Recommended Reading – A New Leaf

A New LeafRecently I read A New Leaf: The End of Cannabis Prohibition by Alyson Martin and Nushin Rashidian. I was initially puzzled by the title. To paraphrase Mark Twain, reports of the death of cannabis prohibition have been greatly exaggerated. During a recent trip to several of the states that have legalized cannabis for medical purposes I heard plenty of reports that confirmed to me the cannabis prohibition is still alive and very well in the U.S.A. But title nit-picking aside this is really an excellent book that every cannabis activist should read.

I’ve been involved in the cannabis reform issue for almost forty years. I am not unique in that regard. There are many fine people who have been slogging away at this issue for quite some time. Martin and Rashidian do an excellent job of paying homage to the “pioneers” while skillfully taking the reader rather quickly to the current scene, a period of time that covers the past fifteen years. It has been a terrifically exciting time as more than twenty states enacted medical marijuana laws and two states, Colorado and Washington, have legalized adult, social use of cannabis.

But legalizing cannabis—either for medical or social use—is not a simple matter of clicking your ruby heels and making the bad old prohibition disappear. It has taken a tremendous amount of hard work, lots of money and there have been some failures. The authors do a fine job of dissecting the failures as well as the victories. For anyone even remotely involved in cannabis reform this information is critical. Just as the ruby heels do not make prohibition disappear neither will Andy-Hardy-enthusiasm and a-barn-for-the-play make the ballot initiatives pass. Everyone knows the prohibition violates numerous civil liberties but screaming as much on a street corner doesn’t cut it. Meticulously learning the issue, being ready to compromise, and creating a well-thought out plan are the essentials. And passing a law is only the first step. The real trick is implementing the will of the people. The result may be a utopia like Colorado or a political quagmire like New Jersey.

There are twenty-two state laws recognizing marijuana’s medical value. The genie is way out of the bottle at this point but the issue is far from being resolved. The patchwork of different approaches in each state is unsettling, offering an erratic level of patient care. The maddening interference of the federal government is particularly well characterized in The New Leaf. The refusal of federal officials to honestly confront the legitimacy of cannabis as medicine is a particularly dark blight on our government. Explaining the duplicity is not an easy task but Martin and Rashidian do a commendable job.

I recommend this book to anyone with the slightest interest in the cannabis issue. For those already engaged it is mandatory reading.

8th National Conference on Cannabis Therapeutics

photoThe 8th National Conference on Cannabis Therapeutics convened in Portland, Oregon on May 8-10. It was a standing-room only crowd in the City of Roses as healthcare professionals from around the globe gathered to learn the latest about the fascinating endocannabinoid system.

If you don’t know what the “endocannabinoid system” is that is okay.  It’s a relatively new discovery, dating back just 22 years, to 1992.  Here’s what Wikipedia says about it:

The endocannabinoid system is a group of neuromodulatory lipids and their receptors in the brain that are involved in a variety of physiological processes including appetitepain-sensation,mood, and memory; it mediates the psychoactive effects of cannabis …

Listen, if your head is  spinning at this point you are not alone. That type of jargon is a lot of what I listened to for three days in Portland. Even Wikipedia has a notation before the definition stating “This article may be too technical for most readers to understand.” But if you can just stay with me for a little bit longer you might find your head spinning for entirely different reasons.

Dr. David Sulak of Maine Integrative Healthcare was one of the speakers in Portland and his explanation of the endocannabinoid system is much easier:

The endogenous cannabinoid system, named after the plant that led to its discovery, is perhaps the most important physiologic system involved in establishing and maintaining human health. Endocannabinoids and their receptors are found throughout the body: in the brain, organs, connective tissues, glands, and immune cells. In each tissue, the cannabinoid system performs different tasks, but the goal is always the same: homeostasis, the maintenance of a stable internal environment despite fluctuations in the external environment.

You might want to take a moment to re-read that paragraph because, honestly, this is important. Make all the jokes that you wish about stoners and pot-heads, this newly discovered aspect of cannabis and its role in our health and general well-being demands a societal shift in attitudes.  We must move beyond the cultural wars that have marked the cannabis issue over the past seventy years and approach the naturally occurring substance with a new spirit.

That spirit is what I saw in Portland. At times the presentations bordered on the type of droll, professorial reports that every college student knows too well. My eyes would glaze over trying to read the charts that clicked by in endless PowerPoint presentation. I was often lost, I confess it. But those moments were very short-lived. The sponsoring organization, Patients Out of Time, wisely limit speakers to twenty minutes. My brain quickly learned that if the middle of the presentation became a muddle of chemical names and lilliputian charts the summary was not too distant and the the summary was where the real news resided. Researchers and scientists who calmly and professionally presented their data became different people as they summarized their data because the implications for the future are just so darned exciting.

2577a2_c1ea99e632bcf18d31191ceaa3c6c779.jpg_srz_965_695_85_22_0.50_1.20_0.00_jpg_srzThe theme was “The Endocannabinoid System and Age-Related Illnesses.” There were at least thirty presentations with most focused on modern day applications of the drug. Many of these applications are well known — pain control, lessening of muscle spasms, use as an appetite stimulant — and some are just emerging. The use of cannabis as an anti-tumor treatment is one area that is particularly exciting. Individuals with various cancers are reporting remarkable results from using oils made from various strains of cannabis.

For me, however, the most remarkable presentations were concerned with using cannabis in the elderly to treat dementia and end-of-life.  Dementia is the scourge of the elderly and many retreat into a world of isolation because they are unable to communicate. In California, where medical marijuana is legal, some doctors are recommending cannabis for their patients with dementia and the results are often more successful than conventional medications. Sadly these treatments can only be conducted in private pay nursing homes because the federal government will not allow medical marijuana in facilities that accept federal funds. This effectively eliminates all hospice organizations from openly using cannabis which is too bad. In Israel they have been using cannabis in nursing homes since 1988.  In the United States, according to the federal government, we need more research.

The 8th National Conference on Cannabis Therapeutics is over and several hundred people like me have streamed out into the world wanting to tell everyone about the wonders of this plant we have denigrated for so long.  I believe we have not even seen the tip of the iceberg yet, just an ice cube floating on a huge sea. The next decade will bring discoveries that we never imagined.


Mary’s Medicinals


A few of Mary's Medicinals products.
A few of Mary’s Medicinals products.


It was another fun day touring Denver’s legal marijuana scene. My guide, the wonderful Marcie Cooper, took me to Mary’s Medicinals where entrepreneurship is once again paving some wonderful new directions.  Mary (not her real name) has figured out how to make transdermal patches with a variety of different ingredients, all from the cannabis plant, of course. A transdermal patch, for those non-nurses in the audience, is like a nicotine or fentanyl patch. The medicine is in the patch and releases over time to the body. For many people it is an optimum delivery agent. For many medical cannabis patients I believe it will become the delivery method of choice.

In the picture above you can see the packaging for three of her products. There are the transdermal patches, in this case a THC Sativa and a CBD patch. Mary can also provide CBN, THCa, THC Indica, and THC Hybrid.  If you are wondering what all those different types of patches might be used for I suggest you visit the website where she has provided a very helpful anatomy map.

Above the patches you’ll see the CBD topical application pen.  Click on it and you receive a dose of 2mg THC or CBD in topical lotion form. Rub the lotion into the skin and you have medication.

Coming from a nursing background I found this application protocol to be very exciting.  No smoking or ingesting, a simple and dose-regulated administration system. Baby, we have come a long way.

Denver – Sanity Prevails

Alice at River Rock
Alice in one of the many grow rooms at River Rock.

This week I have the extreme pleasure to be visiting Denver, Colorado.  Weather aside (it has been windy and cold) it has been a great visit thus far.  I’ve been touring the marijuana dispensaries and clinics including a great visit at River Rock founded by Tony Verzura.  River Rock is not just a grow center and dispensary, it is a philosophy and the future.

The picture accompanying this piece shows me in one of the many grow rooms at River Rock. Tony was very impressive in rattling off the statistics about his growing facility. Unfortunately I was still in a shock at what I was seeing so most of the stats went through my head. Take my word for it, there is a lot of cannabis growing. All the major varieties (sativa and indica) were there, many of them in brilliant flower.

What impressed me even more was Tony’s commitment to the medical marijuana issue, including a new project he is launching called Advanced Cannabinoid Therapy Guide or A.C.T. Now.  It is a wonderful piece of software. Its goal is to standardize patient enrollment and collect information on the cannabis therapies that River Rock and the patient’s doctor recommend.  Look upon it as the first EMR (electronic medical record) for medical marijuana patients. What excited me about A.C.T. Now was the possibility of collecting enough data to actually write scientific papers. They will be poo-pooed by federal agencies but, truth be told, the feds squandered their capital in medical marijuana a long time ago.  They no longer have standing in the issue–only power to wreck more lives as they have for decades. The future is in companies and organizations like River Rock.  The future is now.

Alice in Wonderland Meets Rip Van Winkle

Two fictional characters from my youth are Alice in Wonderland and Rip Van Winkle.  Alice in Wonderland is still a popular story but I think old Rip has slipped in popularity. The classic Washington Irving short story, published in 1819, told the tale of an American colonist who encountered ghosts in the Catskill Mountains, falls under their spell and awakens twenty years later. It is a story that resonates with me today because after a thirteen-year hiatus I am re-entering the world of medical marijuana and like old Rip I am astonished at the new world I have found.

I should explain that my roots in the medical marijuana movement are deep. My late husband, Robert C. Randall, is the acknowledged father of the medical marijuana movement. In 1976 he became the first American to gain legal access to marijuana for medical purposes. We had been arrested in 1975 for growing four plants. At trial we were able to conclusively prove Robert’s need for the drug (he had glaucoma) and through a petition process he gained legal access to federal supplies. For more than a year he was the only person in the country with legal, medical access to marijuana.

For the next 25 years, until his death in 2001, we helped mold the medical marijuana movement and made tremendous progress. It was not exactly a conventional occupation and there were times I identified with the other character mentioned in this blog, Alice in Wonderland.  Drug issues attract some curious people but,  in all honesty,  the oddest parts of my experience in the medical marijuana world came from my dealings with federal bureaucrats.  It is easy to be compassionate towards these faceless men and women who maintain the ridiculous prohibition against marijuana’s use in medicine. After all, they are just doing their job.  But how they sleep at night I do not know.  Compassion can be easily trounced by raw anger at a bureaucracy that will subject thousands of individuals to years of needless suffering in order to maintain a bloated drug abuse industry.

But I digress.  After Robert’s death in 2001 I needed a break. I pursued a dream of being a hospice nurse and spent six years working for hospice in Sarasota, FL. I retired in 2012.

I never completely abandoned medical marijuana. I would speak at conferences from time-to-time and give media interviews. I began to truly re-engage after my retirement. I revised the 1998 book that Robert and I co-authored. (Marijuana Rx: The Patients’ Fight for Medicinal Pot is now out of print although copies can be found on Amazon.) My new book was published in April 2014. It is entitled Medical Marijuana in America: Memoir of a Pioneer and is available on Amazon in hard copy and Kindle.

My speaking engagements have increased and I will be traveling cross-country soon to speak at a conference in Oregon. I plan to use this opportunity to become acquainted with the new players in the medical marijuana issue and have been reading whatever I can find to increase my knowledge of this new world. It is, you will pardon the pun, a heady time for marijuana activists. There is a sense of victory and rightly so. But there are still some huge, make that HUGE, problems–principally the federal classification of marijuana in Schedule I. As long as that situation remains the states and the federal government can continue in their draconian and discriminatory application of the laws against marijuana use.

I’ll be writing about my adventures in this blog. Like old Rip Van Winkle I know that I am about to be astonished and I look forward to sharing that astonishment with you. ❖