge.
Means, Trump’s nominee for surgeon general, on Wednesday appeared before senators to make her case for confirmation. A central figure in the MAHA movement, Means was smooth and gracious in her presentation, yet there were worrying signs for public health — she declined to endorse the seasonal flu vaccine, for instance. She also faces questions about her medical credentials, a key qualification in particular for someone who would serve as the head of the Public Health Service Commissioned Corps.
The issue of abortion access was downplayed in Trump’s State of the Union and Means’ nomination hearing, reinforcing how times have changed since the first Trump administration — and raising questions about whether voters who strongly oppose abortion will be motivated to turn out for the midterm elections. Instead, Trump discussed fertility drugs during his speech, and Means expressed what she said are her concerns about the risks of oral contraceptives.
I arrived in Tokyo in November for the Japanese International Hemp Expo (JIHE) 2025 with a familiar mix of jet lag, curiosity, and professional reflex. After decades working at the intersection of cannabis, law, and global markets, I’ve learned that the plant reveals more about a society than almost anything else. Where it’s embraced, feared, regulated, or whispered about tells you volumes about culture, history, and power.
Japan tells that story quietly, but unmistakably.
I was in Toronto just a few days earlier, where cannabis had been a focused topic at the International Bar Association (IBA) Annual Conference. In Canada, the discussion around cannabis is mainstream and where lawyers, regulators, and business leaders debate policy, compliance, and international markets with the same seriousness they do banking or intellectual property. Cannabis content that touched on cross-border trade, medical access, and compliance frameworks drew interested audiences, and there was no stigma in asking hard questions about the future of cannabis in global law.
It was striking to see how normalized the conversation had become in Canada over the past several years. But also, how this topic has become embraced by the international legal community which, not too many years ago, refused to discuss the topic due to the conservative nature of the legal profession, in general.
Stepping off the plane in Tokyo, the contrast was immediate. In Canada, cannabis is part of public discourse, policy development, and even social culture. In Japan, even the word is whispered. Enforcement is strict, social tolerance is low, and every interaction is filtered through layers of caution. The contrast was not just legal, but also cultural. Having just come from Toronto’s conference halls, I could see how Japan’s approach reflects a different philosophy entirely: patient, deliberate, and deeply conscious of social cohesion. Where Canada’s approach has been expansive and fast-moving, Japan’s feels like the measured heat of an onsen, with careful preparation, slow absorption, and respect for the process.
Tokyo is not just a city; it’s a living system. More than 30 million people move through it daily with a level of coordination that feels almost choreographed—have you seen the Shibuya Crossing, often referred to as the “Shibuya scramble”? The Shinjuku Ward is widely recognized as one of the most intensely dense and bustling urban places on Earth. Trains arrive on the second. Streets are largely immaculate, and there are rarely trash cans anywhere to be found in public! Courtesy is ambient. You are constantly aware that you are being observed, but not in a hostile way, but in a communal one. Behavior matters here.
That awareness becomes especially pronounced if you come from a cannabis culture, like the United States.
Cannabis in a Culture of Restraint
Despite Japan being one of the world’s largest consumers of tobacco, you rarely see anyone smoking in public. Smoking on the street is prohibited or discouraged in many areas. Instead, smokers retreat into sealed, ventilated rooms—often without windows—where the act is hidden away, compartmentalized, and controlled. Those rooms are actually perfect for catching a ‘puff,’ but that is another story for another day.
Cannabis exists even further outside of public life. No one smokes openly. No one jokes about it casually. No dispensaries. No smell. No visible cannabis counterculture. Now, there were several exceptions to this rule; these were so-called CBD dispensaries, such as “Chillaxy,” which primarily sold converted cannabinoids and hemp derivatives. But marijuana was an elusive concept in Tokyo. Cannabis in Japan is not merely illegal; it is stigmatized. It is treated not like alcohol or tobacco, but like a hard drug; something dangerous, shameful, and career-ending. Possession arrests still make national news.
This cultural backdrop shaped everything about JIHE 2025. The Japanese International Hemp Expo was carefully, deliberately focused on hemp. Industrial hemp. Wellness hemp. Historical hemp. Hemp textiles. Medicinal research pathways. This was not a loophole, but a strategy.
The exhibition floor featured CBD products formulated to comply with Japan’s zero-THC expectations, innovative vape technologies designed for legal cannabinoids, hemp textiles and clothing, building materials, cosmetics, and nutraceuticals. Every booth felt precise, intentional, and well thought out.
What struck me wasn’t what was missing, but how much was present, given the constraints.
Japan has a long and underappreciated hemp history, and JIHE leaned into that truth with quiet confidence. Hemp, which is known as ‘asa,’ has been cultivated in Japan for thousands of years, woven into everyday life, spiritual practice, and national identity. Shinto priests still use hemp fibers in purification rituals; sacred ropes (‘shimenawa’) hung at shrines are traditionally made from hemp, symbolizing cleanliness, protection, and the boundary between the human and the divine. For centuries, hemp clothing was common, durable, and practical—especially in rural communities—valued not for intoxication, but for utility, resilience, and spiritual neutrality. In this context, hemp was never countercultural. It was foundational.
What many forget—particularly outside Japan—is that cannabis prohibition here is not ancient or organic; it is relatively modern. Japan’s restrictive cannabis laws largely took shape after World War II, influenced by U.S.-led occupation policies that collapsed distinctions between hemp and psychoactive cannabis into a single prohibited category. In doing so, a plant with deep agricultural and religious roots was recast as a social threat. JIHE, in many ways, felt like a careful act of historical restoration. This was not an attempt to provoke reform, but an effort to remind Japan of what it already knows. Hemp, framed correctly, is not a foreign idea returning home; it is a native one waiting to be remembered.
In that sense, Japan’s relationship with hemp feels less like a revolution and more like a refrain—I’ve been all around this world—and sometimes the future sounds most familiar when it echoes the past. The expo felt like a place where that memory was being carefully reawakened.
Photo courtesy of Yuika Takamura via Unsplash
Reform Without Provocation
The JIHE speaker lineup reflected the maturity of the conversation. These were not provocateurs. They were translators between cultures, legal systems, and futures.
Aaron Justus delivered a measured, regulatory-forward discussion of cannabinoids and compliance, speaking directly to the Japanese instinct for rules and structure. His message was clear: legitimacy comes from precision.
Sergyei Kovalenkov explored the industrial uses of hemp and building materials.
Morris Beegle brought cultural context and sustainability into the conversation, reminding attendees that hemp has always been about more than products, but about systems, communities, and long-term stewardship.
Paul Benhaim, one of the original architects of the modern hemp industry, offered a historical and economic perspective that felt particularly appropriate in Japan, where legacy and credibility matter deeply.
Riccardo Longato, founder and CEO of Clear, brought a message about technology, standards, and certification requirements.
Mariana Larrea discussed stigma, medicine, and patients, grounding the discussion in human outcomes rather than abstract policy.
Joining them was Olivia Ekenuwke, a German cannabis lawyer whose comparative legal analysis highlighted how Europe has navigated reform through incrementalism, court challenges, and patient-first frameworks. Her presence underscored an important truth: Japan is not alone in taking a cautious path, but it must eventually take a path.
Attiyah Ferrouz was also present, contributing insight on compliance and international hemp policy, rounding out a truly global conversation.
Ryan Bellone brought a message of considering cannabinoids as ingredients and highlighted the global cannabinoid ingredient supply chain.
And weaving through it all was the presence of Laura Ramos, an international cannabis journalist whose reporting continues to document these inflection points as they happen, not after the fact. Witnesses matter.
Many of the speakers—including several of those above—had just participated in the Asian Hemp Expo in Bangkok. The geographical proximity between Japan and Thailand makes the contrast impossible to ignore.
A Regional Contrast
Thailand’s cannabis journey has been fast, loud, and at times chaotic. Legalization cracked open cultural doors almost overnight. Cannabis is visible, commercial, and woven into daily life in ways that would be unthinkable in Japan.
But Thailand is now in a recalibration phase. Regulation is tightening. Medical frameworks are being reasserted. The free-for-all is giving way to structure. But that structure has led to the production of some of the world’s finest cannabis, which is being grown, in large part, for export. Jordan Tyler Herring, the visionary and dynamic leader of Hidden Valley Genetics Thailand, brought his California-based experience to Southeast Asia, which serves as a model for how things should be done. But I digress…
Japan, by contrast, hasn’t cracked at all. Instead, it is studying. Observing. Learning.
That difference was formally acknowledged just days before JIHE, during an event at the Thai Embassy in Tokyo, where officials and industry representatives announced a cooperative framework between Japan and Thailand for the continued development of the hemp industry. The symbolism was powerful: two countries, vastly different in cannabis policy, finding common ground through hemp. At the Embassy, Patrick Atagi, of the U.S. National Industrial Hemp Council, delivered a somber talk at the very moment the U.S. Congress had enacted a Resolution to effectively ban hemp derivatives in the U.S.
While Thailand offers a glimpse of what rapid reform looks like, Japan offers a lesson in patience.
In Tokyo, I was so fortunate to meet Satoshi Morimoto. One of the most memorable people I met went simply by his Instagram handle: @mr_japanese_cannabis. He was thoughtful. Soft-spoken. Fully aware of the risks inherent in even being publicly associated with the plant in Japan. He wasn’t loud. He didn’t posture. He connected people quietly, deliberately, like someone who understands that progress here happens in inches, not miles. He hosted a bunch of us one evening at his friend’s karaoke club (there are possibly 100,000 karaoke clubs in Tokyo, by the way), where songs were sung in English, Japanese, Spanish, Italian, and everything in between.
At one point during my travels, someone discreetly gifted me a small amount of cannabis. It wasn’t very good, but that wasn’t the point. What mattered was the warning that came with it:
“Do not smoke this anywhere someone might see or smell.”
It wasn’t paranoia. It was protection.
In that moment, the abstract idea of stigma became concrete. This wasn’t about enforcement alone, but it was about social consequence. In Japan, shame can be as powerful as law.
Japan’s Cannabis Control Act remains one of the strictest in the developed world. THC is prohibited. Possession arrests are aggressively prosecuted. In 2026, Japan is transitioning towards a new framework for medical cannabis—a pharma-like model—following the passage of legislation in late 2023, which aims to legalize cannabis-derived medicines while strengthening penalties for illegal recreational use. CBD exists only when it is demonstrably THC-free.
Hemp cultivation is permitted under narrow licensing schemes, with strict oversight and limited research pathways. Reform discussions exist, but they move slowly, shaped by cultural conservatism and a deep-seated fear of social disruption.
And yet, the irony is unavoidable: Japan is one of the most orderly societies on earth. If any country could manage cannabis responsibly, it would be this one. But that seems like a faraway sunshine daydream.
Japan as a Masterclass of Intention
Outside the conference halls, Japan was endlessly rewarding. The food alone felt like a masterclass in intention. Sushi that redefined freshness. Yakitori eaten standing in alleyways. Tempura so light it seemed to disappear. Even convenience stores offered meals better than many American restaurants. Eating the multi-course Kaiseki dinners, which seemed to never end.
We were once asked to leave at least one restaurant because of strong perfume scent, which apparently, is a recognized, albeit strict, consequence of violating Japanese dining etiquette. Who knew?! One of my favorites was a ramen counter in an alley that bordered on a spiritual experience.
The sake was always exceptional; it’s clean, complex, ceremonial. Like everything else, it was consumed with care.
Traveling across the country on high-speed trains was a revelation. Silent, smooth, precise. The subways of Tokyo were works of art in efficiency.
We visited Hakone, with its surreal gardens and mountainous scenery, and where the nearby views of Mount Fuji felt unreal; almost like a painting refusing to move. But Hakone offered more than scenery; it offered insight. Soaking in the hot springs there while immersed in onsen culture, wearing a traditional kimono, and moving deliberately through spaces governed by ritual and restraint, I began to understand Japan’s regulatory psyche in a way no policy memo ever could.
The Onsen Theory of Change
An onsen is not something you rush. You do not enter it abruptly. You prepare. You wash. You wait. You respect the space, the people around you, and the accumulated wisdom that says timing matters. And don’t be late for your dinner time, or they will come into your room and get you! And the hot pools, where you need to ease into the temperature slowly, or else!
That, it struck me, is Japan’s relationship with hemp…and eventually cannabis.
Where other jurisdictions plunge headlong into reform, Japan is testing the temperature. Hemp is the warm water at the edge of the pool. Regulation is the preparation. Social trust is the gatekeeper. The process is slow by design, not by ignorance. Change here is not meant to be disruptive; it is meant to be absorbed—much like the sixteen-course dinners!
Standing there, wrapped in a kimono, steam rising into the cold mountain air, I realized that Japan may not be behind, but it may simply be waiting until the conditions are right for the body politic to enter without harm. Reform, like the onsen, will come when it can be sustained, not merely survived. Kyoto was a lesson in reverence: temples, torii gates, geisha history, and layers of history that demanded quiet attention.
And everywhere—no cannabis. No smoke. No scent. No signal.
Playing the Long Game
Looking forward, Japan will change. It always has, but never on anyone else’s clock.
Hemp will continue to lead the way, quietly expanding the perimeter of what is culturally and politically acceptable. Medical necessity will slowly develop, introduced not through activism but through evidence. Science will open doors that rhetoric cannot. And when cannabis reform finally arrives in Japan, it will not look like California, Colorado, or Thailand. It will look Japanese.
Thailand, for its part, will continue to mature, moving from exuberant liberalization toward equilibrium and structure. The initial shock has passed. What remains is the harder work of governance. The two countries, now formally cooperating on hemp development, represent opposite ends of the cannabis reform spectrum, but together they sketch the future of cannabis in Asia: diverse, non-linear, and deeply shaped by culture.
JIHE 2025 was not about rebellion. It was about respect…for history, for law, for social cohesion, and for the long game.
As an American, that was both humbling and instructive. We are accustomed to speed, scale, and disruption. Japan reminds us that legitimacy is built differently—and sometimes more durably—when change is allowed to steep.
There is far more to discover here. And when the light finally shifts in Japan, it will do so quietly at first, until, suddenly, it is everywhere.
This article is from an external, unpaid contributor. It does not represent High Times’ reporting and has not been edited for content or accuracy.
El mes pasado, Justin y Amy Miller colmaron sus autos con tres niños, dos perros, un dragón barbudo y todas las pertenencias que pudieron, y condujeron 2.000 millas desde Wisconsin hasta British Columbia, en Canadá, para dejar atrás los Estados Unidos del presidente Donald Trump.
Los Miller se establecieron en Vancouver Island, su refugio rodeado de paisajes naturales y accesible solo por ferry o avión. Justin comenzó a trabajar en la sala de emergencias del Nanaimo Regional General Hospital, donde se convirtió en uno más de los 20 enfermeros formados en Estados Unidos contratados desde abril.
El temor a Trump, dijeron algunos de los enfermeros, fue la razón por la que se fueron.
“Somos muchos los que pensamos igual”, dijo Justin, quien ahora trabaja codo con codo con otros estadounidenses en Canadá. “No estás atrapado. No tienes que quedarte. A los trabajadores de salud los reciben con los brazos abiertos en todo el mundo”.
Los Miller forman parte de un nuevo y creciente número de enfermeros, doctores y otros trabajadores de salud estadounidenses que se mudan a Canadá, y en particular a British Columbia, donde más de 1.000 enfermeros y enfermeras formados en Estados Unidos han recibido autorización para trabajar desde abril pasado.
Mientras el gobierno de Trump implementa políticas de extrema derecha, cada vez más autoritarias, y reduce el financiamiento para la salud pública, los seguros y la investigación médica, muchos profesionales de enfermería se han sentido atraídos por la política progresista de Canadá, su reputación de país acogedor y su sistema de salud universal.
Además, algunos enfermeros se indignaron el año pasado cuando el gobierno de Trump dijo que reclasificaría la enfermería como un título no profesional, lo que impondría límites federales estrictos a los préstamos que los estudiantes de enfermería podrían recibir.
Canadá está listo para sacar partido de esta situación. Dos de sus provincias más pobladas, Ontario y British Columbia, han simplificado el proceso de obtención de licencias para enfermeros estadounidenses desde que Trump regresó a la Casa Blanca.
British Columbia también lanzó una campaña publicitaria de $5 millones —“aprovechando la oportunidad” creada por el “caos e incertidumbre que ocurren en Estados Unidos”— para contratar enfermeros de California, Oregon y Washington.
Temores hechos realidad
Amy Miller, enfermera practicante, dijo que ella y su esposo estaban decididos a sacar a sus hijos del país porque sentían que el segundo mandato de Trump inevitablemente derivaría en violencia.
Primero, los Miller obtuvieron licencias de enfermería en Nueva Zelanda, pero cuando la búsqueda de empleo tomó demasiado tiempo, cambiaron su plan hacia Canadá.
A Justin le ofrecieron un trabajo en cuestión de semanas.
Amy encontró uno en tres meses.
Así que se mudaron. Y solo unos días después, los Miller observaron con horror desde la distancia cómo sus temores se hacían realidad. Mientras fuerzas federales de inmigración se enfrentaban con manifestantes en Minneapolis el 24 de enero, agentes federales dispararon y mataron a un enfermero de cuidados intensivos, Alex Pretti, cuando filmaba un enfrentamiento y parecía intentar proteger a una mujer que había sido empujada al piso.
Vista aérea de Nanaimo, en la provincia de British Columbia, en Canadá.(iStock/Getty Images Plus)
El video del asesinato mostró a los agentes fronterizos inmovilizando a Pretti en el suelo antes de confiscarle su pistola oculta, para la cual tenía licencia, y dispararle.
El gobierno de Trump calificó rápidamente a Pretti como un “terrorista doméstico”. Esa acusación fue cuestionada por videos de testigos que circularon en redes sociales y generaron indignación, incluso entre enfermeros y organizaciones de enfermería, algunos de los cuales mencionaron el deber de la profesión de cuidar a las personas vulnerables.
“No quiero decir que era algo esperado, pero por eso estamos aquí”, dijo Amy Miller. “Incluso nuestra hija mayor dijo: ‘Está bien, mamá, porque ya no estamos allá. Aquí estamos seguros’. Ella lo entiende y ni siquiera está en la escuela media”.
Tanto Estados Unidos como Canadá tienen una gran necesidad de enfermeros. Se proyecta que Estados Unidos tendrá un déficit de unos 270.000 enfermeros registrados, además de al menos 120.000 enfermeros practicantes con licencia, para 2028, según estimaciones recientes de la Administración de Recursos y Servicios de Salud (HRSA, por sus siglas en inglés).
En Canadá, las vacantes de empleo en enfermería se triplicaron entre 2018 y 2023, cuando alcanzaron casi 42.000, según un informe reciente del Montreal Economic Institute, un centro de análisis canadiense.
Consultada para comentar, la Casa Blanca señaló que datos del sector muestran que el número de enfermeros con licencia en Estados Unidos aumentó en 2025. Y desestimó los relatos de enfermeros que se mudan a Canadá como “anécdotas de personas con casos graves del síndrome de trastorno por Trump”.
“La fuerza laboral de salud estadounidense es la mejor del mundo y sigue creciendo bajo el presidente Trump”, dijo Blanca Kush Desai, vocera de la Casa. “Las oportunidades de empleo en el sistema de salud estadounidense siguen siendo sólidas, con posibilidades de avance profesional y salarios que superan ampliamente a los de otras naciones desarrolladas”.
“Una sensación de alivio”
No se sabe con precisión cuántos enfermeros estadounidenses se han mudado al norte desde que Trump regresó al cargo, porque algunas provincias canadienses no registran o no publican esas estadísticas.
Desde que el proceso simplificado entró en vigencia en abril de 2025 hasta enero, la provincia de British Columbia, que ha hecho más esfuerzos para contratar estadounidenses, había aprobado las solicitudes de licencia de 1.028 enfermeros formados en Estados Unidos, según el British Columbia College of Nurses and Midwives. En todo 2023 y 2024, solo se habían aprobado 112 y 127 solicitudes de estadounidenses, respectivamente, informó la agencia.
El aumento del interés de enfermeros estadounidenses también fue confirmado por asociaciones de enfermería en Ontario y Alberta, así como por la Canadian Nurses Association a nivel nacional.
Angela Wignall, CEO de Nurses and Nurse Practitioners of British Columbia, dijo que antes los enfermeros estadounidenses se mudaban al norte porque se habían enamorado de Canadá (o de un canadiense). Pero más recientemente, afirmó, ha conocido a enfermeros que temían que la Casa Blanca fomentara la violencia y la vigilancia, en particular contra familias que incluyen parejas del mismo sexo.
“Algunos vivían con miedo al gobierno y compartieron una sensación de alivio al cruzar la frontera”, dijo Wignall. “Como canadiense, es desgarrador. Y también es una alegría darles la bienvenida”.
Las enfermeras Brandy Frye (izq.) y Susan Fleishman trabajan en el turno de noche del Hospital General Regional de Nanaimo, en British Columbia. Ambas afirmaron que dejaron sus empleos en Estados Unidos el año pasado para alejarse de las políticas de extrema derecha y el discurso de odio del presidente Donald Trump.(Taylor Pradine)
Vancouver Island, que tiene una población de unas 860.000 personas, ha incorporado a 64 enfermeros formados en Estados Unidos desde abril, incluidos los del Nanaimo Regional, dijo Andrew Leyne, vocero de la autoridad de salud de la isla.
Una de las enfermeras fue Susan Fleishman, una canadiense que se mudó a Estados Unidos cuando era niña y luego trabajó durante 23 años en salas de emergencias antes de dejar el país en noviembre.
Fleishman dijo que la retórica de odio de Trump ha alimentado una división que ha permeado y deteriorado la vida en el país.
“No fue una mudanza fácil; eso es seguro. Pero creo que definitivamente vale la pena”, dijo, ya de regreso en Canadá. “Siento que aquí hay mucha más amabilidad. Y creo que eso hará que me quede”.
Brandy Frye, quien también trabajó durante décadas en salas de emergencias estadounidenses, contó que se mudó a Vancouver Island el año pasado tras esperar a ver si Mark Carney se convertiría en primer ministro de Canadá. El ascenso de Carney fue ampliamente visto como un rechazo al trumpismo.
Mientras tanto, dijo Frye, el hospital de California donde trabajaba había estado eliminando de sus documentos palabras asociadas con diversidad y equidad para complacer al gobierno de Trump. No pudo tolerarlo.
“Lo vi como un paso en contra de todo en lo que creo”, señaló Frye. “Y ya no me sentía parte de ese lugar”.
Como muchos de los enfermeros estadounidenses que se han mudado a Vancouver Island, Frye se sintió atraída por primera vez a la zona gracias a un video viral que estaba destinado al turismo, pero que terminó logrando mucho más.
Hace aproximadamente un año, Tod Maffin, creador de contenido en redes sociales y ex presentador de CBC Radio, invitó a estadounidenses a la ciudad portuaria de Nanaimo para un fin de semana de “infusión” diseñado para compensar el impacto de los aranceles de Trump en la economía local.
“Muchos eran trabajadores de salud que buscaban una ruta de escape”, dijo Maffin. “Estaban allí para apoyar nuestra economía, pero también para explorar Canadá”.
Maffin vio una oportunidad. Reutilizó el sitio web del evento como herramienta de reclutamiento y lanzó una sala de chat en Discord para ayudar a estadounidenses a mudarse.
Maffin dijo que cree que la campaña ayudó a unos 35 trabajadores de salud a mudarse a Vancouver Island. Voluntarios en más de 30 comunidades canadienses han replicado su sitio web para atraer a sus propios enfermeros y doctores estadounidenses.
“Hay comunidades en todo Canadá donde la sala de emergencias cierra por la noche porque falta un enfermero. Así de apretado está el personal”, dijo Maffin.
“Un nuevo enfermero en un pueblo pequeño, o en una ciudad mediana como Nanaimo hace la diferencia”, agregó.
Is the brain damage associated with milk consumption due to the banned pesticide heptachlor or the milk sugar galactose?
Parkinson’s disease is a neurodegenerative brain disorder that affects millions of people. What causes it? Well, if you look at lifestyle factors associated with Parkinson’s disease, dairy consumption is the strongest dietary factor associated with an increased risk of Parkinson’s disease. In fact, dairy products are the only food group consistently linked with a high risk of developing Parkinson’s. Five large prospective studies have confirmed the link. This includes the two Harvard cohorts, the Nurses’ Health Study and the Health Professionals Follow-up Study, which followed more than 100,000 people combined for decades in “the largest analysis of dairy and PD [Parkinson’s disease] to date,” analyzing more than 1,000 newly diagnosed cases. All the studies found a link between dairy and Parkinson’s, with most finding a significant link—about a 50% increase in risk overall in those drinking the most milk compared to those drinking the least, at a p-value below 0.00001, meaning there’s less than a 1 in 100,000 chance you’d randomly get a finding that extreme. You can see this in the chart below and at 1:13 in my video, The Role Milk May Play in Triggering Parkinson’s Disease.
Okay, but why is there a link at all? “Despite clear-cut associations between milk intake and” incidence of Parkinson’s, “there is no rational explanation,” concluded one review. A year later, though, we got a clue: “Midlife milk consumption and substantia nigra neuron density at death.” What does that mean? Parkinson’s is caused primarily by the loss of a certain type of nerve cells in a critical part of the brain, with symptoms first appearing once most of these neurons have died. So one study looked at how much milk people drank when they were in their 40s, 50s, and 60s, and then examined their brains at autopsy and counted how many of those critical neurons they had left. In every single quadrant, neuron density was highest “in those who consumed no milk and lowest in those who consumed the most milk.” Even after removing the Parkinson’s cases, those drinking two cups (473 mL) of milk a day had up to 40% fewer nerve cells in most quadrants of that critical brain region. What’s in milk that could be wiping out brain cells? Among the people who drank the most milk, residues of the pesticide “heptachlor epoxide were found in 9 out of 10 brains.” So, maybe the finding of pesticide residues more commonly in the brains of those who drank the most milk could explain how milk could be cause-and-effect related to Parkinson’s disease risk.
Now, that’s not the only potential explanation. In one of my videos, I talked about how meat contains that clumpy neurotoxic protein alpha-synuclein. Well, dairy products may contain trace amounts as well, but we don’t have confirmation of that. Could the milk sugar “galactose be the missing link?” Galactose is what the lactose in milk breaks down into once it’s in the body. It’s also what’s used to induce aging—to experimentally cause aging—in the brain. When you drink it, the galactose is picked up by your brain within a few hours, and for doses above 100 mg/kg, it appears that galactose can cause pathological alterations in brain cells, similar to those observed in Parkinson’s disease. This amount “can be reached and surpassed” by simply drinking two glasses (473 mL) of milk (the main dietary source of galactose) each day. And of all your brain cells, those dopaminergic neurons—the ones that you need to retain to prevent Parkinson’s—may be more vulnerable to galactose-induced damage because they are more vulnerable to oxidative stress.
Galactose may also explain the findings linking milk drinking with higher death rates. You may be thinking, “Well, duh—the saturated butterfat is just cutting people’s lives short,” but higher mortality with high milk consumption has been observed regardless of the milk fat content. Skim milk might be fat-free, but it’s not lactose-free.
Can’t you just drink lactose-free milk, like Lactaid? That has the lactase enzyme added to make lactose-free milk. But it just breaks down lactose into galactose in the carton rather than in your gut, so you’re still ingesting the same amount of galactose. Perhaps it’s no wonder that more milk intake at midlife may be linked to a greater rate of cognitive decline. Remember, researchers use galactose to create brain aging in the laboratory. D-galactose, a metabolic derivative of lactose, has been extensively used in animal models “to mimic cognitive aging” through oxidative stress. Compared to those who said they “almost never” drink milk, those drinking more than one glass (237 mL) a day appear more likely to suffer a decline in global cognitive function.
In this episode we were nominally talking about the rise of the influencer shaman, retreats and money money money but as always it’s psychedelics so off we head on various tangents.
But those tangents are leading to the same conclusion time again in my conversations with many of those have played a part in the USA’s 20th & 21st century psychedelic history and they are all saying the same thing.
Putting these compounds in boxes and try to make money out of them is not a wise path for humanity
Ilike writing about aspects of the psychedelic ecosystem, as well as interviewing people who I find interesting. I don’t consider myself a journalist in the classic sense simply because I am not objective. I have too many opinions and frequently sprinkle them throughout my work.
I’ve become aware of a troubling trend in the rise of a new breed of content creators: psychedelic journalists who are not only reporting on psychedelic issues but are also rapidly becoming high-profile influencers.
Historically, journalism has served as a critical, objective lens through which the public understands complex issues. In the realm of psychedelics, the past decade has seen an explosion of reporting on clinical trials, personal narratives, retreat centers, and policy reform. The digital age has blurred the boundaries between journalism and social media influence. Some journalists are now building personal brands, amassing large followings, and being tempted to monetize their platforms and receive other benefits without transparency. This shift is particularly pronounced in the psychedelic sphere, where the line between reporting, advocacy, and self-promotion is increasingly indistinct.
Now don’t get me wrong, for I am not without sin. I would love to be offered a free 7-day ibogaine retreat or a comped berth on the recent 9-day Wonder Cruise to Antarctica, where I could rub elbows with the likes of Paul Stamets and Rick Doblin. After all, not having to pay a fee that went as high as $24,000 would be pretty tempting for any journalist. But it just might be crossing the line if anything I subsequently reported did not reveal that I was receiving a benefit and special treatment.
The influencer economy thrives on sensationalism and personal stories. In the context of psychedelics, this often translates into glowing testimonials, dramatic before-and-after accounts, and bold claims regarding healing or enlightenment. While personal narratives can be compelling and relatable, they are not a substitute for rigorous, evidence-based reporting.
Many individuals seeking information on psychedelics are vulnerable, grappling with treatment-resistant depression, PTSD, addiction, or existential distress. For these audiences, the difference between responsible journalism and influencer promotion is not merely academic, it can be a matter of safety. When journalists become influencers, their words carry added weight, and any misrepresentation or omission can have real-world consequences.
Ethical journalism demands a duty of care to the audience, especially when reporting on substances that can profoundly impact mental health. Influencer culture, by contrast, often prioritizes engagement and growth over caution and nuance. This fundamental tension is at the heart of the danger posed by the rise of psychedelic journalists as influencers.
The Temptation of Shilling
‘Shilling’ is defined as promotion without revealing the personal gain received. In the psychedelic world, this most commonly occurs when a well-known figure succumbs to the temptation to report on some aspects of the ‘psychedelic renaissance.’ The danger to journalists is the loss of credibility. When bias, based upon a system of reward, creeps into the picture, the validity of that journalist is diminished. There is also danger that content, influenced by creators, is relied upon by the public who have no idea that there is an underlying spin, conscious or not, tainting the message.
Jim has been involved in healthcare for more than 50 years. He first encountered psychedelics during the Summer of Love in 1967. He has been thinking about them ever since.
Lip balm, lip gloss, lip stick, and now lip butter. I’ve created lots of different natural lip products over the years to replace all the tubes of lip products I used to buy. This lip butter is so simple to make with just a few ingredients and melts like butter on your lips, hence the name!
It’s a little more nourishing than some lip balms so it’s perfect for when you need the extra hydration.
Lip Butter vs Lip Balm
When I first heard the words lip butter I thought it was just a strange name for lip balm. It turns out there are some differences between the two (even if they are more subtle). Lip balm uses a blend of waxes and oils to moisturize the lips. A lip butter can also use some wax and oil, but it also adds in more creamy lip butters.
Shea butter, mango butter, cocoa butter, and cupuacu seed butter are some of the top favorites here. Butters are thicker than liquid oils but they’re not as hard or waxy as beeswax or candelilla wax. They also have a unique fatty acid profile that’s great for skin and lips.
Lip Butter Ingredients
I’ve kept the ingredients list simple so you don’t have to buy a ton of different oils and butters to make this. Beeswax helps thicken, while cocoa butter and mango butter add that luxurious emollient feeling. I’ve also included some meadowfoam seed oil to make it spreadable and essential oil for scent and added lip benefits.
Mango Butter
First up we have mango butter. I love how smooth and creamy it feels without being too thick. It’s softer than cocoa butter and feels more like shea butter. Mango butter is one of the few butters that has some astringency, so it doesn’t leave skin or lips feeling overly greasy.
You can substitute shea butter, but shea butter does have more of a tendency to get gritty once it’s cooled down. A good way to prevent this from happening is to cool any product made with shea butter in the fridge, instead of room temperature.
Cocoa Butter
I chose cocoa butter because it’s harder and gives the lip butter more thickness without over relying on beeswax. Cocoa butter is high in saturated stearic and palmitic fatty acids and creates a lipid barrier to prevent moisture loss. It also smells amazing with it’s slightly chocolate scent!
Meadowfoam Seed Oil
This liquid carrier oil may not be one you’ve worked with before. It adds a nice lightness to the blend and makes the creamy butters more spreadable on the lips. Meadowfoam seed oil is an emollient to lock in moisture, but is more easily absorbed than heavier carrier oils like olive or avocado oil. If you don’t have any on hand you use any liquid carrier oil you prefer, but it will affect the overall absorption and texture of the lip butter.
Essential Oil
Not only do essential oils make this smell amazing, but they add additional soothing and aromatherapy benefits. Just be sure to choose lip safe essential oils that won’t irritate this delicate area! Oils like cinnamon, lemongrass, clove, and ginger may smell great, but they can cause burns or sensitivity in lip products. And others like lemon and lime can cause phototoxicity (aka burns when exposed to sunlight).
Here are some of my favorite lip safe essential oils to use:
Lavender
Sweet orange
Geranium
Mandarin
Neroli
Rose
Spearmint
Peppermint
Since the cocoa butter gives this lip butter a chocolatey scent I like using essential oils that smell good with white chocolate. For this batch I used lavender, but peppermint and orange are also really nice with the cocoa butter.
Another important safety note when it comes to essential oils is dilution. In general how much essential oil you use for lip products depends on the exact essential oil. Nothing in the above list is overly harsh, so a good rule of thumb is .5 to 1 percent. This comes to about 5-10 drops in this recipe. It may be tempting to add a whole lot more, but less is usually better when it comes to essential oils!
Here’s how to make your very own lip butter.
Ultra Creamy Lip Butter
This creamy lip butter is super moisturizing and melts on contact to lock in hydration.
Prep Time3 minutesmins
Active Time5 minutesmins
Cooling Time30 minutesmins
Total Time38 minutesmins
Yield: 2ounces
Author: Katie Wells
Add all of the ingredients except essential oils in the top of the double boiler. Heat and stir occasionally until completely melted.
Turn off the heat and add the essential oils.
Immediately pour into your lip balm containers and let cool completely.
Store in a cool, dry place for the best shelf life. This will last about 6-12 months when stored properly.
This recipe yields about 13 regular size lip balm tubes.
Tips For Making Lip Butter
Really we’re just adding everything together, melting, and pouring into containers. No multiphase formulas or complicated steps. I have a heat safe glass bowl that I use only for making DIY products and I’ll use that like a double boiler. You can also melt the ingredients in a dedicated Mason jar for easier pouring.
I’ve found that it’s easy to wipe out the wax/butter residue with paper towels after I’ve poured the product into my containers. Don’t go straight for soap and a washcloth to clean up or you’ll have a waxy mess!
Avoid storing your lip butter in hot or humid conditions which will degrade the ingredients faster. This includes leaving it in a hot car or in a bathroom with a steamy shower.
Have you made your own lip butters or balms before? What are your favorite scents to use? Leave a comment and let us know!
COLUSA, Calif. — Early on, Jean Franklin got some career advice she followed religiously: “Pay yourself first.” So she did, socking away hundreds of thousands of dollars in retirement savings by the time she became a stay-at-home mom at age 41.
She and her husband, Charles, a former high school teacher who goes by Chaz, planned to retire comfortably in the three-bedroom house where they raised their kids about 60 miles northwest of Sacramento.
But early last year, the 63-year-old became unsteady on her feet. One morning in May, she woke up with slurred speech and landed in the hospital, then rapidly lost the ability to move the right side of her body.
In August, as doctors continued to puzzle over a possible diagnosis, the couple received a notice saying that on Jan. 1 their combined health care premium payments through the state insurance exchange would shoot up from $540 a month to $3,899 a month. The reason: Federal enhanced premium subsidies expiring at the end of last year would no longer offset their payment.
They immediately canceled a monthlong cruise they’d been planning with friends and looked through their retirement accounts.
“Now, instead of thinking about where we can go in our retirement, we’re asking the question, ‘Are we still going to be able to stay where we are because of the health care costs?’” said Chaz, who retired in 2021 at age 59.
Then they received more bad news. In October, at the age of 63, Jean was diagnosed with ALS, a debilitating disease that will eventually leave her unable to speak, swallow, or breathe on her own. But Jean’s condition allowed her to enroll in Medicare, the federal health insurance program that covers adults 65 and older and people with disabilities. The diagnosis saved them roughly $1,600 a month in premiums — little comfort as Jean lost her ability to walk, bathe, and dress herself.
Jean was diagnosed with ALS around the time she and Chaz were told their monthly health insurance premium payments would increase sevenfold. The diagnosis, which allowed her to enroll in Medicare, saved the couple roughly $1,600 a month. (Christine Mai-Duc/KFF Health News)
Charlie Franklin helps his mother, Jean, out of her wheelchair. (Christine Mai-Duc/KFF Health News)
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“It’s kind of morbid that, because of my diagnosis, I got put on Medicare right away, so at least we don’t have to pay that out-of-pocket,” Jean said, sitting in a wheelchair in her living room, a quilt draped over her legs to guard against the intense chills she now often gets. “We’re not going to get buried under this.”
Yet the premiums for Chaz’s plan and her Medicare remain a significant strain on their finances. The $2,300 a month they now owe, which includes roughly $342 in premium payments for Jean’s Medicare supplemental insurance, is higher than their monthly mortgage and eats up more than a quarter of their budget.
The Franklins are among the 22 million people across the nation facing greater financial pressure after Congress chose not to extend 2021 enhanced federal subsidies. That assistance helped more than double enrollment in Obamacare plans to over 24 million.
The Congressional Budget Office estimated in 2024 that, without an extension of the tax credits, the number of uninsured Americans would climb by 2.2 million this year alone. As of January, nationwide enrollment in ACA plans was down about 1.2 million year over year, though experts say it could be months before the full effects of rising premiums are known, as people miss payments and lose coverage.
The groups hit hardest will be early retirees, middle-income earners, and people living in high-cost states, said Stacey Pogue, a senior research fellow at the Center on Health Insurance Reforms at Georgetown University. The Franklins are all three.
A Retired Couple Faced a Huge Health Premium Increase. Her Terminal Diagnosis Saved Them Money. Jean Franklin, 63, and Chaz Franklin, 64, of Colusa, California Chaz and Jean Franklin thought they’d saved enough to retire comfortably. But when they found out the premium payment for their “silver” Affordable Care Act plan would soon rise from $540 a month to $3,899, they had to reevaluate. A couple of months later, Jean was diagnosed with ALS, a debilitating neurodegenerative illness that qualified her for Medicare. Her premium payment dropped to $342 a month. The couple still pays a combined $2,300 a month in premiums, more than a quarter of their budget. “It’s the terrible irony that because my wife got a disorder, I’m saving money, and a lot of it,” Chaz said.
“They fell off what we call a subsidy cliff,” Pogue said. “It’s very, very shocking, the amount that a person would have to absorb.”
That’s because the expanded tax credits made the biggest difference for people nearing retirement age who sat just above previous income eligibility thresholds, Pogue said. People such as the Franklins, who likely wouldn’t have qualified for financial help before expanded credits were implemented, are now losing that support at a time when insurers have responded to the uncertainty by dramatically raising rates.
Roughly half of people who were expected to lose eligibility for premium tax credits were ages 50 to 64, according to an analysis by KFF, a health information nonprofit that includes KFF Health News.
Republicans who opposed the extension have said the premium assistance went directly to insurance companies rather than consumers, incentivizing fraud and wasteful coverage. They also say the enhanced subsidies, which had no upper income limit for eligibility, were far too generous in capping premium payments at 8.5% of income, no matter how much an enrollee made.
“Most Americans would agree that taxpayers should not be subsidizing the health insurance of someone making $250,000,” U.S. Rep. Ken Calvert, a California Republican who voted against an extension in January, wrote in an Orange County Register op-ed. “I cannot accept the simple extension of a program that will line the pockets of insurers and is riddled with fraud at the expense of the American taxpayer.”
Patient advocates say the premium increases and expiration of subsidies have forced people into difficult choices. “The young people who are healthy are the first to say, I’m going to roll the dice” and forgo coverage, said Rebecca Kirch, executive vice president of policy and programs at the National Patient Advocate Foundation. “Those who are remaining in the system — because they have no choice — are holding off care, they’re holding off their meds, they’re going without necessary food.”
While the Franklins are getting by, they have relied on their sons to pay for a motorized recliner to assist with lifting Jean and a handicap van to transport her. Chaz, who broke a tooth a year ago, delayed fixing it because a crown would cost him $1,000.
This year, the couple will draw $36,000 more than they had anticipated from their retirement savings, most of it to cover Chaz’s insurance premiums.
“I have a nest egg,” Chaz said. “But there’s a lot of people around here who don’t.”
For a while, he was outraged.
“I wish Congress would get off their butts and solve this issue,” said Chaz, who is a registered Republican but blames both sides of the aisle. “You’re so busy bickering over stupid crap and it’s both parties pointing fingers and blaming. Where was this discussion two years ago?”
Now, Chaz said, he’s focused on making Jean, his wife of 27 years, as comfortable as possible.
Before she got sick, they did practically everything together — hiking, traveling, tai chi, amateur photography, and bug-hunting. One of her favorite specimens was the rain beetle, a fuzzy scarab-like insect that can’t feed as an adult, relying solely on fat stores from its larval stages.
In the mornings, Chaz and their sons, Charlie and Louis, take turns lifting Jean, dressing her, and helping her use the bathroom. It’ll be fodder for the counselor, she jokes to her sons, when they inevitably need therapy later in life.
Chaz practices tai chi three times a week in the auditorium at Colusa City Hall. The exercise helps him deal with the financial and emotional stress of his wife’s illness and their soaring health care expenses. (Christine Mai-Duc/KFF Health News)
Jean laughs with her sons, Louis (right) and Charlie, and Charlie’s girlfriend, Masha Billingsley. Charlie and Louis have helped their mother get dressed and get in and out of her wheelchair since she was diagnosed with ALS last year. (Christine Mai-Duc/KFF Health News)
Most days, Jean’s outdoor adventures rarely extend beyond being wheeled to her back patio, where she loves to watch their backyard chickens bobble around. Chaz’s stubbornness makes him a great patient advocate. Charlie always seems to know exactly when she needs a big hug, and Louis tells jokes that can still make her snort with laughter.
“I don’t know what I would do without my boys making me laugh,” she said.
In December, Chaz will turn 65, old enough to qualify for Medicare himself. “After this year — knock on wood — we should be OK,” Jean said, before pausing and shooting her husband a wry smile.
“Well, you’re gonna be OK.”
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Last month, Justin and Amy Miller packed their vehicles with three kids, two dogs, a pet bearded dragon, and whatever belongings they could fit, then drove 2,000 miles from Wisconsin to British Columbia to leave President Donald Trump’s America.
The Millers resettled on Vancouver Island, their scenic refuge accessible only by ferry or plane. Justin went to work in the emergency room at Nanaimo Regional General Hospital, where he became one of at least 20 U.S.-trained nurses hired since April.
Fear of Trump, some of the nurses said, was why they left.
“There are so many like-minded people out there,” said Justin, who now works elbow to elbow with Americans in Canada. “You aren’t trapped. You don’t have to stay. Health care workers are welcomed with open arms around the world.”
The Millers are part of a new surge of American nurses, doctors, and other health care workers moving to Canada, and specifically British Columbia, where more than 1,000 U.S.-trained nurses have been approved to work since April. As the Trump administration enacts increasingly authoritarian policies and decimates funding for public health, insurance, and medical research, many nurses have felt the draw of Canada’s progressive politics, friendly reputation, and universal health care system.
Additionally, some nurses were incensed last year when the Trump administration said it would reclassify nursing as a nonprofessional degree, which would impose strict federal limits on the loans nursing students could receive.
Canada is poised to capitalize. Two of its most populous provinces, Ontario and British Columbia, have streamlined the licensing process for American nurses since Trump returned to the White House. British Columbia also launched a $5 million advertising campaign last year to recruit nurses from California, Oregon, and Washington state.
“With the chaos and uncertainty happening in the U.S., we are seizing the opportunity to attract the talent we need,” Josie Osborne, the province’s health minister, said in a statement announcing the campaign.
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Fears Realized
Amy Miller, a nurse practitioner, said she and her husband were determined to move their children out of the country because they felt Trump’s second term would inevitably spiral into violence.
First, the Millers got nursing licenses in New Zealand, but when the job search took too long, they pivoted to Canada.
Justin was offered a job within weeks.
Amy found one within three months.
So they moved. And just a few days later, the Millers watched with horror from afar as their fears came true.
As federal immigration forces clashed with protesters in Minneapolis on Jan. 24, federal agents fatally shot an ICU nurse, Alex Pretti, as he filmed a confrontation and appeared to be trying to shield a woman who was knocked down. Video of the killing showed border agents pinning Pretti to the ground before seizing his concealed, licensed handgun and opening fire on him.
The Trump administration quickly called Pretti a “domestic terrorist” who intended to kill federal agents. That allegation was disputed by eyewitness videos that circulated on social media and spurred widespread outrage, including from nurses and nursing organizations, some of whom invoked the profession’s duty to care for the vulnerable.
“I don’t want to say it was expected, but that’s why we are here,” Amy Miller said. “Even our oldest kid, she was like: ‘It’s OK, Mom, because we are not there anymore. We are safe here.’ So she recognizes that, and she’s not even in middle school yet.”
Both the U.S. and Canada have a severe need for nurses. The U.S. is projected to be short about 270,000 registered nurses, plus at least 120,000 licensed practical nurses, by 2028, according to recent estimates from the Health Resources and Services Administration. In Canada, nursing job vacancies tripled from 2018 to 2023, when they reached nearly 42,000, according to a recent report from the Montreal Economic Institute, a Canadian think tank.
When asked to comment, the White House noted that industry data shows the number of nurses licensed in the U.S. increased in 2025. It dismissed accounts of nurses moving to Canada as “anecdotes of individuals with severe cases of Trump derangement syndrome.”
“The American health care workforce is the finest in the world, and it continues to expand under President Trump,” White House spokesperson Kush Desai said. “Employment opportunities in the American health care system remain robust, with career advancement and pay that far exceed that of other developed nations.”
An aerial view of Nanaimo, British Columbia. (iStock/Getty Images Plus)
‘A Sense of Relief’
It is unknown precisely how many American nurses have moved north since Trump returned to office, because some Canadian provinces do not track or release such statistics.
British Columbia, which has done the most to recruit Americans, approved the licensing applications of 1,028 U.S.-trained nurses from when the province’s streamlined application process took effect in April 2025 through January, according to the British Columbia College of Nurses and Midwives. In all of 2023, only 112 applicants from the U.S. were approved, the agency said. In 2024, it was 127.
Increased interest from American nurses was also confirmed by nursing associations in Ontario and Alberta, as well as by the nationwide Canadian Nurses Association.
Angela Wignall, CEO of Nurses and Nurse Practitioners of British Columbia, said American nurses used to move north because they had fallen in love with Canada (or a Canadian). But more recently, she said, she had met nurses who feared the White House would spur violence and vigilantism, particularly against families that included same-sex couples.
“Some of them were living in fear of the administration, and they shared a sense of relief when crossing the border,” Wignall said. “As a Canadian, it’s heartbreaking. And also a joy to welcome them.”
Vancouver Island, which has a population of about 860,000, has gained 64 U.S.-trained nurses since April, including those at Nanaimo Regional, said Andrew Leyne, a spokesperson for the island’s health agency.
One of the nurses was Susan Fleishman, a Canadian who moved to the U.S. as a child, then worked for 23 years in American emergency rooms before leaving the country in November.
Fleishman said hateful rhetoric from Trump has fueled an angry division that has permeated and soured American life.
“It wasn’t an easy move — that’s for sure. But I think it’s definitely worth it,” she said, happily back in Canada. “I find there is a lot more kindness here. And I think that will keep me here.”
Brandy Frye, who also worked for decades in American ERs, said she moved to Vancouver Island last year after waiting to see whether Mark Carney would become Canada’s prime minister. Carney’s rise was widely viewed as a rejection of Trumpism.
Meanwhile, Frye said, the California hospital where she worked had been stripping words associated with diversity and equity out of its paperwork to appease the Trump administration. She couldn’t stand it.
“It felt like a step against everything I believe in,” Frye said. “And I didn’t feel like I belonged there anymore.”
Frye and fellow nurse Susan Fleishman work the night shift at Nanaimo Regional General Hospital. Both said they left their longtime U.S. jobs last year to get away from the far-right policies and hateful rhetoric of President Donald Trump.(Taylor Pradine)
Like many of the American nurses who have moved to Vancouver Island, Frye was first wooed to the area by a viral video that was meant to attract tourist dollars but ended up doing much more.
About a year ago, Tod Maffin, a social media content creator and former CBC Radio host, invited Americans to the port city of Nanaimo for a weekend event designed to offset the impact of Trump’s tariffs on the local economy.
“A lot of them were health care workers looking for an escape route,” Maffin said. “They were there to help support our economy but also to look into Canada.”
Maffin saw an opportunity. He repurposed the event website into a recruiting tool and launched a Discord chatroom to help Americans relocate.
Maffin said he believes the campaign helped about 35 health care workers move to Vancouver Island. Volunteers in more than 30 other Canadian communities have since duplicated his website in an effort to attract their own American nurses and doctors.
“There are communities across Canada where the emergency room closes at night because one nurse is out. That’s how thin staffing is,” Maffin said.
“One new nurse in a small town, or in a midsized city like Nanaimo,” he said, “makes a difference.”
