CA Firefighters May Lose Access to Life-Extending Medicine

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Pasadena fire captain David Marquez is proud of the work his crew did fighting the Eaton Fire, which ignited Jan. 7, killing at least 17 people and burning some 9,000 structures before it was contained 24 days later.

They “did everything I asked them to do,” said Marquez, “but you could tell it took a toll.”

In the first 36 hours battling that explosive blaze, Marquez recalled, “we ate more smoke than we ever have in our careers,” which left some members of his crew with hacking coughs that “progressed to vomiting.”

So Marquez felt fortunate to find The LA Fires First Responders Wellness Program, a partnership of two Santa Rosa-based nonprofits, the Volunteer Fire Foundation, and the Integrated Healers Action Network (IHAN), along with a group called Acupuncturists Without Borders.

Formed during the Tubbs Fire, IHAN is a nonprofit known as “a first responder for first responders.”

They offered a range of treatments to firefighters who stopped by their “healing tent,” including acupuncture, massage and naturopathic medicine.

But the therapy Marquez and his crew found most exciting were inhalable doses of glutathione (glue-tuh-THIGH-own), an antioxidant that’s shown promise in lowering levels of toxins found in the bodies of firefighters, whose line of work puts them at greater risk of cancer than the general population.

But that treatment is in jeopardy, at least in California. On Wednesday, the state Board of Pharmacy is scheduled to vote on new rules that would severely restrict Californians’ access to sterile compounded substances, including glutathione.

“Get this s--- out of our bodies”To help firefighters fully heal lung tissue, naturopathic doctors recommend long-term, daily glutathione treatments.

Still, he and his crew benefited from even limited doses, said Marquez, who feels he has had more energy and is sleeping better, while some of his colleagues “coughed up a bunch of crap,” and are “breathing better, they’re less congested.”

Response from firefighters who stopped by their healing tents was “overwhelming,” said Dr. Jen Riegle, a naturopath and cofounder of IHAN, who pointed out that patients do better “when they can take [nebulized glutathione] every day for one of two months.”

Even after a single treatment, she said, firefighters are so enthusiastic “that they have immediately sent other people in their department to us, and word has quickly spread to other departments.”

That’s a testament to the therapeutic value of even a single dose of glutathione, she said — and to the fact these firefighters had endured “some of the most serious exposures I’ve ever seen,” she said.

Many of the captains she spoke with, said Riegle, told her they were on the line for as many as three days without a break, “which led to many people in their crews vomiting, getting pneumonia, being hospitalized.”

“I’m not running around saying, ‘This is the cure! This is the cure!’” said Marquez, “But it’s exciting enough to say, ‘Hold on, we need to look into this some more.’”

That’s why he’s now working to make glutathione treatments more widely available to members of his department.

“We’re really good about cleaning and decontaminating our gear. But we’ve never had a discussion about, ‘Hey, how can we get this s--- out of our bodies?’”

“Let’s [treat] our people with it, and see how everyone’s feeling, a month from now, a year from now,” he said. “Let’s see what this is actually going to do. This could be an absolute game-changer for firefighters across the country.”

The those questions won’t be answered anytime soon if the California Board of Pharmacy votes as expected at its Wednesday meeting.

Access to treatments in jeopardyEven as Marquez spoke of the prospect of widely available treatments, the board was finalizing plans to pass regulations that will severely restrict Californians’ access to sterile compounded substances, including glutathione.

If adopted, the new rules would make it more difficult for Californians to get the “Category 1” meds that have shown promise clearing toxins from the bodies of firefighters — but also treatments that give patients relief from such ailments as Lyme disease, long COVID, cancer, cystic fibrosis, chronic fatigue syndrome and others.

Compounding is the pharmaceutical process of combining ingredients to create medications tailored to the needs of individual patients — medicine not available in a regular CVS or Walgreens.

Glutathione and methylcobalamin, a form of vitamin B12, are currently on the Food and Drug Administration’s “interim bulk list,” Category 1. That means compounding pharmacies have the green light to dispense it.

At least in theory.

In California in recent years, the pharmacy board has disciplined compounding pharmacies that continued to make and sell those substances — even though doing so has never been against the law, board critics say, and even though glutathione is legal and available in 49 other states.

The rules package up for a vote on Wednesday, they say, would codify regulations the board has already been enforcing.

The author of those regulations, Compounding and Enforcement Committee Chair Maria Serpa, has repeatedly stated that the proposed regulations do not exceed guidelines imposed by the FDA and United States Pharmacopoeia, the highly respected group which sets standards for the quality of medicines, dietary supplements, and health care products in the United States.

That’s false, say the compounders and other critics.

The proposed rules call for “stability studies” that far exceed FDA and USP standards, and which will cost compounding pharmacies $10,000 to $30,000 “per formulation,” according to Scott Brunner, CEO of the trade group Alliance for Pharmacy Compounding.

Brunner made his points in a letter posted in a “comments” section on the Board’s website. As they have been since the original version of the regulations were rolled out in March, those emails are overwhelmingly opposed to the rule changes.

“A pharmacy can't pay $20,000 for a stability study for one prescription,” added Tenille Davis, a spokesperson for the APC, in an interview with the Press Democrat.

Since Jan. 17, IHAN and its partners have run numerous clinics at the Rose Bowl base camp, at fire stations in Pacific Palisades and Pasadena — in addition to pop-up firefighter detox clinics requested by strike teams from CAL FIRE and Sonoma County.

In the first two weekends alone, according to statistics compiled by IHAN cofounder Jenny Harrow-Keeler, the wellness team provided more than 2,500 treatments, including nebulized glutathione, acupuncture, and manual bodywork to over 1,000 firefighters from dozens of agencies.

IHAN and the Volunteer Fire Foundation will be back in Pasadena Feb. 8 and 15, and have been asked to run a large clinic on Feb. 16 at the LA Fire Department’s West Side training center.

What’s happening, said Jacqui Jorgeson, founder of the Volunteer Fire Foundation, is a “word-of-mouth, viral situation” where firefighters are “flocking” to these treatments.”

All this is unfolding at the same time the Board of Pharmacy is poised to pass rules that could put glutathione treatments out of reach for first responders in the state.

Jorgeson, meanwhile, has been wrangling signatures for a petition describing the Feb. 5 Board of Pharmacy meeting as “The Last Stand.”

The petition calls for “an army of firefighters and their loved ones to show up — on the phone or in person — and make a public comment.

The stakes are high: Serpa has explained that the board has one year to pass a regulatory package, after introducing it, and time is almost up.

Failure to pass the rules package on Wednesday could force the Pharmacy Board back to the drawing board — exactly what its critics want.

Interest in glutathione continues to go up, even as that substance has become increasingly endangered. Jorgeson is having conversations with union leaders from the Los Angeles and Pasadena fire departments. Labor leaders from several other fire departments in the region have also reached out in recent days, she said.

“Long term,” said Marquez, the Pasadena fire captain, “it’s really cool to think about what this could mean for our profession.”

That will depend on what happens in the short term, at a meeting on Wednesday.