Grass Roots America Magazine - April 2020 by Grass Roots America Magazine

PA RKI NSO N ’S ISSU E

A PRI L 2 0 2 0

WHAT’S WORKING TO P R AT E D PRO DUC TS

SC I E N T IS T + RES E A RC H E R

DR. ETHAN RUSSO JOSH CROSSNEY QUALITY + EDUCATION + CANNABIS

PARKINSON ASSOCIATION O F SW FL

WELCOME Our April issue focuses on treating Parkinson’s disease with plant medicine, and we have so much more in this issue. GRAM met Montel Williams at Florida Medical Cannabis Conference in Orlando late February, where he was the keynote speaker. Besides telling the story of his medical conditions he treats with cannabis, he spoke on the future of the cannabis industry. Montel is featured and on the cover of our March issue, focusing on multiple sclerosis. He is truly an inspiration. Meet Joshua Crossney, the effervescent founder of the Cannabis Science Conference. GRAM met Josh last April at the first East Coast Cannabis Science Conference in Baltimore. See us there again this April 6-8 and at the Cannabis Science Conference in Portland, OR, Aug 31-Sept 2. Learn on page 26 why Josh began the conference and what drives him. Dr. Ethan Russo has worked most of his past 23 years overseas, doing cannabis research that was not possible in the United States despite the evidence of many successful clinical trials and scientific studies. Read what he has to say to our readers on page 20. The Parkinson Association of SWFL has a plethora of information for patients and families who want to learn more about this disease. We met the fantastic team that offers daily group meetings. Read about this group of volunteers on page 33. The art on March’s back cover and in this issue on page 30 is extraordinary; they are 3D! With unique 3D glasses ChromaDepth 3d glasses, you can see this art come to life. Check out the Nugtopia Gallery online at www.nugtopia. net to see the great selection of art where cannabis buds replace people. JOIN US ON THIS JOURNEY… - NANCY

APRIL 2020 JOSH CROSSNEY QUALITY + EDUCATION + CANNABIS

26 DR. ETHAN RUSSO SCIENTIST + RESEARCHER

THE PARKINSON ASSOCIATION OF SWFL

EDUCATION + RESEARCH 8 CATCHING UP WITH TARA DEMOND 10 CBD + PARKINSON’S 13 NATURAL PLANT MEDICINES 16 MARIJUANA MINUTE WITH NURSE JORDAN 18 WHAT’S WORKING

DIS LIST 6 ALS 3 38 MELANOMA 40 TREMORS 42 WEIGHT LOSS 4

THE USUAL 4 OUTDOOR 4 46 CULTIVATION 49 CELESTIAL EVENTS REFERENCES 50 REFERENCE MATERIALS FOR EASY ACCESS

OUR TEAM FOUNDER | EDITOR IN CHIEF – Nancy Moss COPY EDITORS – Dr. Dawn Hayford,

Ellen Kuwana PRODUCTION | DESIGN – Melissa Morris TECHNOLOGY DIRECTOR – Alex Moss

OPERATIONS – Kara Cave ASSISTANTS – Mirella Hurst, Lila Grace SCIENTIFIC RESEARCH – Dr. Matt Jackson, Sarah Moss SOCIAL MEDIA MARKETING – NisonCo ADVERTISING – advertising@GetGramNow.com

CONTRIBUTING WRITERS & COLUMNISTS

PHOTOGRAPHERS

Ben Owens Dawn Hayford Jordan Person Kaitlin Domangue Matt Jackson

Erick Gibson Evan Duning Photography Jack Shinella Jacqueline Collins Kara Cave

Michelle Martin Maxine Taylor Rachael Carlevale Sarah Moss

Linsey Kelsey Melissa Morris Nadja Lieberwirth Nichole Montanez Russell Gearhart

NEW WRITER | DR. DAWN HAYFORD Dr. Dawn Hayford has been editing and proofreading GRAM since its inception. She is a U.S. Army combat veteran and has her MFA in creative writing and an Ed.D. in organizational leadership. She lives and works in Northern Virginia and is a mother to four rambunctious boys. She loves working with GRAM and constantly learning something new about cannabis.

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GetGramNow.com ALL REFERENCES CAN BE FOUND ON PAGE 50 Copyright © 2020. This magazine is protected by US and International copyright laws. Reproduction without written permission is prohibited. DISCLAIMER: This publication is designed as a reference and is made available to the public with the knowledge and understanding that the publisher and the author are not rendering medical, legal, or other professional advice. You should not use the information contained in this publication as a substitute for the advice of a licensed medical doctor. You should consult a medical doctor to address any health concerns specific to you. We suggest that you consult a legal professional to assess the legality of any described remedies. Mention of specific products, companies, or organizations does not imply that the publisher and author of the publication endorse such products, companies, or organizations. Nothing contained in this publication should be taken as an endorsement for any legislative action. The author and publisher disclaim any liability whatsoever with respect to any loss, injury, or damage arising out of the use of the information contained in this publication or omission from any information in this publication. Natural plant medicines and herbs can interact with medications or affect some medical conditions. You should always check with your prescribing medical doctor before using any of the herbal remedies and natural plant medicines described in this publication.

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Florida Medical Cannabis Conference Feb 20-23, 2020 | Kissimmee, FL Montel was at the Gaylord Palms as the keynote speaker at the Florida Medical Cannabis Convention. This conference was established in 2017 by Dawn Yarnell and Jill Giles to help Florida communities become educated and connected in all things related to medical cannabis. Montel delivered a passionate speech about his medical crisis that led him to cannabis, as well as bringing thought-provoking ideas to the doctors and cannabis industry personnel attending. An interesting point he made was that all the doctors and cannabis industry should have a red cross on their foreheads. He reminded us in times of war, trucks with crosses on top are not bombed by either side, as everyone knows they are there for the patients. As members of the cannabis community, we must remember we are here because of the patients.

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WHERE’S

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DECATUR Blum The Dispensary HENDERSON Essence Jenny’s The Dispensary The Source DOWNTOWN LAS VEGAS Thrive Cannabis Marketplace MedMen NORTH LAS VEGAS Jenny’s Dispensary NuWu Reef Thrive LAS VEGAS Acres Apothecarium BLUM - Desert Inn CannaCopia Canopi Curaleaf Cultivate Essence - The Strip

Essence - West Euphoria Wellness Exhale Inyo Jardin Las Vegas ReLeaf MedMen - The Strip MMJ America Nevada Made Wellness Nevada Wellness Center NuLeaf Oasis Pisos Planet 13 Reef-Strip Sahara Wellness Shango Show Grow Silver Sage The Apothecary Shoppe The Grove Thrive - Sahara Top Notch ZenLeaf

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EDUCATION + RESEARCH

CATCHING UP WITH TARA DEMOND BY JORDAN PERSON

The first time GRAM wrote about Tara DeMond was in our May/June 2019 issue. A year later, we felt it was a good time to catch up with this very busy RN who works as a consultant for medical marijuana treatment centers in Florida, while running a nonprofit she started with her husband, Jeff. Tara and her husband created The Grateful Veteran.1 Their mission is “promoting change through education.” Tara was thrilled to tell us all about the exciting things they have coming up and the changes that have taken place in the last year with Florida’s medical marijuana program. Things at The Grateful Veteran have been extremely busy. “We have a lot of upcoming educational events in the cannabis industry. In addition to providing education to patients and veterans with PTSD, this year we are even more focused on community outreach as a whole,” says Tara. So far, The Grateful Veteran has assisted over 100 veterans with receiving their medical marijuana recommendation. “We help them with the $75 application, we have doctors who donate their services, there are teams of volunteers who make everything we do possible. Thanks to these teams, we are creating future events and fundraisers with local artists,” says Tara. November 8, 2016, medical marijuana finally passed in Florida.2 “When the industry first began, only two routes of administration were allowed. Now, all routes are available. Some patients (myself included), require a topical, a tincture, and a hit of a vape pen at bedtime. That is three routes of administration just to go to bed,” Tara tells us. 8

“One of the most common things we assist new patients with is their paperwork. Changes occur in the patient registry all the time, so we also assist physicians by showing them how to properly fill out all the forms. On the upside, more patients have access to their medicine thanks to more and more dispensaries opening.” “Thanks to more dispensaries opening we have an increase in access and availability, growth in availability of products, ratios in tinctures and pain patients using concentrates. And whole flower now being available has officially changed the game. It has been

so interesting getting to know patients. Older people in South Florida didn’t want to vape, etc. they wanted flower because that’s what they knew from back in the day. They are going back to making their medicine via edibles using whole flower in any way that they choose. You simply can’t categorize age groups when it comes to medical cannabis. We have seen every single age in the spectrum,” explains Tara. In addition to running their nonprofit, Tara and Jeff are actively involved at Florida Gulf Coast University in the Cannabis Career Club (also known as C3). They

assist students by getting them jobs in the industry at dispensaries, doctors’ offices, and more. They hold weekly meetings based on students’ schedules. Last year they created a Cannabis Carnival called CannaCon, and it was such a great success it will now be held as an annual event. Tara leaves us with her future passion, “My goals in the future include something that is near to my heart in general. I want to look more into Alzheimer’s research and science supporting the disease utilizing cannabis, in honor of my mother.”

EDUCATION + RESEARCH

C BD

+ PARKINSON’S DISEASE BY BEN OWENS

Parkinson’s is a neurodegenerative disease that affects 10 million people worldwide, and cannabinoids such as CBD are being studied for their neuroprotective properties as well as their efficacy with symptom management.1-9 Parkinson’s can have a noticeable impact on quality of life due to symptoms such as tremors, spasticity, and pain that can make everything from walking to talking difficult, which can lead to anxiety—all symptoms that CBD has shown to be helpful in managing.10 Early studies are showing CBD can specifically be effective for managing life with Parkinson’s.1-8 While CBD’s legality on a national level is still relatively new, there are quite a few studies already on CBD’s ability to manage the symptoms of Parkinson’s, helping to improve quality of life for those living with the condition. As discussed at length in previous issues of GRAM, CBD has proved to be helpful in managing muscle spasticity often experienced by patients. Additionally, CBD has been shown to mitigate pain and the inflammation that causes it, also be a source of damage to nerve networks within the body in patients with neurodegenerative diseases. Additionally, CBD has been found to be helpful with anxiety that can arise from a variety of situations, including those where symptoms may become noticeable.

In addition to general research supporting CBD’s efficacy in symptom management for conditions such as Parkinson’s, researchers are specifically studying CBD’s ability to help Parkinson’s patients with sleep-related issues and psychosis.1-3 In a pilot study, researchers studied a small sample of men and women with Parkinson’s who had psychosis for at least three months. Participants were given 150 mg of CBD every day for four weeks and showed a “significant decrease” in psychosis during treatment without worsening motor function or other adverse effects.1 Another study examined four Parkinson’s patients experiencing REM sleep behavior disorder (RBD) who were treated with CBD and found the treatment had “prompt and substantial reduction in the frequency of RBD‐related events without side effects” and indicated “CBD is able to control the symptoms of RBD” in those with Parkinson’s.2 Furthermore, a larger sample of

EDUCATION + RESEARCH

Specific to Parkinson’s, CBD has also been shown to be effective with dystonic movement disorders and the motor and cognitive impairments often brought on by the disease.6,8,11 In a small pilot study of five patients with dystonic movement disorders, patients were administered “oral doses of CBD rising from 100 to 600 mg/ day over a 6 week period” and found “dose-related improvement in dystonia was observed EARLY STUDIES in all patients.” The authors ARE SHOWING conclude that “CBD appears to have anti-dystonic and ParkinCBD CAN sonism-aggravating effects in SPECIFICALLY humans.”6 Animal studies designed to model the effects of BE EFFECTIVE Parkinson’s disease resulted in findings that suggest CBD is FOR effective in treating motor and MANAGING cognitive impairments in Parkinson’s patients.8 LIFE WITH

21 patients examined the effects of various daily dosages compared with a placebo and found CBD could improve quality of life in Parkinson’s patients, but the authors reiterated that larger samples in future studies are needed to corroborate these early findings.3

A literature review of current research on CBD and neurodegenerative disorders suggests CBD’s neuroprotective and anti-inflammatory properties could prove promising for treatment of neurodegenerative disorders across the board, including Parkinson's.5 This review found that “at preclinical level, accumulated findings appear more exhaustive and convincing for a possible medical utilization of CBD to improve symptoms and/or delay disease PARKINSON’S. To date, most of the research progression” as well as helpavailable has been done in preing to prevent damage to nerve clinical settings with small samcells.5 These neuroprotective ple sizes. These findings need to properties are mainly associatbe corroborated by much larger clinical studies ed with CBD’s anti-inflammatory and antioxidant for accurate generalization, but these early results properties, and early investigations have found suggest CBD could be effective in the treatment that CBD might have a neurorestorative compo4 of Parkinson’s disease and the management of nent as well. CBD’s ability to target the CB2 reits symptoms. If you’re considering CBD as an alceptors without activating CB1 receptors, in adternative or complementary treatment for Parkindition to its other properties, has suggested that son’s for you or someone you know, talk with a CBD could prove to be helpful in the treatment of 7 physician who is familiar with the patient’s case Parkinson’s. and treatment program to see if CBD may be an option that could help improve quality of life. 12

PLANT MEDICINE HERBAL MEDICINE + PARKINSONâ&#x20AC;&#x2122;S DISEASE BY DR. DAWN HAYFORD

This issue of GRAM discusses the ways cannabis can help with Parkinsonâ&#x20AC;&#x2122;s disease (PD) and its symptoms. There are also a number of other alternative treatments that can be used, oftentimes in conjunction with anti-PD medication. Plants and treatments that are neuroprotective, anti-inflammatory, and antioxidant have all had positive effects on the symptoms and pathogenesis of PD either in animal studies or through historical use that has not been clinically studied. Continue reading to discover various plant medicines that have been used to improve the quality of life for PD patients and even fight the progression of the disease.

EDUCATION + RESEARCH

Herbal medicine (HM) has been used to treat PD and its symptoms in China and other Asian countries. The key ingredients in herbal medicine combinations can include up to 52 to different herbs with 59 different combinations.1,2 A study published in 2018, listed the top 11 herbs found in traditional Chinese herbal medicine used to treat PD: danshen root, debark peony root, gambir plant nod, rehmannia root, desertliving cistanche, fleeceflower root, sichuan lovage rhizome, Asiatic cornelian cherry fruit, Chinese angelica, grassleaf sweetflag rhizome, and milkvetch root.1 Many studies have highlighted the various ways that HMs are combined and used in Asian countries. The way these ingredients are combined and the levels of combination are probably based on individual treatment plans, and it is likely that one specific combination of herbs is not going to work for every patient. Our bodies react differently to herbs and the way they interact with each other. A study published in 2012 identified the wide range of variation in the preparation of HMs; it also identified that when used with conventional drug therapy such as levodopa, led to decreased symptoms and adverse events and a reduction in the dosage of anti-PD drugs.2 This study did point out that in order to get a better understanding of HMâ&#x20AC;&#x2122;s effect on PD, there needs to be standardization of ingredients and further studies over a longer period of time to study any adverse effects.2

One such standardization of Chinese HM is a combination of 8 herbs referred to as Optimized Yinxieling Formula (OYF). It has been used to treat psoriasis because of its anti-inflammatory properties. These same properties were found to be neuroprotective and prevent neuroinflammation in mice.3 In fact, they stopped the activation of the immune cells in the brain that cause cell death in dopamine nerve cells. Another Asian tradition that has been used to treat PD is Ayurveda, an ancient Indian medicine practice. Ancient Ayurvedic texts appear to refer to body tremors or â&#x20AC;&#x153;kampavata.â&#x20AC;? Plant medicines used in Ayurveda to treat PD include Ashwaganda and Mucuna Pruriens (MP).4 In fact, a recent study showed that powdered seeds of MP delivers a naturally occurring form of the anti-PD drug levodopa and provides the same efficacy as synthetic levodopa with fewer adverse effects.5 Oxidative stress has been found to contribute to the loss of dopamine-producing cells in a specific part of the brain called the substantia nigra.6,7 Specifically, ginkgo biloba has been studied in animals to treat PD symptoms and was found to have neuroprotective effects, prevent oxidative stress, and reduce the toxicity of the anti-PD drug, levodopa.8 It is important to note that antioxidants such as ginkgo biloba, vitamin E, creatine, CoQ10, and others have not been found to be extremely effective in treating PD in humans. The reason for this might be that the oxidative stress has already caused the deterioration and/or death of the dopamine-producing nerve cells by the time PD is diagnosed.6 This does not discount the neuroprotective effects of antioxidants for potentially preventing PD in the first place. Due to the worsening effects of PD on patients, the quality of life usually declines as the disease worsens. Using plant medicines; focusing on an anti-inflammatory, antioxidant diet; and cannabis use, in conjunction with modern anti-PD drugs could improve the quality of life and delay the death of the dopamine-producing cells in the brain. Ensure you are discussing any alternative treatments with your physician.

In this column, our readers have the opportunity to ask our staff nurse anything they want to know about using cannabis plant medicine. She will provide quick and concise answers to big questions. In this month’s column, we researched Parkinson’s disease and how those suffering might be able to use cannabis for relief from their symptoms. Due to the abundance of cannabinoid receptors in the brain, the endocannabinoid system might turn out to be a direct delivery system for the relief of some symptoms experienced by patients who have Parkinson’s, according to a study published in Innovations in Clinical Neuroscience in January 2019.1 Parkinson’s disease affects the body’s movements by attacking the nervous system. The disease begins gradually and progresses over time. Sometimes, it begins with a simple hand tremor, others might experience less expression in the face, or speech might slow or soften.2 Pharmaceuticals have been the way patients have sought symptomatic relief until now. Thanks to the advancing laws surrounding medical and recreational cannabis, patients have more options than ever.

WHAT ARE THE BEST METHODS OF CONSUMPTION FOR PARKINSON’S PATIENTS? In states that have medical marijuana or recreational cannabis laws enacted, different products are available at dispensaries. One of the main symptoms caused by the disease is tremors. Some patients have had success with taking cannabis in an oil taken orally. Cannabis oil may contain THC and CBD and is often sold in blunt-tipped syringes or in bottles with a dropper, making self-administration of the cannabis plant medicine easy for the patient. In a study done by the British Association for Psychopharmacology, patients who received 300 mg of CBD a day showed a significant improvement of symptoms compared to those given a placebo.4 In another study done by the Movement Disorder Soci-

ety, doses as low as 1.5 mg CBD: 2.5 mg THC up to 300 mg of CBD were given daily.5 Symptom relief was noted in patients with higher doses. Although there are still no set dosing parameters and more research is needed, do not let that get you discouraged. An open-label study of smoked marijuana decreased tremor and slowness in 22 people with PD.6 Improvement in patients’ sleep and pain scores were also observed. Some patients may prefer using an oil or tincture, others may feel more comfortable smoking. You may find a combination of delivery methods is what works best for you. Keep a journal and document your journey so if it works, you can duplicate what you did.

● What is the route of administration? ● What time did you consume? ● How much of the product did you consume? (e.g., ½ joint, 3 hits of a bowl, 10 mg CBD edible, 50 mg THC edible) ● What is the effect felt 1-2 hours later? ● How long did the desired effect last? 16

WHAT STATES LIST PARKINSON’S AS A QUALIFYING CONDITION? A qualifying condition is a disease/disorder/symptom that a state has approved for a patient to use medical cannabis. Permission is received from a recommending physician and paperwork is filed with the state registry. According to the National Organization for the Reform of Marijuana Laws (NORML), there are 17 states in the U.S as of early 2020 that list Parkinson’s disease as an approved diagnosis.3 In addition to listing Parkinson’s disease, patients may also receive approval for persistent muscle spasms/spasticity.

PARKINSON’S DISEASE Connecticut Florida Georgia Illinois Iowa Louisiana Maine Massachusetts Michigan Missouri

New Hampshire New Mexico New York Ohio Pennsylvania Puerto Rico Vermont West Virginia Virgin Islands

PERSISTENT MUSCLE SPASMS/SPASTICITY Arizona California Colorado Delaware Maryland Michigan Minnesota

Montana Nevada Oregon Rhode Island Utah Washington

TREATING PHYSICIAN DECISION Arkansas (if approved by the Dept. of Health) Kansas Oklahoma Washington D.C Wisconsin

WHAT ELSE SHOULD PATIENTS WITH PARKINSON’S KNOW? If you have not yet taken the time to view a video of a Parkinson’s patient using cannabis, then I highly suggest you take the time to do so now. As people often say, “seeing is believing.” One of the best videos available to see how quickly the effects of the cannabis plant medicine take place can be found on YouTube. By typing in “Ride with Larry” in the search bar of YouTube, you will find videos of a former police officer turned cannabis user. His tremors begin to calm within a matter of minutes after using cannabis oil. Researching at home can feel daunting. Some reports can be conflicting. If you want to try cannabis for your symptoms, it is important that you speak with your doctor, and don’t forget to document your journey.

DO YOU HAVE QUESTIONS FOR NURSE JORDAN? Please submit any questions to info@getgramnow.com Your question might be published in an upcoming issue.

EDUCATION + RESEARCH

WHAT’S WORKING FOR ReLeaf is a free mobile app that encourages patients to mindfully track their cannabis experiences. They believe you will strengthen your relationship with yourself while also learning how cannabis can help alleviate your specific symptoms and ailments. GRAM is proud to share with our readers data gathered using ReLeaf from individuals suffering from Parkinson’s disease.

DOWNLOAD RELEAF APP TODAY TO TRACK, LEARN FROM, 18

PARKINSONâ&#x20AC;&#x2122;S SYMPTOMS? They reported the effectiveness of products for specific symptoms that individuals suffering from Parkinson's disease predominantly experience. The data reflect their individual experiences self-reported using the ReLeaf App.

DATA COLLECTED BY

AND IMPROVE YOUR USE OF CANNABIS BY VISITING: RELEAF.AT/GRAM 19

SCIENTISTS + RESEARCHERS

DR. ETHAN RUSSO BY JORDAN PERSON

If you have done any research on cannabis science, then you likely have come across the name Dr. Ethan Russo. He is a board-certified neurologist who is dedicated to the research and development of plant medicines. He did not come from a family of herbalists. According to Dr. Russo, he had “no familial exposure. When I was a teenager I was interested in Euell Gibbons,1 a plant explorer and herbalist. I always considered herbalism to be a part of medicine. At that time, it was sort of considered old fashioned and folk belief, but it was of definite interest to me.” Seven years into running his neurology practice, Dr. Russo felt he really had a grasp on the limitations of the medicines that were being used. “There are so many treatments that were unsuccessful or downright intolerable. My philosophy became: there needs to be a better way, and I need to think about broadening the field back into herbal treatments,” Dr. Russo explains. “I knew that I wanted plant medicines to be the focus of my work henceforth.” Dr. Russo’s work with plants has been extensive over the years. In his neurology practice he worked with herbs such as St. John’s Wort, kava, ginkgo biloba, and ginger. Each of these plants were used extensively in combination with conventional medicines. “I didn’t start out with a concentration on cannabis, but that has now come to the forefront as the premier phytomedicinal. It is certainly the most versatile that we have,” says Dr. Russo. According to Dr. Russo, deciding what to research comes fairly easy. “Sometimes it comes in the form of what people are requesting, beyond that it’s about identifying holes in our current knowledge. I try to find topics where cannabis may have been underutilized, or it hasn’t yet received the attention that it deserves, or trying to treat conditions where conventional treatment really hasn’t met the mark. There are a lot of those conditions. The most common conditions are probably pain, cancer, and things of that sort.”

SCIENTISTS + RESEARCHERS

Dr. Russo recently released an editorial on cannabis for pain.2 â&#x20AC;&#x153;One of the interesting things about using cannabis for the treatment of pain is that as opposed to morphine that acts directly on the pain, cannabis works differently, and it has a stronger ability to treat the emotional aspect of pain. People may feel the pain is still there, but it does not bother them like it did before and that is extremely important. It certainly can be a big part of how a patient may improve. Without that, the patient will still be miserable in the face of chronic pain, with that they can regain a better perspective on life and be better to function more effectively.â&#x20AC;?

UNFORTUNATELY, WE STILL SUFFER THE OBSTACLES POLITICALLY IN TRYING TO DO THIS RESEARCH. 23

SCIENTISTS + RESEARCHERS

Dr. Russo is very busy these days. He is currently in the process of starting a new research and development organization. He tells us, “We are in the midst of fundraising and getting some intellectual property rights protection at this time, so I can’t be very specific. I can say that I am working on a novel method of extraction, and we are developing a couple of diagnostic tests for disorders that do not currently have proper ways of diagnosing them. I am also working on a treatment for a very common condition where current treatment is either toxic or ineffective. We are also working on a line of nutritional products that may fill a niche that has not currently been addressed.”

... CANNABIS WORKS DIFFERENTLY, AND IT HAS A STRONGER ABILITY TO TREAT THE EMOTIONAL ASPECT OF PAIN. In addition to nutritional products, “An area we are involved in is still trying to identify and develop different chemovars, or chemical varieties of cannabis that are going to emphasize other components. It’s thinking about the world beyond THC and CBD. What people call the minor cannabinoids, and really they are only called that because people have not done selective breeding up till this time to increase their concentration and figure out how they can be used therapeutically.” Dr. Russo thinks we have only begun to uncover the potential of cannabis as both a medicinal plant and as a source of nutrition. He tells us, “Unfortunately, we still suffer the obstacles politically in trying to do this research. It is not really different now as it was in the beginning when prohibition was still in full force. There are still many places in this country where people do not have legitimate access and that needs to change. I have been doing this for 24 years, and every day I realize the increasing potential for cannabis-based medicine. It’s never gotten old; I have never gotten bored with it and I think that there are countless opportunities to come.”

SCIENTISTS + RESEARCHERS

RUSSO’S RESEARCH REPORTED BY SARAH MOSS

Dr. Russo comments in his latest editorial how the medical community has failed to appropriately manage chronic conditions such as pain and other debilitating diseases. “The National Academies of Sciences, Engineering, and Medicine opined in 2017 that “there is conclusive or substantial evidence that cannabis or cannabinoids are effective: for the treatment of chronic pain in adults.”2 RUSSO STATES THAT WE NEED TO FACE THE FACTS: - What doctors are currently using (opioids and non-opioids) is not effective in managing patients’ symptoms, and the lack of willingness tof many medical professionals to consider other options leaves the patients suffering. - There is no longitudinal data that shows the efficacy of using opioids long term for chronic noncancer pain, and there is not much being developed in the drug market that aims to make any difference in how we currently treat patients. - Whether anyone likes it or not, increasingly millions of people around the globe are utilizing cannabis to treat their pain, and observational studies and surveys repeatedly demonstrate that pain is the top medical indication for cannabis usage, in the range of 70% of all patients.5 - No medication is deemed commercially successful unless the patient reports clinical improvements and perceives that they are improving due to the drug. - There truly is no way to take an objective measurement of pain in the clinical field. In order for anything in the medical/ biotechnology field to be taken seriously, there needs to be a randomized, double-blind placebo study with results that can be easily replicated and that is why cannabis has not been taken seriously for its therapeutic benefits. Due to the schedule 1 nature it makes it extremely difficult for researchers to do double-blind placebo studies. There is so much red tape on the subject that we are left with anecdotal evidence from patients along with the few clinical trials that are available using Sativex, the synthetic version of a 1:1 THC CBD oral mucosal spray. 25

JOSH CROSSNEY:

QUALITY + EDUCATION + CANNABIS

HOT TOPICS

BY DR. DAWN HAYFORD

GRAM spoke with Josh Crossney, the founder of Cannabis Science Conference, one of the leading cannabis conferences in the U.S. brings together medical, analytical science, and cultivation experts. More on that in a minute. A career in staffing and recruiting for some of the biggest biological labs across the U.S. gave Josh an in-depth understanding of the importance of quality control and testing. That is what drove him into the medical cannabis industry in 2014. “It really was kind of alarming to me that at the time there were no requirements or quality control testing for cannabis.” “I connected with some people who were using cannabis as medicine out in California and a couple people who were treating children with cannabis,” he says. “Everything, just about, that comes in contact with humans—from food to beauty products to even water and wastewater—has quality control standards or testing,” he says.

IT REALLY WAS KIND OF ALARMING TO ME THAT AT THE TIME THERE WERE NO REQUIREMENTS OR QUALITY CONTROL TESTING FOR CANNABIS.

A passion for changing that was one of the things that drew Josh into the industry. Educating people about medical cannabis was another. “I realized there wasn’t a lot—really any—platforms at the time, that were really catering and creating a space for the world’s leading researchers and medical professionals and cultivation experts to come together and share their information with other like-minded people,” he says. In October 2016, Josh launched the first Cannabis Science Convention in Portland, Oregon. That first show drew about 800 attendees and 75 vendors. By 2019 the event was pulling in close to 3,500 people and almost 200 vendors. Last year, he launched the inaugural Cannabis Science Convention East at the Baltimore Convention Center in Maryland.

Josh is a voice in the cannabis industry for the LGBTQ community, and he regularly speaks about the importance of diversity and inclusion. “More so than most industries that I’ve been a part of, the cannabis industry, and the folks and the col-

HOT TOPICS

“It really was a full circle moment for me when we were able to say ‘Hey, it’s been a few years. The East Coast has really developed when you look at states like Maryland, New Jersey, Pennsylvania, Delaware, and New York that have implemented medical cannabis programs since the time we launched the (Oregon) show.’” The move paid off, attracting over 2,000 attendees and about 110 vendors.

leagues I’ve worked with are very accepting and open to all types of people,” Josh says. He states that the cannabis community and LGBTQ community might have more in common than you would think. “A lot of people don’t realize how many intersections there are between the LGBTQ community and the struggle that we went through in the U.S. and globally, also with the cannabis community. These are both two communities that have been unfairly marginalized and stigmatized by society.”

turn you into a shell of yourself. So I just found that cannabis, for me, was a much better, safer alternative that actually worked a lot better than prescription drugs.”

Knowing firsthand the benefits, Josh has big goals “to educate the masses and let people know this is an option.” He has his own Maryland-based 501(c)3 non-profit called jCanna—focused on advancing cannabis science and specifically cannabis quality control testing and extraction processes and standards. “Everything that I do, everything Josh said that both are human rights issues that that I touch in this industry really is, at the core, have gained traction on a state-by-state basis. He trying to drive more normalization of this plant, acalso pointed out that when California implement- ceptance of this plant.” ed medical cannabis in 1996, it was “largely due “We’re having to dig out of 50 plus years of misinto the advocacy, leaders, and pioneers who were formation and propaganda. It’s not a new converpushing for this as an option for the HIV and AIDS sation. Prohibition and reefer madness was really communities.” something that was based on racism and greed “There are a lot of crossovers that people don’t and the need and want to monopolize the Amerirealize. Cannabis has been used and accepted as can industry, like pharmaceutical and paper. A lot a medicine in society for far, far longer than it has of people don’t realize the first draft of the Constitution was drawn up on hemp paper.” been stigmatized as one.” However, Josh doesn’t see cannabis advocacy as a blanket label and acknowledges people disagree. “I’m definitely all for adult use and recreational use, and this being legalized and normalized federally,” he said. “But I also am a major proponent of medical, and I would hate to see More than a decade later, he still suffers from back the government say, ‘Well, we’re gonna go ahead and shoulder pain as a result. “I use cannabis as and legalize this for recreational use, but we’re not an alternative to the opiates that everyone gets gonna call this a medicine.’ prescribed when you have injuries like that,” he said. It also helps him with PTSD from the acci- “If that was the case and this was regulated like dent. “As a passenger, it was very intense. For me, alcohol, how would the 10-month-old babies, the it can be challenging to be a passenger in cars 2-year-old children, the people who are using this at times. Cannabis really does help me deal with as a medicine, how would they have access to this if it was regulated like alcohol, and it was a 21-orthat.” over situation without any option for them? Yes, Josh also finds relief for his anxiety. “There’s not legalizing and normalizing this plant federally but a lot of pharmaceutical options other than benzos, also maintaining the medical term, and that this is which really are just as bad as opiates; they really a medicine.”

HOT TOPICS

A serious car accident in the winter of 2009 triggered Josh’s firsthand experience using cannabis as medicine. Returning home during a snowstorm from a sleigh-riding excursion, the car he was riding in crashed into the back of a state snowplow.

As a board member of the California based CannaKids, Josh cares deeply about pediatric cannabis use. “If this is legal in your state for an adult to use a medical condition, I think that it should not be any more stigmatized for a pediatric patient going through the same condition to have this as an option.” This brings him back to the importance of quality control and testing in the cannabis industry. “If you’re treating a sick pediatric cancer patient who’s going through chemo and radiation with a highly compromised immune system, contaminated cannabis with mold, heavy metals, or solvents can really negatively affect their health.” It’s not just about contamination, but knowing exactly what is in the medicine and how strong it is. “That is important when you are talking about trying to target and treat conditions. We just want this natural plant to be as natural as possible” he says. In fact, Josh has a quality control dream. “I would love to see this standardized and have quality control required and standardized all over the country and get it to a point where you can send a

cannabis sample to five different labs and get the same result. The problem right now is if you sent a cannabis sample to five different labs, there’s not standardization. They’re using different types of instrumentation, different processes. Any of these factors can change the results of your certificate of quality.” Josh is constantly busy travelling, speaking, and expanding the Cannabis Science Convention. “We’re continuing to grow the shows. We’re on the East Coast and the West Coast. We have been dabbling with the idea of a Midwest show at some point. We’re also really strongly looking at international markets. We’d love to, potentially, do a show in Germany where cannabis is just starting to develop.” “This year, one of the new things is in addition to our analytical science, medical cannabis, and cultivations tracks, we’ve also launched a whole 2-day hemp/CBD track.” Adding the hemp/CBD track is just one way Josh is continuing to educate medical professionals and patients. He is also involving the academic community by shining a light on their contributions to the cannabis science through developments in the curriculum at Johns Hopkins, Rutgers, and Northern Michigan University, and the University of Maryland School of Pharmacy. “We really feel that knowledge is power and empowered patients can make the best decisions about their cannabis care.”

HOT TOPICS

WE REALLY FEEL THAT KNOWLEDGE IS POWER AND EMPOWERED PATIENTS CAN MAKE THE BEST DECISIONS ABOUT THEIR CANNABIS CARE.

FGCU CERTIFICATE PROGRAM

Florida Gulf Coast University has always been a progressive school. They have become what President Martin predicted last year, “Florida’s Greatest Cannabis University.” The Cannabis Professional Certificate Program is an intensive 5-day workshop designed to meet the needs of those in the industry and community who want to increase their understanding of cannabis and its effects, the cannabis industry, and the environment in which it operates. Students at FGCU just completed a 5-day Cannabis Professional Certificate program, with 40 individuals completing the course. The course is an intensive, multidisciplinary workshop geared towards those who would like to enter the cannabis industry or those who want to learn more about cannabis. Dr. Martha Rosenthal, PhD., a professor of neuroscience and physiology and director of the Cannabis Research, Education, and Workforce (CREW) initiative at FGCU, heads the course. Martha holds her PhD in neuroscience from UCLA and a master’s degree in Neuropharmacology. Because of her training, Martha is uniquely qualified to teach about the effects of cannabis on the body. FGCU also curated a group of cannabis professionals, including physicians, botanists, scientists, business leaders, industry managers, attorneys, accountants, to speak to the students.

GRAM was there and spoke to the students during their graduation celebration. Hereâ&#x20AC;&#x2122;s what some of the students had to say about the course:

I BELIEVE THIS PROGRAM SHOULD BE A GENERAL EDUCATION REQUIREMENT FOR EVERYONE. THE CLASS HAS HELPED ME MAKE CONNECTIONS IN THE CANNABIS INDUSTRY. - JACOB MILLER | PSYCHOLOGY MAJOR

DR. ROSENTHAL DEBUNKED THE MYSTERIES OF CANNABIS. - MYRA JAIMES ENTREPRENEURSHIP MAJOR

THIS COURSE GAVE A GOOD OVERALL SYNOPSIS OF THE CANNABIS INDUSTRY FOR STUDENTS TO HAVE A BETTER IDEA OF WHAT IT IS ALL ABOUT. I FEEL BETTER PREPARED TO ADVOCATE AND HELP PATIENTS AFTER THIS CLASS. - CARLY STOEN | LIBERAL ARTS MAJOR, INTEGRATED STUDIES PROGRAM, CANNABIS FOCUS

THE PARKINSON ASSOCIATION OF SOUTHWEST FLORIDA BY BEN OWENS

Parkinson’s disease is one of the fastest-acting neurodegenerative diseases in the human population, yet the condition is largely avoided in conversation. Many people are afraid of the disease and the symptoms it presents, which results in those with Parkinson’s eventually isolating themselves from the world. The Parkinson Association of Southwest Florida has been working to overcome that fear for more than 20 years by bringing discussions about the disease into the open. Not only that, but they also offer a support group specifically focused on medical cannabis and its impact on Parkinson’s patients. I had the chance to speak with members of the Association’s staff and learn more about who they are, what they’re doing, how they’re handling medical cannabis, and the impact that their efforts are having on patients and the community at large.

WHO IS THE PARKINSON ASSOCIATION OF SOUTHWEST FLORIDA? The Parkinson Association of Southwest Florida was started in Naples, Florida in 1997 by two retired school teachers. For much of the Association’s early years, it was a primarily grassroots, volunteer-driven effort, run from their living room. There wasn’t a formal structure or business organization, it was simply volunteers coming together to help patients in the community. The Association has since formalized as a nonprofit organization, but volunteers remain their heartbeat. It is entirely self-funded through the support of the residents of Southwest Florida and receives no government or national organization 33

funding. They are supported by a variety of fundraisers that include the organization’s Step Up For Parkinson’s Walk (Previously Heart and Sole Walk) as well as celebrity visits from people such as Jimmy Choi of American Ninja Warrior and former White House Press Secretary Sarah Huckabee Sanders.

IT’S ONE OF THOSE DISEASES THAT IS VERY MUCH MISUNDERSTOOD, AND A LOT OF PEOPLE BECOME ISOLATED WITH THE DISEASE

According to Linda Goldfield, Executive Director of the Parkinson Association of Southwest Florida, this allows the Association to concentrate its efforts locally, with more than 80 cents of every dollar going towards programming for patients, and 100% of all funds remaining local, supporting the communities of Southwest Florida. “The Parkinson Association of Southwest Florida provides programs that help people live well on a daily basis with Parkinson’s disease, from diagnosis through the progression of the disease ... most of the national organizations are fundraising for a cure, and sadly there is no cure in sight,” remarks Linda.

WHAT DOES THE ASSOCIATION DO FOR PATIENTS? As mentioned, they focus primarily on providing educational classes and programming that supports those living with Parkinson’s, their caregivers, and family members. They offer groups for patients ranging in symptom severity from early onset diagnosis all the way through stage 4 of the disease. “A lot of people don’t understand Parkinson’s, and they feel as though it is shameful to say that you have this disease, but it’s really not. It’s one of those diseases that is very much misunderstood, and a lot of people become isolated with the disease,” explains Tricia Leite, Outreach Volunteer for the Association. The classes include educational groups focused on sharing research, treatments, insight, and anecdotal experiences. There are also movement groups to help patients stay as active as their bodies will allow, and support groups that allow patients to network with one another, speaking openly about their success, trials, and treatments, and finding support in a community that understands what they are going through. Additionally, three years ago, the Association joined 34 PARKINSON’S DISEASE

the Struthers Parkinson’s Care Network to help train facilities and home healthcare providers in proper Parkinson’s care, expanding their efforts to create a Parkinson’s-friendly community.

WHY DO THEY DO IT? The Association was founded by two people who experience what thousands of others experience each year: someone close to them was diagnosed with Parkinson’s disease. The desire to fix a lack of understanding of what the disease is and how it impacts daily life drove them to create a grassroots movement that has evolved into a professionally led organization. As more people affected by the disease move to Southwest Florida, the need for services increases. “In the last three years, we have tripled the number of programming options to meet the growing needs of the community,” explains Linda, who has worked to ensure that access is not limited by a lack of funds or inability to travel to a specific location. “Unlike many Parkinson’s Associations, our programming is free. We never want money to be a barrier to access our programming. We take our programming into the community rather than hosting it in one central location. As the disease progresses, the burden falls on the caregiver to shuttle their loved one to and from programming, so we take the programming to them to make it less of a burden for them. In our community, you can find your programming within ten minutes, and we offer programming six days a week.” “Groups help patients: when you have someone that you know has the same ailments as you and you can speak freely about those things and know you aren’t going to be judged for it, that’s a good feeling,” says Tricia. The Association forums create open discussions that help patients accept, accommodate, and communicate about their conditions as well as offering them a second family. “When you can see a smile on somebody’s face just because you actually talked to them ... It has become like a second family. I see them at the grocery store and they come up and give me hugs.”

“These programming options have not gone unnoticed, even being cited by some as the reason for moving to Naples from other parts of the country. People have been moving here specifically based upon the support that they have here and the support system that we give them. We literally have had people leave reviews on realtor.com about us and why they have chosen to live here in Naples,” says Tricia. THE ASSOCIATION & CANNABIS A medical cannabis support group is offered for PD patients who are registered in Florida’s medical marijuana registry. There is a cannabis industry professional present at each session. The Association recognizes the growing body of research surrounding the efficacy of cannabis use in the treatment of symptom management for those living with Parkinson’s. “When it first became legal in Florida, there was significant interest, and last year we did a fourpart series on medical cannabis ... for some in the medical community, they are more conservative and the jury is still out, but we hear from our members who have used it that they have had good results,” says Linda.

ADVICE ON CANNABIS FOR PARKINSONS Linda advises members that they should speak with a medical professional before making the choice to use cannabis in treatment. “We first recommend that you consult with your neurologist or movement disorder specialist for their input on using medical cannabis.” If all parties feel cannabis could be an effective option, patients can be added to the registry and can then come to the Association’s cannabis meetings and learn what other patients in their community are using and how well it works. HOW TO LEARN MORE ABOUT THE PARKINSON ASSOCIATION OF SOUTHWEST FLORIDA For those patients or relatives and friends of patients looking to get more information on the Association’s programming schedule and volunteer opportunities, you can learn more at parkinsonassociationswfl. org or by visiting their location in Naples. The staff encourages patients, family, and friends to stop by if you’re in town, even if it’s only for a few days; you never know who you might meet, what connections you might make, and what you might learn.

ALS

AMYOTROPHIC LATERAL SCLEROSIS

BY BEN OWENS

Neurodegenerative diseases like ALS have a significant impact upon quality of life for those diagnosed with the condition. As the body’s neural network is damaged, our minds lose control of their ability to control voluntary, everyday movements like walking, eating, and speaking.1 New studies on cannabis as a promising treatment option show that cannabis could potentially help in the management of the disease and symptoms like spasticity and cramps—as well as helping to delay disease progression.2-8 As more research is done on cannabis and conditions like ALS, researchers are hopeful that the endocannabinoid system (ECS) may prove to be a promising route for providing effective treatment.7,9

WHAT IS ALS? Also known as Lou Gehrig’s disease, ALS is “A progressive neurodegenerative disease that affects nerve cells in the brain and the spinal cord.” Discovered in 1869, “ALS usually strikes people between the ages of 40 and 70, and it is estimated there are at least 16,000 Americans who have the disease at any given time.”1 In the same neurodegenerative diseases family as multiple sclerosis, the damage caused by inflammation and a lack of muscle nourishment leads to scarring and hardening along the spine, which blocks motor neurons, resulting in the brain’s diminished ability to initiate and control muscle movement. This can cause patients to lose the ability to control most voluntary movements. Patients lose the ability to eat, speak, move, and even breathe in some cases.

DIS-LIST

There are two types of ALS that are most common: sporadic and familial. Familial ALS (FALS) is responsible for less than 10% of all cases in the U.S. and, as the name suggests, is an inherited condition. Sporadic ALS is responsible for the remaining 90-95% of cases and can affect anyone, anywhere—though men are more likely to be diagnosed with disease, and military veterans are twice as likely to be diagnosed with ALS than non-military adults.1

THERE IS NO CURE FOR MOTOR NEURON DISEASE, SO IMPROVED SYMPTOM CONTROL AND QUALITY OF LIFE ARE IMPORTANT FOR PATIENTS.

ALS & CANNABIS: WHAT DOES THE SCIENCE SAY? As more research comes out surrounding cannabis and its effectiveness as a treatment option, we are learning more specifically about how cannabis can be helpful for patients living with ALS. “There is no cure for motor neuron disease, so improved symptom control and quality of life are important for patients,” Dr. Nilo Riva explained. This particular phase II study looked at the efficacy of orally administered cannabinoids in reducing spasticity in 60 adult ALS patients. The study found that, when taken in conjunction with first-line antispasticity drugs, a 1:1 THC:CBD oral solution reduced spasticity in patients when compared to placebo administration.2,3 Additional studies that have examined the many properties of cannabis as they relate to symptom management for individuals with ALS have proposed that cannabis “Should be considered in the pharmacological management of ALS” due to its applications for “Analgesia, muscle relaxation, bronchodilation, saliva reduction, appetite stimulation, and sleep induction.”7 While some studies have found no noticeable change in symptoms such as cramps when managing symptoms with THC, other studies suggest that cannabinoids are effective “symptom control agents.”4,9 Reviews of the existing literature on the ECS as it relates to neurodegenerative diseases like ALS as well as the therapeutic benefits and potential of cannabinoid-therapy suggest that cannabinoids might be effective at managing symptoms as well as having the potential to slow disease progression.9 Further, cannabinoids are being found to not only help with symptom management but also the underlying causes of ALS. “Two of the primary hypotheses underlying motor neuron vulnerability are susceptibility to excitotoxicity and oxidative damage,” Dr. Chandrasekaran Raman, lead researcher of one such study, explains. “There is rapidly emerging evidence that the cannabinoid receptor system has the potential to reduce both excitotoxic and oxidative cell damage.”6 Dr. Raman’s study involved mice and investigated the efficacy of THC administration before and after symptom onset. It found THC was able to delay motor impairment and prolong survival when administered at the onset of tremors. Additionally, the study noted THC was anti-excitotoxic when administered in vitro, and in vitro administration was “Extremely effective at reducing oxidative damage in spinal cord cultures.”6 Further studies have found that cannabinoids like THC that bind with CB1 receptors help with the inflammation that causes neurodegeneration, and cannabinoids like CBD that bind with CB2 receptors actually help to delay the progression of the disease itself.8 If you’re one of the more than 16,000 people in the U.S. living with ALS, or know someone who is, consider the available information on cannabis’ efficacy at both managing symptoms as well as delaying disease progression. Oral and IV administration are among the most studied administration routes, and current findings suggest that administration involving equal parts THC and CBD might prove beneficial over THC-only administration.1-4,6-8 Before beginning any cannabis treatment, talk with your doctor about current research and ask about how cannabis could be incorporated into your current treatment plan.

MELANOMA BY JORDAN PERSON

Each month we study a specific topic or disease. As you read the title of this article, you may be asking yourself, “What does melanoma have to do with Parkinson’s disease?” Well, there is actually a surprising link between the two.1 A study done a decade ago showed that melanoma prevalence appears to be higher in patients with PD than in the general population. Another study stated that there was an increased risk for melanoma for PD patients using the drug levodopa.2 Levodopa, is a drug commonly prescribed to PD patients, and it impacts the body’s creation of melanin and melanocytes. The association between PD and melanoma may be explained by pigmentation changes in melanin and/or melanin synthesis. Melanoma is the most serious type of skin cancer and is the most common type of cancer worldwide.3 In the U.S., 10,000 new cases are diagnosed every day, and two patients die every hour. Melanoma is a type of skin cancer that develops when the cells that give the skin its tan or brown color, known as melanocytes, start to grow out of control.4 Melanoma has the potential to metastasize anywhere in the body.

DIS-LIST

Standard treatment for melanoma includes surgical removal of the area in question. Depending on the size of the lesion, radiation and chemotherapy are often used in conjunction with surgery. Various intravenous treatments and injections are used when needed as well. These invasive treatments

can be exhausting, especially if the patient has any other conditions or is immunocompromised. Thanks to current studies and the advancements in alternative medicine, we are beginning to see the promising effects of other plant medicines when it comes to the prevention and treatment of melanoma. We are what we eat, and according to the Skin Cancer Foundation, there are certain phytonutrients (plant based nutrients) that we can eat to help prevent skin cancer. Those nutrients include, “vitamins C, E, and A, zinc, selenium, beta carotene (carotenoids), omega-3 fatty acids, lycopene and polyphenols.”5 Many dermatologists recommend high amounts of these antioxidants in your diet to help prevent skin cancer. There are many plants and herbs that contain these nutrients. Herbs, spices, and composite herbal medicines are among the categories that contain the most antioxidants, and there have been over 3,500 identified.6 One of those herbal medicines is cannabis. The cannabinoid receptors in our ECS are located in every cell in our bodies.7 CB1 receptors are present in the nervous system and CB2 receptors are located in the peripheral nervous system. Interestingly, human melanomas and melanoma cell lines express both CB1 and CB2 cannabinoid receptors. In a study published by the Federation of American Societies for Experimental Biology

(FASEB), â&#x20AC;&#x153;Activation of these receptors decreased growth, proliferation, angiogenesis and metastasis, and increased apoptosis, of melanomas in mice.â&#x20AC;?8 This is promising research for using phytocannabinoids for the treatment of melanoma. In another study published in 2019 in the Journal of Surgical Research,9 cannabinoid therapy was introduced to malignant melanoma tumors in mice. The cannabinoid CBD was injected into melanoma tumors in mice, and the tumors shrunk significantly in size. 9 Cannabinoids are proving to be a unique source of treatment based on their targeted action on cancer cells and their ability to spare normal cells.10 These findings should guide research and assist scientists to better understand the mechanisms by which cannabinoids could be utilized as an adjunctive treatment of cancer. In closing, skin cancer is nothing to ignore. It can be 100% effectively treated if caught in time. There is a simple way to keep track of any moles, birthmarks, freckles, or any area on your body that has more pigmentation than other parts, we can call it the skin cancer alphabet. If you pay attention to the letters in this mnemonic device you can put your mind at ease by knowing what to look for and making note of any changes. If you feel like something is different, schedule an appointment with your primary doctor or dermatologist. You can never be too safe when it comes to the prevention and treatment of melanoma.

A B C D E

ASYMMETRY

Are the sides equal?

BORDER

Is there a clearly defined edge?

COLOR

SKIN

CANCER ALPHABET Mayo Clinic Minute: The A, B, C, D, Es of Skin Cancer.

What color is it and is it changing?

DIAMETER

How big is it and is it growing in size?

EVOLVING

Are there any other changes you have noticed?

TREMORS

DIS-LIST

BY MICHELLE MARTIN

Shaky legs and trembling hands or facial muscles are among the afflictions patients with Parkinson’s disease commonly contend. Tremors such as these commonly persist when people are at rest and are often made worse by stress or strong emotions. In addition to these resting tremors, more than 25% of patients with Parkinson’s also have a tremor when they are active. Tremors may first appear in only one side of the body before moving to both sides. And though not life-threatening, tremors can make activities of daily life more challenging, possibly even threatening a patient’s ability to live independently.

More research needs to be done on the effects of cannabis on tremors, because as is often the case, the research that has been done is often small scale and the results are not verified by further studies. The research has yet to detail the extent of benefits, risks, and clinical uses of cannabis. What has been done suggests that tremors in patients with Parkinson’s may be helped with cannabis while evidence for patients with multiple sclerosis is either non conclusive or shows no response. This year, a small, yet well-constructed study of 24 patients with Parkinson’s found that CBD

significantly decreased the size of their tremors. Patients were placed in a public speaking situation—a scenario designed to increase their stress and therefore the size of their tremors.1 Some were given CBD and others were given a placebo and neither the researchers nor the patients knew who received what. Later the groups were swapped. When the results were decoded and analyzed, patients who received CBD had a significant decrease in the severity of their tremors. In a study from 2004, researchers were able to study a larger pool of patients with Parkinson’s disease.2 In this study smoking cannabis significantly improved the tremors for 31% of the 339 Parkinson’s patients in the study. Another smaller study with 22 participants done in 20143 once again found smoking cannabis significantly improved tremors for patients.

THIS YEAR, A SMALL, YET WELLCONSTRUCTED STUDY OF 24 PATIENTS WITH PARKINSON’S FOUND THAT CBD SIGNIFICANTLY DECREASED THE SIZE OF THEIR TREMORS. Researchers have attempted to shed light on tremors in those suffering from MS as well. Initial work on rats in 20004 and 20165, suggested that CB1 was somehow related to this symptom, however later studies in humans did not support this finding. In 2003, a 15-week randomized and placebo-controlled trial, used oral THC (Marinol) versus oral cannabis extract (each with 12.5 mg) versus a placebo and saw no difference in patient ratings of their tremors.6 Later in 2010, another large double-blind, randomized placebo-controlled study with 337 patients with multiple sclerosis lasted for 8 weeks.7 In this study, participants received up to 24 doses of either a placebo or an oral nabiximols spray with 65 mg THC and 60 mg CBD. Again, patients evaluating their own tremors found no effect. It’s important to note that tremors were not the main focus of either of these studies. A significant number of patients suffer from a third kind of tremor called essential tremor. This type of tremor is brought on with movement or activity and affects eight times the number of people who suffer from tremors from Parkinson’s disease. Even less research has been done on the effects of cannabis on this type of tremor than on Parkinson’s or multiple sclerosis. However, research results should be released soon from a small pilot safety and efficacy trial out of the University of California San Diego that looks at oral capsules of THC/ CBD in patients with essential tremor.8

WEIGHT LOSS BY KAITLIN DOMANGUE

Like many other stigmas attached to cannabis, the commonly painted picture of cannabis users as overweight individuals has proven to be nothing more than a fable.

DIS-LIST

THOUGH CANNABIS IS KNOWN FOR ITS APPETITESTIMULATING PROPERTIES, RESEARCH HAS SHOWN THAT CANNABIS USERS ARE LESS LIKELY TO BE OBESE THAN THEIR NON-CANNABIS USING COUNTERPARTS.

Though cannabis is known for its appetite-stimulating properties, research has shown that cannabis users are less likely to be obese than their non-cannabis using counterparts.1 A study from the International Journal of Epidemiology concludes that cannabis may create cellular changes in the human body that affect weight gain. Omayma Alshaarawy, an assistant professor of family medicine says, “It could be something that’s more behavioral like someone becoming more conscious of their food intake as they worry about the munchies after cannabis use and gaining weight.” “Or it could be the cannabis use itself, which can modify how certain cells, or receptors, respond in the body and can ultimately affect weight gain. More research needs to be done.” The American Journal of Medicine expanded on this research and published a study exploring the effect of cannabis use on glucose, insulin, and insulin resistance among adults in the U.S. The study followed 4,657 participants in the National Health and Nutrition Examination Survey (NHANES) from 2005 to 2010.2 Their results show lower insulin levels among cannabis users; however, a surprising finding was cannabis use showing significant correlations to smaller waist circumferences. According to the study, “The mechanisms underlying this paradox have not been determined, and the impact of regular marijuana use on insulin resistance and cardiometabolic risk factors remains unknown.”2

What is fascinating is the results from these studies have proven to be true regardless of sample size, or even factors like gender and age. Dr. Sunil Aggarwal is a cannabis researcher and physician. He says, “There is a correlation between cannabis use and reduction in the BMI. This association holds even after controlling for other variables.” Though this study did not produce definitive results, other plausible explanations include the cannabinoid tetrahydrocannabivarin (THCV) as an appetite reducer and cannabis contributing to the restoration of a healthy gut microbiome. The thought process behind cannabinoid’s role in suppressing appetite is that of THCV blocking the CB1 receptor.3 The CB1 receptor has been shown, through research, to play a role in the regulation of ghrelin, aka the “hunger hormone.”4 When THCV blocks it, appetite is reduced. THCV has also been linked to blood sugar regulation. While solid research has yet to be published, preliminary and anecdotal findings are yielding promising results. Many cannabis companies are realizing the potential THCV holds, and are cashing in. Doug’s Varin is a line of high-THCV products, produced by California Cannabinoids. The product line was founded by Doug who set out to find a way to treat his wife’s medical condition. Doug’s Varin was born, and appetite suppression as a benefit is touted on the company’s website. Even Flow Kana launched a high-THCV cultivar to add to their respected product line. It is pretty well-known that cannabinoids can manipulate endocannabinoid receptors in the digestive tract, resolving symptoms like nausea and vomiting.5 There is, however, also preparatory buzz attributing cannabis’s antimicrobial effects with weight loss when it enters the digestive system. The thought is that the antimicrobial compounds kill off bad bacteria, promoting a healthy gut flora and thus, weight loss. From 2015 to 2016, 39.8% of Americans were considered obese.6 Cardiovascular disease, stroke, type 2 diabetes, and certain cancers have been linked back to obesity. The obesity epidemic is prevalent, and oftentimes, those who have lived a certain lifestyle for so many years need extra help in changing their habits. While research on cannabis and weight loss is new, its findings may be worth looking into in order to potentially put a dent in the obesity epidemic.

CANNABIS, PARKINSON’S, + THE GREAT

OUTDOORS BY BEN OWENS

One of the most notable effects of Parkinson’s disease (PD) is its impact upon mobility and muscle control. Impeded mobility can make daily activities difficult, especially those involving physical activity and exertion. A lack of physical ability—or of confidence in one’s physical ability—can reduce the amount of time enjoyed in the great outdoors. Studies are showing that time spent training the body through cues and coaching can help to overcome mobility issues, resulting in more time outdoors. Studies are also showing time spent outdoors leads to a lower risk of Parkinson’s and can result in improved quality of life for those living with the disease. Programs such as ParkFit have been developed as part of research studies aimed at showing how treatment programs can help PD patients get outside and stay active. Cannabis has also been shown to help with symptom management, helping to ease patients who have been sedentary into a more active lifestyle, allowing for more outdoor activities.

THE USUAL

PARKINSON’S EFFECT ON DAILY LIFE

Two of the most incapacitating symptoms of PD are gait and mobility problems, which are often difficult to treat.1 In spite of the potential benefits, many PD patients do not meet recommended levels of physical activity, largely as a result of these issues.2 “Higher age, being female, and lower physical capacity were the most important determinants of reduced daily physical activity.”3 Studies have also found

a greater sense of autonomy as well as stronger physical performance was correlated with maintaining mobility as we age.4 It is then reasonable to surmise that impeded mobility in PD patients could create a cyclical situation in which mobility impedes autonomy and physical performance, further impeding mobility and thereby continuing to lower quality of life.

THE SCIENCE ON PARKINSON’S, PHYSICAL ACTIVITY, AND THE GREAT OUTDOORS While more men are diagnosed with PD than women, and the fatality rate for males is higher, the working conditions in many male-dominated jobs can also prove beneficial to reducing the risk of PD.3,5,6 Due to the nature of the working conditions, these jobs also require men to work outdoors more, exposing them to more sunlight, which could help to lower their risk of Parkinson’s. Sunlight is the main contributor of vitamin D in humans, and “Inadequate levels of vitamin D have been linked to increased risks for neurodegenerative diseases.”6 In studying this relationship, researchers found that men who work outdoors are at a lower risk for PD, likely a result of increased exposure to vitamin D.

TALK WITH YOUR PHYSICIAN ABOUT WAYS CANNABIS AND THE GREAT OUTDOORS MIGHT BE ABLE TO HELP IMPROVE YOUR PHYSICAL FITNESS AND INCREASE THE AMOUNT OF TIME YOU SPEND ENJOYING OUTDOOR ACTIVITIES. Additionally, freezing of gait (FOG) is a common condition of PD, and when combined with complex transfers and movements such as walking through doorways, rising up out of a chair, or turning over, may be among the most limiting aspects of mobility.7 Researchers are finding aspects that trigger FOG or other mobility symptoms are not as impactful in natural environments, suggesting a biophilic reaction. Patients who experienced freezing when walking through man-made or “built” elements did not experience similar triggers or freezing when passing through natural openings and hedges, reiterating the necessity for a biophilic environment for people with PD.8

Studies on cueing therapy, or the use of rhythmic stimuli to cue certain behavior actions, find cueing could help PD patients overcome FOG and mobility issues. One study examined a multimodal cueing device which allowed patients to choose a cue that was a desirable totem, and use it to navigate through situations where they would otherwise freeze, fall, or succumb to mobility issues. During treatment, patients saw an improvement in overall mobility but that improvement decreased over time once the cues ceased, suggesting that regular cueing could help patients overcome daily hindrances.1 These types of ongoing treatments and studies on programmatic efforts to manage and delay symptom onset have also lent themselves to the idea of coaching as a way to overcome daily challenges to be active and get outdoors. ParkFit is one of the largest of such studies, observing nearly 600 patients over a two-year period.9 Daily physical activity was compared with a 30-minute activity guideline, and 92% of the sample spent 98% of their day on “sedentary to light-intensity” activities.2 ParkFit was developed using behavioral motivation techniques to encourage increased physical activity. Evaluations of the program found the program was effective in almost all subgroups at promoting physical fitness and led to more time spent on outdoor activities.10-12 CANNABIS, PARKINSON’S, AND THE GREAT OUTDOORS As has been discussed at length in this issue, cannabis has been shown to be effective at helping to manage the symptoms associated with PD, including spasticity, tremors, and muscle cramps that can lead to mobility issues, FOG, and decreased quality of life. Cannabis’ anti-inflammatory and analgesic properties make it a promising complementary option for programs such as ParkFit, helping to ease PD patients into new activities at new intensity levels. Cannabis can also help with the social anxiety that might accompany overcoming physical impediments. It is important to remain cautious when using cannabis in unfamiliar settings, especially if you’re new to the effects of cannabinoids like THC and CBD. Talk with your physician about ways cannabis and the great outdoors may be able to help improve your physical fitness and increase the amount of time you spend enjoying outdoor activities. 45

REGENERATION CLOSING LOOPS IN CANNABIS

CULTIVATION BY RACHAEL CARLEVALE

The soil food web powers the life of plants; when we model this natural order, we can grow cannabis in a perpetual closed loop system. When we create the proper environment, we can grow the nutrients our plants need in our gardens, without having to purchase synthetic varieties of nutrients. These principles can be applied indoors in no-till living soil containers, and outdoors in living soil. They can also be applied from small home grows to large-scale operations, by way of regenerative farming practices.

THE USUAL

The first step is to create and mimic the natural soil food web: the network of microorganisms serving to decompose organic matter, and fix nutrients and minerals into available forms for plants. The benefits of growing regenerative cannabis include carbon sequestration, less labor inputs, lower financial inputs, and a clean, healthy, beyond organic end product. Nature has created a perfect system that when bypassed, as conventional agriculture attempts to do, negates these benefits and creates unnecessary problems. Rather, by modeling natureâ&#x20AC;&#x2122;s designs and rhythms, we can develop regenerative cannabis farms that are healthy for the environment, the plant, and the end user.

THE SOIL FOOD WEB POWERS THE LIFE OF PLANTS

LETâ&#x20AC;&#x2122;S TAKE A LOOK AT HOW ONE MIGHT APPROACH EACH STAGE OF PLANT GROWTH TO CLOSE THE LOOP AND PERPETUATE THE CYCLE: GERMINATION 5-10 days. The initial stage of growth begins in a living organic soil medium that is alive and teeming with nutrients, fungi, minerals, and microorganisms. It is ideal to start the plant in its final home to avoid stress, although many people transplant for space reasons. Here, we experience our first inputs that will remain cycle after cycle. The soil for germination will have either a seed or clone that will then be transferred to another container from their initial nursery. SEEDLING 2-3 weeks, 18 hours light. Plants remain in the same soil. Water, mulch, and amendments may be applied. Seedlings may be transferred to a new container where they will remain for the rest of their life cycle. VEGETATIVE 3-15 weeks, 18 hours light. Plants remain in the same soil. Water, mulch, amendments, and integrated pest management (IPM) may be applied. For indoor no-till container gardens, worms may be applied. Cover crops can be planted to provide natural nutrients for the plant. Crops are cut and clippings may be applied as mulch and also serve as organic matter for the soil food web. FLOWERING 8-11 weeks, 12 hours light. Plants remain in the same soil. Water and amendments may be applied. CULTIVATION Plants are harvested. Roots can remain in soil to serve as organic matter for microbiology or removed and composted for a quicker turnaround. CURING Plants are dried and cured before being processed or consumed. Plants may also be harvested for fresh frozen purposes.

To continue the cycle, the next round of seedlings are planted in the same no-till container. If we can create an ecosystem focused on feeding the soil and turn away from the chemical dependent pH/ NPK* model of feeding the plant, we will establish the optimal outcomes for the earth, the people, and the equity of all.

*NPK is fertilizer (nitrogen-phosphorous-potassium)

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M XINE TAYLOR’S

CELESTIAL EVENTS Maxine Taylor became America’s First Licensed Astrologer after mounting a legal challenge to legitimize astrology in the 1960s Bible Belt state of Georgia. She became CNN’s Original On-Air Astrologer when the network launched.

APRIL 2020 ARIES (MARCH 21 - APRIL 19) While now is the time to do what you want, how you want, when you want, the Full Moon on the 7th indicates that you will still be interested in being with others. This creates a lovely balance. On the 20th, you will be able to focus on money and increase your income. Humanitarian endeavors open up and allow you to feel part of a team. TAURUS (APRIL 20 - MAY 20) The first part of the month is a time of preparation and work. After the 20th, you hit the ground running, and you don’t allow anyone or anything to get in your way. Focus on your career and finances, and watch these two areas grow. Throw your energies into your career, and move upward, particularly if you are offered an advancement. GEMINI (MAY 21 - JUNE 20) Your horizons expand as new opportunities present themselves. If you have a chance to travel, particularly to somewhere you’ve never been, go for it. Your social life is active as well, so enjoy the company of friends and loved ones. By the 20th of the month, you may need more solitude and privacy in order to recharge your batteries. CANCER (JUNE 21 - JULY 22) Focus on your home and family the first week of the month. That’s the time to handle all domestic or real estate matters. After that you’ll be able to put your attention on your career. Around the 20th of the month your friendship circle is highlighted, so make time for some social activity. Balance all this activity with time alone. LEO (JULY 23 - AUG 22) As new opportunities present themselves, you will begin to re-think your core beliefs. As your clarity grows, you’ll be able to put new ideas into action in your career, particularly around the 20th of the month. Throw yourself into partnerships, whether business or personal. Give others the same attention you would give yourself. VIRGO (AUG 23 - SEPT 22) You are a psychic detective this month, looking beneath the surface at what is really going on, particularly where money is concerned. By the 20th, you see the big picture, and the pieces of the puzzle fall into place. Throw yourself into your job, and focus on how you can serve. This is the month to keep the big picture in mind.

LIBRA (SEPT 23 - OCT 22) Relationships are always important to you, and you are focused on both business and personal interactions. However, the Full Moon on the 8th encourages you to put yourself first and do what you want to do your way. Your love life and your children are a major focus in April, so leave time for fun and enjoyment. SCORPIO (OCT 23 - NOV 21) Your home and family come first to you now, so spend time on domestic issues. You will want private time alone the first week of April, but as the month progresses you will want to get back out there and be with people, particularly after the 23rd. Your job will keep you busy all month, so combine business with pleasure when possible. SAGITTARIUS (NOV 22 - DEC 21) It’s time to party this month, so make plans to do so, especially if there is one special person in your life. You may be bored easily now, so plan short trips, meetings with friends, and any fun diversions to keep boredom at bay. As we approach the end of the month, you’ll be able to put more of your attention on your job. CAPRICORN (DEC 22 - JANUARY 19) Whatever you put your attention on grows, so throw yourself into money-making ventures this month. In addition, focus on your home and family, even if that means staying home watching reruns of your favorite shows. Your job should move along well, and if you are involved in a new project or venture, it will be enjoyable. AQUARIUS (JANUARY 20 - FEBRUARY 18) It’s your turn, Aquarius, so put yourself first and do things your way. You are ready for fun, so focus on your social life. If you have children, they should bring you lots of happiness now. You are not only a humanitarian; you are a visionary. During the first week of April, you get a glimpse of the big picture, and want to follow it. Do it! PISCES (FEBRUARY 19 - MARCH 20) Pisces, you build a castle in the air, and once a day you must return to it to add another room. Your home is your castle, your sanctuary, your haven. You can throw yourself into that castle this month and barricade the door in order to get the privacy your body and soul crave. Use your time alone to get to the heart of all issues.

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REFERENCES

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dis-List Melanoma 1. Bertoni, J.M. et al. JAMA Neurology. 2010. doi:10.1001/archneurol.2010.1 2. Huang, P. et al. Translational Neurodegeneration, 4 (21). 2015. doi: 10.1186/s40035-015-0044-y 3.Skin Cancer Foundation. “Skin Cancer Facts and Statistics.” www.skincancer.org. 4. American Cancer Society. “What is Melanoma Skin Cancer?” www.cancer.org 5. Skin Cancer Foundation. “Can your diet help prevent skin cancer?” June 8, 2017. www.skincancer.org 6. Paur, I. et al. Herbal Medicine: Biomolecular and Clinical Aspects. 2nd edition. 2011. 7. Pertwee, R. Pharmacology and Therapeutics, Volume 74, Issue 2. 1997. doi: 10.1016/S0163-7258(97)82001-3 8. Blazquez, C. et al. Federation of American Societies for Experimental Biologies. 2006. doi: 10.1096/fj.06-6638fje 9. Simmerman, E. et al. Journal of Surgical Research, Volume 235. March 2019. doi: 10.1016/j.jss.2018.08.055 10. Safaraz, S. et al. American Association for Cancer Research. January 2008. doi: 10.1158/0008-5472.CAN-07-2785 11. “Mayo Clinic Minute: The A, B, C, D, E’s of Skin Cancer.” Ian Roth. May 1, 2018. mayoclinic.org. dis-List Tremors 1 De Faria, S.M, et al. Journal of Pyschopharmacology, 7:269881119895536. 2020 doi: 10.1177/0269881119895536. 2 Venderova K, et al. Movement Disorders, 19(9):1102–1106. 2004. 3 Lotan, I. et al. Clinical Neuropharmacology, 37(2). 2014. doi: 10.1097/WNF.0000000000000016. 4 Baker D, et al. Nature, 404(6773):84–87. 2000. 5 Abbassian, H. et al. British Journal of Pharmacology, 173(22). 2016. doi: 10.1111/bph.13581. 6 Zajicek J., et al. Lancet, 362(9395):1517–1526. 2003. 7 Collin C., et al. Neurological Research, 32(5):451–459. 2010. 8 International Essential Tremor Foundation https://www. essentialtremor.org/ disLIST - Weight Loss 1. Alshaarawy, O., & Anthony, J. International Journal of Epidemiology, 48(5) 2019. doi: 10.1093/ije/dyz044 2. Penner, E. A., et al. The American Journal of Medicine, 126(7). 2013. doi: 10.1016/j.amjmed.2013.03.002 3. Thomas, A. et al. Lesley A Stevenson, Kerrie N Wease, Martin R Price, Gemma Baillie, Ruth A Ross, and Roger G Pertwee. British Journal of Pharmacology, 146(7). 2005. doi: 10.1038/ sj.bjp.0706414 4. Pradhan, G. et al. Current Opinion in Clinical Nutrition and Metabolic Care, 16(6). 2013. doi: 10.1097/ MCO.0b013e328365b9be 5. Parker, L.A., et al. British Journal of Pharmacology, 163(7) 2011. doi: 10.1111/j.1476-5381.2010.01176.x 6. “Adult Obesity Facts.” Centers for Disease Control and Prevention. www.cdc.gov Cannabis, Parkinson’s + The Great Outdoors 1. Nieuwboer A., et al. Journal of Neurology, Neurosurgery & Psychiatry 2007;78:134-140. 2. Dontje M. L., et al. Parkinsonism & Related Disorders. 2013 Oct;19(10):878-82. doi: 10.1016/j.parkreldis.2013.05.014. 3. Miller, I. N., & Cronin-Golomb, A. Movement disorders: official journal of the Movement Disorder Society. 2010; 25(16), 2695–2703. 4. Portegijs, E. et al. Journal of the American Geriatrics Society. 2014; 62: 615– 621. 5. Devore, Chuck. https://www.forbes.com/sites/chuckdevore/2018/12/19/fatal-employment-men-10-times-more-likelythan-women-to-be-killed-at-work/#5fecf0df52e8 6. Kenborg, L., et al. Occupational and environmental medicine.2011; 68(4), 273–278. 7. Danique L.M. et al. International Journal of Neuroscience, 2017; 127:10, 930-943, doi: 10.1080/00207454.2016.1275617. 8. Ottosson, J.,et al. International journal of environmental research and public health. 2015; 12(7), 7274–7299. 9. Bloem, B. R., Munneke, M. Michael J Fox Foundation for Parkinson’s Research. 2011. 10. van Nimwegen M., et al. BMC Neurology. 2010;10:70. 11. Speelman, A. D., et al. Physiotherapy. 2014; 100(2), 134– 141. 12. Kolk, N. et al. Parkinsonism & Related Disorders. 2014; 20. doi:10.1016/j.parkreldis.2014.10.004.

T N A L P L . S P. . E A U T R N I NEX U T DIC A N ME

Grass Roots America Magazine - April 2020

Articles inside

THE PARKINSON ASSOCIATION OF SOUTHWEST FLORIDA

FGCU CERTIFICATE PROGRAM

JOSH CROSSNEY: QUALITY + EDUCATION + CANNABIS

DR. ETHAN RUSSO

CANNABIS + PARKINSON’S + THE GREAT OUTDOORS

REFERENCE MATERIALS FOR EASY ACCESS

CELESTIAL EVENTS

CULTIVATION

ALS

WEIGHT LOSS

WHAT’S WORKING FOR PARKINSON'S SYMPTOMS

CATCHING UP WITH TARA DEMOND

MELANOMA

TREMORS

MEDICAL MINUTE

NATURAL PLANT MEDICINES