Hope After Loss and North Dakota’s Emergency Kratom Ban

Welcome to this Monday edition of Main Street here on Prairie Public. We hope you had a great weekend. I'm Craig Blumen Shine. Coming up in just a bit, Governor Kelly Armstrong has issued an emergency order temporarily prohibiting the sale, use, and possession of Kratum and Kratum products. But what is the stuff? Essential Health Dr. Cole Perringer explains what Kratum is, why people use it, and the potential health risks. But first, finding hope after loss, a retreat for widows. The death of a spouse can change nearly every part of life. from daily routines and relationships to finances and plans for the future. Grief can also be unpredictable, returning in different ways long after the loss itself. The Jamestown Area Grieve Support Team is offering a weekend retreat where widows can step away from everyday responsibilities, spend time with others who understand and find support for the journey ahead. The retreat will be held October 9th through 11th at the Maryvale Retreat Center in Valley City. Eileen Liscoe is a member of the Jamestown Area grief support team. Eileen, it's a pleasure to welcome you to Main Street. Thank you so much, Craig. I'm happy to be able to share some information about this event. Before we talk about the retreat itself, tell me about the Jamestown area grief support team and the need and why it was created and what do you hope to do? Absolutely. Our organization, we are a nonprofit, all volunteer organization, and we were formed in 2002. So we've been around for a little while, and it was originally founded by a woman who at that time was the director of the Jamestown Hospice Program. And then there was a minister in Jamestown who was the hospice chaplain. And the two of them just had a conversation about the fact that they're just... is not a lot of support or resources available for people who have lost a loved one. And they wanted to change that. So they invited people who they thought would be interested in this mission. And we met as a group for about a year doing planning, getting our 501 status and all those kinds of things.

And then we took up the challenge of supporting people who've experienced the death of somebody that was very important in their life. And we've done that, you know, over the past 24 years, we do support groups, grief support groups, not just for widows, but for anyone, for any type of loss. Those are six-week programs. We meet once a week for six weeks. for the support group. And anyone is welcome to come who is grieving. There's no charge for the group and we do those at least twice a year. We also have done our widows retreat for the past 15 years. We have more recently, you know, it seemed like any time we talked about the widow's retreat, someone said, well, how about widowers? What do you have for the men? And for a long time, we didn't have anything specific for men. And now we have one of our members, a young man, a young minister, and he has taken up that challenge. And we have had a widower's day. It's just a day-long experience, but it's been very successful as well. And then we also have a memorial tree planting once a year. That's in conjunction with the hospice program in Jamestown here, although they invite all the people who have been, who have lost a loved one who was. in the hospice program, but it's not just for those people. It's for anyone with any type of loss. And, you know, what we've noticed, you know, grief doesn't go away, you know, overnight. And so we always make sure to say, whether it's the sport group, whether it's the widow's retreat, Widowers Day, anything that we offer. It doesn't matter whether your loss was recent or whether it was years ago. You are grieving that loss. Come. What can be especially difficult or maybe even, Eileen, misunderstood about the grief that follows the loss of a husband, a wife, a loved one? You use the right word, misunderstood. Grief is very misunderstood. You know, people think, oh, they lost their husband, their wife, whomever, and they're going to be sad. They're going to be lonely. Those things are true. They also think that there's a time frame that it's going to last a year. Some people think, oh, that'll last a month, then they'll be fine. And, you know, and those, you know, it can last a lifetime. And the other thing is besides being sad and lonely,

You know, there are so many emotions that go along with the grief experience that people don't expect, if they're going through grief, they don't expect that they're going to be angry, that they're going to be frustrated, that they're going to be confused, that they're going to forget things, that they're going to lack concentration. And many times people think, I must be going crazy. I'm just not functioning the way I'm used to functioning. And all those things are so much part of grief. I mean, I worry that here in the Midwest, here in rural America... That the expectation is, come on, pick it up. Let's go. It's been six months. It's been a year. Let's go. Come on. What are you waiting for? Yep, move on. Yeah. And that's such a troublesome way to frame grief and mental health, quite frankly. How do you assist folks who have maybe heard that? But boy, they're still hurting. Right. And, you know, we have had people, we had a woman come to our widow's retreat. Her husband had died 22 years earlier. And she was still hurting. And she remembered every detail of that day that her husband died. And, you know, we just, we try to be with people in this experience. You know, we can't cure grief. It's not a disease from which anybody is going to recover. But we like to walk. through this journey with them. We call it companioning and let them know that there is no time frame. There is no timetable. And so there's nothing wrong with you. If it's a year later, five years later, ten years later, it doesn't matter. The thing that we teach when we have a support group or when we have a retreat is that there is a difference between grieving and mourning. People often use those two words interchangeably. They think they're the same thing. And they're not. Your grief is what's going on inside of you. It's the thoughts. It's the feelings. It's everything that you're experiencing on the inside. Mourning is when you let that out. You let those feelings and thoughts out. You talk to somebody about what you're going through. You journal about it. You...

express it in tears or whatever way you can to express that grief outside of yourself, that's what's going to help get you through the journey. People who keep everything inside, they don't ever talk about it, they just try to go on as though nothing happened, because they think that's the expectation of others, the way they should be acting, that is going to take them so much longer to... to walk through this journey. The Jamestown Area Grief Support Team is offering a weekend retreat. My guest today is Eileen Liscoe. She's a member of the Jamestown Area Grief Support Team. The retreat will be held October 9th through 11th in Valley City. Tell me, Eileen, what does a weekend retreat offer that may be difficult to find in an occasional support group meeting? Although those are good or just a conversation with family or friends. What does the weekend retreat offer and why should people consider coming? Okay, well, there's many, many advantages to this retreat. One of the main things is that, okay, so a woman has lost her husband and... that's probably the most traumatic experience she's ever going to have. And, you know, everybody's heard the experience, the expression, life goes on. Well, yeah, life does go on for other people. It doesn't really go on the same way for her. It never will. I had one woman say, she got home from her husband's funeral, and there was mail in the mailbox. And it was like she couldn't fathom that something as mundane as delivering the mail could take place. When she's experienced this enormous loss in her life, you know, everything keeps going on around them, but not for them. They're in a whole different place. And so many times to just deal with the issues that they're experiencing because of their grief. is hard because of all the everyday ordinary things that have to happen. They have to go to the grocery store. They have to vacuum. They maybe have to go to work or get their kids off to school or do all these ordinary everyday things that they've always done. But... It's, there's just, they can hardly focus on that because of what they've been through. To come to a retreat removes you from all of that, from all the distractions of ordinary, everyday life. It's just a time to focus on yourself. And most people don't have that, just a time to focus on themselves. The other thing is, There isn't anyone who is going to understand what you are going through like another person who's gone through that.

To spending time with other widows, not that everybody's experience is the same. Everybody's experience is different. But to be able to spend time with other women who've lost their husbands is something that is just so valuable because they get it. They know where you are coming from. And they just, they can understand what you're dealing with. And that's been... Our ladies who have attended in the past have found this to be such a valuable experience and so helpful for them moving forward. And sometimes the ladies that they've met at the retreat become lifelong friends. When participants first arrive at Maryvale on that Friday, October 9th for the retreat. What will they find? What will the atmosphere be? What should they expect? Okay. Well, first of all, if they have not been to the Maryvale Retreat Center in Valley City, it's a beautiful, beautiful place. They have spacious grounds that are just, you drive onto the grounds and you can feel the peace of this place. So we have found, we feel we have found the perfect place to host this retreat. So we begin on Friday evening, and of course, most of the women who are coming do not know one another. For many of them, just making the decision to come is a little daunting. Sure. They're a little... apprehensive about it and so we try to make our Friday evening to be a very relaxing getting to know you just an orientation type of evening we have various you know getting to know you type activities we have um some, you know, we, of course, we're going to have snacks and coffee and whatever people would want. And just a time to settle in and, you know, we show them around to their rooms and let them know where everything is at and introduce all the members of the team who are putting on the retreat. And just let them sort of settle in and feel at ease. and relaxed with the people that they're with. Then the next day on Saturday is when the hard work begins. You know, grief is hard work. It's a lot. It's an exhausting process. And so, and by the way, the meals at Mary Vale are wonderful. So we start with a wonderful breakfast. We come back to our meeting area. And then we start to talk about the experience, what it's like to lose your husband. And there are several members of our team who are widows, and they share their stories. They talk about when their husband died.

what may be what caused the death, what that felt like, what the days were leading up to the death, if it was something somewhat expected, or if it was something very sudden, they talk about that, they talk about how they've processed and how things have managed. And then the women attending are invited to share their stories. It is a very, very emotional mourning. It's, you know, there's a lot of tears. Sometimes there's some laughter. But getting that story out, telling others what that has been like for you is probably the most valuable part of the retreat. And for some of them, they've told the story many, many, many, many times. For some, they never have. But to be able to tell that, and it is so interesting to watch how the dynamics here, because as I said, these women come in as probably the most part as strangers, they go through this sharing. And it is like instant bonding. Once those stories are out, these women can identify with each other. And the support that they show one another is just a beautiful thing to experience. You're having a guest speaker, too, a grief recovery specialist. We are. Jeannie Putnam is wonderful. She's been with us for many years. She comes from the Wappaton area. And she is just... She can zero in on what is going on. She involves people. She will be there in the morning to hear these stories when these women share. And then she just makes it very personal to what their experience is like. And she offers... a lot of helpful coping skills and suggestions. And she, you know, interacts beautifully with all of our ladies. And she's wonderful. We love her. You also have special sessions that address things like cybersecurity, recognizing scams, and staying safe while living alone. Why has that become so important? Exactly. Why are those topics important to include in this setting? Yes, and, you know, this is something new that we've just added in the last couple years because we're finding that, you know, some of our widows are older ladies and they're not really tech-savvy.

And they're like easy targets. And even for those who are very well acquainted with technology and scams and hacks and all those kinds of things, this is a time when they're very vulnerable because... They aren't always concentrating. They aren't always thinking clearly because they have so many emotions going on inside and so many other things on their mind that they're easy targets. And so we have added this and, you know, many of the things, the gal who presents this has, she has done a lot of research. She's very familiar with all this. She brings up things that people are like, oh, I never thought of that. I never thought of how that could happen to me or how easily that could happen to me. And so it's just a way to help everyone know that this is a way to keep you safe and to make sure that you don't fall victim to something when you already have. so many difficulties that you're facing right now. That's the last thing you need. So that has been, I think that has been a very important addition to this retreat and really helped people to look out for those kinds of things. You have many guided activities, but you also have private time for journaling or for walking or resting or maybe just even reflecting. How do you balance that time for attendees? Yes, and it's, you know, we keep them so busy, and it's like we want to make sure that they have time. Some of the, as I said earlier, grieving is an exhausting experience, and some of them are just tired. And, you know, if they just feel like I need to go to my room where it's quiet and peaceful and take a nap. Okay, that's acceptable. You know, we like them to participate in all activities, but it's not required. We wanted to be what these ladies needed to be. But we do build in some free time. Usually early in October, the weather is beautiful. And to be able to go out on these beautiful grounds and just walk, maybe with somebody that you've met at the retreat, maybe. by yourself because you need some private time is just a very refreshing experience rejuvenating and um so we do try to build that in and you know we we even kind of put in we once someone is registered when it gets closer to the retreat we send them a letter giving them directions and what to bring and you know just so they know a little bit what to expect and we often even say you might want to bring an umbrella and a jacket along even if it is raining could go out if you want to and we have sunday morning a religious chapel service and it's non-denominational and it's optional people don't want to get up early and come but it's a very beautiful little chapel service with some readings and some you know little

discussion and so on, beautiful music and people have really that have really liked that. And we also have after that on Sunday, we have a memory service where it's kind of a time to honor these husbands. We, you know, we, we, we ask them to talk a little about their husbands. They, they light a candle in memory of their husbands. We have some beautiful poetry and some beautiful music that round out that service. And, yeah, it's, it's very, it's very nice. And it's really meant a lot to these women who come. I'm guessing there are some women who are listening who, you know, this is a good idea, but. but I'm nervous about attending alone or spending a weekend with people I've never met. What would you say to them? Well, of course, I would say give it a try. And, you know, we, if they, if someone thinks they might be interested, but they have apprehensions and they're not quite sure, just we'll give some phone numbers here. call. You can, any of us would be happy to talk to them about the retreat. And you're not obligated just because you call someone. You're not obligated to come. We can answer any questions, you know, kind of maybe put them a little bit more at ease. You know, if some woman is thinking that she might benefit from this. But she is apprehensive about coming and not knowing anyone. And she knows another widow, invite her to come with you. We have had people who've come with a friend who is also a widow. And we've had people come from some distances away. We've had many come from Minnesota. We've had some come from South Dakota. Some, we've had a woman come from Nevada one year. So it doesn't, I mean, if you are, you know, interested in it, give yourself a chance. Give yourself a chance. And. We've never had one person in 15 years who has said, oh, this isn't for me, I need to leave, or this wasn't a good experience. We always ask them at the end to fill out an evaluation. We've gotten very, very wonderful reviews, and we often hear from these women maybe months, maybe years later. You mentioned you had phone numbers that you want to share. Anyone's welcome to call me. I'm very happy to talk to them about it. My name is Agana, Cilene. And my phone number is 701, 269, 4521. Another one of our members, Carol, is also very happy to take phone calls. 701, 320, 3801.

If you would call one of us and don't get us the first time, feel free to leave a message with your phone number. And I promise we will call you back and answer all your questions. Is there a place where people can go online to look at more information? We are on Facebook, J-A-G-S-T, an acronym, James Town Area Grave Support Team, J-A-G-S-T on Facebook, and that has more information on it. And we aren't able to accept registrations online. They would need to send those in by mail, which, you know, we can send out a brochure if you're just, even if you're not sure, but you just... think you might be, call us. We'll send you the brochure and the registration form. Maybe you send it in. Maybe you don't. Again, you're not obligated just because you're receiving information from us. I mean, what does the fee of $175 cover? It covers your room. Everyone has a private room. For two nights? It covers all your meals. Pardon me? For two nights, correct? For two nights, yep, for two nights. And you have all your meals. So Friday night is, there's not a meal on Friday night. We start like at 7 o'clock, but we will have snacks and so on around on Friday night. Well, all throughout the retreat, we always do. And coffee is always available. Tea is always available and so on. So then there's breakfast, lunch, and dinner on Saturday. And then there's a... a little continental breakfast and a brunch on Sunday. So all the meals. And then there will be some materials that they'll be given, you know, things that they'll be given, books and so on at the end. And so all of that is covered in the fee. The Jamestown area grief support team's Widows Retreat will be held October 9th through the 11th at the Maryvale Retreat Center in Valley City. The $175 registration fee includes two nights in a private room. five meals and retreat materials. For more information, you can call Eileen. Let's go at 701-269-4521. Or Carol at 701-3203801. Best wishes. Best wishes, I think this is a valuable, wonderful thing that you do, Eileen. I hope things go very well. And I'm really appreciative that you've reached out to us. And thanks for joining me today on Main Street. Thank you so much. I appreciate being able to share this information.

One in four adults is caring for someone they love in North Dakota. If that's you, AARP can help. The Family Caregiving Kit is available at aARP.org slash ND Care Kit. Still to come, on this Monday's Main Street, Governor Kelly Armstrong has issued an emergency order, temporarily prohibiting the sale, use, and possession of Kratum and Kratum products. But what is the stuff? We'll learn from Ascentia Health's Dr. Cole Perringer. That's right after this news. This is Main Street. I'm Craig Blumen Shine. Until this week, Kratum could be sold in North Dakota without a minimum purchasing age, standardized labeling, or consistent limits on its potency. Governor Kelly Armstrong has now declared a public health emergency and prohibited sale, possession, or use of Kratum, and Kratum products effective August 5th. Governor also called lawmakers into a special session that will begin September 2nd to consider a permanent prohibition. and address enforcement. Kratum comes from a tree native to Southeast Asia in the United States. It's sold in powders, capsules, beverages, and highly concentrated products. Some people use it for energy, pain relief, or help with opioid withdrawal. Federal health officials warn that Kratum has not been approved to treat any medical condition and has been associated with dependence, seizures, liver toxicity, and other serious health problems. Dr. Cole Perringer is a medical toxologist, addiction specialist, and hospitalist at Ascentia Health in Duluth, and he serves as the medical director of Ascentia's substance use and addiction care program. Dr. Perringer, welcome to Main Street. Thanks. I appreciate you having me on. I'm happy to be here. It is great that you are with us today. For listeners who are unfamiliar with Kratum, what is it and what happens in the body when someone uses it? Great question. So in order to answer that, I'm going to give a little bit of background that touched on a couple of the points that you made and maybe elaborates on a few others just to kind of give us context. So Kratum, as you mentioned, from Southeast Asia and has been used for hundreds of years by locals for pain control, for anxiety management, for sleep, for a lot of different things. And the reason it can be used for a lot of different things or has been is because it has various substances in it. One of them is called metragene, what named is not really that important, but is an opioid. And as in their stimulants, substances that are stimulants are kind of uppers. There are other substances that are more downers. This is natural in the plant. And one plant is going to be different from the next. One crop is going to be different from the next crop. So it's really variable.

It's sold as a supplement in the U.S. And as a supplement, it has no regulation whatsoever. So I could make, have a cratim leaf in my house, crush it up and sell it as a supplement. And there's no one checking what concentration I say or what's in it. That's just that's by definition what supplements are. And as such, they can be sold all over, all over the country. Get gas stations anywhere. And so. Pratum has these substances in it. Matraginine, the opioid, is probably the most important. So an opioid is a class of substance or medication that you can, oxycodone as an opioid, heroin is an opioid, morphine, fentanyl. So these are all substances that have two properties. One, they cause, or three properties. One is they cause people to be sleepy. what we call CNS depression, or central nervous system depression. They calm people down causing to be sleepy and also help with pain in that realm. But the other thing that they do is at higher doses, they cause people to start breathing shallowly and very not shallow, slow breaths. And ultimately what that can do is that can lead to death. We don't get enough oxygen to our heart, stops beating. We don't get enough blood flow to our brain. That's what happened. So that's the big concern. With taking a step back again and looking at Kratum, we have metragene, which is this opioid. And what typically happens when we have a substance or a drug in the U.S. is when we introduce regulation, those sellers or distributors usually react by creating a more potent alternative. And so what they've done is as the threat of regulation of Kratum has come around, is there is a substance that's found in just trace amounts in Kratum called 7 hydroxymatrogenin. And it is the very potent, about 20 times more potent than regular metragone. And it's being concentrated and sold in pills and drinks. And basically it's kind of replacing cratum. It's synthetic. It's synthetic. It's small amounts naturally from plants, but it is being concentrated. And so it's not created in a lab. It comes from the plant, but it's being concentrated and sold as these very concentrated capsules usually. Dr. Perringer, we have the synthetic part and we have the natural part of cratum, and we've talked about that just a little bit. Is there any place for the natural cratum to exist safely? that lawmakers or others should think about? Possibly. I think that we need to study it like we do other medications and drugs. And if we have evidence that it shows, you know, improves pain or improves anxiety, then...

It absolutely could be used and sold or prescribed, like other medications. But I think sold is a supplement, particularly with the dangers, regardless of it's natural or not. I mean, morphine and opium and thibane and all those, that's natural from the opium and poppy. But that's going to do the exact same thing. Is Crate in place somewhere, like is it a Schedule I drug that we've heard about in different places on how it can be studied? Not yet. That's what this legislation will do. So in Minnesota, it's being the derivatives of Kratum, so seven hydroxy, pseudo-indoxal, blah, blah, blah. The really potent metabolites are being scheduled as Schedule 1. But so far, it's really variable upon state. One comment about synthetic versus natural. Sure. When I think of those, synthetic is made in a lab. Natural is not. When I think of a synthetic opioid, I think of fentanyl. If you take the molecule of fentanyl and morphine, they look nothing alike. There is nothing in the opium poppy plant that would lead to fentanyl. Same thing with methadone. It is made in a laboratory. But morphine and all the things we're talking about with Kratum, like 7-hydroxy, metragone, they're natural because they come from this plant. Even if we make them in a lab and concentrate them, like that's a natural substance. Everything that we're talking about with Kratum is all natural. That doesn't mean it's safe. And that synthetic is just a totally different molecule that's made in a lab. The similarity is that they both interact with what we call the mu opioid receptor. That's it. And so natural doesn't mean safe at all, at all. Thinking of the lab and breaking bad in my mind. Where's this stuff made? Yeah, good question. I can't answer that. A lot of different places. Our truck supply tends to go up through Canada, down through Mexico, through Chicago, and make its way up to here, clandestine labs. But it ends up in a grocery store and in a convenience store? It does, yeah. And so gas stations, head shops, and usually really bright packaging. And the concern is, like other opioids, is they may help with pain, especially in the short term, but they can absolutely lead to addiction or an opioid use disorder. How does it present? With these more potent derivatives, what typically happens is when they're using those. If they don't have access for whatever reason, they don't have enough money, anything that you get off the street is fentanyl. So which is much more potent than that. So the typical progression, often if they're struggling with seven hydroxy use is the use of fentanyl. And the mortality rate of fentanyl use is exceedingly high. Chances of being alive in like two years is, you know, just under 50%. It is insanely deadly. And so that's the concern. Some people say that this stuff helps them with pain or helps them with opioid withdrawal. Why do they use it in the first place? Just because someone told them to? Yeah, or they found it online. I think those are the two main sources. They found it online or someone told them to. The important thing to note here is that, like I mentioned that if people are using seven hydroxia or creatum and stop using it, there's a wicked withdrawal syndrome. Just.

Very complicated one, but we have treatment for it. A very good treatment called buprenorphine that we also use for opioid use. And so we have legitimate treatments or substitutions you can kind of view it, at least in the short term, that treat and manage this. So it's absolutely treatable. And that is what we would. I think we need a lot more education and public awareness about so that if we do cut off this supply, we're not leaving these individuals to, and we're in terrible withdrawal to turn to something. easy off the street. What do we know about tolerance and physical dependence and addiction among people who use Kratum regularly? What do we know about tolerance? Is this something that a little bit worked? Now I need a little bit more. Now I need a little bit more. And now I'm in big trouble. Great, great question. So there's no question that it might help some populations. And the risk of developing a use disorder from any opioid, including Kratum, is... less than half the people do. So it's not, it's not in a lot of people are going to use cratum in a short term safely. That said, it's also, it's like it mentioned, it's unregulated. So we have this extremely variable doses that we're getting at gas stations and head shops to treat pain when we have other options where we give a known medication and drug at known doses for a known period of time. And. So there is a definitely a portion of patients, and it's really hard to estimate because our epidemiologic data are like how much of the population is using is... is hard to get in these unregulated supplements. Enjoying my conversation with Dr. Cole Perringer. He's a medical toxicologist, addiction medicine specialist, and hospitalist at Ascentia Health in Duluth, serves as medical director of Ascentia's Substance Use and Addiction Care Program. If somebody gets this stuff, is there any way they can tell how potent it is or isn't? No, simple answer. This, it strikes me as a part of a larger market of products that we see in convenience store displays and smoke shops, I guess, if you go. And they're energy boosters. They're mood enhancers. They're legal, which some people equate to safe alternatives to other drugs. What are their substances are you worried about? And what should consumers watch for? Oh, I don't want to go off on too much of a tangent, but cannabinoids. So we take, for example, we take the cannabinoid plant. So cannabis has around 2 to 300 different cannabinoid molecules or cannabinoid substances in it. One of which is delta 9 THC, which most people are aware of. Delta 9 THC is regulated.

But there's all these other cannabinoids in cannabis, some of which are psychoactive, some of which are even more potent than Delta 9 THC, which are not regulated. So in 2018, there's something called a Farm Bill passed. The only reason I even mention it is it made it legal to grow hemp. The difference between hemp and marijuana are the same plant. The only difference is the concentration of Delta 9 THC. So if I have less than 0.03 or 0.3%, very low percentage of Delta 9 THC, it can be grown and sold as hemp. However, I could have loads of those other psychoactive substances like Delta 8, Delta 10, THCP, cannabinol, like you name it. So many different cannabinoids, I can sell freely and distribute freely as I wish. They are sold as supplements. There's no regulation around those. If I'm using Kratum and I'm hearing this conversation, I don't want to get in trouble, but what should I do? Please reach out to a local physician or provider. We have effective treatment for withdrawal management, and we can get people onto buprenorphine. Some people might say, oh, this is a substitution therapy. It is a substitution therapy, but it's a substitution therapy that works, that keeps people alive and allows them to live a normal life. We know how to treat their withdrawal with using buprenorphine as this backbone and giving some other medications to help with symptomatic anxiety that might break through. We can treat this and we can transition this and frankly much easier than a fentanyl use disorder. Is there any place where Kratum should be allowed to continue? It depends who you ask. There's going to be some Kratum lobbyists that absolutely support that. My opinion is that we need long-term cratum regulation. So I'm in favor of this regardless of age restriction. And that at least if it is prescribed, that it's prescribed. And we know the dose en route. I am most concerned about how the... Any regulation is brought about, how fast it's brought about without education about buprenorphine or what to turn to. Dr. Robert Perringer, he's a medical toxologist and addiction medicine specialist. He also serves as medical director of essential substance use and addiction care program. North Dakota's prohibition on the sale, possession, and use of creatum and creatum products took effect August 5th. Legislature is now scheduled to begin a special session September 2nd to consider a permanent prohibition. and related enforcement measures. Dr. Perringer, it's my pleasure to visit with you. Thank you so much for joining us. Absolutely. Thank you for having me.

Support for Prairie Public is provided by Starian Bank, determined to provide smart banking solutions with innovative checking accounts and personal banking tools that match your lifestyle. Starian, taking you farther. Learn more at starianbank.com. If you're listening to the 3 p.m. broadcast of Main Street catch up on the news and stories from around the world, the nation, and here at home on all things considered. That's up next on Prairie Public. And if you're listening to us during the evening broadcast, keep it here for Hidden Brain. That follows Main Street on Prairie Public. This is Bird Note. Sometimes birds have common names that aren't very descriptive. Not so for the black and white warbler. Smaller than a sparrow, these stripy, black and white songbirds are always on the move. They feast on insects gleaned from leaves or plucked from cracks and tree bark. You'll often find them clinging to tree trunks or the undersides of thick branches, acting more like a nut hatch than a warbler.

In the winter months, black and white warblers thrive in a wide variety of habitats from the southern U.S. to Colombia. But they breed in North America's deciduous forests, where males sing a repetitive, high-pitched, wheezy, wheezy song, a little bit like a squeaky shopping cart. Like many songbirds, black and white warblers migrate at night, using the stars to navigate. Unfortunately, nocturnal light pollution can disrupt their sense of direction or cause them to collide with buildings. You can help black and white warblers by turning off outdoor lights and shading your windows at night, especially during migration season. Learn more about lights out initiatives for birds when you visit our website, birdnote.org. I'm Ariana Rimmel. Birdnote is supported by Chris Cluitt of Seattle and by generous listeners around the world. This is Dakota Datebook for August 10th. The United States had entered World War I on April 6, 1917. fourteen thousand troops of the american expeditionary force landed in st nazare france on june twenty sixth more than thirty five thousand north dakotans served in world war one with approximately twenty eight thousand deployed overseas that number does not account for all the north dakotans who served during the war Estimates suggest that around 53,000 men with connections to the United States joined the Canadian Expeditionary Force before the U.S. entered the war. they enlisted for a variety of personal political and economic reasons some may have wanted to leave ordinary lives behind and seek adventure an unknown number of those men were north dakotans because swearing allegiance to a foreign government and especially bearing arms on its behalf could result in the loss of u s citizenship many concealed their american citizenship from canadian recruiters For their part, recruiters did not ask many questions in their hurry to sign up badly needed men. Howard Shipley was born and raised in Jamestown. He had shown no strong feelings about the war and surprised family and friends when he enlisted in the Canadian Expeditionary Force serving in an artillery unit. In October of 1916, a friend received a postcard from Shipley listing his location as Somewhere in France. on this date in nineteen seventeen his family received a letter describing how shipley had been wounded at vimy ridge he had been hit three times by shrapnel and was recovering in an english hospital he seemed undaunted by the experience writing i've had some close calls but am still able to find the cook-house if fritz don't get me i'll be home to tell you about it shipley did indeed make it home

in nineteen nineteen after sixty months with the canadian artillery he returned home for a visit he had seen action in several major battles he remembered we had to carry water in our steel helmets to pour on our machine guns which were red-hot years later in nineteen thirty the bismarck tribune published an extensive article about him by then shipley was living in prince rupert british columbia and working as a conductor for the canadian national railway The newspaper noted that Shipley had remarkable stories to tell, but they were too vivid and dramatic for publication. It doubted he would ever write down his experiences because the lingering effects of shell shock made reliving them too painful. Today's Dakota Date book was written by Dr. Carol Butcher. I'm Merrill Pepcorn. Dakota Datebook is produced in cooperation with the State Historical Society of North Dakota, with funding by the Study ND, North Dakota's largest lifelong learning community. We'd like to thank the North Dakota Council on the Arts for supporting art programming here on Prairie Public.

Six states hold primary elections Tuesday. Some Alabama residents are voting for a second time due to redistricting after the Supreme Court gutted the Voting Rights Act. Just the plain confusion of seeing stuff and being told, it's now, it's then, it's here, it's there, it's really going to play into voter turnout. Continuing coverage of primary season on the next morning edition from NPR News. Starting at 4 a.m. Central, right here on Prairie Public. Sleepy Hollow Theater and Arts Park in Bismarck presents a night of great jazz featuring Scott Prebis and Friends August 13th at 7 p.m. outdoors at Bud's Corner Gazebo in the park. Ticket information is available at shtap.org. And that's it for this Monday's Main Street. We are deeply grateful that you spent time with us. Tomorrow on the show, helping little learners start school strong. North Dakota teacher of the year, Franny Tunseth, shares practical ways parents can build curiosity, confidence, and strong learning habits as young children get ready to head back to school. That's ahead tomorrow on Main Street, and we look forward to your joining us again.