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Top USA Federal Drug Official- There is “No Evidence” that Marijuana Use is Harmful for Adults

By Michael Patterson, NHA, OTR/L, CEAS

The head of the nation’s top federal drug research agency, Director Nora Volkow of the National Institute on Drug Abuse (NIDA), says that she has yet to see evidence that occasional marijuana use by adults is harmful.

“There’s no evidence to my knowledge that occasional [adult] marijuana use has harmful effects. I don’t know of any scientific evidence of that,” Volkow said. “I don’t think it has been evaluated. We need to test it.”

The quote stood out because NIDA typically highlights possible risks of cannabis use while providing an overview of studies that run the gamut on marijuana health impacts. Volkow also said she found it “surprising” that research has indicated that cannabis consumers tend to have a lower body mass index (BMI).

“BMI is lower in marijuana users, and that was very surprising, and yet we know that high BMI, particularly the older you get, can have negative effects,” she said. “This is why we need to study it.”

However, this does not mean that the NIDA director supports marijuana commercialization efforts. Nora verbalized she is “absolutely” concerned about use by young people and said that daily consumption of high-THC products “can have harmful effects even on the adult brain.”

But Volkow has taken a fairly level-headed approach to marijuana, pointing out potential dangers for adolescents and pregnant women, for example, while at the same time acknowledging that her expectations about the impact of state-level reforms haven’t always come to fruition.

For example, she recognized in a podcast interview released in August that cannabis legalization has not led to increased youth use despite her prior fears, and she spoke about the therapeutic potential of certain psychedelics that have long been deemed “dangerous” under federal law. Nora has also emphasized the need to address substance misuse with a public health lens, rather than subject people to criminalization for using drugs.

She said in an op-ed earlier this month that “stigma remains one of the biggest obstacles to confronting America’s current drug crisis,” and the government bears some responsibility in perpetuating those stigmas.

“Government policies, including criminal justice measures, often reflect—and contribute to—stigma,” she said. “When we penalize people who use drugs because of an addiction, we suggest that their use is a character flaw rather than a medical condition. And when we incarcerate addicted individuals, we decrease their access to treatment and exacerbate the personal and societal consequences of their substance use.”

Furthermore, when it comes to marijuana research, Volkow has said that scientists should be allowed to investigate products from state-legal dispensaries instead of using only government-grown plants.

NIDA separately submitted a report to congressional lawmakers emphasizing that the Schedule I status of controlled substances like cannabis is preventing or discouraging research into their potential risks and benefits.

It also said that current restrictions that block scientists from studying the actual cannabinoid products that consumers can purchase at dispensaries is impeding research to an extent that constitutes a public health concern. ANALYSIS

To put this in perspective, these statements are extremely welcomed and beneficial to the legalization movement. It is extremely encouraging to see a federal health official rely on the science and acknowledge that, as it stands, the evidence hasn’t pointed to serious harms for adults who occasionally use cannabis.

Also, it is very notable admission given that NIDA has historically gone to great lengths to highlight the potential risks of cannabis consumption. NIDA has been notorious for only approving studies related to cannabis that will show detrimental affects of the use of cannabis, but never studies which show positive results of using cannabis on specific health issues.

This is one more of the many roadblocks to US federal legalization that is slowly being removed. As more federal agencies continue to report on the benefits of cannabis legalization in different aspects of our society (medical, research, societal benefits, etc.), it is now not “if” cannabis is legalized by the US Government, but “when.”

Michael Patterson NHA, OTR/L, CEAS is CEO of US Cannabis Pharmaceutical Research and Development LLC. (uscprd.com). Mr. Patterson is a healthcare executive with over 25 years experience in the following areas: Cannabis-Hemp investment, Law, Regulation, Compliance, Operations, and Management, Skilled Nursing, Pharmacy, Laboratory, Assisted Living, Home Healthcare, and Healthcare Analytics. Michael is a subject matter expert in the Global Cannabis and Hemp Industry with Gerson Lehrman Group (glg.it) and Guidepoint. Mr. Patterson is an editorial board member of the American Journal of Medical Cannabis, licensed Nursing Home Administra-

tor, and licensed Occupational Therapist in 4 states. 

Surgeons, LLC – Leaders in CVT Surgical Services Since 1985

By Lisa Monroe

Atlantic Cardiovascular & Thoracic Surgeons, LLC (ACTS), is the only private cardiothoracic practice in the Ormond Beach area. With more than 10,000 open-heart surgeries combined, Drs. William H. Johnson, III, F.A.C.S. and John B. Holt, F.A.C.S. have been providing cardiac, thoracic, vascular and endovascular surgical services in Volusia and Flagler counties for nearly 60 combined years, and are still going strong with excellent results.

ACTS also offers an on-site accredited vascular (peripheral arterial and venous) lab, which is convenient and available to cardiologists and other physicians in the area whose patients need diagnostic results, and is especially beneficial for those who need fast patient diagnoses.

EVOLVES Vascular Lab gives Johnson and Holt, who’ve been practicing surgeons in the area for 33 and 26 years respectively, an edge as a private surgical practice in the area because it makes it easy for them to monitor and provide continuity of care to their own post-operative patients.

“We follow our patients with Doppler examinations which is done through the vascular lab usually every six months or as allowed by their health insurance, as follow-up after carotid surgery, abdominal aneurysm surgery and after peripheral vascular surgery on the leg. It’s very important that these patients are followed long-term and EVOLVES makes it very convenient for us to be able to do that,” Dr. Johnson said.

“You know from a surgical standpoint, when patients are either getting surgical bypasses or they’re getting stents placed, we need to make sure everything’s still open and working well and if they start having buildup or start having some partial occlusions, the sooner you detect those, the easier it is to fix them,” he added.

“If you can provide continuity of care like that and you know the person doing the tests, and when you have a good ultrasound technologist like we do performing them, you can trust the results.” Sometimes physicians get results from unfamiliar labs or mobile labs somewhere in a parking lot and the results just aren’t reliable, he said.

“EVOLVES Vascular Lab also provides varicose vein treatment for the medically necessary. We treat varicose veins with minimally invasive radiofrequency ablations after they are evaluated by the lab. And we really want to grow the venous aspect within EVOLVES,” said Johnson, adding that the lab welcomes referrals from family physicians as well as internal medicine specialists. We’ll tell you more about the minimally invasive CLOSUREFAST™ Radiofrequency Ablation Procedure performed in the lab later in this article.

Besides their heart surgery patients, the two surgeons have also performed thousands of thoracic surgeries over the past two-and-ahalf decades, primarily in patients with lung cancer. “Now that we have a new cancer center adjacent to the hospital, that helps, but we are mainstays in doing lung cancer surgery and that’s in coordination with the oncologists and the radiation oncologists. Every two weeks we have a surgical cancer conference to present cases and talk about the cases - all of us participate - even our competitors. We all are there,” said Johnson, who recently finished a two-year stint as president of the Florida Society of Thoracic and Cardiovascular Surgeons. We’ll tell you more about his experience as president later in the article.

Dr. Johnson providing patient interaction alongside Rita, LPN.

NEW REFERRALS TO ACTS ARE ALWAYS WELCOME

ACTS welcomes referrals from new physicians and practitioners in Volusia and Flagler counties, and the surrounding counties of Putnam, Orange, Seminole and Cape Canaveral. “We are always looking for new referrals from those new in the medical community,” Johnson explained.

Referrals to ACTS typically come from the other cardiologists in town, he said. “We have a good rapport with them now as we have through all these years, but as for vascular and thoracic, it’s a little different. The family physicians or internists can refer directly to us for their patients that need our type of specialties. We do currently have a steady referral pattern from family practice, internists, pulmonary physicians, cardiologists, and basically the whole gamut of the medical specialists.”

“I’ve dedicated my services to Florida Hospital which has grown significantly over the past 25-years,” Dr. Holt said. Both Johnson and Holt perform their surgeries at Florida Hospital Memorial Medical Center, a large general medical and surgical facility in Daytona Beach.

“We participate with many major insurances and we participate with the hospital’s insurance plan and so we’re on the same plan as the employee physicians are through the hospital so anybody, whether they are employed by the hospital or not, can refer to us,” said Johnson. MORE ABOUT THE EVOLVES VASCULAR LAB

What does EVOLVES stand for? It’s an acronym for East Volusia’s Optimal Lab for Vascular Evaluation and Surveillance, according to Fuller, who came up with the name back in 2006 when Dr. Johnson first came up with idea for opening a new lab—which has proven to be an invaluable asset to his and Dr. Holt’s patients.

But having EVOLVES Vascular Lab on-site can benefit other physicians as well because it’s close by and they can get their patients into the lab conveniently and quickly. Speed can be crucial, and sometimes even the different between life and death, explained Dr. Johnson. For example, the lab can test for blood clots in the leg and abdominal aneurysms, which can potentially be life threatening, making time of the essence.

“Accessibility is also big thing. Other physicians can call our office and schedule a patient and, if need be, we can test that day or the next day. We can do it as soon as they need it so there’s no waiting,” he added.

Dr. Holt and Amanda, RVT, with patient using current, quality imaging systems for proficient ultrasound result. EVOLVES Vascular Lab is an accredited facility by the Intersocietal Accreditation Commission and is staffed by a Registered Vascular Technician (RVT), certified by the American Registry for Diagnostic Medical Sonographer. “We have a very comfortable office setting for patients and we are very good at getting them in and out quickly for ultrasounds,” according to practice manager Vicky Fuller, whose been with the practice since 1997. “They have an allotted time so there’s no prolonged waiting. And being in an office setting, if they have out-of-pocket fees, those fees are typically lower than that of a radiology facility.” The following duplex ultrasounds are performed in the lab: Aorto-Iliac Duplex or Abdominal Aorta Ultrasound, Aneurysm Imaging in Extremities, Arterial Duplex Lower & Upper Extremities, Duplex Imaging for Pseudoaneurysm, Duplex Imaging & Color Flow Analysis of Carotids, Subclavian, Vertebral & Peripheral Arteries, Mapping of Radial and Ulnar Arteries, and Vein Mapping of the Greater Saphenous. VARICOSE VEIN TREATMENT EVOLVES offers the CLOSUREFAST™ Radiofrequency Ablation Procedure, a minimally invasive procedure for treating Venous Reflux Disease and Chronic Venous Insufficiency, which are associated with varicose veins, at its Ormond Beach site. Varicose vein patients are referred to ACTS by family physicians and occasionally from internal medicine physicians in the area. The CLOSUREFAST™ procedure is performed on-site in the EVOLVES exam room. During the procedure, a catheter guided by ultrasound technology and powered by a portable generator is inserted into the vein through a sheath. Then using the catheter, a segment of the vein is heated to precisely close the vein so that blood is redirected to surrounding healthy veins in the leg.

Varicose veins are not just cosmetic. They can result in poor circulation and may eventually lead to pain and serious medical issues that can lower a patient’s quality of life if left untreated, according to Dr. Johnson. “These include the inability to heal wounds, inflammation and skin diseases. Varicose veins can cause significant problems if not treated – pain, swelling and it gets extremely serious when you start getting skin breakdown and leg ulcerations and then you can obviously proceed on to infections of the leg,” he said, emphasizing that early intervention is key.

“Long-term varicosities that aren’t treated eventually end up causing these big ulcerations around the ankles and the lower legs that just don’t heal,” he explained. “It’s a really bad thing to treat from a physician’s standpoint, but if you can treat these varicosities and the varicose veins then you can have a chance at getting these things healed up. But the number one thing is to not let it get to that point and that’s why we’d like to see patients earlier on.”

THE IMPORTANCE OF A GOOD PARTNERSHIP AND STAFF

Although ACTS has been in practice for just four successful years, Drs. Johnson and Holt have been practicing in the same location since 1985 and 1992, respectively. And they have been partners for 26 years, providing quality surgical services for the community.

Drs. Johnson and Holt have a good rapport with each other which they’ve nurtured over the years. “We can run cases by each other and we both have a lot of experience so you get two minds on each case trying to figure out which is the best thing to do for each patient. I think it means a lot to be able to have somebody to, you know, sort of bounce ideas off of and to get another trusted opinion,” Johnson said.

The physicians also have the support of a very efficient, professional and dedicated staff. “They are a small group that are all easy to work with,” Dr. Holt said. In addition to the registered vascular technologist, Fuller said the staff includes herself, her assistant who also supervises the front office, a licensed practical nurse, a vascular scheduler who also assists with appointment scheduling, a receptionist who also assists with appointment and surgery scheduling, and a main scheduling coordinator who can help out as a medical assistant when needed. Basically, Fuller feels it is best that most staff be cross-trained in all departments as it assures more proficient patient care. THE SURGEONS BELONG TO THE COMMUNITIES THEY SERVE

Dr. Johnson was born and raised in the small town of Wildwood, Florida. He moved with his family to Ormond Beach in 1985. He has participated in a number of community awareness events such as public TV, radio, newspaper, and hospital-based awareness conferences regarding the advancement of surgical procedures he performs. He is also a huge Florida Gators fan. He and his wife Kaye are involved in their church. They have four grown children.

Dr. Holt moved to town in 1992. He and his wife Diane are members of Salty Church and are active with the American Heart Association. They have three children; Blake, Meredith and Madeline. “Besides being dedicated to his family and practice”, he said, “My hobbies are fishing and road biking for exercise.”

Both Dr. Johnson and Dr. Holt are certified by the American Board of Thoracic Surgery and are fellows of the American College of Surgeons, in addition to membership in a number of other medical organizations. THE FLORIDA SOCIETY OF THORACIC AND CARDIOVASCULAR SURGEONS

Florida is one of only a handful of states in the U.S. to have its own medical society specifically for cardiovascular and thoracic medical practitioners, said Johnson, and the Florida society is very well respected. He recently completed a two-year stint as president of the society and is currently serving in an advisory capacity to the new president.

“It was a great experience to be able to get to know the cardiac surgeons around the whole state of Florida basically,” he said of the experience. “And by being associated with the society, you certainly can see the trends in cardiac surgery in the different areas of Florida and how certain areas are doing certain cases and you can learn a lot from all the other surgeons…It was a great learning experience for me.”

Dr. Johnson has been involved with the society, which is moving into its 52nd year, for 25 years. The group meets annually for three days in July at the Ocean Reef Resort in Key Largo, and everyone brings their families so it turns into a real family event. “Just getting that meeting together—getting the speakers and all the logistics of it, you certainly talk to a lot of surgeons not only from the state of Florida, but also from peers in the same field of specialty spanning across the United States,” Johnson said.

“We have out-of-state national speakers and it’s a well-rounded academic event. Everyone brings their kids and family and it’s really a very nice time,” he added. Prior to serving as president, Johnson served as secretary/treasurer for two years, and was active as a councilman for many years prior to that.

To learn more about Atlantic Cardiovascular & Thoracic Surgeons, LLC or the EVOLVES Vascular Lab, visit www.act-

sllc.org. 

588 Sterthaus Dr • Ormond Beach, FL 32174 Phone: 386.672.9503 • Facsimile: 386.672.0386 website: www.actsllc.org