LIFESTYLES
OPPORTUNITY
EDUCATION November/December 2015 2015
SHELLY VAN WINKLE,RN " The Dragon Slayer"
Nurse Profile Alice O’Leary-Randall, LPN The First Lady of Medical Cannabis
Job Opportunities CNM features job postings
Living Well Cannabis Nutrition: An Introduction
CannaBall Run 2015
Come join us in Washington D.C.
Editor’s Letter What an amazing journey that Cannabis Nurses Magazine has begun. Upon the successful launch of our first issue on October 1, 2015, we have found a tremendous positive response to our publication from across the nation and internationally. Professionals, doctors, nurses, ancillary health care workers, business owners in the health care industry, nursing schools and universities, organizations, patients and their caregivers, Veterans, and cannabis industry professionals are taking a look at the new platform that has taken the Cannabis Industry to a new level. Cannabis Nurses Magazine publishes the most recent and compelling health care information on cannabis health, studies, research and professional nursing issues with medical cannabis. As a refereed, clinical practice bimonthly journal, it provides professionals involved in providing optimum nursing care with the most up to date information on health care trends and everyday issues in a concise, practical, and easy-to-read format. Readers can view the magazine digitally for free online at: CannabisNursesMagazine.com or subscribe to a printed copy to be delivered to your door or office. In this issue, with Veterans Day on November 11, 2015 we decided to dedicate the Cannabis Nurses Magazine November/December 2015 Issue to honor the United States Veterans who have given their lives to protect our freedoms in order to bring awareness to the ranks that PTSD is real and there is a solution to their pain. Medical Cannabis is their answer. Our featured Cannabis Nurse this issue is, Shelly Van Winkle, a Veteran of the United States Army who now lives in Iowa. She is known as The Dragon Slayer who confronts some of our top politicians on their campaign trails with the simple question of how, if they gain entrance into office, will they as an Executive Branch leader, create change to assist patients to gain safe access to cannabis across the nation? She is a guiding light for Nurses across the nation and an example of how to approach legislation and politicians on these delicate issues of suppression and is confronting some of the largest dragons imaginable. We also honor, Alice O’Leary- Randall, The First Lady of Medical Marijuana, who is our national nurse mentor who has lead the way slaying dragons for decades. She provides a historic approach and reveals her trials and tribulations in order to assure that we learn from their endeavors so to not have history repeat itself in her book: Medical Marijuana in America Memoir of a Pioneer. The Weed for Warriors Project (WFWP) has started their national march across the nation with The Cannaball Run 2015 which is a national march of heroic Veterans traveling from California to Washington D.C. in support of bringing recognition to the VA to allow Medical Cannabis to be a treatment option. I had the privilege of meeting their crew and interviewed the founder, Sean Kiernan, during their stop in Las Vegas, Nevada on October 19th, 2015. The Cannaball Run is leading the cross-country education campaign to raise awareness of how PTSD is taking Vets lives of well over twenty-two Veterans per day by suicide and informing Veterans that there is a treatment option that works, Medical Cannabis. You can join their campaign by visiting: Weed4warriorsproject.org When Veterans realize that there is a better treatment choice to their PTSD and to their many other symptoms, they can learn of the organization, Grow for Vets, which offers Veterans free Medical Cannabis. Cannabis Nurses Magazine had an exclusive interview with the Executive Director, Roger Martin, here in Las Vegas, Nevada who shared his story on how this organization came to be, where they are now, and where they see their future vision. Roger, an Army Veteran who suffers with PTSD himself, discovered and created the Grow for Vets Non-Profit Organization based out of Colorado to provide free Medical Cannabis to thousands of Veterans from across the nation and its working. As Roger stated, “We owe our American Heroes”. We are proud of all our heroic Veterans, Nurses, Doctors, and Scientists that are featured here in this issue and all of those from across the nation who dedicate their lives to speak the truth and bring awareness to the world. Thank you for being on the front lines. You are our change and we are proud to educate you further on the science behind the plant and the positive effects Medical Cannabis has to offer and provide hope that there is a treatment plan worthy of being accepted everywhere. Medical Cannabis is the answer and we are proud to bring you further awareness to keep our American Veterans alive and well back on the home front. Julie Monteiro RN, BSK “Ask Nurse Juhlzie” Editor@Cannabis Nurses Magazine
Contributors November/December 2015
Publisher
Robert Herman
Managing Editor
Julie Monteiro RN, BSK
Creative Director
Tiffany Watson
Contributors Heather Manus, RN Leslie Reyes, RN Marcie Cooper, RN, MSN, AHN-BC Lisa Buchanan, RN ,OCN Mary Lynn Mathre, RN, MSN, CARN Alice O'Leary-Randal, LPN Jessica Aragona MS, RD, LDN Eloise Theisen MSN, RN, AGPCNP-BC Shelly Van Winkle, RN Cannabis Nurses Magazine publishes the most recent and compelling health care information on cannabis health, studies, research and professional nursing issues with medical cannabis. As a refereed, clinical practice bimonthly journal, it provides professionals involved in providing optimum nursing care with the most up to date information on health care trends and everyday issues in a concise, practical, and easy-to-read format. Readers can view the magazine digitally for free online at: CannabisNursesMagazine.com or subscribe to a printed copy to be delivered to your door.
We are currently accepting articles to be considered for publication. For more information on writing for Cannabis Nurses Magazine, check out our writer’s guidelines at: cannabisnursesmagazine.com/writers-guidelines or submit your article to: editor@cannabisnursesmagazine.com 1100 S 10th St. #420 Las Vegas, NV 89104 Editor@cannabisnursesmagazine.com Online 24/7 at: cannabisnursesmagazine.com
Heather Manus, RN Heather Manus is a native New Mexican and Registered Nurse specializing in all aspects of medical cannabis care. She is currently a board member of the American Cannabis Nurses Association, serving as Chairwoman for the ACNA conference committee. She also holds a certificate of completion for The Core Curriculum for Cannabis Nursing.
Leslie Reyes, RN Leslie Reyes, RN is a Board Member and the Secretary for the American Cannabis Nurses Association (ACNA). Leslie has worked as a Registered Nurse in Urgent Care, Psychiatric and Behavioral Health, and has been involved in cannabis patient advocacy for over nine years. She is a co-creator and co-author of the Core Curriculum in Cannabis Nursing owned by the ACNA, and is also on the committees for Communications and Media, Conference Planning, Certification, Events, Membership, Nominations, and the Executive Committee.
Marcie Cooper, RN, MSN, AHN-BC
Marcie Cooper is Board Certified as an Advanced Holistic Nurse and licensed as a Registered Nurse in Colorado. Originally from Memphis, Tennessee, she started her nursing career on a general med-surg hospital floor in 2004 and began a focus specializing in Oncology.
Lisa Buchanan, RN, OCN
Lisa Buchanan is an Oncology Certified Nurse (OCN) who has worked with the seriously ill and dying for more than 20 years. She a member of the Oncology Nurses Society (ONS), American Cannabis Nurses Association (ACNA), and the Washington State Nurses Association. (WSNA). She has earned certificates in the Core Curriculum for Cannabis Nursing and the Advanced Curriculum for Cannabis Nursing.
Mary Lynn Mathre, RN, MSN, CARN Mary Lynn (ML) Mathre, RN, MSN, CARN is the President and Co-founder of Patients Out of Time, a national non-profit organization dedicated to educating health care professionals and the public about the therapeutic use of cannabis, and the founding member of American Cannabis Nurses Association (ACNA).
Contributors Eloise Theisen, RN, MSN, AGPCNP-BC is a certified adult geriatric nurse practitioner who specializes in cannabis therapeutics and has over 15 years experience working in oncology, treating hundreds of patients with various ailments. She is the founder of Green Health Consultants in Lafayette, CA and on the leadership team of the American Cannabis Nurses Association (ACNA), working on advance certification and credentialing for medical practitioners in cannabinoid therapeutics.
Alice O’Leary-Randall, LPN Alice O’Leary-Randall, is the widow of Robert C. Randall, the acknowledged founder of the medical cannabis movement. She lives in Sarasota, Florida and is a retired Hospice Nurse. Since retirement, she has returned to the fight for medical cannabis on many fronts. She serves as the medical cannabis ambassador for Mary’s Medicinals and on the Board of Directors for Mary's Foundation of Caring. Additionally she is on the Board of Directors for the American Cannabis Nurses Association. She is a frequent contributor to Huffington Post, Cannabis Now Magazine, and is a first time contributor to Cannabis Nurses Magazine. She is the author of two books on the medical cannabis issues. Medical Marijuana in America: Memoir of a Pioneer is an autobiography published in 2014. In 1998 she and her late husband co-authored Marijuana Rx: The Patients' Fight for Medicinal Pot. She is known for her decades of remarkable collaboration that changed the way America looks at marijuana and is known as: The First Lady of Medical Marijuana.
Shelly Van Winkle, RN I am a Certified Cannabis nurse and a nurse activist. I obtained my Certification through the ACNA and plan to obtain further certifications through them in the future. I am proud to be a member of the American Cannabis Nurses Association. I am also a Founder and a Director of the Iowa Hemp Association. My goals are educating and advocating for whole plant medicine, and advocating for the cultivation of industrial hemp in Iowa. I demand both a bipartisan and a legal approach to these issues through states rights, Federalism. We must have bills that are legal under Federal law. There is no other way. I regularly meet with my legislators and educate them regarding medicinal cannabis and discuss the laws and needs of Iowa's citizens. I attend legislative forums and hold my own educational presentations all over the state of Iowa. Dr. Michele Ross holds a Doctorate in Neuroscience from the University of Texas Southwestern Medical Center and has researched addiction, mental health, and psychopharmacology for over 10 years. She has a Bachelors in Psychology from Boston College, and worked as a Postdoctoral Research Scholar at the California Institute of Technology (Caltech) before she appeared on Big Brother. Dr. Michele Noonan Ross is known across the globe as the first female scientist on reality television, starring on the hit CBS show Big Brother in 2009. She is also one of the first scientists to come out of the cannabis closet, and has become a vocal advocate for patient rights after her own rights were violated. She is a frequent media expert speaking on the Endocannabinoid System.
Contact Information Publisher ND1Media Editorial Robert Herman
Art&Graphic Design To submit artwork/ad creation Email: ads@cannabisnursesmagazine.com
Advertising & Marketing For advertising opportunities Email: ads@cannabisnursesmagazine.com Sales/Product Director Email: sales@cannabisnursesmagazine.com
Writers To submit articles for publication Email: editor@cannabisnursesmagazine.com
Reach Us By Post Cannabis Nurses Magazine 1100 S. 10th St. Ste 420 Las Vegas, NV 89117 info@cannabisnursesmagazine.com www.cannabisnursesmagazine.com
Table of
Contents :+$76 ,16,'( 3
(',725,$/ 3$*(
3
2XWVLGH WKH %R[ )RU 376'
3
3ULPLQJ WKH (&6 IRU &DQQDELV 7KHUDS\
3 2
7KH )LUVW /DG\ RI 0HGLFDO 0DULMXDQD $OLFH 2 /HDU\ 5DQGDOO /31
3 6
7+( &$11$%$// 581
1RYHPEHU 'HFHPEHU )($785(6
201 2XWVLGH WKH %R[ )RU 376'
3$*(
3ULPLQJ WKH (&6 IRU &DQQDELV 7KHUDS\
3$*( 3 20
6KHOO\ 9DQ :LQNOH 7KH 'UDJRQ 6OD\HU
7KH &DQQDEDOO 5XQ 3 2
6HQLRUV DQG 0HGLFDO &DQQDELV
3 4
*52: )25 9(76 3$*( 6
3 18
&ORJ 7UHQGV
3 28
1XUVLQJ +XPRU
3 29
5(6285&(6 5HFRPPHQGHG %RRNV
3.30
$Q ,QWURGXFWLRQ WR &DQQDELV 1XWLWLRQ
3 32
)22' )25 7+( 628/
3 4
1XUVH -RE 2SSRUWXQLWLHV 3HUP 7UDYHO
3 5
+HOSIXO $SSV IRU +HDOWK &DUH 3URIHVVLRQDOV
6KHOO\ 9DQ :LQNOH 51 7KH 'UDJRQ 6OD\HU
3$*( 20
7KH )LUVW /DG\ RI 0HGLFDO 0DULMXDQD $OLFH 2 /HDU\ 5DQGDOO /31
3$*( 2
"OUTSIDE THE BOX FOR PTSD" BY Marcie Cooper RN, MSN, AHN-BC
Myths and Facts about PTSD MYTH: PTSD only affects war Veterans. MYTH: People should be able to move on with their lives after a traumatic event. Those who can’t cope are weak. FACT: Although PTSD does affect war Veterans, PTSD can affect anyone. Almost 70 percent of Americans will be exposed to a traumatic event in their lifetime. Of those people, up to 20 percent will go on to develop PTSD. An estimated 1 out of 10 women will develop PTSD at some time in their lives. Victims of trauma related to physical and sexual assault face the greatest risk of developing PTSD. Women are about twice as likely to develop PTSD as men, perhaps because women are more likely to experience trauma that involves these types of interpersonal violence, including rape and severe beatings. Victims of domestic violence and childhood abuse are at tremendous risk for PTSD. MYTH: People suffer from PTSD right after they experience a traumatic event. FACT: Cannabis and Cannabis oils can help with the symptoms of people who suffer from PTSD.
06
NOVERBER/DECEMBER 2015 CANNABISNURSESMAGAZINE.COM
Statistically, PTSD is by far once of the most common complications inherited as a result of joining The Armed Forces, ranking in at the third most prevalent psychiatric diagnosis among Veterans using the Veterans Affairs (VA) hospital. (“PTSD and Comorbid AUD”; Substance Abuse Rehabil.2014, 5:25-36, Raleveski et al.) Of Veterans with PTSD 50% will not even seek treatment and of the other 50% that do only one half of them report treatment received as “minimally adequate.” (RAND study) Which means without a doubt, 100% of Veterans are essentially being failed by the very healthcare system that is supposed to ensure their health and wellness. In looking for treatment options for PTSD it is no surprise that Veterans have begun to look outside of traditional western treatments for relief. Veterans are experimenting with options such as cannabis, acupuncture, art, meditation, music, and anything else besides another pill. Veterans are helping Veterans now by forming organizations for supporting one another, their voice and experiences resonate and offer hope when there is such a heavy feeling of despair that too often continues to linger when on traditional pharmaceuticals or cognitive behavioral therapies alone. The Art of War Veterans Project is one such Veteran started organization that is making a difference. USMC Iraqi war Veteran, Curtis Bean, has turned the Denver, Colorado VFW Post 1 into a healing mecca for Veterans. The Art of War Project was started, “To inspire hope and contribute to the health and wellbeing of American Veterans dealing with PTSD by providing a positive outlet through art”, but the truth is it offers many other alternative and complimentary therapies that can be helpful for the patient suffering with PTSD. Art of War has weekly Tuesday night Yoga and Wednesday night Meditation, in addition to the art and photography classes. They also offer special events and bring in speakers to discuss the implications of PTSD and treatment.
I recently had the experience of being present at a free event sponsored by War of Art at the VFW Post 1 where Veteran, Matt Kahl, the former president of the Colorado Weed for Warriors chapter and Dr. Sue Sisley, University of Arizona shunned PTSD Cannabis researcher shared their experiences with cannabis as a treatment from both the provider and the patient perspectives. The house was packed and without a doubt listening to them both gave the Veterans attending a sense of hope and community and left every civilian with a better understanding of the treacherous journey Veterans have to make in order to get assistance (I cannot in good conscious call it help) in the VA system. This program, in addition to cannabis therapeutics that was discussed this night, have the potential to save so many lives. Art of War needs to spread across every VFW in the country.
Vets Doing Yoga Which brings me to Weed for Warriors, another Veteran started organization. Kevin Richardson, USMC Veteran with PTSD living in California started Weed for Warriors after a treacherous journey that had led him down a failed path of multiple pharmaceuticals for treatment. After a friend re-introduced him to cannabis, he found remarkable healing and knew he had to share with his fellow Veterans still suffering. This organization is spreading awareness to anyone who will listen about the potential lifesaving benefits of cannabis for PTSD. They are able to pair up Veterans with compassionate growers in legal states which donate cannabis to them for therapeutic use. At the time of writing this, Weed for Warriors and Magical Butter have teamed up to embark on a cross country tour where they will spread the truth about cannabis therapy for Veterans. This tour, named appropriately as “Cannaball Run 2015” will kick off in Los Angeles, California on October 17 and the caravan of Magical Butter vehicles will escort the Weed for Warriors Veterans across the country with stops in Las Vegas, Denver, Phoenix, Nashville, Spring Hope, Atlanta, Charlottesville, Philadelphia, and then ending on Veterans Day, November 11th, 2015 in Washington D.C. where they will unload a pile of prescription bottles symbolic of the failed treatments for PTSD. Their message is simple, “Cannabis is a safe, effective medical option that is growing in mainstream acceptance nearly everywhere but the VA.” It is time that the U.S. Military Healthcare system look at its failures in terms of lives lost, and take appropriate steps to remove the barriers to this plant for healing. NOVERBER/DECEMBER 2015 CANNABISNURSESMAGAZINE.COM
07
" Path of the Cannaball Run 2015 put on by the Weed For Warriors Project (WFWP) Road to the White House"
There is an epidemic of suicides related to PTSD when a known 22 Veterans a day choose to end their life (that is even under reported as these statistics do not include suicides from Texas or California, two heavily Veteran occupied states). Nurses must take a stand to help change these statistics. There are many ways you can help someone who is suffering with PTSD, and many of these can apply to anyone, not just Nurses. 1. Increase your knowledge about PTSD so you have a good idea what the patient, your friend, or relative is going through. 2. Offer to go to doctor visits with your friend. Help with discussions surrounding holistic approaches, including cannabis. 3. Offer free classes or groups for those dealing with PTSD. Many nurses are also certified in Reiki, Massage Therapy, Aromatherapy, NADA Acupuncture or acupressure, and many more “outside the box” techniques. These can all be beneficial to cope with stress and side effects of living with PTSD. 4. Listen with an open heart and be understanding if someone doesn’t want to talk. Do not argue, do not judge. Just be present. 5. Plan a group get together or other fun activities. Be aware of the environment and plan events to be as stress-free as possible. The American Cannabis Nurses Association is a proud sponsor of The CannaBall Run 2015. You can make a donation to assist in their Cross Country Tour at: http://www.indiegogo.com/projects/america-s-veterans-demand-change Marcie is on the Board of Directors for The American Cannabis Nurses Association and is Board Certified as an Advanced Holistic Nurse and trained in the NADA Auricular Acupuncture protocol for PTSD in 2008. She offers these treatments for Veterans and others suffering with PTSD including Nurses and domestic violence survivors in the Denver, Colorado area.
References & Resourses http://www.ptsd.va.gov/professional/treatment/overview/clinicians-guide-to-medications-for-ptsd.asp http://www.veteransandptsd.com/PTSD-statistics.html http://medicalmarijuana.procon.org/view.resource.php?resourceID=000881 http://www.artofwarproject.com/ http://www.ptsd.va.gov/professional/treatment/overview/complementary_alternative_for_ptsd.asp http://www.pdhealth.mil/downloads/
08
NOVERBER/DECEMBER 2015 CANNABISNURSESMAGAZINE.COM
Michele Ross, PhD in Neuroscience from the University of Texas Southwestern Medical Center
Priming the ECS for Cannabinoid Therapy A common problem with Cannabinoid Therapy is that not all patients with the same condition respond to the same treatment. A lack of response to treatment can be as damaging psychologically as a negative response to treatment. In addition, cannabis and its derivative products like CBD oil can be quite expensive, and treating a patient before the patient’s body is ready to accept cannabinoid treatment can be a big waste of money. One can compare it to spending tons of money on vitamins the body doesn't absorb, only to pee the majority of them out. Many people live an unhealthy lifestyle and their body is unable to respond properly to cannabinoid treatment. Others have medical conditions or genetic mutations that prevent the Endocannabinoid System (ECS) from being fully functional. Cannabis treatment should be part of a holistic health plan. Like any major lifestyle change, from losing weight to quitting smoking, beginning cannabis treatment must utilize concrete, realistic goals that are practiced daily. Support should be offered at least three weeks prior to treatment as well as the first week of treatment to ensure patient satisfaction and reduce likelihood of cessation of treatment. Digital health apps that log how much medication patients use and how it makes them feel is key to treatment compliance and patient satisfaction. About the Author – Michele Ross, PhD Michele Noonan-Ross has a PhD in Neuroscience from the University of Texas Southwestern Medical Center and a BA in Psychology from Boston College. She is the author of two books, including, “Vitamin Weed: A 4-Step Plan to Prevent and Reverse Endocannabinoid Deficiency.” As founder of the Endocannabinoid Deficiency Foundation (ECDF), she promotes the use of cannabinoids as vitamins our body makes and needs. Her focus is providing patients, health professionals, and policy makers with medically correct information on the Endocannabinoid System (ECS) and Cannabinoid Therapy. Dr. Ross broke boundaries as the first female scientist on reality television, starring on the hit CBS show, “Big Brother”. She has leveraged her platform as a public figure to advocate for cannabis patients and change drug policy around the world. Contact Dr. Ross Twitter: @drmicheleross Instagram: @drmicheleross Email: michele@theecdf.org Website: www.theecdf.org
10
NOVERBER/DECEMBER 2015 CANNABISNURSESMAGAZINE.COM
ENDOCANNABINOID DEFICIENCY FOUNDATION
Endocannabinoid System 4 Steps to Priming the ECS for Cannabinoid Treatment: 1) Elimination: Identify and reduce foods, medications, and lifestyle factors that reduce ECS function. 2) Prime Receptors: Unlock ECS genes by adding diet and lifestyle factors that boost their function and extend the length and potency of Endocannabinoid activity. 3) Stress Management: Promote a healthy ECS that does not downregulate cannabinoid receptors in response to cannabinoid treatment. 4) Vitamin Weed: Identify appropriate cannabinoid products and adjust dosage based on genetic factors, health, lifestyle, location, and budget. Step 1: An in-depth health and lifestyle assessment is key to identifying the degree to which the patient’s dietary, medication, health, or lifestyle factors that will prevent cannabinoid treatment from working. This will also identify appropriate cannabinoid products, as some people may require targeting of specific cannabinoid receptors (CB1 vs CB2) or route of administration (bypassing the liver) due to medication or genetic factors. Help the patient make small changes in their diet each week and incentivize this behavior using gamification or rewards at the dispensary. Step 2: The Entourage Effect occurs in the human body in addition to the cannabis plant. Numerous phytocannabinoids and endocannabinoids work synergistically in the human body to boost ECS function. By adding foods that support the ECS, the patient may be able to use a lower dose of Cannabinoid Therapy, saving them money in the long run. Adding healthy foods to the diet will reduce disease symptoms and boost energy, increasing the chances that the patient will view their cannabis treatment as a positive experience.
The Endocannabinoid System Priming the ECS for Cannabinoid Therapy Step 3: Unhealthy patients are often stressed patients. High levels of the stress hormone cortisol can downregulate cannabinoid receptors and downstream pathways, preventing Cannabinoid Therapy from working. Managing stress through exercise, good sleep hygiene, meditation, and cognitive behavioral therapy at home ensures Cannabinoid Therapy will be effective at the start of treatment and throughout the course. Step 4: Medical marijuana patients have little or no support once they pick up cannabis products from the dispensary. If the product causes adverse side effects, or does not alleviate the symptoms they are using it for, they do not have a doctor or pharmacist to call. Budtenders are minimally trained without the proper medical background to field complex dosage adjustments, nor are they aware of pharmacology, physiology, or diseases states. It is up to support staff such as trained Cannabis Nurses or coaches to fill in the treatment gaps until a nationwide standard of care for patients is established. When Cannabis Nurses establish a relationship with patients prior to beginning treatment, patients know who to talk to when an adverse event happens so risk is minimized. A budtender should refer new patients without a cannabis coach to one after the purchase of cannabis products. Cannabis Nurses Magazine promotes the National Campaign: Every Patient Deserves a Nurse.
Marijuana users who have taken large doses of the drug may experience an acute psychosis, which includes hallucinations, delusions, and a loss of the sense of personal identity.
Marijuana’s Effects on the Brain
Š Alice Y. Chen, 2004. Adapted from Scientific American.
When marijuana is smoked, its active ingredient, THC, travels throughout the body, including the brain, to produce its many effects. THC attaches to sites called cannabinoid receptors on nerve cells in the brain, affecting the way those cells work. Cannabinoid receptors are abundant in parts of the brain that regulate movement, coordination, learning and memory, higher cognitive functions such as judgment, and pleasure.
NOVERBER/DECEMBER 2015 CANNABISNURSESMAGAZINE.COM
11
Article: Alice O’Leary-Randall “The First Lady of Medical Marijuana” Written by: Julie Monteiro RN, BSK Alice O’Leary-Randall is a senior spokesperson for the medical marijuana movement, co-founded in 1976 with her late husband, Robert C. Randall, the first person in the U.S. to legally receive medical marijuana. Following her husband’s untimely death in 2001, Alice took a wellearned break from the frontlines of the medical marijuana movement and embarked on a nursing career. It is here where she is honored as a national nursing mentor across the nation giving light on the history she was part of. She has continued to educate and celebrate the contributions of many brave individuals who courageously fought for medical access to cannabis. Her book, Medical Marijuana in America: Memoir of a Pioneer was released in April 2014. A year later, through this book, Nurses across the nation have learned from her paved path of history, biography and expose’ to assure that history does not repeat itself. Once called, “The First Lady of the Medical Marijuana Movement,” Alice O’Leary-Randall, communicates her singular perspective on the emotional and long-running movement to legalize marijuana as medicine. She was literally there at the start.
12
NOVERBER/DECEMBER 2015 CANNABISNURSESMAGAZINE.COM
We as Cannabis Nurses, a specialty of nursing in its infancy being born, from across the nation and world, have the opportunity to learn from her great wealth of knowledge and path of history to assure that all humans have the inevitable right to choose their medical care of choice. We, as Nurses, are the voice of the patients and are here to continue to carry the torch to bring light to the world and advocate for the common good of humanity. It is our human right and our nursing duty. Today we honor her as a National Nurse who paved the way for Nurses across the nation to learn from the history she was part of and to have a way to collaborate and continue to change the way America looks at marijuana.
Medical Marijuana in America: Memoir of a Pioneer Written by: Alice O’Leary-Randall
Medical Marijuana in America:
Memoir of a Pioneer Written by: Alice O’Leary-Randall
m
uch of this book was first published in 1998 as a memoir entitled Marijuana Rx: The Patients’ Fight for Medicinal Pot. It was co-written by Robert C. Randall and me, his wife Alice O’LearyRandall. More than fifteen years have passed and there have been many changes. Robert died in 2001, agents have retired, publishers have gone defunct, and e-pub books are the norm. Our original book is technically “out of print” although copies can still be obtained on Amazon.com.
At the time of Robert’s death in 2001 I felt that my days in the medical marijuana movement were complete. I had no burning desire to “keep up the good fight” and, thankfully, Robert did not extract a promise from me that I would do so. Instead I pursued my dream of becoming a hospice worker and spent six years as a Hospice Nurse before retiring. Now it is 2014 and the fight for medical access to marijuana continues. Twenty states [now 24 states] and the District of Columbia currently recognize marijuana’s medical use and provide a means of legal access to the drug, usually through a “grow your own” method. But the federal government remains unyielding, still classifying marijuana as a drug “with no currently accepted medical use.” The familiar adage that those who do not read history are condemned to repeat it certainly applies to the medical marijuana issues. On a certain level it saddens me to read press reports about the passage of state laws in the 21st Century when I know that many of these same states-- some thirty-four states in all government years of suffering by countless seriously ill individuals would have been avoided.
—passed laws more than three decades ago which attempted to provide the citizens of their states with legal, medical access to marijuana. It is wrong that medical care should be based on politics and geography rather than medical need. For the issue to be resolved citizen activists must turn their attention to removing the federal roadblocks against marijuana’s medical use. In preparing this edition I have sought to retain as much of the original work as possible while also acknowledging that in our first book there was, perhaps, too much detail. Thus excessive details have been removed as well as dated references to the late nineties. For those seeking detailed documents please contact the Wisconsin Historical Society where our archives now reside. www.wisconsinhistory.org
What remains in fact in this current book are the stories of the brave men and women who with honesty and great concern for their fellow human beings approached the federal government for help and were repeatedly denied and ridiculed for their efforts. It is a shameful legacy of our federal government that those who are seriously ill are denied access to this venerable plant with a 5,000 year history of medical applications.
Memorable Quotes in the Book: “Those who do not read history are condemned to repeat it certainly applies to the medical marijuana issues.” “It is a shameful legacy of our federal government that those who are seriously ill are denied access to this venerable plant with a 5,000 year history of medical applications.” NOVERBER/DECEMBER 2015 CANNABISNURSESMAGAZINE.COM
13
M E D I C A L
PR OF E SS I O N A L
L I A B I L I TY
I N S U RA N C E
GUIDE GUARD ADVOCATE
MEDICAL PROFESSIONAL LIABILITY INSURANCE
CALIFORNIA PHYSICIANS DESERVE Your Guide: Awarding more than 35,000 CME certificates in 2014* Your Guard: Resolving 89%* of claims without indemnity payments Your Advocate: Largest contributor to the No On 46 coalition
Our heart beats in California ... and has for almost 4 decades. Talk to a NORCAL Mutual agent/broker today. Š 2015 NORCAL Mutual Insurance Company. * Based on 2014 data.
844.4NORCAL | CA.NORCALMUTUAL.COM
16
NOVERBER/DECEMBER 2015
CANNABISNURSESMAGAZINE.COM
Our Veterans Deserve Some Good News
MagicalButter.com and the Weed For Warriors Project (WFWP) are coordinating a cross-country education campaign to raise awareness of a bright hope for military Veterans facing ongoing medical challenges. Many Veterans report experiencing relief from natural cannabis medicine that surpasses the current approach used by the Veterans health Administration to address their various issues--while avoiding the dangerous side effects common to pharmaceuticals. Cannabis is a safe, effective medical option that is growing in main stream acceptance nearly everywhere but the Veterans Administration (VA). Raphael Mechoulam, Ph.D., the eminent biochemist who discovered THC and our internal cannabinoid system, agrees that "therapeutic cannabis provides a significant improvement in quality of life, both for those suffering from PTSD and for their family and friends." And the good news doesn't stop there. While whole cannabis alone is very effective for symptomatic relief, Dr. Mechoulam notes it could even be enhanced to the level of CURE by a new type of FAAH inhibitor, a substance that prevents cannabinoid molecules from being split apart. These agents act to promote memory extinction, abnormal brain function, so that former triggers no longer cause emergency responses. Unshackled, the patient's quality of life is free to soar!
Pulling Out all the Stops to Stop all the Pills Many civilian doctors are discovering that their patients can do without some or all of their toxic, addictive medications for pain and trauma if they have access to cannabis. Yet, every day Veterans are denied full access to the federal health care system designed specifically for them. They cannot have a doctor's prescription for cannabis medicine filled, though they can easily obtain addictive opiates like oxycontin and hydrocodone. And due to the gag order placed on the VA, Veterans and their doctors are precluded from even discussing cannabis therapy.
Party with a Purpose Join us as we shine a well deserved spotlight on our military men and women in need . The Cannaball Run 2015 for Veterans is now on the last leg of the event. The next stop for The Cannaball Run will be stopping in Nashville; Spring Hope, North Carolina; Charlottesville, Virginia; and Philadelphia. Bound for our nation's capital, Washington D.C. Events planned at the various stops include 5K boxers-andboots runs, powerful speaking events, networking receptions, a hemp factory tour, and a premiere film screening about lifechanging cannabis research. Veterans will share their stories of successfully transitioning back to civilian life throught Cannabis Therapy. They will be joined by other Veterans and military families throughout the tour. Speakers will discuss the cannabis movement and how it relates to Veterans' issues such as but not limited to PTSD, TBI (Traumatic Brain Injury) and other trauma. We will hear from medical practitioners, scientific researches, legal minds, advocates and educators. The general public is also encouraged to come out to these events, learn about Veterans coping with pain and trauma, and then go home and make positive change happen in their state and local community by promoting commonsense legal reforms. Receptions will be held in the evening after each event. The WFWP is collaborating with MagicalButter.com, Patients Out of Time, The American Cannabis Nurses Association, Cannabis Nurses Magazine, Hemp Inc. and other organizations to make this happen. For more information on the tour, please visit the Weed For Warriors Project Facebook event page. Thank you for your support, for raising your voices, and for taking action to protect and defend our nation's defenders. For more information please visit: cannaballrun.com
NOVERBER/DECEMBER 2015 CANNABISNURSESMAGAZINE.COM
17
Clog
Trends Kayla - Good Vibes
Footwear Trends for 2015 come as varied as the nursing population itself…
2015
By Alegria - Kayla Collection. This slip-on shoe features a mild rocker outsole to reduce metatarsal
Revive
pressure, stain resistant upper, and a footbed
By Landau - Mens. Enhanced slip-resistant all rubber
loaded with cork, memory foam; compat-
outsole and longer lasting EVA footbed provide extra
ible with custom orthotics. Priced
support. Moisture wicking Poliyou sock-liner; extra thick insole provides more shock absorbing comfort &
starting at $119.99
support. Priced starting at $44.99
Blue Caiman
Austin By Klogs- This versital clog features a polyurethane sole is slip resistant, oil-resistant and nonmarking. The removable footbed is latex-free,
By Dansko – Professional XP collection. Provides the same down-curve and rocker movement of the clas-sic Dansko stapled clog in a lighter weight con-struction.
antimicrobial, odor-resistant and orthoticfriendly. Heel height: 1 3/4”. Priced
Features a removable triple density EVA footbed with memory foam.
starting at $111.99
Priced starting at $149.99
White Smooth Shayla
Dove
By Dansko - This lightweight shoe features stain resistant
By Nurse Mates - This easy slip-on shoe features a tum-
mesh uppers, durable slip-resistant outsoles, cushion-
bled leather upper with stain-resistant finish and ultra-
ing underfoot for comfort and odor control. The
lightweight flexible construction including rubber
removable multi-density footbed features
inserts for slip-resistance and longer wear.
superior arch support. Priced start-
Heel height: 1 4/8”. Priced start-
ing at $69.99
ing at $69.99
Lewiston By Alegria - Mens - Lewiston Collection. This ankle high slip on shoe features double-sided goring for comfort, removable footbed with cork & mem-ory foam; hand sewn leather lining, arch support and a roomy toe box. Priced starting at $149.99
Debra By Algeria. The Debra slip-on features a handcrafted sole and a 1.5 inches heel, leather for durability, contrast stitching edges, foam footbed for comfort, elastic goring for easy slip-on and slip-off. Priced starting at $68.99
Professional Lindsey By Koi (Sanita) - This shoe features a patent upper, rocker bottom, skid resistant outsole, reinforced padded instep, absorbent insole, and roomy toe box for comfort. Priced starting at $129.99
Shelly Van Winkle
The Dragon Slayer “And I try, oh my God, do I try ,I try all the time in this institution And I pray, oh my God, do I pray I pray every single day FOR A REVOLUTION! And so I cry sometimes when I'm lying in bed Just to get it all out, what's in my head And I, I am feeling a little peculiar And so I wake in the morning and I step outside And I take deep breath and I get real high And I scream from the top of my lungs, WHAT'S GOIN' ON!! And I say hey.... hey.... I said hey, what's goin' on And I say hey.... hey....Then I said, hey, what's goin' on?”
Before I met Benton and Loretta Mackenzie, I knew very little about the Justice System and how things truly work in a courtroom. I was shocked at the denial of basic Constitutional Rights that ran unchecked through the Mackenzie's Trial. I saw a man denied the right to tell a jury his truth because the law decides what is true in Iowa. Iowans, through ignorance and complacency, have allowed this to be the machine of manufactured justice, a slow insidious chipping away of their basic rights established by a stark legal fact. Medicinal Cannabis is not allowed by the state law of Iowa, nor Federal law; therefore, is not allowable as a legal defense. You don’t get to tell your truth, unless your truth is legal under a state law (in this case, in front of the jury). Benton was only allowed to tell his truth with the jury dismissed, in front of the judge. The legal experts can wrestle with this fact. I did what I could do as the Registered Nurse: my first act of disobedience that didn’t involve going a few miles over the speed limit.
20
NOVERBER/DECEMBER 2015 CANNABISNURSESMAGAZINE.COM
I was threatened with contempt of court because Benton was denied his request to have his Nurse present in court. Benton was terminally ill. I was not his assigned nurse through Hospice, and she was not allowed to be there, but I showed up in court (after talking to Loretta) as a Nurse to be there for Benton. I couldn't stand knowing how sick he was and how he was suffering, and being denied what had been ordered as necessary by a physician, because a judge didn't want the jury to know Benton was sick. If the jury figured out Benton grew Cannabis to treat his aggressive cancer, what would happen? Apparently Judge Harry Latham of Scott County, IA, didn’t want to find out. I came back for sentencing, and I brought signs and helped organize protesters, even reaching out to then-candidate for Iowa governor Dr. Lee Hieb and her candidate for Lt. Gov. Jake Porter to show up; they did. I was humbled when Benton, facing his entire family losing everything, while he faced death,
Benton and Loretta Mackenzie realized I had forgotten my lunch and shared his sandwich with me. This man was a giant, a gentle spirit of love and kindness. He profoundly touched my faith and renewed something in me that I had given up on. I had given up on being a Nurse because I am sick too. Benton showed me true courage, as did Loretta and Cody and his entire family. I promised Benton I would help Iowans in need of Medicinal Cannabis.
During Benton’s trial, a new CBD Oil Only Law took effect for children with intractable epilepsy, I had heard very little about it, and there had been very little news coverage about it. I did not even know what CBD oil was or how it could help epilepsy. I started reading, researching. I went to a hearing at the Davenport library and took some notes and heard the frustrations being voiced by parents over the processes being imposed on the parents of very fragile children, just to attempt to apply for a CBD oil card, that would only allow them to possess the oil in Iowa, but not actually give them a place to obtain/access the oil, nor a safe, regulated, dosed, medicinal product. As a Nurse, I was thinking, well, what kind of medicinal legislation is this? It is just a straight decriminalization of possession of CBD oil bill for one medical diagnosis. That is all the law in Iowa does. I spoke up at this hearing, and was invited to come testify in Des Moines as an RN for an Intermediary Committee meeting on 9/11/2014 regarding the CBD oil bill and issues that surrounded the bill that needed amended, resolved, clarified. This was a bipartisan panel of Senators and Representatives and it was my first trip to the state capitol and my first introduction to the processes of state government. I decided that to make a true difference as an RN for medicinal cannabis in the state of Iowa, the only way was going to be through education, advocating and true bipartisanship. I had to improve my education, and I had to grow my courage. I had to learn patience. I applied for a scholarship for the Patient’s Out of Time Conference in Florida and obtained a Cannabis Nurse Certification. I am now Iowa’s only Certified Cannabis RN. I enjoyed telling US Senator Chuck Grassley that his home state had a Certified Cannabis Nurse when I urged him to move forward with the CARERS Act and remove Cannabis from Schedule 1, to allow for greater ease of research and use of cannabis as medicine, to put an end to patients in 40 plus states with medicinal cannabis laws being criminals under Federal law. I helped found and am a Director of the Iowa Hemp Association and travel all over Iowa giving education on medicinal Cannabis. This is especially dear to me because I care deeply about Iowa as a state
and our environment and Industrial Hemp can help remedy the grievous harm years of heavy industrious farming has done to our soils and waterways. A healthy environment will make for healthy Iowans. I am a Veteran of the US Army, and I honor my brothers and sisters of all branches of service and advocate for their needs in my efforts in Iowa as well. I gave a speech on the steps of the state Capitol where I said, “Veterans are surviving war, but they are coming home, and they can’t survive Iowa” because last winter we lost 5 Veterans to suicide that I could verify via the news. I asked Carly Fiorina, a presidential candidate, at a local forum in Davenport Iowa, a question about Federalism, and what she would do as President for medicinal cannabis patients, and she proceeded to tell a story about breast cancer and how you can’t have chemo and cannabis together. I decided to step back up to the microphone and stop her from speaking any more misinformation, because what she was saying was untrue and could cause harm to cancer patients. I said, “that is not true” and the audience gasped at me. This was a packed ballroom of about 1,000 people who adored her, and who were not there to hear the Certified Cannabis Nurse speak. I was nervous. One of her people came up to me and pulled me from the microphone and told me to be quiet. I left and the people in the audience applauded. I was trying to hurry to the elevator and several people were chasing me, turns out, they were reporters. I was interviewed and ended up on Huffpost Live and MSN. My kids nicknamed me The Dragon Slayer, because I am slaying the dragons who perpetuate the mythology of reefer madness that kills the sick and suffering at the hands of those who are ruthless and hungry for power or who display a complete willful ignorance to science and medicine in our country. I have put 7,000 miles on my car in 7 months. I have attended 20 plus legislative forums, driven up to my state Capitol in Des Moines for meetings with my Senators and Representatives and developed relationships and friendships with them. I speak up when misinformation will be presented as fact by Corporate Hospitals at educational forums. I will show up. Yesterday I took on, Chris Christie, and yes, he too is a dragon, and yes, I stood my ground and I told him, "Cannabis is medicine".
A President is not just a leader of those who are well, he must lead those who are sick and suffering and if he or she lacks compassion for those among us who have the least ability to raise their voice to represent their needs, they lack a key character component of a President. Service. Nurses get this. We serve our fellow human beings endlessly. We expect it out of our leaders. I strive to make Medical Cannabis an election issue because it can help effect true change at a Federal level for all medical cannabis patients, but also because, there is no other way to go in Iowa. We are not a ballot state and resources are limited to move legislation forward. To effect true change, one must have tenacity, moral courage, an unshakable belief in the truth of what you are seeking to accomplish and the humility to accept failure, learn from it, and persevere in your final goal. Benton. I will keep my promise. I will slay dragons. Shelly Van Winkle
Benton B. Mackenzie, 49, a resident of rural Eldridge, Iowa died on Monday, January 12, 2015 at his home following an extended illness. Services will be private. Memorials may be made to the family. McGinnisChambers Funeral Home of Bettendorf, Iowa is assisting the family with arrangements. He was born in Enid, Oklahoma on October 23, 1965, the son of Charles D. & Dorothy L. (Wright) Mackenzie. In 1992, he was united in marriage to Loretta L. Yearack in Arizona. Those left to honor his memory include his beloved wife, Loretta; his son, Cody Mackenzie of Eldridge; his parents, Charles & Dorothy Mackenzie of Eldridge; his sisters, Marjorie Jesse, D.C. of Smyrna, Delaware and Becky Thurston of Pearland, Texas; and his brother, Jeffrey Mackenzie of Liberty, Missouri. I Decate this story to The Barton Family.
NOVERBER/DECEMBER 2015 CANNABISNURSESMAGAZINE.COM
21
MEDICAL
Cannabis
SENIORS AND MEDICAL CANNABIS WHAT YOU SHOULD KNOW
M
Most of the patients I see are geriatric with the average age being seventy six. Eighty four percent have never tried cannabis
before. And most of them have more than one health condition. Even in the traditional health care model, seniors need to be closely evaluated for additional health conditions. When a medication is warranted, all disease states need to be factored in before starting a new medication. I feel medical cannabis is no exception. More and more seniors are coming to medical cannabis as a treatment option for many different conditions. In my practice, fifty-nine percent of patients are seeking relief from pain and thirty-four percent are having trouble sleeping. And many of them have more than one condition in which they are seeking relief from.
22
NOVERBER/DECEMBER 2015 CANNABISNURSESMAGAZINE.COM
The National Institute for Health (NIH) estimates that fifty percent of older adults who live alone suffer from chronic pain and seventy-five to eighty-five percent of older adults living in extended care facilities suffer from chronic pain. Living with chronic pain can lead to other ailments such as insomnia, anxiety, depression, loss of appetite. Since pain can be difficult to manage, many older adults need more than one medication to treat their pain and with that comes more side effects which then leads to more medications. This is known as polypharmacy. Many of the patients I see come to cannabis because they are tired of being on pills that are not working for them. According to the American Association of Retired Person (AARP), ninety percent of adults over the age of 60 are taking at least one medication and thirty percent of those adults are
BY: Eloise Theisen, MSN, RN, AGPCNP-BC
taking five or more medications a day. I would argue that those numbers are actually underreported. In my practice, I found that 51 out of 57 patients reported taking at least one medication daily, whether over the counter (OTC) or prescribed and the average number of Polypharmacy puts a patient at an increased risk for adverse drug reactions (ADR). The incidence of ADR’s in the elderly is double that in non-elderly and accounts for approximately one third of hospital admissions in the elderly. The chances of an ADR is ten percent with one medication and increases with the addition of each medication. When someone is taking ten or more medications, there is a one hundred percent chance they will have an ADR. And polypharmacy is big business. In 2005, 34 billion dollars was spent on pharmaceuticals for the elderly. This is not a number that is decreasing, in fact
Grown-Ups are doing it! Seniors Makin Their Lives Longer with Cannabis
it is rising at an alarming rate. Pharmaceutical companies are concentrating on developing new medications for the elderly, specifically for diabetes, Alzheimer’s and heart disease. Are the pharmaceuticals commonly prescribed as safe as we think? Take Ambien for example. Ambien (Zolpidem) is a non-benzodiazepine hypnotic sleep aid. It is not recommended in patients over the age of 60. According to the Beers List, a list of potentially inappropriate medications in older adults, Ambien is to be avoided for the use of insomnia. Evidence shows that nonbenzodiazepine medications like Ambien increase the older adults risk for falling, delirium and fractures while minimally improving sleep latency or duration. Believe it or not, non-steroidal antiinflammatory drugs (NSAID’s) such as ibuprofen and naproxen are also on the Beers list. NSAID’s are common prescription and over the counter (OTC) medications to treat pain. There is strong evidence to show that NSAID’s increase the risk of gastrointestinal (GI) bleeding and peptic ulcer disease, especially in seniors. Of course, we can put patients on an additional medication to reduce the risk of GI bleeding. Once again, leading to polypharmacy. Now there is even stronger evidence to demonstrate that NSAID’s can increase the risk of stroke or heart attacks.
Seniors Fighting the Effects of Cancer with Cannabis
Cannabis can undeniably help with sleep and pain with little to no side effects. In fact, studies have found that cannabis can be used as a harm reduction agent. Many seniors turn to alcohol for pain management. A recent study demonstrated that cannabis is 114 times safer than alcohol. Yet cannabis continues to be demonized and many people fear using it. Unfortunately, medical cannabis is still seen as a last resort. Most patient will have tried and failed all other conventional and even some alternative treatments before trying medical cannabis. The reason? Cannabis is a schedule I drug and therefore viewed as a dangerous drug. Most physicians and health care professionals (HCP’s) know little to nothing about cannabis. How can a HCP recommend something if they don’t know how it works, where to get it or potential side effects? It may be a while before physicians feel comfortable recommending cannabis. The EndoCannabinoid System (ECS) and cannabinoids are not taught in over ninety percent of medical schools. So where does that leave patients? Many are left to navigate on their own. They turn to the internet that has almost too much information. The information on the internet is not uniformed and can often be contradicting from one site to the next. There are reputable information sites out there such as United Patient’s
Group (UPG) and the American Cannabis Nurses Association (ACNA) dedicated to educating patients and HCP’s. Still many patients do not find the help they need and often give up on cannabis before they see the benefits. I feel that success depends on the amount of support patients have when coming to cannabis medicine. For example, dosing is an important component often over looked in seniors. With the average number of medications being ten, seniors need to have lower doses of cannabinoids to avoid drug interactions. Cannabidiol (CBD) is attractive to older adults because of the mild psychoactivity associated with it. However, CBD can either increase or decrease the effectiveness of other medications. A recent article by Projectcbd.org highlighted how CBD can interfere with the metabolism of other drugs thereby making CBD and other medications ineffective. This finding alone points out the importance of monitoring patients who are using cannabis and pharmaceuticals concurrently. Seniors deserve special attention. They are a vulnerable population that would benefit from the use of medical cannabis. However, we need to assess for potential medication side effects, risk for falls, and additional elements specific to the elderly. It is my hope that dispensaries will begin to employee Nurses who can begin to facilitate this process. NOVERBER/DECEMBER 2015 CANNABISNURSESMAGAZINE.COM
23
GROW FOR VETS
Roger B. Martin
Inspired by encounters with fellow Veterans suffering from PTSD and other serious medical conditions, I began offering free cannabis to Vets in March 2013. In January 2014, I formalized my efforts by establishing Grow for Vets (originally Operation Grow4Vets), as a Colorado nonprofit corporation. To date, Grow for Vets, now an IRS recognized tax-exempt organization, has provided free cannabis to thousands of Veterans.
My journey into the “world of cannabis” has been, I think, a rather unusual one. First, I am a proud Veteran of the United States Army and I credit cannabis with having saved my life by helping me overcome a ten year dependency on prescription drugs, including Oxycontin and Ambien.
We began expanding nationally a few months ago and now have chapters operating in Colorado, Oregon, Nevada, and Michigan. We will soon open chapters in California, Washington, Arizona, Texas and in other cities all across the U.S.A. Many will be support chapters in states, like Texas, where cannabis is not yet legal in any form. As a result of our desire to help Veterans everywhere, we are currently looking for individuals who would like to lead chapters in their area.
As naive as it probably sounds, I actually believed that our government would step up and do the right thing with regard to the treatment of Veterans. However, the only news regarding medical treatment being provided by the VA seems to be nothing more than I also have a background in law enforcement. Consequently, it one scandal after another. was not easy for me to accept the fact that, like most Americans, I had been duped into believing that cannabis was Eventually, I became sick and tired of waiting around for politicians a dangerous drug; rather than perhaps the most important and greedy, bonus-driven government bureaucrats to take action. I natural medicine on planet earth. was appalled that these people had no problem with Veterans dying needlessly and I decided to take matters into my own hands. In my view, we have greedy politicians, driven by billions of dollars in “contributions” they receive from pharmaceutical Driven by the knowledge that more than fifty Veterans die each day companies, to blame for deceiving the American public about from prescription drug overdose and suicide, I decided to spend my the true benefits of cannabis. “retirement” giving free cannabis to Veterans. Simply stated, I believe that we owe American heroes far better than what they are currently receiving.
24
NOVERBER/DECEMBER 2015 CANNABISNURSESMAGAZINE.COM
More Than 50 American Heroes Die Every Day
From Prescription Drug Overdose and Suicide. NOVERBER/DECEMBER 2015 CANNABISNURSESMAGAZINE.COM
25
I am absolutely convinced that cannabis should be the first treatment option offered to Veterans suffering with serious medical conditions. Grow for Vets is working to convince VA administrators, elected officials, medical professionals, and the public at large that cannabis is a much safer treatment option for Veterans than our deadly prescription drug cocktails. Most people are shocked to learn that more Veterans die from prescription drug overdose and suicide in one year, than died on 9/11 and in the wars in both Iraq and Afghanistan combined. In addition to the neglect and abuse they suffer at the hands of the VA, two other important obstacles face many Veterans. One is the lack of knowledge regarding how to properly administer their cannabis medication. The other is the lack of affordability associated with obtaining cannabis medications. The cutting edge work being done by the American Cannabis Nurses Association is filling a critical need for all medical cannabis patients and, in my opinion, particularly for Veterans. Unlike many in the civilian sector, patients who are receiving care from the VA are rarely afforded the opportunity to engage in a meaningful dialog about cannabis with their healthcare providers. That’s where the ACNA and Nurses play a crucial role. I concur with the ACNA’s belief that there should be a Nurse in every dispensary to consult with patients. In most states, the cost of obtaining cannabis is out-of-reach for Veterans. This problem is greatly compounded by the oftentimes outrageous cost of being granted the mere “privilege” to purchase cannabis. Far too often, the cost of a medical examination and state licensing fees can reach into the hundreds of dollars. Nevada, for example, requires its citizens to pay a $25 fee just to request an application! The patient must then obtain a "recommendation" from a doctor, which can cost as much as $250, before submitting his or her application along with another $75 to the state. Many states offer Veterans perks like free fishing and hunting licenses. Yet, they feel that Veterans should have to pay hundreds of dollars for the privilege of utilizing cannabis as a safe alternative to the deadly drugs that kill more than fifty of their brothers and sisters every day. This is government greed at its worst. It’s an absolute outrage that someone who has sacrificed so much for others now has to undergo financial hardship in order to acquire the medicine that works best for them. We might be living in a much better world today were the government to requires anyone wishing to purchase prescription medications from their local pharmacy to pay hundreds of dollars a year for the privilege.
I have spoken with countless non-Veteran medical cannabis patients over the past few weeks regarding this issue. Without exception, they have all indicated that they would be willing pay an extra $5 - $10 for their medical card if Veterans were allowed to receive free cards. In the coming months, Grow for Vets will be calling on states to immediately stop collecting fees from Veterans seeking medical cannabis. We will also soon be announcing a new Grow for Vets initiative geared directly toward bringing about that reality. Since founding Grow for Vets, I have had the honor of meeting thousands of brave Americans, Veteran and non-Veteran alike, who have chosen to treat their medical conditions with the medicine that works best for them – cannabis. Further, serving as the Executive Director of Grow for Vets is the most humbling and rewarding experience of my life. It is obvious to all that the VA's intent on shirking its responsibility in caring for the bravest among us. Consequently, Veterans are blessed to have the knowledge, guidance, and support of the ACNA. As any Vet will tell you, men and women in uniform have always regarded Nurses as our Angles. The dedicated Nurses that comprise the ACNA are the Angles that have followed us home. Roger B. Martin | Veteran - United States Army | Founder and Executive Director Grow for Vets
26
NOVERBER/DECEMBER 2015 CANNABISNURSESMAGAZINE.COM
yes, harm. yes, foul. Prescription drug abusers usually don’t start because they’re seeking a high. For three-quarters of them it begins innocuously, according to the DEA — they get hooked after taking a legitimate medication for a legitimate reason. Once that hook takes hold, though, addicts will bend over backwards to get another hit. That starts by faking pain and getting another prescription... or two, or three. Then comes begging and stealing from friends and, often, doc-shopping. Doc shopping — seeing multiple doctors and getting multiple scripts for pain meds — will raise flags with insurers, which means addicts can find themselves forced to pay cash. That’s when irony rears its ugly head, and those addicts find that street-corner heroin is actually less expensive than prescription meds. (So concluded the DEA in its 2015 National Heroin Threat Assessment Summary.) And with the boost to the heroin trade comes all the associated problems, from overdoses to crime to HIV/AIDS, which has been spiking lately thanks to the sharing of dirty needles. A more direct issue is simple overdosing. In 2013, almost twice as many Americans died from ODing on prescription opioids (16,200) than on heroin (8,300). Think about that : More than 16,000 Americans died in a single year from overdosing on prescription painkillers. And then there’s the monetary cost: lost labor, hospital bills, emergency responders, police, and so on. Earlier this year, the DEA calculated that, “The economic cost of nonmedical use of prescription opioids alone in the U.S. is in excess of $53 billion annually.” That’s a lot of money that could be used in a lot of other ways. The business of prescription drug diversion is big enough and profitable enough that criminals, street gangs, and organized crime groups are starting to go for a piece of the action. Considering where most prescription drugs come from — your shelves — that doesn’t bode well for pharmacies.
“The inherent benefit of this is getting more people to purchase marijuana here locally to help drive up revenues for the city and state.�
Nursing Humor
28
NOVERBER/DECEMBER 2015 CANNABISNURSESMAGAZINE.COM
Resources
Recommended Books
Understanding Marijuana By Mitch Earleywine A New Look at the Scientific Evidence
Marijuana is the world's most popular illicit drug, with hundreds of millions of regular users worldwide. One in three Americans has smoked pot at least once. The Drug Enforcement Agency estimates that Americans smoke five million pounds of marijuana each year. And yet marijuana remains largely misunderstood by both its advocates and its detractors.
Beyond Buds: Marijuana Extracts Hash, Vaping, Dabbing, Edibles and Medicines by Ed Rosenthal and David Downs
Beyond Buds is a handbook to the future of marijuana. Prohibition’s end has led to a technological revolution that’s generated powerful medicines and products containing almost zero carcinogens and little smoke. Marijuana icon, Ed Rosenthal, and leading cannabis reporter, David Downs, guide readers through the best new consumer products, and demonstrate how to make and use the safest, cleanest extracts.
The Pot Book: A Complete Guide to Cannabis by Julie Holland M.D. Exploring the role of cannabis in medicine, politics, history, and society, The Pot Book offers a compendium of the most up-to-date information and scientific research on marijuana from leading experts, including Lester Grinspoon, M.D., Rick Doblin, Ph.D., Allen St. Pierre (NORML), and Raphael Mechoulam.
The Cannabis Grow Bible: The Definitive Guide To Growing Marijuana For Recreational And Medical Use The Cannabis Grow Bible is an authoritative source that features almost 200 color and black-and-white photographs, charts, and tables. With an emphasis on the day-to-day aspects of maintaining a garden and European expertise, this book ensures that growers will enjoy a successful harvest.
NOVERBER/DECEMBER 2015 CANNABISNURSESMAGAZINE.COM
29
Balanced Nutrition is the Foundation for a Healthy Life
An Introduction to Cannabis Nutrition By Jessica Aragona, MS, RD, LDN
It may not seem obvious at first but cannabis and nutrition go hand in hand.
F
or centuries, the cannabis plant has been revered and utilized by several cultures throughout the world with the utmost respect, as both a medicine and a sacred herb for healing purposes. One of the earliest known records of human use of this plant dates back over 10,000 years to the island of Taiwan. Records indicate cannabis was used by the ancient Chinese as a treatment for ailments such as gout, malaria, rheumatism. Other evidence suggests the ancient Egyptians used cannabis to treat glaucoma, inflammation, menstrual pain and constipation through enemas. In pioneering the field of cannabis nutrition science and dietetics, I look at the cannabis plant and see not only its medicinal and sacred value but
30
NOVERBER/DECEMBER 2015 CANNABISNURSESMAGAZINE.COM
also its prospective nutritional value; providing protein and healthy fats as well as its potential use as a leafy green vegetable (such as kale or spinach) for juicing and salads. Like most of the research around this topic, the study of cannabis and nutrition is in its infancy. However, the hemp plant has been widely studied for years. Hemp or Cannabis Sativa L., is the non-psychoactive cousin to the “marijuana” plant. Although many states and other countries have already chosen to legalize cannabis and/or hemp for agricultural, medicinal and/or recreational purposes; cannabis, in its entirety, remains federally illegal in the United States.
Nutritional Content and Health Benefits
As a food, hemp has an exemplary nutritional profile. Documented studies dating back to the 1950’s show that ingestion of hemp foods, seeds, and in particular, the oil found in those seeds, can provide both preventative and therapeutic health benefits from head to toe.
Hemp seed is made of three major components: Fat, Protein and Carbohydrates, along with vitamins, minerals and a small amount of water. Hemp seeds and the foods that can be made from hemp seeds are one of the best (vegan!) sources of complete protein, containing all the essential amino acids (building blocks of protein) necessary for human health. Hemp protein is one of the easiest complete proteins for the body to digest. This means the body can efficiently and effectively utilize the nutrients found in hemp foods. In fact, our bodies can digest the protein in hemp more easily then certain grains, nuts and pulses*. *Pulses: the edible seeds of legumes, like lentils, dried peas, dried beans and chickpeas. • The list of potential beneficial compounds found in hemp seed oil continues and includes; cannabinoids, terpenes, and methyl salicylate also known as oil of wintergreen, an essential oil, which studies have shown (when applied topically) may help to reduce pain, fight infections and help stimulate the secretion of certain hormones, digestive enzymes, and bile, which can help to ensure proper functioning of the liver, digestive system and various glands. • Hemp foods, especially hemp seed oil, are a great source of Cannabidiol or CBD; a beneficial compound and potent antioxidant known to help reduce inflammation, improve cell communication, lower blood pressure and boost immune functions within the body.
Practical Application At the end of day, the question is: What simple recommendations can you provide patients today, to help them include more healthimproving hemp foods in their daily diet? Fortunately, hemp foods such as seeds, milk, protein powder, and oil can easily be found at a natural foods market, health food store or online. As with any food choice, good quality is most important for maximum benefits. • Not all hemp foods are created equal. Recommend that patients read labels before buying a product. In most cases, the fewer the number of ingredients and the more recognizable those ingredients are, the better the product: this tip can be applied across the board with almost any packaged food. • Even though thirteen states and Canada have allowed industrial hemp farming for research and commercial purposes, China is the world’s leading producer of hemp but that does not mean it is grown in a responsible way. Support our economy by choosing products grown and produced in North America if possible. • Finally, suggest patients choose organic products when available to help avoid exposure to harmful pesticides, chemicals and other toxins that may be used in agricultural practices.
Bio: Jessica Aragona MS, RD, LDN A Registered Dietitian and nutrition consultant specializing in complementary and alternative healthcare with a focus on holistic nutrition practices. As The Holistic Nutritionist, Jessica teaches patients practical ways to incorporate the cannabis plant in its many forms and delivery methods, into their daily lifestyle. In addition to working privately with patients, Jessica is a published writer and educator; teaching classes and speaking at various seminars and conferences across the west coast.
NOVERBER/DECEMBER 2015 CANNABISNURSESMAGAZINE.COM
31
FOOD FOR THE SOUL
Berry Sorbet with Raw Cacao Topping THIS “SORBET” IS QUICK, EASY, HEALTHY AND NUTRIENT DENSE. IT IS THE PERFECT DAIRY AND GLUTEN FREE RAW TREAT. UNLIKE MOST STORE-BOUGHT ICE-CREAMS AND SORBETS THIS CREATION IS FREE FROM ARTIFICIAL FLAVOURS, PROCESSED WHITE SUGAR AND ADDITIVES. THE RAW CACAO IS THE PERFECT ALTERNATIVE TO TOPPINGS THAT ARE LOADED WITH SUGAR. THE RAW CACAO TOPPING “HARDENS” AS SOON AS IT IS SERVED WITH THE SORBET – MAGIC! THE ENTIRE FAMILY WILL LOVE THIS CREATION AND FEEL NOURISHED AND HEALTHY.
RECIPE KAYLA THOMPSON
Serves 2-4 Ingredients: 2 cups frozen berries 2 bananas 1 tbsp coconut oil 1 / 3 cup coconut milk ½ tsp cinnamon 3 medjool dates (soaked) Alternatives to dates would be agave, honey, coconut palm sugar or stevia for a low GI alternative. For the topping: 3 tbsp raw cacao* 2 tbsp agave ½ cup coconut oil, melted (should just be melted, not warm or hot in temperature) For serving: Crushed nuts Coconut flakes Method: Process the ingredients together in a food processor. To make the topping, whisk together all the ingredients.
32
NOVERBER/DECEMBER 2015 CANNABISNURSESMAGAZINE.COM
Scoop the ice-cream into a serving glass and pour over some of the “cacao topping” and sprinkle some nuts and coconut flakes on top. If “sorbet” is a little “softer” than desired, place in freezer before serving. *Raw cacao is a nutrient dense super food that is loaded with many vitamins and minerals such as magnesium, iron, zinc, and calcium. Raw cacao is also a great source of antioxidants and known to increase health and wellbeing. KAYLA THOMPSON, owner and founder of Natural Naughties is a well-known foodie who is passionate to inspire others to lead a healthy lifestyle. Kayla has been teaching raw food classes across Australia for nearly two years. Kayla inspires all her “followers” through blogging, workshops and her inspirational e-books. More Raw Food recipes feature in Natural Naughties top selling e-book, The Raw Food and Lifestyle. naturalnaughties.com
FOOD FOR THE SOUL
Choc Good! WORDS & RECIPE JILL MILNE, Owner of the Goodness Gracious Organic and 100% Gluten Free Cafe
C
hocolate is one of our favourite flavours here in the cafe, so Easter is our favourite time of year! We choose to use Organic Cacao in our chocolate recipes as it’s gluten free, vegan and raw as well as totally yummy! Raw cacao is cold pressed without solvents that gives a product of over 360% more antioxidants than regular cocoa, 14 times more antioxidants than red wine, 21 times more than green tea and 7 times more than dark chocolate!!! We always said chocolate was good for you! Here is one of our popular biscuit recipes using cacao at the Goodness Gracious Organic Cafe in Yandina. It’s very simple and very yummy!
Join us on Facebook at: Goodness Gracious Organic and Gluten Free Cafe
Cacao and Peanut Cookies This recipe makes about 14 medium cookies or about 30 button sized cookies and is gluten free and dairy free. Ingredients: 1 cup organic peanut butter (you can change this to other nut butters if you prefer) 1 cup organic coconut sugar (really tasty! but you can change this to dark brown sugar) 20ml raw cacao 10ml cinnamon (less or more to your taste) 1 organic egg
Method: Mix all ingredients together in a bowl, then roll out to your desired thickness and size. Place on a tray in 160° C oven, between 10 and 15 minutes and keep an eye on them as they can burn easily! Take out of oven when tops are firm, allow to cool then eat!
NOVERBER/DECEMBER 2015 CANNABISNURSESMAGAZINE.COM
33
Job Opportunities Perm & Travel
Cannabis Nurse Job Board has over 2,000 job opportunities in all nursing specialties.
Get started... High paying travel nursing positions all over the country!
Emerald currently provides travel nurses to hundreds of hospitals and currently is offering assignments in every major specialty (ICU, L&D, ER OR, TELE PACU, PICU, NICU, and PEDS). Contact Emerald at any time at 1-800-917-5055, or respond to this message via E-mail or you can also visit us on the web at www.emeraldhs.com
Needs:
Apply Today!
1- 877-447-3376 x709
Nightingale, a nationally recognized leader in travel healthcare professionals, has Immediate and Exclusive needs for all Nursing Specialties with excellent pay.
ICU, CVICU, LDR, MS, Tele, Neuro ICU, ER, LDR, & OR RNs!
Give us a call at 800-755-1411 for additional information! Don’t forget to ask about our Referral Bonus!
34
NOVERBER/DECEMBER 2015 CANNABISNURSESMAGAZINE.COM
If you are available for consideration, please reply to this email and a recruiting specialist will contact you as soon as possible. Call us immediately: 800-591-7860 or scan the QR code To complete a full application, please scan the QR code
Apps for Health-Care Professionals Smartphone apps and web-based tools are increasingly important resources for health-care practitioners. Check out these great tools and put a wealth of health-care information in your pocket.
01
NURSING CENTRAL
06 EPONYMS
Nursing Central is the complete mobile solution for nursing produced by Unbound Medicine. The app includes disease, drug and test information for nurses. http://goo.gl/XWglb
A browse-able and searchable app that provides short descriptions of more than 1,700 obscure medical eponyms. http://goo.gl/BKP0H
02 LIPPINCOTT NURSING
07
DRUG HANDBOOKS
Keep over 300 outstanding anatomical flash cards on your device. This app enables you to carry the popular Atlas of Human Anatomy (4th edition) and its detailed anatomical illustrations on your phone or tablet. http://goo.gl/jr9Th
This app provides up-to-date drug information on your device, including contraindications, nursing considerations, patient teaching and integration of the nursing process. http://goo.gl/em9E1
03
MANAGEMENT GUIDELINES FOR NUSING PRACTITIONERS WORKING WITH ADULTS The app is a best-practice guide for health-care professionals who work with adult patients. Other apps in the series provide guidelines for working specifically with women, with children, with older adults or in family practices. http://goo.gl/o2hC6
04 JOURNAL WATCH This tool from the Massachusetts Medical Society notifies you about new papers published on topics of your choice. http://goo.gl/dxbrd
05 3M PREP This app provides a detailed rationale for selecting surgical prep solutions. You can view how to correctly apply solutions while listening to a detailed set of instructions. http://goo.gl/QGwsY
NETTER’S ANATOMY FLASH CARDS
08 CNOR EXAM PREP The Competency and Credentialing Institute, the governing body of the Certified Nurse Operating Room (CNOR) credentialing program, has created the CNOR exam prep app to help perioperative nurses prepare for the CNOR exam. The app helps individuals assess their exam readiness and develop critical thinking skills; it also provides tips for success, reviews knowledge related to the CNOR exam and can enhance test-taking confidence. http://goo.gl/n1DMo
09 EPOCRATES Rx The app includes a drug guide, formulary information and a drug interaction checker. This product also includes continual, free updates and medical news. Additionally, the app works on your device when you are offline, so you can look up information without a wireless connection. http://goo.gl/fqchG
10
MACEWAN LIB
The MacEwan University Library app simplifies searches for books and articles. It allows you to place a hold on library catalogue items, renew items, download full-text resources and perform many other tasks. http://goo.gl/YAUQe
NOVERBER/DECEMBER 2015 CANNABISNURSESMAGAZINE.COM
35
If a probiotic is CLINICALLY DOCUMENTED to work on even the most upsetting digestive issues...
DAILY DIGESTIVE WELLNESS *
INTEGRATED BOWEL SUPPORT *
Imagine what it can do for you! INTRODUCING:
Probi 20 Billion AND Probi 30 Billion FROM SOLGAR. ®
®
On again off again digestive issues can alter your living
over 10 years of scientific review and human clinical
routine to the point that where you go and what you do
studies. Probi’s active probiotic has been substantiated and demonstrated to effectively help with occasional gas and bloating and support daily abdominal comfort.*
still disrupt a normal day. Taken once a day, Probi from
Finally, getting your digestive system on track is easily
Solgar effectively helps balance your digestive tract, so
within your reach.*
®
feeling well… becomes that easy.* With the right probiotic strain delivered in the right place Probi from Solgar is different. Focusing on today’s
in the right dosage, Probi® from Solgar can make a real
probiotic advances, Probi concentrates less on the
difference in your life… day after day after day.*
quantity and number of different strains, and more on
True potency of 20 or 30 billion live probiotic cultures…
identified strains that are documented to work through
GUARANTEED. All that in one little capsule once a day.
®
®
THE COMPLETE LINE OF SOLGAR NUTRITIONAL SUPPLEMENTS IS AVAIL ABLE AT FINE HEALTH FOOD RETAILERS WORLDWIDE. FOR STORE LOCATIONS AND ADDITIONAL INFOR M ATION, VISIT SOLGAR.COM OR CALL 1. 8 0 0 . 6 4 5 . 2 24 6 Probi ® is a registered trademark of Probi AB. *These statements have not been evaluated by the Food and Drug Administration. These products are not intended to diagnose, treat, cure or prevent any disease.
©2015 Solgar, Inc.
has to be carefully planned. Even if your digestive issues
are less “concerning,” the occasional and unexpected can