On July 13, Dr. Weiss testified before the Subcommittee on Crime and Terrorism, part of the Senate Judiciary Committee, on the topic of “Researching the Potential Medical Benefits and Risks of Marijuana.” Laying aside what seems like an inappropriate subcommittee to hear testimony on the science of cannabis (the focus is crime and terrorism), the testimony did release some interesting tidbits.
As research into the endogenous cannabinoid system (ECS) uncovers more and more therapeutic applications of cannabis it is likely that Big Pharma will get involved. In fact, it already has.
A different perspective on the CARERS Act, the U.S. Senate bill that would reform federal laws regarding medical cannabis use in certain states.
As we enter the second decade of state-authorized medical cannabis the growing pains are evident and the maturing industry is entering a time of reckoning. Having millions of Americans legally using cannabis, medically or otherwise, is a true victory but, frankly, the time has come for a bit of reform within the industry. Those of […]
The use of cannabis by those experiencing post traumatic stress disorder (PTSD) is well known, but cannabis doesn’t cure PTSD. In fact, there are many who feel that PTSD can never be cured since the underlying problem is memory of psychological trauma that can never be fully erased. PTSD, like grief, must be assimilated into […]
Two decades ago, in 1989, the administrator of the Drug Enforcement Administration rejected the findings of his agency’s chief administrative law judge who had ruled that marijuana has accepted medical value in the U.S. and should be rescheduled. In dismissing the judge’s decision the administrator stated that anyone who supported medical marijuana was perpetrating a “cruel hoax” on the American public.
Those words came back to me as I read the news of North Carolina’s medical marijuana law that was signed on July 3, 2014. North Carolina became the tenth state to enact the so-called “CBD only” medical marijuana law. (The other nine states are Alabama, Florida, Iowa, Kentucky, Mississippi, South Carolina, Tennessee, Utah and Wisconsin.) While the intent of lawmakers may have been compassionate the result is, in my opinion, a cruel hoax.
These laws have tremendous appeal to the lawmakers. Pressure for passage of such laws has come from the parents of young children who are stricken with rare forms of epilepsy. When all conventional medications fail, and they often do, parents have found success with CBD oil, derived from the cannabis, or marijuana, plant. The results can be breathtakingly dramatic as you can see in this video. https://www.facebook.com/photo.php?v=721753387847681&set=o.1423068877953424&type=3&theater
So in passing these bills lawmakers are showing their compassion for seriously ill, especially the young, while tackling the tricky political question of legalizing marijuana for medical purposes. “But wait,” the lawmakers say, “we aren’t legalizing ‘pot’ we are legalizing CBD, one of the ingredients in marijuana. And CBD doesn’t get you ‘high’ so drug abuse is impossible.”
Okay, CBD doesn’t get the patient ‘high’ but CBD is just one of the ingredients in the cannabis plant and the North Carolina law, like several others, still prohibits growing marijuana to obtain the CBD. So, just how exactly are the North Carolina patients going to obtain this needy medication?
You might think these states could simply turn to those states which have legalized the entire plant for medicinal purposes and buy the needed medicine. Simple, right?
Wrong. Marijuana, on the federal level, is still illegal, still a Schedule I drug. That’s what the DEA administrator decided it should be when he over-ruled his chief administrative law judge back in 1989, calling anyone who promoted the medical use of marijuana a “snake oil salesman.” As long as marijuana remains in Schedule I it cannot be shipped inter-state. So the ten CBD-only states cannot simply import marijuana from states where it is already legal for medical purposes.
So, just where do those ten states propose to get their CBD-only supplies? Well, I’m not privy to all their plans but I think a little hint was dropped in the coverage of WBTV in Raleigh.
“For now, it’s not sure how natural CBD oils made from actual marijuana plants in Colorado will get to North Carolina. Until that’s figured out, legislators say a pharmaceutical company making a trial CBD oil, called Epidiolex, will be rolled out immediately. ‘
Oh, I see. We’re going to “immediately” roll out a new pharmaceutical drug that has not yet been approved by federal officials so that we do not have to grow a plant that has a 5,000 year history of medical use or adjust its current standing in the federal drug hierarchy.
But wait, there’s more.
“All kids who sign up for this trial will be part of a study. That data will then be used to learn more about how the medicine works best.”
Okay, so your child also needs to be part of a research study. Well, that may not have been what the parents’ wanted when they started lobbying for the bill but it looks like that may be the only way to obtain the legal CBD trial drug. Does this mean the children may be exposed to placebo doses of CBD? Will there be double-blind, randomized testing which guarantees that some children will not receive the real CBD?
Do you see why the expression “cruel hoax” may have come to mind?
Postscript: To the parents in these states — I am very happy that your state has enacted a law that recognizes your child’s need but the battle is not yet won. You cannot let your guard down or expect that bureaucrats will resolve all the problems. It was your voice and those of friends and activists that passed this law and you cannot go silent now.
The 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 appetite, pain-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.
The 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.
I was recently interviewed by Kevin Quinn for the podcast “Illegally Healed.”
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 www.marysmedicinal.com 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.