Getting out from under America's Opiate epidemic by Elevate Nevada Magazine

SEPTEMBER 2016

In 2012, 259 million prescriptions were written for opioids, which is more than enough to give every American adult their own bottle of pills. -- American Society of Addiction Medicine

OPIATES’ GRAVE CONSEQUENCES

AS AMERICA’S OPIOID SCOURGE CONTINUES UNABATED, IS CANNABIS A REMEDY?

A GUIDE TO THE CITY’S MOST POPULAR VAPE PENS

Where science and cannabis collide ReleafWellness.com september | elevatenv.com 1

from the publisher

Publisher Guy Bertuzzi, guy@elevatenv.com

Editor-In-Chief Beth Schwartz, beth@finetheagency.com

Creative Director Brooke Bertuzzi, brooke@finetheagency.com

Contributing Writers: Justin Alexander, Amanda Connor, Stephen McCamman, Melissa Parks, Julie Vigil

Media Consultant: Mark Damkroeger, mark@elevatenv.com

ELEVATION PUBLISHING LLC President Jonathan Fine

Chief Financial Officer Cassandra Lupo

FINE THE AGENCY Partner Kelli Maruca, kelli@finetheagency.com

Graphic Designer James Nigbur, James@finetheagency.com

Digital Services Austin Grantham, austin.grantham@finetheagency.com Peter Chen, peter.chen@finetheagency.com

Elevate Nevada magazine makes every effort to ensure the accuracy of the information it publishes, but cannot be held responsible for any consequences arising from errors, false data or omissions. Elevate Nevada assumes no responsibility for any claims or representations contained in this publication or in any advertisement. Elevate Nevada magazine does not encourage the illegal use of any of the products or advertisements within. Reproduction in whole or in part strictly prohibited. All rights reserved. 7120 Rafael Ridge Way, Las Vegas, NV 89119 Phone: 702.737.8464 | Email: info@elevatenv.com

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January 23, 1993 haunts me every day. It is the day I lost my sister Donna to an opiate overdose. Since we started elevate Nevada, I have often wondered if my sister had been using cannabis at the time, rather than opiates, would she still be with us. A lot has changed since 1993 with regard to cannabis and its medical discoveries and, yet, in some ways nothing has changed at all. On August 11 the DEA, again, decided not to reschedule marijuana from a Schedule I drug because they do not believe that it has any medicinal value and that it is highly addictive. I could fill a phonebook with the anecdotal evidence of how cannabis provides relief and medicinal value for myriad diseases and conditions, but that’s another column for another day. Because the DEA does truly believe cannabis has no medical value, I have to wonder if the powers-thatbe at the DEA did their due diligence. There is certainly plenty of compelling research to consider with regard to cannabis and the opiate epidemic that is plaguing this country. For instance, the National Bureau of Economic Research released a study in 2015 that showed: “States permitting medical marijuana dispensaries experience a relative decrease in both opioid addictions and opioid overdose deaths compared to states that do not.” And if the DEA was really doing their job and looking out for the American public, wouldn’t

they reschedule opiates from Schedule II to Schedule I? Research shows that opiates are more than likely, and quite ironically, the real gateway drug. According to the American Society of Addiction Medicine, four in five new heroin users start out misusing prescription painkillers. As a consequence, the rate of heroin overdose deaths nearly quadrupled from 2000 to 2013. During this 14-year period, the rate of heroin overdose showed an average increase of 6 percent per year from 2000 to 2010, followed by a larger average increase of 37 percent per year from 2010 to 2013. All of this brings me to my point. You have to be your own healthcare advocate. It is okay to question your doctor about your treatment options and do your due diligence about what they want to prescribe for you. Read this issue with an open mind, and ask your doctor about cannabis as an alternative treatment plan for pain. Addiction is a disease and cannabis is an option. No one has ever died from a cannabis overdose, but in 2014 opioids caused 18,893 overdose deaths. So you tell me which should be classified as a Schedule I drug? Salute

Guy

CONTENTS 7 7 Cooking with Cannabis

Lemon ricotta pancakes with blueberry cannabutter

8 The Essential Vape Guide An introduction to the city’s

most popular vape pens

14 Legalease

Your right to grow cannabis at home

8 14

16 Demystifying Clinical eCB Deficiency Syndrome

A compromised endocannabinoid system could be the underlying cause of many conditions that modern medicine has failed to cure

20 Getting out from Under America’s Opiate Epidemic

Can an illegal plant help a misguided country in its dire fight against addiction and pain?

20 32 28

28 Healing: the Power of Cannabis

Neuropathy patient improves quality of life by making switch from opiates to CBD oil

30 Dispensary Map

A patients’ guide to finding medical cannabis in the Las Vegas Valley

36 Elevating the Conversation with Liz McDuffie

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ELEVATE YOUR STATE

Medical cannabis updates from across the United States

MINNESOTA: The state of Minnesota implemented its medical marijuana program in 2015 with a list of nine qualifying conditions, which allowed smoke-free forms of the substance to be consumed by those with doctors’ recommendations, but incurable pain was not one of the conditions. Starting in July, patients with incurable pain were allowed to register for Minnesota’s medical marijuana program with their doctor’s recommendation. During the last month, approximately 500 patients have registered as medical marijuana patients, which is more than five times the number of patients who registered when the program launched last year. Patients with intractable pain began legally purchasing the medicine on August 1.

ARIZONA: On June 30, the Campaign to Regulate Marijuana Like Alcohol (CRMLA) submitted 258,582 signatures to state officials in order to place an initiative to tax and regulate marijuana on the November ballot. Their submission exceeded the required number of 150,642 signatures. The ballot initiative would “allow adults 21 and older to possess limited amounts of marijuana; establish a system in which marijuana is regulated similarly to alcohol; and enact a 15 percent tax on retail marijuana sales, from which a majority of the revenue would be directed to Arizona schools and public education programs.” The submission was presented a day after the Joint Legislative Budget Committee announced findings that the initiative would generate around $82 million a year in tax revenue, at least $55 million of which will go to K-12 education.

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ARKANSAS: In July, the Arkansas Secretary of State announced that Arkansans for Compassionate Care’s medical marijuana initiative qualified for the ballot in November. The measure, the Arkansas Medical Cannabis Act, would allow seriously ill patients, who have a certification from their doctor, to obtain medical cannabis from nonprofit compassion centers. In addition, patients – or their licensed caregivers – could cultivate up to 10 cannabis plants at home provided they take steps to ensure it is secure. Support for medical marijuana in the state is strong, with one of the latest polls putting it at 58 percent which is in contrast to four years ago when a medical cannabis legalization measure in Arkansas failed by two percent.

MASSACHUSETTS: In July, Massachusetts Secretary of State William Galvin announced that the ‘Legalization, Regulation, and Taxation of Marijuana’ initiative will appear as Question 4 on the November ballot. The initiative would allow persons aged 21 and older to purchase, possess, use, and transfer marijuana and products containing marijuana concentrates, including edible products. It would also allow a taxed and regulated marijuana market in the state.

FLORIDA: Trulieve, the first dispensary to open in the Sunshine State, came on line in late July in Tallahassee. For now, only lowTHC cannabis products will be available for Florida’s patients, but cannabis with more THC will eventually be available for terminally ill patients. To recommend or order the drug for a patient, doctors must have a three-month history with the patient, in addition to taking a ‘Low THC Cannabis’ Continuing Medical Education course, which is followed by an exam. Qualifying conditions for patients to use medical cannabis in Florida include cancer, seizures, or severe and persistent muscle spasms. If a patient qualifies, they will be assigned an identification number and added to a patient registry through the state. The state's Office of Compassionate Use, which oversees state regulation of medical cannabis, projects there will be dispensaries in 19 of Florida’s cities.

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Cooking Cannabis LEMON RICOTTA PANCAKES WITH BLUEBERRY CANNABUTTER BY MELISSA PARKS, VERT EDIBLES Executive Chef Melissa Parks of VERT Edibles is an expert on cannabis-infused cuisine and recognized authority on preventative healing through cuisine. Parks is also well-versed on the science behind the metabolization of cannabis, herbs and food. A graduate of Le Cordon Blue College of Culinary Arts in Minneapolis and having studied culinary nutrition at Johnson and Wales University, Parks is the author of “HERB: Mastering the Art of Cooking with Cannabis.”

BLUEBERRY CANNABUTTER* INGREDIENTS: 1 cup cannabutter ½ pint fresh blueberries ¼ cup confectioner’s sugar 1 Tbsp. blueberry preserves zest from ½ lemon pinch of sea salt

DIRECTIONS:

1. Bring cannabutter to room temperature (let butter sit on counter to soften). 2. Mash ½ pint fresh blueberries with potato masher. 3. Add mashed blueberries, preserves, confectioner’s sugar, lemon zest and sea salt to cannabutter. 4. Stir to combine all ingredients well. 5. Transfer butter to plastic wrap and roll into a log.

1. Preheat a non-stick griddle to medium heat. 2. Combine all dry ingredients (flour, baking powder, cinnamon, salt and sugar) into a bowl. 3. Whisk together ricotta, eggs, milk, lemon juice and zests in another bowl. 4. Add the dry ingredients to the ricotta mixture until just combined. 5. Spray griddle with cooking spray. 6. Ladle approximately ¼-cup size pancakes onto griddle. Cook until golden brown on both sides. 7. Repeat until batter is used up.

6. Refrigerate to harden.

LEMON RICOTTA PANCAKE INGREDIENTS: ¾ cup all-purpose flour or whole wheat flour 2 Tbsp. coconut sugar 1 Tbsp. baking powder ½ tsp cinnamon ¼ tsp sea salt 1 cup Ricotta cheese ⅔ cup whole milk 2 whole large eggs ½ tsp lemon oil zest and juice from 1 lemon zest from ½ orange

TO SERVE: Stack 3-4 pancakes, top with desired dose of blueberry cannabutter, and drizzle with warm maple syrup. The warm pancakes and maple syrup allow the cannabutter to melt slowly over the fluffy pancakes.

*Base cannabutter recipe adapted from: “HERB: Mastering the Art of Cooking with Cannabis” by chefs Laurie Wolf and Melissa Parks, InkShares, Inc., San Francisco, 2015, pages 24-27.

Please remember when cooking with medicinal cannabis you are cooking with a medicine and the medicine amount and portions of the food ingested should always be taken into consideration. Always start out with small portions or doses and wait 30 minutes to an hour before eating any additional portions of food that has been medicated.

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THE ESSENTIAL VAPE GUIDE AN INTRODUCTION TO THE CITY’S MOST POPULAR VAPE PENS By Justin Alexander

Most medical experts would agree that vaping cannabis is healthier than smoking it. By using a vape pen, patients are able to avoid inhaling the harmful by-products found in cannabis smoke. Although studies on the subject aren’t plentiful, there has been some research that shows vaporizing eliminates harmful toxins, shows a decrease in respiratory symptoms, and preliminary data from a 2010 study even reveals meaningful improvements in respiratory function. Because vaping is a discreet and less harmful way of ingesting cannabis, elevate has compiled a guide of the city’s most popular vape pens.

JORGE’S DIAMOND CARTRIDGE, THE+SOURCE Jorge’s Diamond, an Indica-dominant hybrid with a ratio of 53.1% THC to 0.1% CBD, reduces inflammation and pain, acts as a sleep aid, and presses delete on the day’s anxieties. The taste is sweet and smooth and the feeling of euphoria is long lasting resulting in a deep calm. This strain is also great at inducing hunger with its intense fruitforward flavors. The most striking feature of The+Source’s Jorge’s Diamond cartridge is the viscosity of the oil and its deep amber color. “We mix our cartridges with propylene glycol, which is used in baby inhalers,” Chris Vickers, general manager at The+Source, says, noting the darker it is, the more highly concentrated, due to less mixing agent. Another reason for the dark color is that as cannabis grows it develops trichomes, or crystals. At 10 to 12 weeks, the trichomes actually change to a dark amber color. Also, Indica is normally darker because it has more resin in it. A wide variety of strains are grown and then extracted by the production team to make cartridges at The+Source’s cultivation facility. According to Vickers, their cartridges are crafted with a ceramic plate versus a wick, which gives better flavor

elevatenv.com | september

and an even vapor. Currently, The+Source has more than 10 strains available as pens and cartridges. With new scientific developments to help with extraction, the product is improving with each release. Also, vapor cartridges provide a healthier alternative to smoking because they separate the patient’s lungs from the combustion of a lighter, ultimately resulting in the patient ingesting fewer carcinogens when inhaling cannabinoids.

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KABUNKY KLEAR SKYWALKER OG, KABUNKY MARIJUANA PRODUCTS Superb for pain relief and relaxation with its reaching-for-new-levels climb, at 79.24% THC Kabunky Clear Skywalker OG promotes a sound and peaceful

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sleep without any worries. This Indica-dominant hybrid cartridge packs all the same outstanding qualities for which Skywalker OG flower is known, such as the great all-over body feeling. “The terpenes and cannabinoids in the Kabunky Klear pen are pure. No plant matter or lipids,” explains Ronan McConnon, laboratory manager of Kabunky Concentrates. Overall, vape concentrate is more discreet because there is no burn factor and it is easier on the lungs than smoking flower. McConnon says he will be releasing “exciting flavors” in the next few months. The purity of the product accounts for the clarity. “Each step of the process removes contaminants,” McConnon says, noting that he does not use glycol or glycerine. “Pure cannabinoids and terpenes will always have a honey color.” Kabunky is a 100 percent self-contained operation: They grow the cannabis, process the raw material, and load the pens. McConnon used his biochemistry and physics background to develop an extraction process that affords the purest cannabis product possible. “The viscosity is managed during the process so that I do not have to use additives like PG, PEG, VG,” McConnon explains. “The oil is activated, so you can vape at lower temperatures without sacrificing potency.” Kabunky cartridges have only a two percent mechanical fail rate and an instant replacement guarantee.

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EG.O TRIP PLUS SATIVA, EVERGREEN ORGANIX EG.O Trip Plus Sativa by Evergreen Organix is based on Sour Diesel, which is legendary for being cerebrally-charged and provides relief from stress, pain and depression with a THC component that ranges between 50 and 70 percent. The feeling is energetic, creative, happy and euphoric. This won’t put you in a trance and it will get you off the couch, promoting big idea flow. Sour Diesel, as its name suggests, smells like lemons and diesel fuel, a surprisingly harmonious pairing. All these factors equate to immediate relief for most ailments. According to Jillian Nelson, operations manager of Evergreen Organix, more strain-specific vapes will be available soon so patients will have access to varieties such as Sweet Tooth and Silver Surfer. The above products are not flavored because Evergreen is focusing on quality oil versus synthetic taste, but the EG.O line will

eventually be expanded with more options. EG.O Trip Plus Sativa’s deep, dark shade of amber is a result of the CO2 extraction process. Evergreen Organix grows the flower for its EG.O Trip Plus cartridge in its own cultivation facility. Evergreen Organix started production and cultivation in fall 2015, growing and making cannabis-infused edibles, topicals and vapes. Made with only strain-specific flower, this is a trim-free product. While the Evergreen Organix vapes are new to market, the oil has been in development for several months to ensure quality and consistency. The overall goal was to create a formula that wasn’t cut with propylene glycol or vegetable glycerin. “Finding a way to refine CO2 extract to vape-quality was a little challenging at first,” Nelson says. “Our team developed a refining method that gave us a great end product that keeps almost all of the qualities of the original flower that it was extracted from.”

MTF, KYND CANNABIS COMPANY As a strain, everything about the Indica-dominate MTF is big and strong—giant earthy, piney, fruitiness with a long-lasting body high. It tastes like a run through the forest on a crisp autumn day or a spicy Mexican hot chocolate with just enough chili powder to ignite all the senses. At a ratio of 58.71% THC to .2% CBD, MTF gives a steady euphoric rise, sustained stress relief and energy, and increased mental clarity. According to Kynd Cannabis’ Ryan Clendenin, MTF’s aromas are derived from a perfect storm of terpinolene, limonene, humulene, beta-caryophyllene and beta-pinene. “Each cartridge is strain-specific and homogenized from industrial scale batches of vape oil,” he says. While Kynd potency numbers may appear lower in THC, they are partnered with incredible terpene profiles that express each strain’s medicinal potential to its fullest. The light color of the oil and absence of plant waxes and chlorophyll can be attributed to a process known as winterization that refines the vape oils without losing or stripping out their best characteristics. Raw cannabis extract is bathed in lab quality ethanol, it gets cold, and then undesirables are filtered out of the extract. “The alcohol is then distilled off of the solution in order to retain a pristine oil,” Clendenin explains. “This process also preserves terpenes, increases the shelf (continued on page 12)

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DEFINING CANNABIS By Bruce Burnett and Darryl Johnson, Ace Analytical Laboratory

Nevada has positioned itself at the forefront of cannabis safety and potency testing by requiring all medical marijuana products to undergo laboratory testing. Following analysis from a Nevada-accredited Independent Testing Laboratory, a “lot” of sample is given a Certificate of Analysis (COA), which displays safety and potency testing results. While the information provided on a COA may seem overwhelming, these results can be invaluable when deciding which strain will be best suited to address a patient’s medical needs. The following glossary is intended to assist patients when selecting a medicinal cannabis product. Indica: species of the cannabis plant typically associated with inducing a body-high. Indica strains tend to have sedative and relaxing effects, best suited to treat anxiety, insomnia, pain, and muscle spasms. Sativa: species of the cannabis plant typically associated with inducing a cerebral-high. Sativa strains tend to be uplifting and creative, best suited to treat depression, ADD, fatigue, and mood disorders. Hybrid: a combination of indica and sativa genetics and characteristics. Hybrid strains can be indica- or sativa-dominate and are typically described as a ratio, such as 80/20 indicadominate or 60/40 sativa-dominate. Cannabinoid: compounds found in the cannabis plant that interact with cannabinoid receptors producing the psychoactive and medicinal effects associated with cannabis use. In cannabis, cannabinoids are concentrated in glandular structures known as trichomes. Trichome: small crystal-like hairs that cover cannabis buds, giving them a frosty appearance. Trichomes consist of a stalk and resin gland, and are responsible for producing cannabinoids and terpenes in the cannabis plant. Terpene: small aromatic compounds that give cannabis distinct flavors and smells. Cannabis contains more than 100 different terpenes, many of which are found in other plants, fruits, and flowers. Terpenes are found in significantly different concentrations in different strains, which can help explain why different strains have different effects for patients. Alpha-Bisabolol (terpene) has a floral, earthy, herbal scent and is used in some cosmetics. It is known to have antiinflammatory, anti-irritant, and anti-microbial properties. Alpha-Humulene (terpene) possesses a hoppy, herbal scent and is also found in hops, sage, and ginseng. It is believed to have anti-inflammatory, analgesic, and antibacterial properties. Alpha-Pinene (terpene) is the most common terpenoid found in nature, possessing a pine resin scent. It is also found in rosemary, sage, and pine trees. Primary effects include antiinflammatory, antiseptic, bronchodilator, and anti-cancer. Alphapinene is believed to improve mental focus and memory retention. Alpha-Terpinolene (terpene) possesses a woody, smoky

odor and is also found in lilac, tea tree, apple, and cumin. It has both antibacterial and antifungal effects and can function as a mosquito repellent. In addition, it also has potent antioxidant effects and is thought to have anti-proliferative properties. Beta-Caryophyllene (terpene) has a spicy, wood aroma and is found in herbs and spices including black pepper, oregano, cloves, hops, and rosemary. It possesses analgesic, anti-inflammatory, antifungal, and antidepressant properties. It activates CB2 receptors even though it is not a cannabinoid. Beta-Myrcene (terpene) is most commonly associated with indica strains of cannabis and has a musky, herbal scent with hints of citrus flavors. It has sedative properties, and may be useful in treating insomnia, muscle spasms, and inflammation. Beta-Pinene (terpene) is similar to alpha-pinene, possessing pine scents and is abundant in nature. Along with analgesic, bronchodilator, and anti-inflammatory effects, it is also believed to possess antitumor properties. Caryophyllene Oxide (terpene) is closely related to betacaryophyllene and possesses a lemon balm odor. It is likely the primary odor which drug-sniffing dogs use to identify cannabis. Limonene (terpene) has a citrus, lemon odor and is also found in citrus fruits, rosemary, juniper, and peppermint. Limonene is thought to possess antidepressant and anti-anxiety effects and is used to treat acid reflux and relieve nausea. Linalool (terpene) has a flora scent and is found in lavender, mint and cinnamon. It possesses anti-anxiety, anti-depressant, sedative, and pain relief effects. Some evidence suggests it may have antitumor properties against certain human cancers. Delta 9 Tetrahydrocannabinol (Δ9-THC) (cannabinoid) is the biologically active form of THCA. It is the most abundant cannabinoid in cannabis and possesses psychoactive properties. In addition, Δ9-THC also possesses analgesic, anti-inflammatory, and anti-emetic properties. Tetrahydrocannabinol Acid (THCA) (cannabinoid) is the non-psychoactive form of Δ9-THC. Following heating or burning, THCA is converted into the psychoactive compound Δ9-THC. THCA is thought to have neuroprotective, anti-spasmodic, antiinflammatory, anti-proliferative, and anti-vomiting properties. Cannabidiol (CBD) (cannabinoid) is non-psychoactive, but evidence suggests it improves mood and can alleviate pain. CBD also possesses sedative, anti-nausea, anti-seizure, anti-spasticity, anti-inflammatory, anti-anxiety, and antipsychotic properties. In addition, it has shown beneficial effects for pediatric seizure patients with Dravet and Lennox-Gastaut Syndrome. Cannabidiolic Acid (CBDA) (cannabinoid) is the acidic form of CBD, commonly found in cannabis plants with elevated CBD levels. It possesses antioxidant, neuro-protective, antiemetic, and potent antimicrobial effects. Cannabinol (CBN) (cannabinoid) is a degradation product of THC. It has psychoactive properties similar to Δ9-THC, but only at about one-tenth of the potency. CBN has powerful sedative properties and has been shown to possess pain relieving, anticoagulant, antimicrobial, and antidiarrheal properties.

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(continued from page 10) stability of the cannabis oil and the overall potency to weight ratio of the final product.” Kynd Cannabis Company products are born and bred in a state-of-the-art indoor, controlled agricultural environment and a lab grade production facility in Sparks, Nevada. “Kynd vape oil is extracted using supercritical CO2 to selectively extract the whole plant compounds needed to bring out all of the essential characteristics of the MTF and other strains,” Clendenin says. “Kynd Vape oils will never touch hydrocarbons like butane or propane, and will never need to endure the extreme temperatures of laboratory distillation techniques in order to purify the product.”

CRAFT RESERVE MR. NICE, O.PEN VAPE FROM THE GROVE Mr. Nice, an Indica-dominant strain, is super strong on both the nose and palate. While it comes on with force, overall it’s a mellow high that works ideally for daytime use when focus and attentiveness is imperative. Patients will experience only mild pain relief, but super stress relief with this strain, which is comprised of 94.4% THC, 2.04% CBN and 2.42% CBD. Its almost clear, golden quality is achieved through distillation. “The color of the oil is achieved through a proprietary process, but, in short, we are using very high-quality strains of hand-picked flower put through a distillation process to include the same strain-cannabis terpenes reintroduced to give you a fully activated, pristine oil,” explains Robbie Wright, head of production for The Grove, which has a partnership with Colorado-based O.Pen. Craft Reserve oil is made using a CO2 extraction and then a refinement process that yields high-quality oil. “The goal for me actually isn't necessarily the highest THC percentage possible, but rather the most activated cannabinoid profile, including a full terpene profile,” says Wright, who notes The Grove sources 75 percent of its flower and trim from its own cultivation facility. One of the smoothest puffs on the market, the O.Pen Craft Reserve oil is comprised of 100-percent cannabisderived terpenes medicating with consistency. The packaging, like the name, emphasizes a craft experience with a hewn look. The cartridge has a metal tip and a chamber that is noticeably smaller than comparable products. Its vessel comes filled with 250 mgs.

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september | elevatenv.com 13

LEGALEASE Your right to grow cannabis at home By Amanda Connor, Esquire

Although the passage of the law permitting the use of medical marijuana in Nevada has provided some clarity and public awareness with regard to who can grow cannabis and how much they can grow, the law can still be confusing. Most importantly, it’s key that potential patients and growers know their rights when it comes to growing medical marijuana in the state, especially given the ways in which the law may change in the future.

Growing Your Own Medical Cannabis The current Nevada Revised Statute (“NRS”), 453A.200, allows medical marijuana patients and caregivers to possess, deliver, and produce certain amounts of cannabis. However, the law does not allow patients to grow marijuana unless certain conditions are met. Patients would be well advised to note that these conditions may change after April 1, 2018. Before this date, a patient can be “grandfathered” into being permitted to grow marijuana (by having obtained a patient card prior to July 1, 2013) or they can meet one of the following compassionate care exceptions: • Exception 1: A patient may be permitted to grow their own cannabis if all of the medical marijuana dispensaries in the county of residence of the person who holds the patient card are unable to supply the quantity or strain of marijuana necessary for treatment of that person’s medical condition. • Exception 2: A patient may be permitted to grow

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marijuana due to illness or lack of transportation. One example being if the person who holds the patient card is unable to travel to a medical marijuana dispensary. • Exception 3: No medical marijuana dispensary is operating within 25 miles of the residence of the person who holds the patient card at the time the person first applied for his or her patient card. The first exception—whether a medical marijuana dispensary carries the correct strain for a patient—could present interesting issues going forward. Who will enforce this provision? Will scientific evidence be presented and who would require such proof that strains grown at home are different from those sold in a dispensary? While the second and third exceptions are fairly self-explanatory, it is important to note that the burden will be on the patient to establish that he or she fits within the exception. Limits on Home Grows It is important to note that regardless of whether or not a patient grows or purchases their medicine, all patients are bound by the same limits on possession of plants and usable marijuana. Under NRS 453A.200, each patient may possess 2.5 ounces of usable marijuana (or equivalent in edibles) and 12 plants (mature or immature). The language in Nevada’s Revised Statutes states that each person cannot collectively possess more than 12 plants and 2.5 ounces with another person. This leaves rooms for questions such as -- what does “collectively possess” mean? Further, the law requires that each patient must ensure that the usable marijuana or marijuana plants are “safeguarded in an enclosed, secure location.” Educated and well-informed patients are best able to take advantage of the benefits that Nevada’s flourishing medical marijuana industry has to offer. If you’re a patient or a caregiver who finds yourself an exception to the rule when it comes to growing cannabis in Nevada, it’s a good idea to go over your options to be sure that your medicine can be obtained legally and thoughtfully, before and after April 1, 2018.

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Demystifying Clinical eCB Syndrome

A compromised endocannabinoid system could be the underlying cause of many conditions that modern medicine has failed to cure. By Stephen McCamman

We've all been bombarded by the “disease awareness” campaigns sponsored by pharmaceutical companies. You've probably even had the experience of rubbing your eyes as you toddle off to bed mumbling to yourself “maybe I do have chronic dry eye syndrome.” Unfortunately, these ads play to our deep seated concerns about the frequency of our bowel movements (CIC), the quality of our sexual performance (ED), or our potentially restless legs (RLS) while putting billions of dollars into the pharmaceutical industry's pockets. Often, as we know, the side effects are sometimes worse than the issue the drug claims to cure. It is understandable, then, if you are skeptical about yet another syndrome, or a pharmaceutical claiming to cure yet

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another disease. However, unlike the pharmaceutical industry's faux diseases, Endocannabinoid Deficiency Syndrome flips the script and may, in fact, be the underlying deficiency of a large number of diseases that modern medicine has failed to cure: one disease with a thousand faces. eCB deficiency has been linked to migraines, irritable bowel syndrome, and fibromyalgia. Recent research also suggests that autoimmune diseases, like rheumatoid arthritis and lupus as well as mood disorders such as anxiety and depression, may also be linked to eCB deficiency. More clinical research is necessary to scientifically confirm this, but thousands of patients have found relief through regulating their eCB system.

YOUR BODY’S OWN MARIJUANA

Your endocannabinoid system is a physiological signaling network spread throughout the body that keeps the other systems, such as the immune system, digestive system, and central nervous system (yes, pretty darn important stuff) operating at an optimal level. In other words, it keeps your major systems in balance, or homeostasis, and acts as a major part of the body's self-healing system. You'll be surprised to learn that as part of this eCB system, your body essentially makes its own marijuana. The hormones, called endocannabinoids, are the body's way of regulating the other bodily systems. For a variety of reasons, including poor diet, inactivity, and environmental toxins, and an absence of hemp oil and seeds from our diet, the eCB system is not producing enough endocannabinoids to manage the job of regulating the other systems, hence the deficiency.

WHAT IS CLINICAL ENDOCANNABINOID DEFICIENCY SYNDROME?

In 2004, Ethan Russo, M.D. coined the termed Clinical Endocannabinoid Deficiency Syndrome (eCB Syndrome for short) to describe this problem. His research into the endocannabinoid system revealed that three conditions -- migraines, irritable bowel syndrome, and fibromyalgia -- usually appear in a cluster, that is, people with one of these problems usually had the other two.

RESOLVING ECB SYNDROME

The first thing to do is take a look at your diet and lifestyle. Detoxifying the body through fasting and healthy eating is the first step toward optimum health. Of course, you've heard it before, but getting out for moderate exercise also up-regulates the eCB system. Getting rid of chemical-laden soaps, shampoos, and (continued on page 32)

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eCB Deficiency Syndrome is not yet part of the official diagnostic bible your doctor uses, but it explains why some diseases are not successfully treated with conventional medications (they’re treating the symptom, not the cause) and why those diseases are best managed by cannabis and hempbased medicinal products. While there are other reasons, including inherited problems, for a dysfunctional eCB system, common sense tells us that the primary reason for an overall deficiency of our body's own marijuana is dietary and lifestyle choices. eCB Syndrome may also emerge following sustained unhealthy lifestyle habits, including stress and chronic alcohol or drug abuse, among others, that may act as a cumulative “trigger” in the development of presenting symptoms. These chronic, sustained stressors on the body and mind suggest that eCB Syndrome may appear more frequently in middle aged or older people as it may take the body years to develop the symptoms of these endocannabinoid system inhibitory factors.

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GETTING OUT FROM UNDER AMERICA’S

OPIATE EPIDEMIC Can an illegal plant help a misguided country in its dire fight against addiction and pain? By Julie Vigil

pioid pain killers don’t just kill pain, they kill people. According to the most recent data from the Centers for Disease Control and Prevention (CDC), 2014 was a killer year. More people died from drug overdoses than in car crashes or by gun violence. And more than half of those overdoses were linked to opioid analgesics or heroin. To put a finer point on this statistic, that’s 47,055 lethal overdoses. Of those deaths, 18,893 were from prescription painkillers and 10,574 were from heroine. Compared to the almost 30,000 who died by either car crashes or gun violence — those are some sobering stats. When nearly 29,000 people die from an opioid overdose in one year — that’s 78 Americans per day — it’s safe to say we have an addiction problem of epidemic proportions. The CDC agrees.

elevatenv.com | september

This addiction crisis didn’t just happen overnight though, and it isn’t just about illegal street drugs like heroin. What led to our escalating dependence on opioids are simple American ideals like customer satisfaction, instant gratification, and profit.

Just What the Doctor Ordered

Prior to the 1990s, strong opioid painkillers were typically reserved for the dying, not for your run-of-the-mill acute or chronic pain patients. So while millions of patients were complaining about all kinds of pain, doctors were eager to find better solutions to ease their patients’ ailments. Enter the industry leader in pain management: Purdue Pharma. The pharmaceutical company was already enjoying much success with its popular pain meds, including hydromorphone, oxycodone, fentanyl, codeine, and hyrocodone, but apparently it wasn’t enough to satiate patients’ pain complaints, doctors’ desires to relieve their patients’ pain, or the pharmaceutical company’s quest for more profit. So after some tinkering, in 1996 it slapped a timerelease element onto oxycodone (ensuring a new patent and exclusive sales until 2025) and crowned it OxyContin. OxyContin is the company’s golden child, or rather its golden goose, and Purdue did everything in its power to promote it far and wide as a miracle drug. Armed with its “new” formula, Purdue Pharma set out to proselytize the medical community, claiming that because of the time-release component, OxyContin was nearly impossible to abuse and its risk of addiction was “under one percent.” That was music to doctors’ ears. Who wouldn’t be sold on a powerful narcotic that was great at helping a wide array of chronic ailments and only boasted a mere 0.028 percent addiction rate? Physicians ate up Purdue’s marketing campaigns and patients gobbled up the pills as fast as their docs could write a ’scrip. The plan was working. And starting in 2012, according to CDC data, doctors prescribed enough opioid painkillers to give a bottle of pills to every adult in the country. But the information Purdue Pharma was aggressively spreading was misleading at best, and flagrantly false at its worst. The company not only promised its drug was safe, it harped on its effectiveness and ease of use. Oxy sales skyrocketed. OxyContin and other opioid painkillers are powerful drugs that are an effective treatment for addressing chronic and severe pain, but with long-term use its addictive properties betray its benefits. Patients’ tolerance builds so rapidly that users need ever-increasing doses to achieve the same initial effect. Forget the marketing mantras, addiction was inevitable.

A Prescription for Addiction

As it turns out, the three “studies” Purdue Pharma based all of its “educational” information on were misrepresented, exaggerated, or fictionalized. In a review by the FDA in 2001, Dr. Art Van Zee concluded that Purdue Pharma had “oversold the benefits of opioid therapy for chronic non-malignant pain, while providing false reassurance about what the real risks are of addiction for patients taking (them).” The time-release component was supposed to be a great safety feature but it was just a thin, waxy coating that was so easy to scrape off it was as if it was actually designed to be abused rather than be a deterrent. Sadly, when the pills and prescriptions ran out, for many people, it was just easier and cheaper to turn to street drugs like heroin to catch the same elusive highs. The American Society of Addiction Medicine (ASAM) reports four in five new heroin users started out misusing prescription painkillers. The overdose death rate quadrupled between 2000 and 2013, with an average increase of six percent per year up to 2010; from 2010-2013 heroin overdoses increased 37 percent. The ASAM data also show that from 1999-2008 overdose death rates, sales, and substance use disorder treatment admissions related to prescription pain relievers increased in parallel. Meanwhile, Purdue Pharma, fully owned by the Sackler family, was rolling around in piles and piles of profits. In 1996, OxyContin’s freshman year sales were $40 million dollars. Five years later, sales ballooned to $1.1 billion; by 2011, $2.8 billion. On the flipside, in the biggest-littlest coup in pharmaceutical lawsuits ever, in 2007 Purdue Pharma and three of its top executives were court-ordered to pay a $634 million penalty for misbranding OxyContin. No one went to jail. The penalty only amounted to less than half of the company’s annual OxyContin sales that year. It was more like ripping off a Band-Aid; it hurts for a second but you’re okay. Today, the Sackler family is sitting pretty on Forbes’ magazine list of Top 20 Wealthiest Families with a conservative estimated net worth of $14 billion. The company is still marketing its pain pills, but now they do it under the industry-accepted guise of “public-service” programs, resources and informational web sites aimed to educate doctors, pharmacists, patients, families, and law enforcement on the benefits of opioid pain meds for chronic pain as well as some nods to prescription drug addiction. One positive to come of this marketing-blitz-turned-publichealth-crisis is that more formal government attention (but not necessarily more money) is being placed on the epidemic and some efforts are underway to begin addressing it. The CDC presented guidelines and in July President Obama signed the Comprehensive Addiction and Recovery Act in to law. Both of these measures discuss multiple pathways to improving

the prescribing of opioids, expanding treatments for addiction, and reducing access to illegal opioids.

The Elephant in the Exam Room

While recognizing the problem is a noble start, the elephant in the room remains. As everyone’s looking the other way trying to find options for handling painkillers in a more responsible manner and dealing with addiction, nobody’s addressing the core issue. “Western medicine doesn’t always have all the answers so let’s look at what will actually help patients versus just shoving a pill down everyone’s throat. Some people can’t sleep so we give them a sleeping pill versus actually figuring out why they can’t sleep. If they have pain, we give them pain medication. If they’re having anxiety, there’s a medication for anxiety versus figuring out why they have these symptoms. We have become a society of people looking for quick fixes. This is how all the doctor shopping and patients going to pill mills was created in

elevatenv.com | september

the first place,” offers Dr. Pouya Mohajer, a local pain management doctor who is part of NuVeda, which holds six medical marijuana establishment licenses in Nevada, two of which are for dispensaries. Another local physician, Dr. Timothy Beckett of Valley Center for Cannabis Therapy, agrees. “The time when we’re just going to throw a drug at an illness is coming to an end. We’ve gotten ourselves in trouble time and time again because of that. “So bringing in something like medical marijuana, which certainly doesn’t have the addictive potential that something like opioids has nor does it have all of the horrible side effects or potential overdose and death associated with it, is a fantastic thing to bring to this whole regimen of treating opioid abuse and pain.” Drs. Beckett and Mohajer are not alone in exploring cannabis as an alternative. More and more, doctors are turning to cannabis as an option for weaning people off opioids, and with

good reason. A July 2015 paper published in theJournal of the American Medical Association (JAMA) cited evidence that cannabis is effective at treating chronic pain. The JAMA review found "30 percent or greater improvement in pain with cannabinoid compared with placebo," across 79 studies it surveyed. In a study published by National Bureau of Economic Research (NBER), also from July 2015, titled ‘Do Medical Marijuana Laws Reduce Addictions and Deaths Related to Pain Killers?’, researchers found that access to state-sanctioned medical marijuana dispensaries is linked to a significant decrease in both prescription painkiller abuse, and in overdose deaths from prescription painkillers. In the NBER study, authors reviewed admissions to substance abuse treatment programs for opiate addiction as well as opiate overdose deaths in states that do and do not have medical marijuana laws. Researchers found that (continued on page 26)

september | elevatenv.com 23

OPIATE ABUSE By the Numbers

4.3

Of the 21.5 million Americans 12 or older who had a substance use disorder in 2014, 1.9 million had a substance use disorder involving prescription pain relievers and

MILLION AMERICANS ENGAGED IN NON-MEDICAL USE OF PRESCRIPTION PAINKILLERS IN THE LAST MONTH. –NATIONAL SURVEY ON DRUG USE AND HEALTH (NSDUH); 2014

586,000

had a substance use disorder involving heroin. --American Society of Addiction Medicine

IN 2012,

DRUG OVERDOSE IS THE LEADING CAUSE OF

accidental death IN THE US, WITH

MILLION PRESCRIPTIONS WERE WRITTEN FOR OPIOIDS, WHICH IS MORE THAN ENOUGH TO GIVE EVERY AMERICAN ADULT THEIR OWN BOTTLE OF PILLS. -- AMERICAN SOCIETY OF ADDICTION MEDICINE As many as 1 in 4 people who receive prescription opioids long term for non-cancer pain in primary care settings struggles with addiction. –Addiction; 2010

Every day, over

1, 000

PEOPLE ARE TREATED IN EMERGENCY DEPARTMENTS FOR

MISUSING PRESCRIPTION OPIOIDS.

--Substance Abuse and Mental Health Services Administration; 2013

OF RESPONDENTS IN A 2014 SURVEY OF PEOPLE IN TREATMENT FOR OPIOID ADDICTION SAID THEY CHOSE TO USE HEROIN BECAUSE PRESCRIPTION OPIOIDS WERE “FAR MORE EXPENSIVE AND HARDER TO OBTAIN.”

--American Society of Addiction Medicine

14,000

TODAY, AT LEAST HALF OF ALL U.S. OPIOID OVERDOSE DEATHS INVOLVE A PRESCRIPTION OPIOID. IN 2014, MORE THAN

PEOPLE DIED FROM OVERDOSES INVOLVING PRESCRIPTION OPIOIDS.

elevatenv.com | september

--NATIONAL CENTER FOR HEALTH STATISTICS; 2016

LETHAL DRUG

OVERDOSES IN 2014.

OPIOID ADDICTION

epidemic, IS DRIVING THIS

WITH

OVERDOSE DEATHS RELATED TO

PRESCRIPTION PAIN RELIEVERS, AND

OVERDOSE

DEATHS

heroin IN 2014. RELATED TO

--AMERICAN SOCIETY OF ADDICTION MEDICINE

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(continued from page 22) the presence of marijuana dispensaries was associated with a 15 to 35 percent decrease in substance abuse admissions. Opiate overdose deaths decreased by a similar amount. "Our findings suggest that providing broader access to medical marijuana may have the potential benefit of reducing abuse of highly addictive painkillers," the researchers concluded. Dr. Beckett has seen it prove true in his practice. “I think it’s been tremendously successful in solely treating pain. I’ve seen fantastic results in patients. For the patients who come here who are truly motivated to get off of their opioid or to, at least, reduce the consumption of opioids, again, it’s been very very successful. I can’t think of an instance where medical marijuana wouldn’t in some way or another reduce the amount of pain and/or opioid dependence that a person would be experiencing,” he explains. Dr. Mohajer has also found cannabis to be effective, noting that 80 percent of the patients he has seen experience a

elevatenv.com | september

positive response. “Anecdotally, I do have the patients who come back and the ones that it’s working for, they are the ones who we start cutting their narcotics down as much as we can,” he explains.

Could Cannabis be the Remedy?

But cannabis doesn’t just aid in getting people off opiates, it also addresses the underlying problem. “Cannabis actually has a lot of the anti-inflammatory properties that are necessary to fix things that are at the root of the pain itself,” explains Dr. Beckett. “When we give somebody cannabis for their pain issues, we’re literally treating it in two phases. We have this acute, within 24-hour, phase where the cannabis itself is going to make you feel good, it’s going help change your perception of the pain, it’s going help change the way you experience the pain. “Then we have this kind of delayed response that is the real meat and bones of it, which is the anti-inflammatory

effects of the CBD (cannabidiol) property of the cannabis. It’s basically quieting down those nerves, quieting down the swelling and all the problems to get to the root of the actual pain itself,” continues Dr. Beckett. “That’s why a person who uses medical marijuana twice a day in 50 years could probably still be using medical marijuana twice a day or maybe even less to treat that same ailment. Whereas, if you look at somebody on opioids, they could be using two pills a day and in six months they’ll be using 20 pills a day." But is cannabis the solution? “I’ve been practicing for 13 years and this is the only thing that I’ve come across that has such widespread medicinal benefits or health benefits for so many different classes of patients,” concludes Dr. Beckett. “And we haven’t even hit the tip of the iceberg yet for all the different benefits that we’re going to be able to find in the long-run with something like marijuana.”

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As a result of a car accident in 1989, Lance Daniels, 46, was paralyzed from the waist down. Even though he was told he would never walk again, four years after the accident Daniels suddenly stood up one day and with the help of his walker started to hobble across the room. “My doctors were surprised -- it was nothing but a miracle. The doctors had no explanation for why I could suddenly walk again because they had told me I would be paralyzed for the rest of my life,” he explains. Miracle aside, there were other after effects from the accident. “I knew something was wrong because I was dizzy all the time, I was seeing dark spots, and my head was so hot

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I had to sleep in front of a fan. They did MRIs and CAT scans and they couldn’t find nothing,” says Daniels. “I went to the doctor and he and his colleagues were going back and forth and they finally decided I had a four-millimeter tumor in my pituitary gland.” Days after his diagnosis in April 2007 Daniels suffered a stroke. In spite of the stroke, his doctors discouraged chemotherapy and radiation and instead determined they couldn’t operate on Daniels’ tumor until it was 12 millimeters in diameter. During Daniels’ last checkup in April his tumor was eight millimeters. But Daniel’s believes his tumor must be growing because he has started to suffer from headaches. Earlier this year due to the recent FDA/DEA cracking down on opiate abuse, Daniels’ doctors encouraged him to consider using cannabis in lieu of narcotics. “I have a lot of nerve damage from the tumor in my pituitary gland pressing on my nerves so my legs were in so much pain,” says Daniels, who was taking 60 milligrams of morphine and 30 milligrams of oxycontin daily. “They wanted to take me off of it and to use marijuana instead to help with my nerve pain.” Daniels was not an easy sell. His mother is a pastor and so he was raised with a church upbringing and had moral issues with marijuana. “I am so against it,” he says, noting his mother and sister were also not proponents. It was a friend who finally talked Daniels into giving CBD oil capsules a try this past March. “It actually worked. I have more energy, I stopped using my morphine and oxy. My bottles are full because I don’t need them anymore due to marijuana. I hadn’t even touched them and that’s when I decided I am going with this all the way,” proclaims Daniels. “I feel more energetic, my mind is clear, I am thinking better and before I was slurring my words. I am motivated now. I have taken out a loan to start a business. If I wasn’t taking these pills, there’s no way I would have had the motivation or drive to pursue my business ideas. “With that pill it made me do the impossible and everything is positive.”

september | elevatenv.com 29

DISPENSARY MAP

A Patients’ Guide to Medical Cannabis in Southern Nevada

2. Blackjack Collective blackjackcollective.com 1860 Western Ave Las Vegas, NV 89102 702.545.0026

10a. Nevada Medical Marijuana nevadamedicalmarijuana.com 3195 St. Rose Pkwy Ste #212 Henderson, NV 89052 702.737.7777

19. The Apothecary Shoppe theapothecaryshoppe.com 4240 W. Flamingo Rd Ste #100 Las Vegas, NV 89103 702.740.4372

3a. Blüm letsblum.com 1921 Western Ave Las Vegas, NV 89102 702.476.2262

10b. Nevada Medical Marijuana nevadamedicalmarijuana.com 1975 S. Casino Dr Laughlin, NV 89029 702.737.7777

20. The Clinic theclinicnevada.com 4310 W. Flamingo Road Las Vegas, NV 89103 702.447.1250

3b. Blüm letsblum.com 3650 S. Decatur Blvd Las Vegas, NV 89103 702.476.2262

11. NevadaPure nevadapure.com 4380 Boulder Highway Las Vegas, NV 89121 702.444.4824

4. CannaCopia cannacopialv.com 6332 S. Rainbow Blvd #105 Las Vegas, NV 89118 702.487.6776

12. Nevada Wellness Center nvwellnessctr.com 3200 S. Valley View Blvd Las Vegas, NV 89102 702.470.2077

5a. Canopi OPENING SOON 6540 Blue Diamond Rd Las Vegas, NV 89139 702.420.7301

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15b. Reef Dispensaries reefdispensaries.com 1366 W. Cheyenne Ave North Las Vegas, NV 89030 702.410.8032

7. Inyo Fine Cannabis Dispensary inyolasvegas.com 2520 S. Maryland Pkwy Ste #2 Las Vegas, NV 89109 702.707.8888

16. Sahara Wellness 420sahara.com 420 E. Sahara Ave Las Vegas , NV 89104 702.478.5533

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17. Showgrow showgrowlv.com 4850 S. Fort Apache Rd Ste #100 Las Vegas NV 89147 702.227.0511

W Lone Mountain Rd

W Alexander Rd W Cheyenne Ave

215

21a. The Dispensary thedispensarynv.com 5347 S. Decatur Blvd Las Vegas, NV 89118 702.476.0420

Summerlin Pkwy

22a. The Grove TheGroveNV.com 1541 E. Basin Ave Pahrump, NV 89048 775.556.0100

Charleston Blvd

Hualapai Way

Town Center Dr

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24a. Thrive Cannabis Marketplace thrivenevada.com 2755 W. Cheyenne Ave Ste #103 North Las Vegas, NV 89032 702.776.4144 24b. Thrive Cannabis Marketplace thrivenevada.com 1112 S. Commerce St Las Vegas, NV 89102 702.776.4144

N Buffalo Dr

18. Silver Sage Wellness sswlv.com 4626 W. Charleston Blvd Las Vegas, NV 89102 702.802.3757

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1. Apothecarium apothecariumlv.com 7855 W. Sahara Ave Las Vegas, NV 89117 702.778.7987

W Ann Rd

22a

160

Blue Diamond Rd

Pahrump Mts Edge Pkwy

E Bonanza Rd

Cactus Ave

R St

y kw

3rd st

6th st

Main St

S Commerce St

Las

Paradise Rd

lvd Veg a

dA ve lan igh SH

nA ve

We s

ter

S Nellis Blvd

S Pecos Rd

10b Laughlin

N Racetrack Rd

Dr ad Me ake

N Stephanie St on

riz

UN LV Maryland Pkwy

Bermuda Rd

515

y wk

21b

Wigwam Pkwy

Windmill Pkwy

10a

Sands Ave

515

E Sunset Rd

E Silverado Ranch

E St. Louis Ave

E Desert Inn Rd

S Decatur Blvd

McCarran Int. Airport

Karen Ave

S Rainbow Blvd

E Flamingo Rd

E Oakey Blvd

Sahara Ave

15a

W Warm Springs Rd

CANOPI

12 Sirus Ave

Gibson Rd

rial

W Sunset Rd

7 E St Louis Ave

22b

21a

Russell Rd

Stewart Ave

Charleston Blvd

Las Vegas

20 19

Las Vegas Blvd

15a

E Sahara Ave

Ind

Valley View

W Flamingo Rd Tropicana Ave

24b 5b 2 13 3a 8 16

ust

S Jones Blvd

515

S Eastern Ave

rial

We ste rn Av e

W Washington Ave

ust

Vegas Dr

W Oakey Blvd

Ind

CANOPI

Lake Mead Blvd

24b

Charleston Blvd

S Rancho Dr

Buehler Dr

Strong Dr

Cahlan Dr

N Nellis Blvd

Ra Carey Ave

GREEN DISTRICT

N Lamb Blvd

15b

24a

N Pecos Rd

Craig Rd

Camino Al Norte/MLK

Simmons St

Allen Ln

N Decatur Blvd

N Jones Blvd

Ann Rd

Mesquite

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Losee Rd

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Henderson

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(continued from page 17) body creams can eliminate chemicals that disrupt your endocrine system, but may also impact your endocannabinoid system. (Visit www.elevatenv.com/ endocannabinoidsystem to read more and access healthy recipes designed to regulate your eCB system.) Meditation and various talk therapies have demonstrated benefits of alleviating eCB Syndrome. Moreover, massage therapy with or without cannabinoid-infused oils (though the latter is recommended) acupuncture, chiropractic work, yoga, and spiritual practices may also be effective tools in properly toning the eCB system. In addition, learning to relax, getting a good nightâ&#x20AC;&#x2122;s sleep (all of which can be achieved through cannabis use) enhances quality of life. Getting a medical marijuana card in Nevada, or using your out-of-state card, and visiting a local medical

marijuana dispensary is perhaps the best way to jumpstart optimizing your eCB system. Starting with a pure CBD tincture is the safest route to take as CBD is non-psychoactive and doesn't show up on an employment urine test. Most dispensaries in Nevada have well-trained staff who can assist you in choosing the correct product and helping you accurately dose. If CBDs, coupled with lifestyle and dietary changes, don't improve your condition, moving toward THC products is the next logical step. Be sure you are aware of the risks before embarking down this path. Each person reacts differently so start at a low dose and go slow when choosing to consume more psychoactive products. Everyone reacts to and processes cannabinoids in a unique manner. Accurate dosing and recording your improvement in a health journal is

fundamental to the development of a successful treatment protocol. Experimentation with dosage, cannabinoid and terpene combinations, as well as a method of administration may be necessary. The road to resolving your eCB deficiency has many curves in it. It includes altering lifestyle choices, exercising, reducing life stressors, changing your diet, and getting on a regime of cannabinoid therapies. If eCB deficiency is one deficiency with a thousand faces, then the solution is making a thousand proper choices to improve one life: yours. Stephen McCamman is writing a book on nutrition and the Endocannabinoid System. He is also co-founder of the Clinical Endocannabinoid System Consortium and president of mmjpatientsguide.com He can be reached at mccamman@gmail.com.

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DISPENSARY SPOTLIGHT THE GROVE www.thegrovenv.com 4647 Swenson Street, Las Vegas, NV 89119, 702.463.5777 1541 E. Basin Avenue, Pahrump, NV 89048, 775.556.0100

coming to a dispensary, budtenders ease concerns using their knowledge to help patients feel conformable with cannabis.

TOP SELLING STRAINS | Las Vegas: Head Cheese, Gorilla Glue -- Lee Roy and Strawberry OG (from The Grove’s Kannabis strain line) Pahrump: Head Cheese, Gorilla Glue, Lee Roy (from The Grove’s Kannabis strain line), 9LB Hammer TOP SELLING CONCENTRATES | Las Vegas: Sin Valley OG, Gorilla Glue, Tangerine Power Pahrump: Sin Valley OG, Sin Mint Cookies, Blue Powder TOP SELLING EDIBLES | Las Vegas: Evergreen Organix Dark Chocolate Bar, Chocolate Chip Cookies and Cake Pops Pahrump: Evergreen Organix Dark Chocolate Bar, Chocolate Chip Cookies and Hard Candies TOPICALS | Las Vegas & Pahrump: Evergreen Organix intimacy arousal massage oil and Trew Balance CBD cream MISSION STATEMENT | To distribute high quality medical marijuana products to qualified patients in an

ethical manner while striving to share our knowledge of the endocannabinoid system and its role in health with our patients in a continuing effort to improve effectiveness and safe use of medical marijuana. RANGE OF PRODUCTS | CBD products, concentrates, edibles, flower, kief, O.penVAPE, tinctures, topicals, and variety packs. Additionally, The Grove is a one-stop-shop for non-medicated items including accessories such as vape pens and batteries, glass pieces, grinders, and lighters. MEDICINE SOURCE | The Grove has its own high-tech, state-of-the-art indoor cultivation and production facility growing its products under the Kannabis banner. The Grove also sources flower and products from other facilities. UNIQUE ATTRIBUTE | Because The Grove is vertically integrated, patients benefit from unique strains such as Strawberry Chem OG and Lee Roy (both from their Kannabis line) available only at The Grove. CUSTOMER SERVICE | The Grove personalizes its customer service with oneon-one patient attention. Knowing patients may have insecurities or fears about

SPECIAL EDUCATIONAL PROGRAMS The Grove hosted a ‘Barriers to Medical Marijuana Research’ event earlier this year, and is currently in the planning stages for a veterans-focused event this fall in a continuing effort to offer education on a wide variety of topics for patients. STAFF EDUCATION | The Grove’s budtenders undergo an extensive training and intake process taking a detailed course to ensure they understand the products, profiles and pairing benefits. Courses are led by The Grove’s Master Grower Kevin Biernacki, Head of Production Robbie Wright, and VERT Master Chef Melissa Parks. Budtenders also attend a weeklong product training class, in addition to state compliance seminars. NOTEWORTHY EXPERTS | Dr. Sue Sisley is The Grove’s Medical Director and a member of the Nevada State Independent Laboratory Advisory Committee (ILAC). She is recognized for her groundbreaking work as the SITE principal investigator for the only FDAapproved research using whole plant medical cannabis to study the risk and benefits of cannabis for combat veterans with treatment resistant post-traumatic stress disorder (PTSD).

september | elevatenv.com 35

Elevating the Conversation

with Liz McDuffie

s director of the Medical Caregivers Institute, mccdirectory.org, Liz McDuffie is all about education. She has been teaching cannabis classes since 2006 in California and now she is bringing that valuable knowledge to Nevada. Her ultimate vision is to create a Nevada Medical Marijuana Information Resource Center that will house a cannabis bookstore, a cultivation workshop for patient growers, a doctor’s office with telemedicine services, and a classroom area. Of the center, McDuffie says, “I have lived it, I have done it, it’s the happiest place on earth.”

HOW DID YOU DISCOVER THE MEDICINAL BENEFITS OF CANNABIS? When I discovered it in 1967 I was working in Germany for the Army. As a child I suffered from very severe headaches and those followed me into adulthood and they were very debilitating. I went to see a German doctor there and she recommended hashish, I didn’t know what it was or anything about it, but I did find hashish in Frankfurt. It didn’t stop the pain altogether but for the first time in my life I could function, and before I would have to go in a dark room and put ice on my head and it was just a really horrible experience. I was really impressed with this medicine and so I started reading about it and there was just a preponderance of history of its medicinal use and I became a proponent of cannabis as a medicine. HOW DID YOU BECOME INVOLVED IN THE CANNABIS INDUSTRY? I decided the best way to proceed was to have an educational program and so I began to recruit people to help teach California’s medical marijuana program and that’s how I started in 2006. I promise you, no matter how much you are going to try to give out to that community, it’s nothing compared to what comes back to you in resources. It’s been a breathless 10 years of working with all of these different instructors on subjects that include everything from extraction to teaching physicians about compliance approval.

elevatenv.com | september

WHY DID YOU DECIDE TO OPEN A MEDICAL CAREGIVERS INSTITUTE IN NEVADA? I had to come to Nevada because the MMJ program just blew me away. It was wonderful because, first of all, the program allowed physicians to own MMEs. That was it for me because for the very first time the medical was brought into the program. The federal government has kept the doctors at arm’s length because you can’t prescribe it, you can’t dose it. They tried very hard to keep that Pandora’s box shut. But thank goodness the federal government upheld the physician's right to recommend it or approve it but they drew that big red line – you can’t tell them where to get it, you can’t prescribe it. I said I went to Vegas for the doctors and that was true, it was everything to me because it put medicine into this program, it made it medical and doctors could own MMEs and that was defiant of federal laws. WHAT’S BEEN THE BIGGEST SURPRISE TO YOU AS FAR AS DISCOVERIES IN THE CANNABIS FIELD? They were doing telemedicine in California so I wanted to see about doing that here in Nevada. When I found out from the medical board that telemedicine could be used in Nevada legally, I did the Jackie Gleason shuffle all the way down the hallway. Because one of my major goals, the irony of it, is that with all of these dispensaries

we never got it to the people for whom it was intended. Is that an irony or what? Because they are in hospice, residential care, assisted living, hospitals, rehabilitation centers, senior daycare. We now have telemedicine and that’s the final key to me. The very basis of the legality of using telemedicine in the healthcare field is for a physician to complete a medical form created by state statute so it opens it up to every patient who can’t get to the doctor. IN ADDITION TO OFFERING TELEMEDICINE AT MEDICAL CAREGIVERS INSTITUTE, YOU HAVE PLANS TO START A CULTIVATION WORKSHOP. I have been running around trying to protect the individual’s right to grow so I want to open up a cultivation workshop, a safe place for patients to come and learn to grow organic medicine that is Clean Green certified. We will have a cultivation manager there at all times supervising activity. Their crop will be weighed in, documented, and it will go through the correct channels and we will also help them get excess medicine into dispensaries. This way we are allowing a patient to learn to cultivate and actually benefit and be a part of the program. To read our entire interview with Liz McDuffie, visit elevatenv.com/Elevating_ the_Conversation.

This November, you will have the opportunity to vote Yes on 2 to regulate marijuana like alcohol. You can learn more about the initiative at: RegulateNevada.org /RegulateMJinNV A regulated adult-use marijuana market will:

● Reduce or eliminate the underground marijuana market in Nevada ● Make it more difficult for our children to access by requiring an ID to purchase ● Provide funding for K-12 education ● NOT change existing medical marijuana laws or affect patients’ rights Email: info@regulatenevada.org to learn how you can get involved.

Paid for by the Coalition to Regulate Marijuana like Alcohol.

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