The Canadian government announced back in August that it would allow terminally ill patients to use psychedelic mushrooms as part of “psilocybin therapy” to help ease their end-of-life anxiety.
In April, four Canadians suffering from terminal illness asked the government’s Health Ministry for a legal exemption for them to obtain and use “magic mushrooms,” which studies have shown help alleviate anxiety and depression, CTV News reports.
Canadian non-profit organization Therapeutic Psilocybin (TheraPsil) revealed Minister of Health Patty Hajdu’s approval for exemption Tuesday, noting that the four patients will be the first four Canadians to legally use psychedelic mushrooms since they became illegal in 1974.
“I want to thank the Health Minister and Health Canada for approving my request for psilocybin use,” Laurie Brooks, one of the four terminally ill applicants, said in a statement via TheraPsil.
“The acknowledgement of the pain and anxiety that I have been suffering with means a lot to me, and I am feeling quite emotional today as a result. I hope this is just the beginning and that soon all Canadians will be able to access psilocybin, for therapeutic use, to help with the pain they are experiencing, without having to petition the government for months to gain permission.” Another patient stated that their prescribed anti-anxiety medication was no longer working and sought the use of psilocybin therapy.
Founder of TheraPsil, Dr. Bruce Tobin went on to say,
“Although it has taken a long time we are impressed with their willingness to listen to patients who have not been heard and to shift focus and policy to accommodate their interests and protect their needs. We also thank the brave Canadian patients who have been public in their fight for psilocybin access, along with the honorable Canadian MPs who have demonstrated courage, standing up for patient rights.”
With the exemption, the production, possession or sale of “magic mushrooms” remains illegal “unless authorized for clinical trial or research purposes,” the CTV reported.
In the U.S., cities like Oakland, Portland and Denver have led the charge in decriminalizing magic mushrooms, with the FDA also weighing approving a psychedelic drug for treating depression. More recently voters in Oregon became the first state to legalize Magic Mushrooms for therapeutic use during this November Election.
N,N-dimethyltryptamine (DMT) is a component of the Ayahuasca brew traditionally used for ritual and therapeutic purposes across several South American countries.
The research examined, in vitro and vivo, the potential neurogenic effect of DMT. Our results demonstrate that DMT administration activates the main adult neurogenic niche, the subgranular zone of the dentate gyrus of the hippocampus, promoting newly generated neurons in the granular zone.
Moreover, these mice performed better, compared to control non-treated animals, in memory tests, which suggest a functional relevance for the DMT-induced new production of neurons in the hippocampus.
Interestingly, the neurogenic effect of DMT appears to involve signaling via sigma-1 receptor (S1R) activation since S1R antagonist blocked the neurogenic effect. Taken together, our results demonstrate that DMT treatment activates the subgranular neurogenic niche regulating the proliferation of neural stem cells, the migration of neuroblasts, and promoting the generation of new neurons in the hippocampus, therefore enhancing adult neurogenesis and improving spatial learning and memory tasks.
New research has come to light, first published in the journal Translational Psychiatry, is reporting on several years of animal studies showing how a psychedelic called DMT (Dimethyltryptamine) can promote brain plasticity and prompts the formation of new neurons. This new research presents evidence to suggest the hallucinogenic effects of the drug may be able to be separated from this neuron-generating mechanism.
iStock/Svisio
Ayahuasca
Ayahuasca is a hallucinogenic preparation known to be consumed in shamanic and religious contexts such as ceremonies by indigenous populations in South America. People still today practice and take part in ceremonies. There are even Psychedelic tours available to experience in South American countries which I’ll talk more about in future articles. DMT is the main psychoactive compound in the psychedelic brew, and it has become the focus of an immense deal of research due to it’s profoundly powerful, but short-acting, hallucinogenic elements.
The recent awakening in psychedelic science has found psychedelics such as psilocybin can induce potent antidepressant effects. Preliminary studies investigating Ayahuasca have seen similar antidepressant benefits. It has been hypothesized that the positive mental health outcomes from these psychedelic compounds stems from their ability to stimulate new neuron production, a process referred to as neurogenesis.
What Is Neurogenesis?
Neurons are born through the process of neurogenesis, in which neural stem cells divide to produce differentiated neurons. Once fully differentiated neurons are formed, they are no longer capable of undergoing mitosis. Neurogenesis primarily occurs in the embryo of most organisms. – Wiki.
This new research, led by a team of Spanish scientists, set out to understand by what mechanism DMT could induce neurogenesis. Across several mouse experiments the study first established DMT does indeed promote acute neurogenesis, and furthermore, these new neurons can be linked to detectable improvements in the animals’ memory and cognition.
“These [new hippocampal neurons] have a functional impact since DMT treatment during 21 days clearly improved mouse performance in learning and memory tasks, in which the hippocampus is considered to play an essential role,” the researchers have written in the new study.
“These observations are in agreement with previous works showing that adult hippocampal neurogenesis plays an important role in these cognitive functions.”
Perhaps the most fascinating finding in the new research is the confirmation that this psychedelic-induced neurogenesis seems to be produced by a mechanism that is separate to that which generates the drug’s hallucinogenic effect.
The hallucinogenic qualities of most psychedelics are commonly thought to be generated through the stimulation of 5-HT2A serotonin receptors in the brain but it is still up for debate whether neurogenesis induced by psychedelics is mediated through the same serotonin receptor activity.
The new research suggests neurogenesis may be mediated through sigma-1 receptors (S1R), which prior research has established are also influenced by DMT. The study reveals the neurogenic effect of DMT could be effectively blocked when mice were administered a S1R antagonist.
“The results here obtained indicate that the observed effects of DMT are mediated by the activation of the S1R,” the researchers write in the study. In this regard, it has been shown that the stimulation of the S1R by different agonists enhances neurogenesis in the hippocampus.”
What Does This All Mean?
It’s possible the new-neuron-stimulating effect of DMT could be separated from it’s hallucinogenic and psychoactive properties. José Ángel Morales, an author on the new research, suggests this promisingly points to new research pathways investigating ways to harness the therapeutic potential of neurogenesis.
“This capacity to modulate brain plasticity suggests that it has great therapeutic potential for a wide range of psychiatric and neurological disorders, including neurodegenerative diseases,” says Morales.
Not The First Psychedelic Research Study
This research is not the first to raise the possibility of divorcing the therapeutic potential of psychedelics from their hallucinatory effects. Both the US government and commercial pharmaceutical companies are investigating ways to either moderate, or eliminate altogether, the psychedelic effect of psychedelics.
However, there is considerable debate within the psychedelic research community as to how fundamentally important the overwhelming psychoactive experience actually is to the drug’s subsequent therapeutic benefits.
Morales went on to say “The challenge is to activate our dormant capacity to form neurons and thus replace the neurons that die as a result of the disease, this study shows that DMT is capable of activating neural stem cells and forming new neurons.”
How Are Neurons Generated?
Neurons are born through the process of neurogenesis, in which neural stem cells divide to produce differentiated neurons. Once fully differentiated neurons are formed, they are no longer capable of undergoing mitosis. Neurogenesis primarily occurs in the embryo of most organisms.
If you’d like to read more into this research and topic, you can right here.
On Tuesday, Oregon became the first state to legalize access to Magic Mushrooms [Psilocybin]. Specifically, Measure 109 directs the state to establish and regulate a program whereby adults in the state will be able to consume psilocybin, a psychoactive compound found in magic mushrooms.
Multiple cities have decriminalized the substance, but Oregon will become the first to permit supervised use statewide if that majority holds.
The first of its kind measure is backed by chief petitioners wife-and-husband Sheri and Thomas Eckert of Beaverton, this will allow regulated use of psychedelic mushrooms in a therapeutic setting.
Measure 109 was passing by 56.12% Tuesday at 8:50 p.m. with 1,832,513 votes counted.
Photo by Visually Us
The mushroom bill, measure 109, allows trained “facilitators” to give patients psilocybin — the psychedelic compound in mushrooms — as a mental health treatment, and guide them through trips at licensed centers.
Regulatory details, including how to qualify as a therapist, will be hammered out over the next two years, according to the bill — which was passing with more than 56 percent support Tuesday night, according to the OregonLive.com website.
There’s More Good News for Cannabis & Psychedelics
It was a big night for drug policy reform. In Oregon, voters also passed Measure 110, which decriminalizes several drugs, including psilocybin, as well as cocaine, heroin, methamphetamine. It also funds drug addiction treatment. Voters in DC also seemed poised to overwhelmingly pass a measure to decriminalize magic mushrooms and other psychedelic plants. And so far tonight, New Jersey and Arizona passed measures to legalize recreational cannabis.
Partial returns Tuesday showed the measure had passed with 62 percent support.
TEL AVIV – A hospital in Israeli will begin testing COVID-19 patients with medicinal cannabis, which is known to have anti-viral properties, as part of a new experimental treatment in a fight against this virus which has disrupted life all around the world.
Researchers are investigating cannabidiol, the non-psychoactive component of cannabis also known as CBD oppose to the one we all know and love, THC. CBD can slow down the spread of the virus and stop moderate patients conditions turning to critical.
There are dozens of COVID-19 patients in moderate condition at Ichilov Medical Center in Tel Aviv are expected to be treated with Cannabis.
COVID-19 Studies In Israel
Barak Cohen, the senior anesthesiologist who is in charge of managing and overseeing the hospital’s response to COVID, stressed that the treatment would alleviate symptoms by using “a component of the cannabis plant that is considered safe and non-addictive.”
Another groups of researchers at Tel Aviv University have begun developing a CBD-based drug that has been shown to be effective against inflammation for coronavirus-infected lung cells.
The Technion Institute of Technology in Haifa is also working on developing two complementary drugs based on various cannabis strains to fight the virus. The first drug will attempt to reduce the patient’s immune response while the second aims to slow down the course of the disease by lowering the expression of the receptor, this is a protein that allows the virus to receive and release substances outside of the cell.
“Our lab has been approved to operate as a coronavirus lab, and we are currently promoting two studies based on existing cannabis studies,” Prof. Dudi Meiri, who is leading the Technion’s team, as mention here on Calcalist.
“First, we will try to identify the plant’s immune cells that are capable of suppressing the immune response to the coronavirus, which causes inflammation and disease. Cannabis plant molecules have the ability to lower the immune system response without suppressing it entirely, thereby providing better complementary treatment than steroids, which completely suppress the immune system.”
Professor Dudi Meiri
The second study will be conducted on the receptor which allows the virus to inject its genetic expression into human cells and proliferate.
“There is a process that examines the effect of cannabis molecules on proteins as well,” he explained. “We are now examining which ones are relevant to the same receptor, with the goal of lowering its expression, making it difficult for the virus to enter the cell and proliferate.” said Professor Dudi Meiri.
The state has officially legalized sales of THC-Infused Edibles from January 2021 onwards.
If you’re a Medicinal Cannabis patient in the beautiful state of Hawaii, you already have something to look forward to in 2021. Governor David Ige signed legislation that will allow patients to have access to cannabis-infused edibles. Patients enrolled in the state’s medical cannabis access program will be able to purchase THC-infused edible products from licensed dispensaries for the first time under legislation.
Is Weed Legal In Hawaii?
Weed is illegal for recreational use by anyone in the sate, Hawaii implemented a Medical Marijuana program 20 years ago this allowed cardholders to possess and grow their own Marijuana or appoint a caretaker to do so. At that time there were still no dispensaries or a legal market of any kind to purchase directly from.
The House Bill 2097 allows licensed medical dispensaries in Hawaii “to manufacture and distribute THC infused edibles.” The Hawaii Department of Health will administer the development of rules on the production, labeling and packaging of cannabis-infused edibles.
The new law also for the first time permits and encourages dispensaries to “provide, disseminate, and publish educational and scientific materials related to medical cannabis and its approved products and sponsor events about medical marijuana.”
Decriminalization
On July 1, 2019, Governor David Ige decriminalized small amounts of cannabis. Beginning on January 11, 2020, this bill made possession of three grams or less of marijuana punishable by a $130 fine. Under the former law, anyone possessing even a small amount of cannabis was punished to 30 days in jail and a fine of up to $1,000 – Ridiculous.
When Does The New Law Take Effect?
Governor Ige signed the measure into law earlier this month. The new law takes effect on July, 2021.
The Victorian government will back a push for medicinal cannabis patients to be able to drive in an Australian-first move. Victorian Reason Party MP Fiona Patten – behind the push supported in parliament on Wednesday – said it was “simply unfair” Australia was “the only jurisdiction” that prevented medicinal cannabis patients from driving 24/7.
Sydney
She also said, “I am pleased that the government has seen sense and will move to change the laws around medicinal cannabis and driving – it’s about time,”
The bill aims to treat medicinal cannabis, prescribed by a doctor, in the same way as any other prescription medication under the Road Safety Act.
It would mean driving laws are changed, the government will establish a implementation taskforce that will work with doctors, legal experts and MPs around those changes. The taskforce will then report back to parliament by the 18th Of December.
Fiona Patten went on to say, “The average Medicinal Cannabis patient is a 55 year old woman. These patients gain great relief from their medication but should be able to drive their kids to school in the morning,”
Of course the move was met with opposition from the ignorant Liberal Party, with Member for Northern Metropolitan Region Craig Ondarchie likening the government’s approval of the bill to an episode of The Block. “You get to vote on it before the job is complete – there is still a lot of work to be done on this bill before it should come to the house for approval,” he said.
Opposition health spokeswoman Georgie Crozier said the bill was “somewhat risky”. “It’s really about the inability to test that impairment level,” she said.
“We can do that with blood alcohol but the ability to detect the presence of THC (tetrahydrocannabinol) is very difficult … until there can be that specific test being undertaken then it is somewhat risky.”
Medicinal cannabis is generally prescribed for epilepsy, multiple sclerosis, symptom relief in palliative care and symptoms associated with cancer and cancer treatment.
Cannabis in Australia is only legal for medicinal use. Patients can acquire a prescription from a physician who is qualified to prescribe Cannabis.
Photo by Aphiwat
What Is Medicinal Cannabis Generally Prescribed For?
The below list is a handful of a what Medicinal Marijuana has been prescribed for, this not limited to the below. It’s entirely up to your Doctor if they think you will benefit from it.
Epilepsy
Multiple Sclerosis
Symptoms associated with cancer
cancer treatment (such as nausea, pain and loss of appetite)
Pain
Symptom relief in palliative care
For more information on who Fiona Patten is, you can visit the below links:
Marijuana may be illegal in Hong Kong, but a new cafe is offering a range of food and drinks that are infused with compounds derived from the cannabis plant without breaking any local laws.
The cafe, named Found, is a first for the city to offer a range of beverages, biscuits, beer and fruit juices that contain cannabidiol, or CBD, a substance from the cannabis plant that is said to offer therapeutic effects without getting users intoxicated.
Cannabis’s tetrahydrocannabinol compound — commonly known as THC — is the psychoactive ingredient that gives users get high or stoned. But unlike THC, CBD is typically used to help reduce stress without the high.
WATCH
What’s CBD Coffee Like?
One Found customer, Killian Hussey, who works in finance in Hong Kong, said consuming CBD coffee is relaxing.
“The coffee is delicious, and I like the effect that the CBD has on me,” Hussey said. “Cognitively and physically, it kind of helps me get through the aches and pains of a normal day.”
A bottle of cold CBD-infused coffee costs 80 Hong Kong dollars ($10) at Found, while a can of CBD beer is HK$70 ($9). The cafe, which had a soft opening this month, is expected to be fully operational in October.
“Hong Kong is actually one of Asia’s most progressive cannabinoid markets,” said Fiachra Mullen, co-owner of Altum International, a cannabinoids supplier in Asia that operates Found. “Unlike other parts of the region — Australia, New Zealand, Singapore — it’s actually quite a progressive cannabinoid law in Hong Kong.”
Mullen said that he hopes the cafe can help break down the stigma surrounding CBD products, and wants to distance CBD from cannabis and the recreational use of drugs.
Found can sell cannabinoids in food as long as there is no THC in the products, he said.
According to the Hong Kong government’s Centre for Food and Safety, under the Dangerous Drugs Ordinance, the illicit import of cannabis or any products that contain controlled cannabinoids constitutes a criminal offense.
Although CBD is a cannabinoid, it is not classified as a dangerous drug under Hong Kong law.
Porsche has released two variants of the hemp-made vehicle, including a special Track Day Version.
From aluminum to the racing carbon fiber, the list of lightweight materials used in modern cars grows longer by the day. But the Porsche 718 Cayman GT4 Clubsport — a racing version of the German automaker’s 718 Cayman sports car — tries something different. Parts of the body are made from what Porsche calls an “organic fiber mix” derived from agricultural byproducts such as hemp and flax.
Porsche isn’t the first automaker with this sort of idea, however. Back in 1941 Henry Ford built a prototype with a body made entirely from plastic that reportedly used cellulose from hemp, wheat and soybeans in its construction, although the exact formula has been lost to history.
The hemp material is used in the Clubsport’s doors and rear wing spoiler. It has “similar properties to carbon fiber in terms of weight and stiffness,” according to Porsche, but is a bit more eco-friendly. The track car weighs only 1320kg.
The Clubsport isn’t road legal, but it likely previews a new Cayman GT4 road car that you will be able to slap license plates on. The last Cayman GT4 was a limited-edition model beloved by enthusiasts for its pure driving experience. Porsche has traditionally restrained the Cayman so that it doesn’t overshadow the 911, but with the GT4, it briefly seemed to let the Cayman off that leash.
While all current 718 Cayman models use turbocharged four-cylinder engines, the Clubsport continues to use a 3.8-liter naturally aspirated boxer-six from the model’s previous generation. The mid-mounted engine produces 425 horsepower and 313 pound-feet of torque. Power is sent to the rear wheels through a six-speed dual-clutch transmission. The car also features upgraded suspension (derived from the 911 GT3 Cup race car) and brakes, as well as mandatory safety equipment like a roll cage, six-point harnesses, and rescue hatch in the roof.
Porsche will sell two versions of the Clubsport. The Trackday model is aimed at amateur drivers looking for a fun toy, while the Competition model is designed for actual racing. The main upgrades for the Competition include adjustable shock absorbers, adjustable brake balance, an air jacking system, and a quick-release steering wheel.
Both versions of the 718 Cayman GT4 Clubsport are available to order now. The Trackday starts at $152,895, while the Competition starts at $179,140. Cars like this are arguably the soul of Porsche, which has always tried to maintain a close relationship between its racing and street legal models. We’ll see if that continues as Porsche road cars and race cars gradually go electric.
All customer orders come from the factory with an integrated roll cage, racing bucket seat, and six-point harness, all certified for racing. Speaking about the model, Troy Bundy, head of Motorsport at Porsche Cars Australia, said:
“While our Porsche PAYCE Carrera Cup and Porsche Michelin Sprint Challenge series remain our focus domestically, we also see a place in the market for the 718 Cayman GT4 Clubsport as a track day car and GT4 race car. The 718 Cayman GT4 Clubsport is an ideal track day car for graduates of Level 5 of our Porsche Track Experience, who may be keen to do more track days and state-based racing before moving up the Porsche Motorsport pyramid into Porsche Michelin Sprint Challenge.”
Troy Bundy | Head Of Motorsport | Porsche Cars Australia
Switzerland’s Council of States has approved a plan to start cannabis trials for recreational use, but only ‘experienced cannabis users’ should apply. The study, which was approved by the Council of States on Wednesday, hopes to find out more about the effects that a controlled legalization of the drug would have in Switzerland.
As reported in Swiss news outlet Watson, the government is looking “only for adults who already use cannabis to take part in the study”.
The proposal was previously approved by Switzerland’s lower house – the National Council – in June.
The decision to embark upon the trial was to be made in March but was delated due to the coronavirus pandemic. The experiments are to be carried out in Switzerland’s larger cities. Basel, Bern, Biel, Geneva and Zurich have all expressed interest in conducting the trials.
The study wants to understand how the market for cannabis works – and how to combat the black market. The social effects of legalisation are also set to be studied.
“The models must be tested before starting the debate on whether or not to liberalise cannabis,”
Only people who currently use cannabis – and can prove it – will be allowed to participate. Proof will be determined through a hair sample.
Organic Swiss Weed
There remains one sticking point between Switzerland’s lower and upper house. While the National Council has demanded that Swiss-grown, organic cannabis be used as part of the trial – the Council of States has said it does not want to make this a requirement.
Instead, organic, Swiss-grown cannabis must be used in the trial “wherever possible”, with the Council of States noting that such cannabis is hard to find.
Minister of Health Alain Berset said that a legalisation should benefit Swiss farmers even though “very few producers have experience in this area”.
Cannabis Users In Switzerland
An estimated 200,000 people smoke cannabis products in Switzerland. Those in favour of the new trial argue that this shows the war on drugs has failed miserably.
The sale of cannabis products containing up to one percent tetrahydrocannabinol (THC) – the ingredient that makes users high – has been legal in Switzerland since 2011. Regular strength cannabis and other associated products such as hashish are also illegal, although small amounts (less than ten grams) are decriminalised and will only attract a 100 franc on-the-spot fine.
A poll by the World Health Organisation showed that more teenagers smoked in Switzerland than in any other European country, with 27 percent of 15 year olds having smoked at least once. The use of cannabis for medical purposes is also heavily restricted in Switzerland, with only one product – CBD oil – legally available for sale.
There’s plenty of anecdotal evidence that Cannabidiol (CBD) oil – a concentrated oily extract made from cannabis – can help treat a variety of ailments. It’s said to help with everything from epileptic seizures to opioid addiction, PTSD to arthritis.
But despite CBD oil’s high profile status, there’s still a lot of confusion about what it actually is, and what it’s made from. Certain types of CBD oil are already legally available in the UK – such as those made from hemp – whereas other types are very much illegal in the UK – though are available to buy in other countries
CBD oil extracted from hemp is often marketed as a food supplement to promote well-being – similar to other herbals like Echinacea – and boost the immune system. Although Hemp CBD oil is legal, it is not a medicine and should not be confused with the recent confiscation of 12-year-old Billy Caldwell’s CBD oil at Heathrow airport.
Billy had flown with his mother to Canada to buy the CBD oil – which helps to keep his daily epileptic seizures at bay. But his oil was confiscated because it was made from cannabis flowers and leaves, and so was classed as illegal in the UK, pushing childhood epilepsy and CBD oil into the spotlight.
So far, so confusing, but part of the problem is that terms like cannabis and hemp are often used interchangeably – which masks the nuances and complexities of the cannabis plant.
Cannabis sativa L, the scientific name of the cannabis plant, is cultivated to produce two distinctive products – industrial hemp, and cannabis. The main difference between hemp and cannabis is based on two criteria. First, the levels of cannabinoids – a family of chemical compounds, the cannabis plant naturally produces – and second, the end use.
According to current UK drug laws, cannabis is classified as an illegal drug because of the psychoactive properties of THC, the component in it that creates the “high”. And under UK law, cannabis is deemed to have a high potential for abuse – with no accepted medical properties.
Hemp Vs Cannabis
But this is where it gets even more confusing because cannabis can be bred to create different strains. Cannabis consumed for recreational purposes is selectively bred to optimise high THC content strains – to maximise the “high” feeling. But cannabis also contains CBD, which is a non-psychoactive component.
Hemp, on the other hand, is harnessed as seed, oil and fibre to produce a wide range of products. It is cultivated to produce a low concentration of the psychoactive cannabinoid THC – as well as higher levels of the non-psychoactive cannabinoid CBD.
Cannabis is classified as hemp if it has a maximum level of 0.2% THC. Billy’s CBD oil, confiscated at Heathrow, was made from cannabis with a higher level than 0.2% of THC – so it was classed as cannabis, which is why it was confiscated.
Medical Marijuana
A recent survey conducted by Sky News found that 82% of their poll subjects agreed that medical cannabis should be legalized. Professor Dame Sally Davies, the chief medical officer for England, who was appointed to investigate the current scientific and medical evidence, about the therapeutic properties of cannabis-based products, also believes this. She recently said that “doctors should be able to prescribe” cannabis.
Davies has recommended the removal of cannabis from schedule one classification – which covers a group of drugs considered to have no medical purpose, that cannot be legally possessed or prescribed.
In Billy Caldwell’s case, the home secretary, Sajid Javid, made the decision to grant Billy access to imported CBD oil. This fresh approach to reconsider the classification of cannabis has been seminal, and mirrors wider sentiment in other countries. In the US, for example, medical cannabis programmes have been initiated in 30 states. Hence, medical tourism to Canada – where cannabis is legal for medicinal purposes – and the US to gain access to CBD oil.
In the UK, however, Sajid Javid will not reclassify cannabis until the Advisory Council on the Misuse of Drugs provides recommendations about the public health implications – which will include the abuse potential of cannabis-based CBD. Though it seems very likely that the home secretary will continue to move towards a patient focused resolution.
For patients like Billy then, what this means is that cannabis-based CBD oil could soon be prescribed in the UK under controlled conditions, by registered practitioners, and for medical benefit.
