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Integrating Integrating Cannabis Cannabis into into Health & Wellness Wellness Integrating Health & Cannabis into Health & Wellness

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(GLWRU·V /HWWHU Cannabis is a powerful spiritual teacher that has been with humanity for thousands of years. More and more people are now able to legally access Cannabis through medical marijuana programs, as well as through legalization. Due to the prohibition of this plant for so long, there have been many unhelpful attitudes professed about this sacred plant, and many people have had negative attitudes or experiences about or with Cannabis. There is also a lack of spiritual information and guidance about this medicine.

In this issue of Cannabis Nurses Magazine we explore Cannabis with: Holistic Medicine. We learn that by optimizing cannabis as part of a Holistic Nursing Care Plan means integrating it with other modalities, such as nutrition, yoga, acupuncture, breathe work and, yes, aromatherapy. This approach gives the Cannabis Nurse a well-stocked toolbox to individualize patient treatments as cannabis can lead the way in personalized medicine.

We are first guided by Uwe Bleshing, Ph.D., who defines, 9 Ways to Deepen Healing with Cannabis and Consciousness, and Karen Ferguson, Ph.D., with Cannabis as Medicine: A Holistic Approach to Healing. These cannabis experts define how cannabis can be incorporated into the modalities of the mind-body-spirit defining a Holistic Nurse; one who shares authenticity of unconditional presence that helps to remove the barriers to the healing process.

We then explore the article, Integrating Cannabis into Aromatherapy, authored by the Holistic Cannabis Academy co-founders, Laura Lagano and Donna Shields, and Academy faculty aromatherapy expert, Jessica Baker, as they build the way by defining ways in which to integrate Cannabis into holistic practice through aromatherapy. As our understanding about phytocannabinoids and their potential interactions with other plant compounds and as our discovery of the Endocannabinoid System (ECS) evolves, so will the need for Nurses and Healthcare professionals to help guide their patients. The success of Cannabis as a healing tool lies in its integration with other holistic modalities such as Aromatherapy, Nutrition, and Massage. Thus, it’s critical that Healthcare professionals become Cannabis competent in this rapidly evolving area of Holistic Medicine.

Marcie Cooper, RN, MSN, ADS, AHN-BC, then defines, What is Holistic Nursing?, encompassing the American Holistic Nurses Association’s vision of, “a world in which nursing nurtures wholeness and inspires peace and healing.” She describes how Cannabis Therapeutics is fast becoming one of the most common holistic therapies being utilized. Healthcare professionals need to know and understand how their patients are incorporating cannabis into their lives for health and wellness and how to properly chart its use. Cannabis Nursing and Holistic Nursing are complementary to each other and incorporate the same philosophies and goals. Thus, understanding Cannabis Therapeutics as a practitioner is becoming as important as utilizing a holistic approach.

We also review, HIPAA and Medical Marijuana, with Sue De Gregorio-Rosen, RN, as she points out the need to protect Patient Rights, especially the right to privacy, within the Cannabis Industry. HIPAA Laws still need to be considered in this arena of medicine more than ever. Especially since there is still a stigma and “Reefer Madness” mentality due to lack of understanding and fear of the unknown. Many were raised in the, “Just Say No” Drug War-Nancy Reagan Era thru the 1980’s and some will never want to accept the proven benefits and science behind the plant. Dr. Sunil Aggarwal digs into its deep history and its health potential, in defining, Cannabinoid Integrative Health Science 101, debunking the myths of marijuana and lifting the stigma it carries for professionals. Enjoy!

We must Grow.

Julie Monteiro, RN, BSK “$VN 1XUVH -XKO]LH” Editor@CannabisNursesMagazine

“IF Cannabis were unknown, and bioprospectors were suddenly to find it in some remote mountain crevice, its discovery would no doubt be hailed as a medical breakthrough. Scientists would praise its potential for treating everything from pain to cancer, and marvel at its rich pharmacopoeia - may of whose chemicals mimic vital molecules in the human body.” ~ Dr. Sunil Aggarwal

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Contributors

&RQWDFW ,QIRUPDWLRQ Jessica Baker, LAc, RH (AHG) Jessica Baker is an acupuncturist, herbalist, aromatherapist and educator. Her passion for sharing the messages of the plants is reflected in her private practice and her classes on Aromatherapy, herbalism, and Chinese medicine. As a continuing education provider to acupuncturists, she teaches the importance of traditional medicine to health care professionals as well as to lay people. She is on the faculty of the Colorado School of TCM and the Holistic Cannabis Academy. She teaches at several herbal symposia and acupuncture conferences throughout the U.S. www.jessicabakerlac.com | jbakerlac@gmail.com

Laura Lagano, MS, RDN, CDN

Laura is co-founder of the Holistic Cannabis Academy and a clinician with an integrative nutrition practice in the NYC area. With advanced training in functional medicine, she is positioned to become one of the first certified RDNs with the Institute of Functional Medicine. With years of experience in continuing medical education development, Laura possesses a unique combination of science and communications savvy.

Donna Shields, MS, RDN Donna is the co-founder of the Holistic Cannabis Academy with an expertise in health communications.

As a former Army dietitian and faculty at the Culinary Institute of America, Donna's diverse experience provides a rich background for innovative wellness programs and food product development. Based in Boulder, CO, Donna is also a contributor to The Cannabis Kitchen Cookbook.

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5HDFK 8V %\ 3RVW Cannabis Nurses Magazine 4780 W. Ann Rd., Suite 5 #420 N. Las Vegas, NV 89031 info@cannabisnursesmagazine.com www.cannabisnursesmagazine.com

Karen Ferguson, PhD Karen Ferguson, PhD first studied Health Education at Eastern Illinois University. Wanting to create an interdisciplinary study of holistic health, she moved to California and attended a Naturopathic Medical school.

After cutting up on a cadaver for a semester, the thought, “This isn’t my kind of healing,” urged her to leave. She received her MS in Holistic Health at JFK University.

Wanting to know more about psychology, she then attended the California Institute of Integral Studies, San Francisco, studying East-West psychology & Organization Development. After four years, she quit wanting more experiential learning and finished her Ph.D. at the Institute of Transpersonal Psychology [SOFIA]. Creating a Compassionate Care Program of Merida, Yucatan, Mexico for those in need with serious illness, she’s an evangelist for the many uses of a harmless healing herb: Cannabis. Currently, Dr. Ferguson is writing curriculum for a 2016 Educational Achievement Award series of classes/presentations on Cannabis: Healing and Practical Use of an Herbal Heather Manus RN He Medicine, to be taught in the Fall of 2017, has a private practice, lectures and is a Brand Cannabis Nurses Magazine Ambassador for Xternal, a full spectrum extract.

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'eatures 9 Ways to Deepen Healing with Cannabis Consciousness By: Uwe Blesching, PhD

Inside 24| STEPPING STONES Natural Health Care By: Jiny Varghese et al.

08 Cannabis as Medicine: A Holistic Approach to Healing

34| What is Holistic Nursing?

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By: Sue Degregorio-Rosen, RN

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By: Karen Ferguson, PhD

18 Integrating Cannabis into Aromatherapy By: Jessica Baker, LAc Dipl OM, RH (AHG), Laura Lagano, MS RDN CDN, and Donna Shields, MS, RDN

Marcie Cooper RN, MSN, ADS, AHN-BC

9 Ways to Deepen Healing with Cannabis and Consciousness Uwe Blesching, PhD The clinical cannabis experience and consciousness research have independently demonstrated 9 mechanisms to deepen our healing process. Each of these mechanisms are subject to conscious intervention, and the more we know and understand about them the easier we can achieve the kind of healing that goes beyond the mere management of symptoms, and bring about profound and positive changes in the quality of our lives.

For instance, consciousness research in cancer has discovered that the single most common trait that determined cancer survival had been a sense of emotional authenticity. Similarly, many cannabis-using patients suffering from various cancers report disease regression in connection with the deep relaxation and frame of mind that makes it easier to accept one-self in the present moment even in the presence of otherwise intolerable feeling or emotions.

Another example, chronic negative affect, or the tendency to feel constricting emotions such as fear, worry and stress have been determined to harm our well-being just as the opposite has been proven true. Cannabis is broadly recognized for its capacity to diminish negative affect and replace it with a gentle attitude, an easy smile and more optimistic outlook, all of which have proven to support out natural self-healing abilities. Forgiveness has demonstrated a powerful ability to supercharge our healing process. Cannabis has the capacity to send a pink slip to the slave driver in the back of our mind that insists on punishment and blame as tools for growth and motivation. As a result, implementing forgiveness becomes easier and more elegant, and in doing so contributes to our healing.

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Whether we are choosing to work with cannabis as an ally, whether we are working with consciousness alone, or whether we use a combination of both – the more we become conscious about these 9 natural mechanisms to deepen our healing process, the more our natural healing abilities multiply. Some will appear more familiar to us, others may take a little effort to master, but all can be learned, applied, and used to deepen our health and healing.

1) Release Suppressed and Repressed Emotions:

Clinical trials have shown that chronically suppressed or repressed emotions exacerbate a variety of medical conditions such as hypertension, cardiovascular disease, and breast cancer and thus eventually reduce life expectancy. While suppressed or repressed emotions can make us sick and shorten our lives, they can be found, acknowledged and released.

2) Replacing Chronic Negative Emotions with Habit for Positive Emotions: Studies have shown that persistent experiences of negative emotions and stressful experiences can worsen chronic degenerative illnesses. The opposite is true for longstanding habits (daily exercise) and entrenched ways of thinking (seeing the best in people). Being prone to expressing expansive or positive emotions strengthens the immune system, improves quality of life and contributes to longevity.

3) Taking Ownership of Where We Are – Self-Acceptance:

When we lack conscious ownership of thoughts and emotions that we have labeled intolerable or unacceptable, we spend a significant amount of energy engaged in avoidance mechanisms. For example, we may try to avoid unacknowledged emotions by bingeing on “comfort” foods that in fact make us ill. To reverse the damaging influence of our avoidance strategies, and the loss of vital energy that comes with it, it is important to begin by accepting where we are, no matter where we find ourselves.

We need to find ways to accept and honor ourselves when we are experiencing selfpity, entitlement, envy, hostility, grief, despair, loneliness, shame, or any thought or emotional state we have previously labeled intolerable or unacceptable. We don’t have to linger in this emotional state, but in order to shift our experience we must first accept where we are. Studies have shown that honest self-expression, alone or with a close and trusted friend(s), reduce both the frequency and the intensity of seemingly intolerable states of mind.

4) Conscious Choice – Healthy Choice:

Every instant we are making a choice. And, these choices are not limited to the obvious, do I go right or left but include any number of perspectives each with different consequences to our physical and emotional health and well being. For instance, a fear-based choice can safe our life if we are standing near a cliff but can also prevent us from loving life or learning from new experiences. Generally speaking a choice based on unwarranted fear tends to be an unhealthy one and one grounded in appropriate love a healthy one.

5) Gratitude and Happiness: A simple gratitude exercise in which patients at UC Davis’ Medical Center were instructed to write down five things they were grateful for every day, using no more than one sentence to describe each item. After two months, researchers noted a heightened sense of well-being, more hours of sleep, reduced pain, increases in optimism, happiness, fewer physical symptoms, positive states of alertness, greater attentiveness and determination, high energy, positive moods, feeling connected to others, increased empathy towards others, and more positive attitudes toward their family.

6) Forgiveness:

Psychoneuroendocrinology, the study of the interplay between emotions and hormones, has shown that hormone profiles respond to forgiveness. In one study, merely imagining forgiving an offender produced measurable improvements in heart rate and blood pressure compared to study participants who were instructed to imagine not forgiving them.

7) Replace Unhealthy Beliefs with Healthy Ones

In the context of health and healing, it is important to understand that beliefs are not right or wrong, good or bad. Beliefs are just recipes for various emotional responses, each of which have physiological consequences. For instance, people with significant fear-based belief(s) will often try to control their environment and the people in it. One of many expressions of a fear-based belief structure can be a type A personality, which numerous studies have shown to be involved in the genesis of coronary artery disease (CAD). Fortunately, we can choose to nourish or banish any beliefs we have made conscious.

8) Disease is a Message – Answer the Demand for Change

Depending on severity diseases are a request or demand for change. In a way disease allows us to experience physically any unfinished mental, emotional or spiritual work in need of our attention. When we are finally ready to respond to the demand for change, it is paramount to interpret and understand the message correctly. If the message indicates that we must express emotions we have labeled “unacceptable” or face memories we have repressed, then this is the corrective action required to alter the internal landscape of our psyche.

9) Overcome Resistance to Healing (and Using Illness to Manipulate)

When resistance to healing is present, a part of the self attributes something positive to the presence of the disease. Perhaps the most difficult thing to do in deep healing is to examine the reasons why we might not want to heal. A reluctance to completely heal could be a reflection of our yearning for attention from others, a belief that we deserve punishment, misplaced family loyalties, fear of loss, or an idea like “as long as I am sick she will never leave me.”

If this reluctance to fully heal is not addressed and resolved, we will consciously or unconsciously nourish the disease rather than our health. By owning, forgiving and releasing the resistance we speed recovery.

About the Author

Uwe Blesching Ph.D., has written this article based on his research conducted for the book entitled The Cannabis Health Index: How to Achieve Deep(er) Healing of 100 Chronic Symptoms and Diseases by Linking the Science of Medical Marijuana with the Art of Mind-Body Consciousness. For more information visit: www.cannabishealthindex.com or Amazon.

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Cannabis as Medicine: A Holistic Approach to Healing By: KAREN FERGUSON, PhD Cannabis is considered a healing herb. Healing on a multitude of levels: Body, Mind, and Spirit: it treats the person, holistically. When the psychological [mind] and spiritual [spirit] aspects of a being are incorporated into the healing-body protocol, healing is increased and quality changes emerge.

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Mind: The mind is a powerful healing tool. To say that our conditioning, the culture of our lives may contribute to our illness can feel shaming and blaming. The truth is that it’s not meant to be that way: it is more information that empowers us to respond to a healing situation, to acknowledge and break free of internalized dogma. When the mind is explored, we are, in essence, getting to know ourselves and our needs thus, responding responding to our lives instead of reacting. The health professional, including nurses, doctors, health educators, integrative practitioners, massage therapists etc. can help facilitate patient’s awareness of the connection between emotion and physiology. With this awareness, we are on our way to learning expression vs. repression, de-stressing vs. stressing and how our health is deeply affected by both.

Body: Every mammal [cat, dog, horse, human] has an Endocannabinoid System [ECS] that oversees all the other systems, regulates and promotes these systems. The ECS was founded in the mid-80’s by Raphael Mechoulam, from Israel & NIMH researchers: W. Devane and Dr. L. Hanus.

It used to be that the doctor had to inspire and listen to his patient to affect a healing: it was a partnership. Today, we have the medical industrial complex that forces us look at “staying out of the system” if possible, to look at prevention and a nontoxic approach to healing with no side effects and contraindications. The herb, Cannabis, minimizes and heals not only the symptom (i.e. pain) but also a primary cause of the pain (i.e. inflammation).

Gabor Mate, MD’s text, When the Body Says No: Exploring the Stress-Disease Connection, draws correlation between personalities of his clients and their ailments. He cites a North Carolina study that revealed that the majority of women with IBS have suffered abuse and only 17% of their doctors were aware of their patients’ history. Personal histories are powerful healing tools: without the history, our medical establishment reaches for the newest miracle in the form of a pharmacological drug or surgery.

Cancer, ALS, MS, and Rheumatoid Arthritis are a few of the conditions that have a psychological component that points to those who live in a reactive mode. Hence, self-examination is practiced in addition to the other healing modalities to heal vs. cure. Mate addresses “aligning with our innate wisdom, encouraging self-examination, insight and transformation.” Without question, it is time that healing addresses the WHOLE person: Body, Mind, Spirit as they are intrinsically interwoven.

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Spirit: In The Benefits of Marijuana: Physical, Psychological, Spiritual, Joan Bello writes how she sets an intention in the morning and accepting what else is to be learned throughout the day with a ‘go-with-the-flow’ attitude. Another phrase of complete acceptance is “not pushing the river”. In other words, not making LIFE happen.

Instead, allowing LIFE to happen while doing the footwork.

• •

Decreased cognitive skills Rare side effects: unusual perception s of all senses, anxiety, hallucinations, slight increase in heart rate

•

Study in LA of 1,252 smokers: a lung protective.

Not associated with an increased risk of lung cancer

Who Should NOT use Cannabis?

I believe there are as many religious/spiritual systems as there are cultures. Often, cognitive dissonance enters into the health equation and paradigm shifts help us connect our hearts and minds to Spirit.

Our behavior can evolve as we learn and implement what makes us healthy, happy, and at peace. The internal spirit is a mechanism that will always reflect the alignment in one’s health.

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Cannabis may be a co-factor in schizophrenia later in life

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If a history of psychosis or schizophrenia, suggested to avoid all mind-altering substances such as cocaine, methamphetamines, cannabis

The form of Spirit is what resonates within, like the strain of cannabis that locks into our specific ECS receptors easing the body of anxiety, the mind of depression and the spirit bolstered and respected.

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Addiction has not been found to be physical addiction, like heroin, nicotine and alcohol.

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May develop a psychological component of addiction. Use of the non-psychotropic topicals or sub-lingual can often be

Lastly, I have taken a small survey of friends, some dealing with illness, a nurse and paramedic who offered their experiences and what they wanted to know and what their patients wanted to know, regarding the basics of Cannabis.

The reader can become acquainted with some of the basic facts about Cannabis under each heading. NOTE: This list is a small fraction of information, benefits and practical uses etc. attributed to Cannabis.

Please note the resources at the end of this article.

General Benefits: paradox depending on the individual ECS • • • • • • •

Neuro-Protectant: PD, AD, MS, ALS Chemotherapy induced Vomiting, HD [Hyperemesis Gravidarum] Cancer Anxiety/Depression/PTSD Pain Relief: Inflammatory Diseases, Migraines, CNMP, Spasms Grounding/Relaxing Heart Health

Practical Use of Cannabis?

•

Not yet practical within the majority of hospitals or healthcare centers • Use of edibles and topicals [creams, balms, sprays] has become more popular and in great demand because of their non-psychotropic effect.

Depending on the state, Nurse Practitioners are allow to assess patients and suggest Cannabis for specific disorders (ANA 2016). It is important to note that Cannabis is still illegal on the Federal level.

Side Effects?

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Munchies Sleep Temporary Paranoia Relaxation Dry mouth

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Addiction Issues?

substituted

Cannabis is an herb with healing properties. These are exciting times to change our practices, promote change in clients/patients to more integrative medicine, and spread the word about a medicine that has few contraindications and fewer side effects than pharmaceuticals prescriptions. In my humble opinion, stay away from the real drugs.

Bibliography Bello, Joan, The Benefits of Marijuana: Physical, Psychological, and Spiritual,Blesching, Uwe, The Cannabis Health Index, 2013 Mate, MD. Gabor When the Body Says No: Exploring the StressDisease Connection, 2003 Mikuriya, MD. Tod, Chronic Conditions Treated with Cannabis Encountered Between 1990-2004

Webliography Green Flower Media- https://www.learngreenflower.com Center for Cannabis Research at UCSD- http://www.cmcr.ucsd.edu For Nurses/Health Professionals CE/Certificate Credit: www.CannabisEducationNetwork.com For Nurse Supported Products: www.NatureNurseHealth.com For Evidence-Based Education: www.CannabisNursesMagazine.com

By: Sue Degregorio-Rosen, RN Many nurses have been asking about how medical cannabis is playing into the protected fields of HIPAA (Health Insurance Portability and Accountability Act of 1996) which is United States legislation that provides data privacy and security provisions for safeguarding medical information. Here’s an article that will assist you in your profession to assure your state medical marijuana/recreational programs and dispensaries are in alignment with protecting patient’s medical information.

Because of its reputation, the Medical Cannabis Industry is diligent about keeping within the confines of federal law and in so doing, relies heavily on these patient verification systems.

These systems usually contain protected health information (PHI) such as medical record numbers, patient contact information (including addresses), diagnosis codes, and other personal information used for verification (such as driver’s license numbers).

At a glance, a few factors will give away if a business is serious about their compliance. For one, their website will have a Secure Socket Layer (SSL) certificate. This means that your address bar will show a lock and/or be green to indicate that website traffic is encrypted. In addition, the provider will need to host their data in a HIPAA Compliant data center. Having the data on-site or in a typical server location is a flagrant violation of HIPAA. If you are concerned, you should be aware

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that violating HIPAA security regulations is a serious crime and often includes fines for the violator.

Understand the differences between standard web hosting vs. HIPAA compliant hosting to ensure that you have the correct type of provider.

Medical Dispensaries fall under the auspices of HIPAA and are required to keep confidential all of the PHI that is collected durign a customer transaction.

The information that is given to qualify for a medical marijuana card in the first place is also covered under HIPAA and cannot be released without the patient’s written consent or a court subpoena. To do so, even accidentally, would be a violation of HIPAA and most likely would result in a fine. However, if a credit card is used when purchasing marijuana from a dispensary, completely restricting this transaction information is not possible. It is also worthwhile noting that Visa and MasterCard have recently stopped

allowing medicinal marijuana purchases or have used high per-transaction rates to make accepting credit cards not feasible.

When it comes to HIPAA compliance, the rules for medicinal marijuana are strikingly similar to the rules for any other medical substance or service. Patient information is protected under HIPAA regulations in terms of both data storage and employee inquiries. Businesses and their associates that handle PHI are compelled to abide by these regulations and are subject to fines and legal action, even if the PHI data pertains to medicinal marijuana.

Medical Marijuana: A Primer on Ethics, Evidence, and Politics Nayna Philipsen, JD, RN, Robin D. Butler, MBA, RA, Christie Simon-Waterman, MSN, FNP-C, and Jylla Artis, MSN, FNP-C ABSTRACT Controversy in the United States about the decriminalization of cannabis to allow health care providers to

recommend it for therapeutic use (medical marijuana) has been based on varying policies and beliefs about cannabis rather than on scientific evidence. Issues include the duty to provide care, conflicting reports of the therapeutic advantages and risks of cannabis, inconsistent laws, and even the struggle to remove barriers to the scope of practice for Advanced Practice Registered Nurses. This article reviews the ethics, evidence, and politics of this complex debate.

Keywords: advanced practice registered nurse scope of practice, advocacy, barriers to advanced practice registered nurse practice, cannabis, compassionate care, criminalization, decriminalization, gateway drugs, marijuana, medical marijuana, palliative care, paternalism, patient autonomy, therapeutic cannabis, HIPAA. MEDICAL MARIJUANA AND PRIVACY Related to patient autonomy is a patient’s right to privacy (i.e. to control his or her own body and his or her own personal information).

The ancient Hippocratic Oath included the statement that “Whatever I see or hear in the lives of my patients, whether in connection with my professional practice or not, which ought not to be spoken of outside, I will keep secret, as considering all such things to be private.” When personal health information is likely to result in social stigma or negative consequences, such as when psychiatric, drug, or alcohol treatment information is released or when the patient is a celebrity, the duty to protect patient privacy is heightened.

This special circumstance has long been an issue and is recognized under the Health Insurance Portability and Accountability Act (HIPAA) of 1996 (PL 104- 191; 42 U.S.C. xx1320d et seq.). The use of therapeutic cannabis is likely to be in this category, as long as its use remains illegal or continues to be viewed negatively by society.

Even if medical use is a defense, association with a drug that many consider illicit could impact a person’s ability to be employed or create other social handicaps. Therefore, caregivers, including APRNs, need to be prepared to extend these additional protections of privacy for a patient who is using medical marijuana. Where the possession of therapeutic cannabis is illegal, patients have an additional concern about criminal penalties and may well be concerned about the protection of their information from release to organizations and individuals. HIPAA does exempt certain entities from the confidentiality requirement and grants them access to patient information without patient consent for the greater good of society.

Law enforcement is not generally an exception. Examples of exceptions include public health reporting requirements and regulators like the US Department of Health and Human Services, which needs access in order to enforce HIPAA. APRNs can reassure their patients that most entities are not entitled to the patient’s health records without the patient’s consent, including the US Drug Enforcement Administration (DEA). HIPAA (the Privacy Rule, at 45 C.F.R. xx160 and 164) specifically limits access to identifiable health information, whether it is medication listings, discharge, or progress reports, including those cases in which DEA officers request information to show the patient’s criminal intent. All health entities and caregivers are held accountable by HIPAA to protect patient privacy and generally are not required to expose the patient’s past or present medical history, including prescriptions or drug use, to authority outside of that health entity.

References: www.npjournal.org The Journal for Nurse Practitioners – JNP 6 http://lib.ajaums.ac.ir/ booklist/Nurse%20Practitione478.pdf Medical Marijuana: A Primer on Ethics, Evidence, and Politics Nayna Philipsen, JD, RN, Robin D. Butler, MBA, RA, Christie Simon-Waterman, MSN, FNP-C, and Jylla Artis, MSN, FNP-C http://www.npjournal.org/article/ S1555-4155(14)00375-4/abstract https://www.hhs.gov/hipaa/ https://www.nlm.nih.gov/hmd/greek/ greek_oath.html https://www.vmracks.com/resources/hipaacompliant-hosting-insights/hipaa-complianthosting-vs-standard-web-hosting/ https://www.vmracks.com/resources/hipaacompliant-hosting-insights/medicalmarijuana-industry-regulated-by-hipaa/? option=com_content&view=article&id=58:tru e-hipaa-compliance&catid=11:services& Itemid=73

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health

Cannabinoid Integrative Health 101 Dr. Sunil Kumar Aggarwall On Jan. 23, 2016, I delivered a TED-style talk at the 2016 Virtual Cannabis Health Summit produced

by Green Flower Media. Below are some highlights: I resolved to “leverage my privilege” and strive to make a difference by “coming out” about cannabis in my scholarly and medical work. This is a way to heal, to turn a “badge of shame and target for state oppression” into a badge of courage.

I’m here today to tell you that there is a “marijuana drug fundamentalism” in society built on willful ignorance of cannabis and its effects that I wish to disrupt and do away with, using the strongest tools for knowledge-making that we have — science and social science — and build in its place a legitimate new edifice that links cannabis and health in a natural understandable way that empowers you as it has me.

Cannabinoid Integrative Health Science 101 First things first: Let’s “unlearn” what governments have long propagandized and fooled people into believing that cannabis, referred to with that foreign-sounding name “marijuana,” is an invasive, “illegal” alien threat that does not belong here, and needs to be monopolized away from the commons out of our reach for our own good. Let’s instead re-integrate the plant cannabis back into our sense of the naturally evolved web of life on planet Earth, of which we are a part. Cannabis is an advanced, wind-pollinated plant which comes in two sexes, male and female (and occasionally hermaphrodites) which evolved around 38 million years ago

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somewhere in Central-Southern Asia. One theory of how some of the key chemical compounds came to be so abundant in ancestral cannabis plant flowers is that they evolved as a protective response to increasing UV radiation from the sun that they were exposed to in their native habitat as they rose to higher and higher elevations during the massive geological uplift that began 50 million years ago when the Indian subcontinent began to collide with the Asian landmass, creating the Himalayas, the world’s tallest mountain range. Archaeological evidence suggests that this wild cannabis plant (which still grows wild abundantly in these parts), was domesticated in South Asia as early as 18 thousand years ago. Its use as a medicinal agent quote “known for 1,000 years” is recorded in the Government of India’s traditional knowledge digital library to protect it and medical knowledge of its many uses from international biopiracy.

Not only that, but Cannabis use as an aid in spiritual development, such as meditation, has been part of Indian religious traditions dating back thousands of years and cannabis remains consecrated and closely associated with certain deities and saints.

Second, let’s also unlearn that whole plant herbal cannabis medicinal use and experimentation is the business of unscientific quacks and know-nothing charlatans....

In actual fact, the history of cannabis in Western science and medicine is pretty striking, and we owe our modern understanding of cannabis as an end-of-life palliative, pain, spasm, and convulsion-relieving compound to Sir Dr. William O’Shaughnessy, a brilliant Irish scientist, physician, and educator virtually no one has heard of, who as a medical student helped to define the life-saving electrolyte hydration treatment of cholera victims. He was an early proponent of integrative medicine, learning from local healers, and his writings and work on cannabis from India in the 1830s, helped to bring it into the medical mainstream where it was looked upon quite favorably for use in painful menstrual disorders and neurological disorders such as migraine, spasms, Parkinson’s, dementia and epilepsy, touted by some of the great physicians of the 19th and 20th centuries, such as Sir Dr. William Osler, the father of internal medicine and cofounder of Johns Hopkins, Sir Dr. William Gowers, who first started checking hemoglobin levels in patients and commonly utilizing an ophthalmoscope to peer into the retina, and Sir Dr. J. Russell Reynolds, who laid the groundwork for our modern understanding of epilepsy

and was Queen Victoria's personal physician. Even 200 years before their time, the legendary scientist Robert Hooke, who invented the reflecting microscope and described “plant cells” for the first time, grew and self-experimented with cannabis and described its salutary effects. Knowing this history, it should not surprise us to learn that one of the final projects in the early 2000s of the late Nobel Laureate in Medicine Dr. Julius Axelrold, famous for his fundamental discoveries on how adrenaline and dopamine are produced, stored, and used in our bodies, was on the use of cannabis compounds as powerful antioxidants and protectants of the brain from damage due to injury, stroke, and diseases such as Alzheimer’s. He felt this to be so valuable that he co-patented the idea for the government. Knowing all this allows us to integrate cannabis into our collective geologic, cross-cultural, and hallowed science histories so that it will never again seem alien or marginal.

Like maple trees make sap, cannabis female flowers make a sticky resin, produced biologically for the practical role of protection from the elements but also for the procreative role to help get wild male pollen blowing in the wind to stick to and fertilize females. In many domesticated settings, females are separated from males to optimize resin production. Cannabis resin is truly one of the great finds and wonders of nature. As The Economist magazine, which understands value, poetically wrote in 2006:

IF CANNABIS were unknown, and bioprospectors were suddenly to find it in some remote mountain crevice, its discovery would no doubt be hailed as a medical breakthrough. Scientists would praise its potential for treating everything from pain to cancer, and marvel at its rich pharmacopoeia — many of whose chemicals mimic vital molecules in the human body.

Now, here’s the rub — the really big deal that stands to revolutionize nearly every branch of medicine. Serious scientists around the globe, in studying the effects of cannabis on the body, discovered in the last decade of the 20th century, a whole new field of biology and physiology — the science of cannabinoid signalling — a phenomenon which has been integrally part of life itself for 600 million years. It was discovered over time by picking up a thread that began with finding a new widespread protein in our bodies that fits lock-and-key with a major cannabinoid in cannabis, and following that thread until it revealed a massive tapestry of DNA-encoded molecules working in unison, the endocannabinoid signalling system.

Cannabinoid signalling, which is going on all of the time in many bodily tissues and organ systems, has major ramifications for our health, playing a key role in regulating mood, appetite, memory,

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inflammation, pain perception, muscle tone and movement, extinction of traumatic memories, protection of nerves and brain tissue, bone growth, tumor regulation, baby breastfeeding reward, stress management, eye pressure, gastrointestinal motility, seizure activity, and other areas of health. The Endocannabinoid System (ECS) is a molecular signalling network that plays a key role, like a symphony conductor — more of this signal, less of this signal, in maintaining healthy homeostasis and equilibrium in our bodies.

There have been tens of thousands of scientific papers published on the ECS and over 8,000 human subjects have been part of published controlled clinical studies with cannabis and cannabinoids proving their effectiveness in treating real ailments, some of which you will hear about at this Summit. What's remarkable is that compounds from cannabis resin when consumed are able to either gently hook directly into specific endocannabinoid receptors or indirectly increase the activity of the system, thereby helping us to treat symptoms such as chronic pain, anxiety, depressed mood, nausea, loss of appetite, and spasms. They can also lead lead to tamping down of inflammation, reduction of toxicity from excess release of neurotransmitters, quieting of seizures, and many other exciting possibilities such as controlling cancers, fighting infections, diabetes, and autoimmune diseases, and yes, learning how to relax.

This cannabinoid science mechanistically explains why cannabis resin has therapeutic utilities that have been observed for millennia and shows that its use in the preservation, promotion, and restoration of health is scientifically sound and sustainable, as an organic, herbal, renewable, therapeutic cannabinoid delivery vehicle. We need more research to further our understanding of what types and how much of cannabis preparations are best for which conditions, desires, and individual chemistries.

In closing, let me stress again that the cannabis plant truly does belong to the global commonwealth of all peoples. I hope by learning about its deep history and its health potential, we would build better regulatory systems that respect and optimize the human-cannabis relationship, including our freedom to farm it, trade and share it, which is our birthright, as we move from criminalization to civilization, and stop discrediting and start crediting cannabis-knowledgeable folks. It is normal and okay to have an affinity and gravitate towards certain plants in our commons, and we can heal violence and injustice if we acknowledge that and integrate it into our understanding of who we are and what we care about in the world, especially in our health systems and our laws.

References: Cannabinoid Integrative Health 101 -- prepared remarks for opening of 2016 Virtual Cannabis Health Summit -- (Produced by Green Flower Media, Delivered January 23, 2016, Pleasanton, CA) http:// cannabinologist.org/CannabinoidIntegrativeHealth101_000.htm Use of cannabinoids in cancer care: palliative care; S.K. Aggarwal, Current Oncology, Vol 23 (2016) http://www.current-onc ology.com/index.php/oncology/article/ view/2962 Health Scientist Blacklisting and the Meaning of Marijuana in the Oval Office in the Early 1970’s (2015) Unpacking the Nixon Tapes: The Meaning of Marijuana for the U.S. Presidential Administration Which Created and Placed It in Schedule I Medicalization of Marijuana JAMA November 12, 2014 https:// www.ncbi.nlm.nih.gov/pubmed/25387197 Palliative and Supportive Care, page 1 of 6, 2015. Cambridge University Press, 2015 1478-9515/15 http://cannabinologist.org/Documents/2015%20NIH-MM_PPCS.pdf Excerpt on Cannabis and Entheogens in Complementary and Alternative Medicine In Palliative Care in Amyotrophic Lateral Sclerosis: From Diagnosis to Bereavement, edited by David Oliver, Gian Domenico Borasio, Wendy Johnston, May 2014.

Gregory T. Carter, Sunil Kumar Aggarwal, Michael Weiss, and Richard S. Bedlack http://cannabinologist.org/Documents/ excerpt_CAM_cannabis_entheogens_ALS.pdf Point/Counterpoint Medical Marijuana for Failed Back Surgery Syndrome (2014) Sunil K. Aggarwal and Gregory T. Carter http://cannabinologist.org/Documents/2014%20PM&RPoint-CounterPoint-Medical-Marijuana.pdf Cannabis for Symptom Control #279 Journal of Palliative Medicine. Vol. 17. No. 5 Sunil K. Aggarwal and Craig Blinderman http:// cannabinologist.org/Documents/2014% 20JPM_CannabisforSymptomControl.pdf Cannabis: Evolution and Ethnobotany 1st Edition

by Robert C. Clarke (Author), Mark D. Merlin (Author) Reefer Madness; April 27, 2006 http://www.economist.com/node/6849915 Harm reduction- the cannabis paradox, Robert Melamede, MD, Harm Reduction Journal 2005. https://harmreductionjournal.biomedcentral.com/ articles/10.1186/1477-7517-2-17 The Discovery of the Endocannabinoid System, Martin A. Lee, O’Shaughnessy’s, 2010. http://www.beyondthc.com/wp-content/ uploads/2012/07/eCBSystemLee.pdf The Endocannabinoid System as an Emerging Target of Pharmacotherapy Pal Pacher, Sandor Batkai, George Kunos; Pharmacol Rev. 2006 Sep; 58(3): 389–462. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2241751/ Review on clinical studies with cannabis and cannabinoids Mikael A. Kowal, Arno Hazekamp, Franjo Grotenhermen, annabinoids 2016;11(special issue):1-18. 2010-2014. http://www.cannabis-med.org/data/pdf/ en_2016_01_1.pdf 0Dy June CANNABISNURSESMAGAZINE.COM

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Integrating Cannabis into Aromatherapy Jessica Baker, LAc Dipl OM, RH (AHG), Laura Lagano, MS RDN CDN, and Donna Shields, MS, RDN With medical Cannabis approved in half the country plus [43] states for legalized adult (or recreational) use, the Cannabis industry is growing at an astounding rate in the US and around the globe. Cannabis has therapeutic application for various conditions such as seizure management, inflammatory pain relief, insomnia, and anxiety. To help you make an informed decision about how and when to incorporate Cannabis into a health and wellness plan, it is important to first dispel misconceptions and gain basic knowledge about the interplay between cannabinoids, terpenoids and the Endocannabinoid System. Once you have a basic understanding of THC and CBD, as well as the other constituents of Cannabis, the numerous products on the market will be easier to evaluate.

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and the effects they have on our endocannabinoid system (ECS).

Phytocannabinoids There are several chemovars found in Cannabis: the primary phytocannabinoids are tetrahydrocannabinol (THC) and cannabidiol (CBD). The Federal assignment of Cannabis as a Schedule 1 drug has made research in the US difficult, so researching these compounds and their complex interactions with each other and with our ECS has been challenging. Until more is known, be aware that products claiming to have certain effects based on their cannabinoid profiles may be based on testimonial experience.

Cannabis “varieties” Perhaps the most widespread and misleading myth surrounding the uses and effects of Cannabis lies in whether the plant is a sativa or an indica. A widespread belief about the effects of Cannabis is that Cannabis sativa produces more of a head-trip effect (mind racing, heart pounding) and that Cannabis indica results in a more sedating effect (chill on the couch, relax). Products in the marketplace perpetuate this myth.

THC Delta-9-tetrahydrocannabinol acid (THCa) is the component in Cannabis that upon decarboxylation via heating converts to THC, eliciting the well-known psychotropic effect. Besides conferring a “high” effect, THC may offer health benefits such as bronchodilation, neuro-protective antioxidant stimulation for brain injuries and strokes, anti-inflammation without COX-1 or COX-2 inhibition, muscle relaxation, anti-emetic uses, and the reduction of the b-amyloid plaques found in Alzheimer’s.

In actuality, it is the mixture of phytocannabinoids and terpenoids, which interact with our own endocannabinoid system, creating these sensations. These mixtures vary widely across both species, and there is an ongoing discussion among medical researchers and botanists about whether the distinction between sativa and indica is relevant. To make intelligent recommendations to your clients, you must move beyond these broad and disputed categories and develop an understanding of the underlying chemovars

The appetite-stimulating effects of THC were confirmed in a long-term study of 94 AIDS patients. Of the patients who completed the trial, 25% achieved a weight gain of 2 kg or more during a 12-month period (Beal et al., 1995). Oral THC has been found to be effective against cancer pain in doses of 15 mg and 20 mg in two clinical trials, although some participants reported intolerable side effects such as dizziness, confused thinking, and panic (Regelson et al., 1976).

A clinical trial of inhaled Cannabis for neuropathic

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pain showed that low potency (3.5% THC) and high potency (7% THC) Cannabis had equivalent analgesic properties (Wilsey et al., 2013). The discovery that higher THC percentages are not necessary for pain reduction is significant because some individuals do not welcome its psychotropic effects.

and prevention of the spread of pain. As an autoimmune protectant, CBD antagonizes tumor necrosis factor, which is present in autoimmune disorders such as rheumatoid arthritis. It has also been found to inhibit the activity of THC (Russo and Guy, 2006), which can modulate the psychotropic effects.

Despite these early and encouraging results, there is a lot of controversy surrounding the laboratory testing of THC. To date, there is no standard for testing and there are large differences in THC percentages from lab to lab. The desire for high-THC varieties in adult, or recreational, use has spilled over into the medical field. Thereâ&#x20AC;&#x2122;s market pressure for dispensaries and edible-product producers to offer products with high percentages of THC. As we examine the synergy of cannabinoids and terpenoids, we will see that THC is only one of the key Cannabis constituents.

Optimal dosing and the proper application of Cannabis products is an emerging topic. Early indications have produced a recommendation of beginning with 0.1 mg/kg/day, gradually increasing the dosage until the desired impact is achieved. Further research and experimentation will help us determine optimal dosage.

CBD Cannabidiol (CBD) is the other primary constituent in Cannabis. Unlike THC, it does not have any psychoactive properties. Research has shown its medical uses to be quite varied. It has been found to be effective against methicillin-resistant Staphylococcus aureus (MRSA) (Appendino et al., 2008); as an anticonvulsant (Jones et al., 2010); and as an analgesic (Costa et al., 2007). It has been shown to reduce anxiety (Russo et al., 2005) and it is cytotoxic against certain breast cancers (Ligresti et al., 2006).

Its neuroprotective antioxidant properties are well established and have been found to be more potent than ascorbate (vitamin C) or tocopherol (vitamin E) (Hampson et al., 1998). In fact, US Health and Human Services has a patent on cannabinoids as antioxidants and neuroprotectants (US 6630507 B1; 2001). This is in direct contradiction to the illegal status of Cannabis as a Schedule I drug, which are drugs with no medicinal value and a high potential for abuse.

CBD has also been shown to help reduce the occurrence of seizures in infants. Research has also discovered anti-seizure properties in vitro and in vivo, as well as anti-convulsant effects in animal models for temporal lobe and partial seizures (Jones et al., 2010).

Other properties have been attributed to CBD including bone growth stimulation and the reduction

CBG, CBN, CBDV and THCV Though less studied than CBD or THC, several other phytocannabinoids have also been identified. Cannabigerol (CBG) has been found to antagonize prostate cancer and work as an analgesic (De Petrocellis and Di Marzo, 2010). It is a GABA-uptake inhibitor (Banerjee et al., 1975) with possible antidepressant properties. Cannabinol (CBN) is an oxidative byproduct of THC that has been shown to have sedative and anticonvulsant properties (Turner et al., 1980).

It is effective against MRSA (Appendino et al., 2008), and can be useful for treating burns. Cannabidivarin (CBDV), too, is a potential anticonvulsant (Jones et al., 2010), as is tetrahydrocannabivarin (THCV), which has been shown to be effective in treating metabolic syndrome (Cawthorne et al., 2007; Riedel et al., 2009).

Again, further research into these compounds and their interactions promises great potential effects.

The Endogenous Cannabinoid System The Endocannabinoid System (ECS), present in all vertebrates, is a network of neuro-modulation receptors within our brains, immune systems, and other parts of the body. Our ECS is a hemostatic regulatory system essential for key processes such as pain, appetite, memory, and mood and pain regulation. It plays a hand in regulating mitochondrial activity and in neurogenesis. Three components of ECS are known: endogenous cannabinoids (endocannabinoids); cannabinoid receptors (CB1, CB2, TRPV1); and the enzymes that synthesize and degrade endocannabinoids.

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to date are arachidonylethanolamide (anandamide) and 2-arachidonoylglycerol. Anandamide is a fatty acid neurotransmitter, referred to as the “bliss molecule” because of its pleasurable effects. Notably, anandamide has been shown to inhibit breast cancer cell proliferation by inhibiting DNA synthesis (De Petrocellis et al., 2011).

Cannabinoid receptors are neuro-modulating receptors that halt neurotransmitter release upon binding with an endocannabinoid. CB1 receptors, which are psychoactive, are the most abundant receptors in the brain. Most CB1 receptors are found in the limbic system, cerebellum, and cerebral cortex. Non-psychoactive CB2 receptors are found in immune tissues such as leukocytes, the spleen, and tonsils, and in the heart, bones, and muscles. They are expressed in the brain when injury or disease occurs, such as multiple sclerosis. As immuno-modulatory receptors, they are important in reducing pain and inflammation. CB2 agonist drugs have been shown to be effective for hepatic fibrosis and other fibrotic conditions.

CB1 and CB2 receptors are also in the gut, where they help modulate propulsion and secretion, and are distributed along the skin where they modulate pain and inflammation. TRPV1 receptors mediate pain signals, and therapeutic agents that work on this receptor may reduce neuropathic pain.

The ECS is triggered by various external sources, including herbs, foods, and even exercise. What was once believed to be endorphins producing the feelgood effects post-exercise is actually the ECS at work. Other activities including meditation and orgasm impact the ECS. Metabolism and digestion are also factors in the functioning of ECS, as cannabinoid receptors affect the digestive system.

Phytocannabinoids and the ECS The various phytocannabinoids interact with the ECS at the cannabinoid receptor sites to induce various biological and psychoactive effects. THC, THCV (at higher doses), and anandamide are all CB1 agonists and elicit the euphoric effects of Cannabis. CBD has the opposite effect – it antagonizes the CB1 receptors, reducing the psychoactive effects of THC. CBG has also been shown to have agonist effects on both CB1 and CB2 receptors, though its effect is weaker than THC’s. This self-balancing regulatory system

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provided by the Cannabis plant is one reason why using whole plant medicine is more beneficial than standardized extracts of phytocannabinoids.

Knowledge of the ECS and the effects phytocannabinoids have upon it can quickly help you separate fact from fiction in an unregulated marketplace where manufacturers often make dubious claims or tout measurements that have little basis in science. As you make decisions about how to incorporate Cannabis products into your practice, it is important to know the correct phytocannabinoid profiles to ensure consistency in treating specific conditions.

Not only is the source important, but as with any other botanical product, each harvest can yield a slightly different profile due to environmental conditions. The more information you can acquire, the better equipped you will be to help your clients.

Terpenoids Beyond the phytocannabinoids, Cannabis also contains terpenoids – over 200 have been discovered.

We are already familiar with the therapeutic properties of common constituents such as a-pinene in Pine (Pinus spp.) needles, d-limonene in citrus, and b-caryophyllene in Carrot (Daucus carota) seeds.

These are among the many constituents also found in Cannabis. Research into these and into the ways in which Cannabis interacts with other oils and terpenoids could well yield dramatic results. According to neurologist and Cannabis researcher Ethan Russo (2011), some of these phytocannabinoid-terpenoid entourage effects could well come from the interaction of Cannabis with Frankincense (Boswellia carterii), citrus oil, Lavender (Lavandula angustifolia), Spearmint (Mentha spicata), Pine, Black Pepper (Piper nigrum), Rosemary (Rosmarinus officinali ), Sage (Salvia offic nalis), and others (Table 1). Because terpenoids are already an area of expertise for the Aromatherapist, adding Cannabis terpenoids into the mix can be a logical and natural extension of a care plan.

Cannabis Products There are countless Cannabis products on the market today. Many of these are unregulated and the manufacturers behind them may have limited experience or education in phytochemical interactions. Until there is greater understanding about the benefits and entourage effects of phytocannabinoids, it is wise to purchase only Cannabis-extract products

Table 1. Phytocannabinoids and possible synergistic terpenoid partners. The table first appeared in the article Taming THC: Potential Cannabis synergy and phytocannabinoid-terpenoid entourage effects (Russo, 2011), British Journal of Pharmacology. 163, p1344-1364. Š E. Russo. Used with permission.

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that have undergone rigorous third-party testing and provide a certificate of analysis.

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CBD oil has been promoted for children and young adults with seizure disorders. Many of the claims attributed to CBD oil are not unfounded, yet it is important to remember that it is not a panacea and common sense should be applied when working with these oils. As with all herbal products, it is important to know your source and ask about growing practices, pesticide use, and application and extraction methods.

Not only are many of the claims about cannabinoid profiles spurious, there are also significant health concerns with ingestion. Cannabis is an effective phytoremediator, which means it draws heavy metals and other toxins out of the soil. Tests have shown that THC may concentrate these heavy metals, so it is References and bibliography very important to know the source of the Cannabis Appendino G, Gibbons S, Giana A et al. (2008). Antibacterial cannain the products you purchase. binoids from Cannabis sativa: a structure-activity study. The Journal of The lack of regulation of Cannabis has allowed producers of Cannabis oil to sell medical and retail Cannabis products with solvent and pesticide residue, adulterants, and contaminants. Edible Cannabis products are usually made with solvent-extracted hash oil. Besides the residual solvent and pesticides, they may also contain GMO ingredients, refined flours or sugar, and other inflammatory ingredients.

It is also important to remember that flavored Cannabis products often contain hexane-extracted terpenoids that were added after the fact, as is popular within the food industry. A better approach would be to breed Cannabis for specific terpenoid profiles instead of adding them.

Inhaled Cannabis oil products such as vape pen cartridges often contain propylene glycol as an additive and the Cannabis oil itself is often solvent- or CO2-extracted. Residual solvent left in the product is always a concern, as inexperienced people are making the extractions in unregulated laboratories.

With CO2 extraction, it is important to know what pesticides were used to avoid contamination in the products.

Natural Products. 71, p1427-1430.

Banerjee S P, Snyder S H and Mechoulam R. (1975). Cannabinoids: influence on neurotransmitter uptake in rat brain synaptosomes. Journal of Pharmacology and Experimental Therapeutics. 194, p74-81.

Beal J E, Olson R, Laubenstein L, Morales J O, Bellman P,Yangco B, Lefkowitz L, Plasse T F, and Shephard K V. (1995). Dronabinol as a treatment for anorexia associated with weight loss in patients with AIDS. Journal of Pain and System Management. 10 (2), p89-97.

Cawthorne M A, Wargent E, Zaibi M, Stott C and Wright S. (2007).

The CB1 antagonist, delta-9-tetrahydrocannabivarin (THCV) has antiobesity activity in dietary-induced obese (DIO) mice. Proceedings of the 17th Annual Symposium on the Cannabinoids. June 26-30, 2007, Saint-Sauveur, QuĂŠbec, Canada. Unpublished conference paper.

Costa B, Trovato A E, Comelli F, Giagnoni G and Colleoni M. (2007). The non-psychoactive Cannabis constituent cannabidiol is an orally effective therapeutic agent in rat chronic inflammatory and neuropathic pain.

The European Journal of Pharmacology. 556, p75-83.

De Petrocellis L and Di Marzo V. (2010). Non-CB1, non-CB2 receptors for endocannabinoids, plant cannabinoids, and synthetic cannabimimetics: focus on G-protein-coupled receptors and transient receptor potential channels. Journal of Neuroimmune Pharmacology. 5, p103-121.

De Petrocellis L, Ligresti A, Moriello A S et al. (2011). Effects of cannabinoids and cannabinoid-enriched Cannabis extracts on TRP channels and endocannabinoid metabolic enzymes. British Journal of Pharmacology.

163 (7), p1479-1494.

Hampson A J, Grimaldi M, Axelrod J and Wink D. (1998). Cannabidiol and (-)Delta9-tetrahydrocannabinol are neuroprotective antioxidants.

Proceedings of the National Academy of Sciences. 95, p8268-8273.

Previously published in the International Journal of Professional Holistic Aromatherapy, (Volume 5, Issue 4, Spring 2017).

Special Thanks to: Laura Lagano and Donna Shields of Holistic Cannabis Network

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Jiny Varghese et al., IJPSR, 2010; Vol. 1 (10): 1-10

ABSTRACT Holistic living is an art of living in harmony with nature and deals with a concern for the whole universe. The term holistic medicine is derived from the term â&#x20AC;&#x153;Holismâ&#x20AC;? which means that a living being is not to be viewed as a composite of different organs but as an integrated entity viewed as a whole. The holistic concept takes into account individualâ&#x20AC;&#x2122;s physical, spiritual, nutritional and even social background. Holistic medicine is an intelligent combination best utilizing both streams i.e. while mainstream medicine is well suited for crisis intervention and alternative medicine is for health maintenance. Alternative medicine denotes a system of health care where combinations of healthcare systems are used instead of conventional or mainstream medicine to treat diseases. Alternative medical practices are based on a belief system and are not derived from modern science. But holistic medicine neither rejects conventional medicines nor comprises alternative practices. It is high time to recognize the emerging awareness, need and practice of Holistic and Integrated medicine. Drawing from various systems of healing from across the globe holistic medicine has widened the scope of treatment making it effective, safe and affordable.

INTRODUCTION: Holistic healing means taking a holistic approach when seeking treatment for imbalances and choosing to live a more balanced lifestyle. What primarily distinguishes holistic healing apart from alternative medicine, complementary medicine and integrative medicine is the fact that physical health is not necessarily the main focus. Complementary and Alternative Medicine1 (CAM) includes a variety of healing approaches and therapies taken from around the world that historically have not been included in conventional Western medicine.

Many aspects of CAM are rooted in ancient, indigenous systems of healing, such as those of China, India, Tibet, Africa and America. Many of these treatments and health care practices are popular, and nowadays even some of them are being used in the hospitals (for example, acupuncture and some chiropractic treatments). Because of increased interest and use of CAM, more and more medical schools are including information about CAM treatments, such as acupuncture, herbal medicine, chiropractic treatments, and homeopathy.

Complementary Medicine: CAM practices are used in conjunction with conventional medicine. Although the distinction between conventional medicine and alternative medicine is not easy to determine, a basic philosophical difference exists. Conventional medicine generally defines health as the absence of disease or dysfunction. The main causes of disease and dysfunction usually are considered to be isolated factors, such as pathogens, biochemical imbalances, and aging, and treatment often involves drugs or surgery. In contrast, alternative medicine practices often define health holistically, that is, as a balance of systems- physical, emotional and spiritual- involving the whole person. Disharmony among these systems is thought to cause illness. Treatment in this case involves strengthening the body's own defence. In this communication, we want to throw some light about the general aspects and the therapeutic

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benefits of holistic approach2 which is an emerging trend in modern medicine.

Various CAM Therapies Included in the 2017 ;       

Acupuncture Ayurveda Biofeed back Chelation therapy Chiropractic or osteopathic manipulation Deep breathing exercises Diet-based therapies;       

      

Atkins diet Macrobiotic diet Ornish diet Pritikin diet South Beach diet Vegetarian diet Zone diet

Energy healing therapy/Reiki Guided imagery Homeopathic treatment Hypnosis Massage Meditation Movement therapies;    

Alexander technique Feldenkreis Pilates Trager psychophysical integration

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Natural products (nonvitamin and nonmineral, such as herbs and other products from plants, enzymes, etc.)

Naturopathy Progressive relaxation Qi gong Tai chi Traditional healers  Botanica  Curandero  Espiritista  Hierbero or Yerbera Native American healer/Medicine man

 

Shaman Sobador

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    

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Acupuncture: Acupuncture is one of the oldest healing

practices in the world; a part of traditional Chinese medicine. It is based on the concept that disease results from disruption in the flow of Qi and imbalance in the forces of Yin and Yang. Practices such as herbs, meditation, massage, and acupuncture seek to aid healing by restoring the yin-yang balance and the flow of qi (energy). Acupuncture3 is the stimulation of specific points on the body by a variety of techniques, including the insertion of thin metal needles through the skin.

It is intended to remove blockages in the flow of qi and through the stimulation of specific points on the body helps to restore and maintain health. In the United States, where practitioners incorporate healing traditions from China, Japan, Korea, and other countries, acupuncture is considered part of complementary and alternative medicine. Relatively few complications have been reported from the use of acupuncture. However, acupuncture can cause potentially serious side effects if not delivered properly by a qualified practitioner.

The Ayurvedic medicine generally helps to cure a particular disease; the physical, mental, emotional and spiritual wellbeing is taken into consideration. The best part of acquiring an Ayurvedic treatment is that the prescribed doses of medicine are taken in the form of powders, tablets, decoctions, and medicated oils that are prepared from natural herbs, plants and minerals. Traditional techniques and processes are used to prepare the medicines at home, while certain amount of mechanization is inevitably used for large-scale production.

The beauty of the therapeutics is that they contain the active principles in their natural forms and their administration in prescribed doses does not cause any side effects to the patients.

Ayurveda gives a complete look into the lifestyle of a person, like starting from his/her personality to the daily food habits.

The Science of Life helps us in understanding each individual at a very subtle personal level and giving a detailed description about the diet, daily routine, lifestyle, actions and activities to be followed. The science teaches how to live life in a balanced way. Ayurveda aims at having a healthy and happy society, free from diseases. India has gained worldwide recognition for its indigenous and extensive Ayurvedic treatment. Various centers are established throughout the length and breadth of the country, wherein authentic Ayurvedic treatment is given. Kerala is the hub of Ayurvedic treatments in India. Ayurvedic treatment's soothing effect on the body and soul has attracted tourists from different parts of the country as well as from across the globe.

Biofeedback: Biofeed back5 uses simple electronic devices

Ayurveda: An Ancient medicinal form, developed during the Vedic times, about 5000 years ago. The word 'Ayur' means life. Ayurveda also proposes treatments for specific health problems, whether they are physical or mental. The chief aim of Ayurvedic practices4 is to cleanse the body of substances that can cause disease, and this is believed to help reestablish harmony and balance. Ayur means life while 'Veda' means science.

Therefore, Ayurveda literally means the 'Science of Life'.

It is not just a medicinal system, but also a way of life.

The medicinal form is governed by the laws of nature, which suggest that life is a combination of senses, mind, body and soul. According to the Science of Life, the structural aspect of every individual comprises of five elements - earth, water, fire, air and space.

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to teach clients how to consciously regulate bodily functions, such as breathing, heart rate, and blood pressure, in order to improve overall health. Biofeedback is used to reduce stress, eliminate headaches, recondition injured muscles, control asthmatic attacks, and relieve pain.

Chelation Therapy: Chelation therapy6 is a chemical

process in which a substance is used to bind molecules, such as metals or minerals, and hold them tightly so that they can be removed from a system, such as the body. In medicine, chelation has been scientifically proven to rid the body of excess or toxic metals. For example, a person who has lead poisoning may be given chelation therapy in order to bind and remove excess lead from the body before it can cause damage

Diet Based Therapies: A variety of alternative diets9 are

Chiropractic Care: It is a health care discipline and profession that emphasizes diagnosis, treatment and prevention of mechanical disorders of the musculoskeletal system, especially the spine, under the hypothesis that these disorders affect general health via the nervous system. This care involves the adjustment of the spine and joints to influence the bodyâ&#x20AC;&#x2122;s nervous system and natural defense mechanisms to alleviate pain and improve general health. It is primarily used to treat back problems, headaches, nerve inflammation, muscle spasms, and other injuries and traumas.

It is generally categorized as complementary and alternative medicine (CAM), a characterization that many chiropractors reject. The main chiropractic treatment technique involves manual therapy, including manipulation of the spine, other joints, and soft tissues; treatment also includes exercises, health and lifestyle counseling. Traditional chiropractise assumes that a vertebral subluxation or spinal joint dysfunction interferes with the body's function. D. D. Palmer founded chiropractic in the 1890s and his son B.J. Palmer helped to expand it in the early 20th century. It has two main groups: â&#x20AC;&#x2DC;straightsâ&#x20AC;&#x2122;, now the minority, emphasize vitalism, Innate Intelligence and spinal adjustments, and consider subluxations to be the leading cause of all disease; "mixers" are more open to mainstream and alternative medical techniques such as exercise, massage, nutritional supplements, and acupuncture. Chiropractic7 is well established in the U.S., Canada and Australia.

Deep Breathing: Deep breathing8 involves slow and

deep inhalation through the nose, usually to a count of 10, followed by slow and complete exhalation for a similar count. The process may be repeated 5 to 10 times, several times a day.

offered for treating cancer, cardiovascular disease, and food allergies. Virtually all these interventions focus on eating fresher and freshly prepared vegetables, fruits, whole grains, and legumes. Allergy to food has become a major area of research.

Food intolerance is being studied as a causal or contributing factor in rheumatoid arthritis, and there is evidence that foodelimination diets may help many hyperactive children. Some alternate dietary lifestyles are believed to offer a greater resistance to illness. These include several variations of the vegetarian diet, such as those consumed by Seventh-Day Adventists and proponents of the macrobiotic diet. Studies have found a significant lowering of risk factors for heart disease and certain forms of cancer in these two groups. Recent studies have also reported that certain cultural eating styles, such as the Asian and Mediterranean diets, appear to lower risk factors for heart disease and certain forms of cancer as well. Eskimo diet is another one which has fascinated researchers. In spite of the high fat food they eat, they are found to be very healthy. The latest theory is that it is because of the marine fat rich in Omega-3 that they eat which offer them such protection.

Buttermilk and yogurt were used to treat thrush (oral candidiasis), a fungus infection of the mouth, before the invention of fungicides. Fresh limes were used to treat scurvy in sailors; cod liver oil was used to treat rickets in children, before the "invention" of vitamins. Many generations of people sipped warm milk before bed time to aid in the sleep. Now we know that milk contains an amino acid that causes the brain to release a mildly tranquilizing substance that encourages drowsiness.

Food can be therapeutic in several ways. It provides nutrient that is needed by a sick person in a form he or she can use. It also provides nutrients for persons who are deficient in them.

Sometimes food also supplies an agent or chemical that aids in the metabolism of other nutrients. Food such as buttermilk can help stabilize the fungus/bacteria balance in the mouth. Such foods act by changing the ecology within the human body. Many of the old time remedies stress food avoidance as well as specifying what to eat. For example, the ancient Indian practice of Ayurveda is mainly based on diet control. As you can learn by referring to the section on Ayurveda in Holistic Online, foods are classified as either helping or hurting the three doshas, the governing principles under which all living being are classified in Ayurveda. Food is used to stabilize the "doshas" along with other things such as meditation, yoga etc.

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Many people are allergic to some foods such as chocolate, lactose etc. Similarly some people get constipation from excessive high intake of fiber.

Diabetes patients, especially Type 2 diabetes, need to watch out what they eat especially food containing sugar. People with heart disease need to control the intake of foods containing high amount of fat and cholesterol. These are all common sense diet therapies. Macrobiotic diet- A macrobiotic diet is low in fat, emphasizes whole grains and vegetables, and restricts the intake of fluids. Of particular importance is the consumption of fresh, non-processed foods.

and balance of life energies are necessary for maintaining health and described tools to restore them. Herbal medicine, acupuncture, acupressure, moxibustion, and cupping, for example, are all believed to act by correcting imbalances in the internal biofield, such as by restoring the flow of Qi through meridians to reinstate health. Some therapists are believed to emit or transmit the vital energy (external Qi) to a recipient to restore health. Examples of practices involving putative energy fields include: Reiki and Johrei, both of Japanese origin and, Qi gong, a Chinese practice.

In the aggregate, these approaches are among the most controversial of CAM practices because neither the external energy fields nor their therapeutic effects have been demonstrated convincingly by any biophysical means. Yet, energy medicine is gaining popularity in the American marketplace and has become a subject of investigations at some academic medical centers.

Energy Medicine: Energy medicine10 is a domain in CAM that deals with energy fields of two types:

Veritable, which can be measured and; Putative, which have yet to be measured.

The Veritable energies employ mechanical vibrations (such as sound) and electromagnetic forces, including visible light, magnetism, monochromatic radiation (such as laser beams), and rays from other parts of the electromagnetic spectrum. They involve the use of specific, measurable wavelengths and frequencies to treat patients. Therapies involving putative energy fields are based on the concept that human beings are infused with a subtle form of energy. This vital energy or life force is known under different names in different cultures, such as Qi in traditional Chinese medicine (TCM), Ki in the Japanese Kampo system, doshas in Ayurvedic medicine, and elsewhere as prana, etheric energy, fohat, orgone, odic force, mana, and homeopathic resonance.

Vital energy is believed to flow throughout the material human body, but it has not been measured by means of conventional instrumentation.

Practitioners of energy medicine believe that illness results from disturbances of these subtle energies (the biofield). For example, more than 2,000 years ago, Asian practitioners postulated that the flow

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Reiki: Reiki11 is a healing practice that originated in Japan. Reiki

practitioners place their hands lightly on or just above the person receiving treatment, with the goal of facilitating the person's own healing response. In the United States, Reiki is part of complementary and alternative medicine. People use Reiki to promote overall health and well-being. Reiki is also used by people who are seeking relief from disease-related symptoms and the side effects of conventional medical treatments. Reiki12 has historically been practiced as a form of self-care.

Increasingly, it is also provided by health care professionals in a variety of clinical settings. Scientific research is under way to learn more about how Reiki may work, its possible effects on health, and diseases and conditions for which it may be helpful.

Hypnosis: Hypnosis13 is an altered state of consciousness characterized by increased responsiveness to suggestion. The hypnotic state is attained by first relaxing the body, then shifting attention toward a narrow range of objects or ideas as suggested by the hypnotist or hypnotherapist. The procedure is used to effect positive changes and to treat numerous health conditions including ulcers, chronic pain, respiratory ailments, stress, and headaches.

Massage: Massage14 helps to enhance the function

of certain tissues (esp. muscle and connective tissue) and promote relaxation and human well-being.

Naturopathy: The word naturopathy15 comes from Greek and Latin words and literally stands for ‘nature disease’.

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A central belief in naturopathy is that nature has a healing power (a principle called Vis medicatrix naturae).

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Another belief is that living organisms (including the human body) have the power to maintain a state of balance and health, and to heal themselves.

Meditation: Meditation is a group of techniques,

which started in Eastern religious or spiritual traditions, where a person learns to focus his attention and suspend the stream of thoughts that normally occupy the human mind. ‘Yoga is an ancient practice that helps us to create a sense of union between the body, mind, and spirit’. The exercises of Yoga are designed in such a manner so as to put pressure on the glandular Systems of the body, thus increasing its efficiency and thus, total health. It energizes the inner cells, strengthens the spinal cord and activates the nervous system. It allows us to use the body as an instrument for eternal awareness, so that we can receive wisdom and knowledge.

Man, who is in constant search of joy and happiness, keeps running away from his Self, which is the real source of joy. A human being normally seeks joy in money or possessions, in power or human love and ultimately in religion, which is also outside his self.

The inner self, which is our awareness, is energy, called the energy of Divine Love. All the manifestation of material energy is guided by the supreme energy of Divine Love. The silent working of awareness is automatic, minute, dynamic and precious. After Selfrealization, this divine energy appears to us as a silent throbbing vibration flowing through our being. But we have been unable to achieve Self-realization because we cannot fix our attention on something that lacks form (abstract being). Yoga has been proven to be helpful in the prevention and cure of various diseases which includes: Asthma, Back- Pain, Constipation, Drug-Addiction, Headache, Heart-Diseases, Hernia, Hyperacidity, Hypertension, Hyperthyroidism, Insomnia, Memory loss, Migraine, Pile-Hemorrhoids, Slipped-Disc, Sexual-Disorder, Sinusitis, Spondylitis, Stress, Tonsillitis, Varicose-Veins; in menstrual disorders to alleviate menstrual pain, ensure an easier delivery, manage stress, menopause, eliminate excess fat making muscles more flexible and stronger, etc.

Practitioners of naturopathy prefer to use treatment approaches that they consider to be the most natural and least invasive, instead of using drugs and more invasive procedures.

Naturopathy was named and popularized in the United States by Benedict Lust, born in Germany in the late 1800s. When Lust became seriously ill with tuberculosis, he was treated by a priest and healer in Germany named Sebastian Kneipp. Kneipp's treatment was based on various healing approaches and philosophies that were popular in Europe, including:  

Hydrotherapy (water treatments) The "nature cure" movement, which focused on restoring health through a return to nature. This movement advocated therapies such as gentle exercise, herbal medications, wholesome dietary approaches and exposure to sun and air.

Naturopathy is also called naturopathic medicine; a whole medical system that originated in Europe. Naturopathy aims to support the body's ability to heal itself through the use of dietary and lifestyle changes together with CAM therapies such as herbs, massage, and joint manipulation. Its emphasis is on supporting health rather than combating the disease.

People seek naturopathic care for various health-related purposes, including primary care, support wellness, and treatment of diseases and conditions (often chronic ones).

Naturopathy focuses upon treatments considered "natural", but it is not without risk.

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Homeopathy: Homeopathy17 is a system of medical

Hydrotherapy: Hydrotherapy is the use of water in the 16

treatment of disease. Hydrothermal therapy uses its temperature effects, as in hot baths, saunas, wraps, etc.

Hydro and hydrothermal therapies are traditional methods of treatment that have been used for the treatment of disease and injury, by many cultures, including those of ancient Rome, China, and Japan. The ancient Greeks took therapeutic baths. Water is an important ingredient in the traditional Chinese and Native American healing systems. A Bavarian monk, Father Sebastian Kneipp helped to re-popularize the therapeutic use of water in the 19th century. The recuperative properties of hydrotherapy are based on its mechanical and/or thermal effects. It exploits the body's reaction to hot and cold stimuli, to the protracted application of heat, to the pressure exerted by the water and to the sensation it gives to our body. The nerves carry impulses felt at the skin deeper into the body, where they are stimulate the immune system, influencing the production of stress hormones, invigorating the circulation and digestion, encouraging blood flow and lessening pain sensitivity.

Generally, heat calms and soothes the body, slowing down the activity of internal organs. Cold, in contrast, stimulates and invigorates, increasing internal activity. If you are experiencing tense muscles and anxiety from your stress, a hot shower or bath would be quite refreshing. If you are feeling tired and stressed out, you might want to try taking a warm shower or bath followed by a short, invigorating cold shower to help stimulate your body and mind. When you submerge yourself in a bath, a pool, or a whirlpool, you experience a kind of weightlessness. Your body is relieved from the constant pull of gravity. Water also has a hydrostatic effect. It has a massage-like feeling as the water gently kneads your body. Water, in motion, stimulates touch receptors on the skin, boosting blood circulation and releasing tight muscles.

Hydrotherapy and hydrothermal therapy are chiefly used to tone up the body, to stimulate digestion, the circulation, and the immune system, and to bring relief from pain.

Water has special powers in getting rid of stress and rejuvenating our body. It affects the skin and muscles. It calms the lungs, heart, stomach, and endocrine system by stimulating nerve reflexes on the spinal cord.

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practice based on the theory that any substance that can produce symptoms of disease or illness in a healthy person can cure those symptoms in a sick person. For example, someone suffering from insomnia can be given a dose of coffee. Administered in diluted form, homeopathic remedies are derived from many natural sources—including plants, metals, and minerals. Homeopathy, also known as homeopathic medicine, is a whole medical system that originated in Europe. Homeopathy seeks to stimulate the body's ability to heal itself by giving very small doses of highly diluted substances that in larger doses would produce illness or symptoms (an approach called ‘like cures like’).

Homeopathy is used for overall wellbeing and to treat many diseases.

Disadvantages:  

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Not an effective treatment for any specific condition Its key concepts are not consistent with the current understanding of science (particularly chemistry and physics) There is limited research on the safety of homeopathic treatments

Aromatherapy: Aromatherapy means ‘treatment using scents’. It is a holistic treatment which involves caring for the body with pleasant smelling botanical oils such as rose, lemon, lavender and peppermint. The essential oils are added to the bath or massaged onto the skin, inhaled directly or diffused to scent an entire room. Aromatherapy18 is used for the relief of pain, care for the skin, alleviate tension and fatigue and invigorate the entire body. Essential oils can affect the mood, alleviate fatigue, reduce anxiety and help in relaxation. When inhaled, they work on the brain and nervous system through stimulation of the olfactory nerves.

Essential oils19 are aromatic essences extracted from plants, flowers, trees, fruits, bark, grasses and seeds with distinctive therapeutic, psychological, and physiological properties, which improves and prevents illness. There are about 150 essential oils. Most of these oils have antiseptic properties, antiviral, anti-inflammatory, painrelieving, antidepressant and expectorant. Other properties of the essential oils which are taken advantage of in aromatherapy are their stimulation, relaxation, digestion improvement, and diuretic properties. To get the maximum benefit from essential oils, it should be made from natural raw materials. Synthetically made oils are not effective.

Aromatherapy is one of the fastest growing fields in alternative medicine. It is widely used at home, clinics and hospitals for a variety of applications such as pain relief for women in labor pain, relieving pain caused by the side effects of the chemotherapy undergone by the cancer patients and rehabilitation of cardiac patients.

Aromatherapy has already started getting into the mainstream. In Japan, engineers are incorporating aroma systems into new buildings. In one such application, the scent of lavender and rosemary is sprayed into the customer area to calm down the waiting customers, while the perfumes from lemon and eucalyptus are used in the bank teller counters to keep the staff alert.

Herbal Therapy: Herbal therapy is a broad term used to refer to any type of healthcare treatment done using fresh or dried herbs. The use of herbs may take the form of supplements, fusions or teas, tinctures, topical creams and poultices. Herb therapy20 may also include the creation of a healing steam that is scented with various combinations. The origins of herbal therapy still remains a mystery but every culture has used herbs as a means of dealing with different physical and emotional illnesses.

Perhaps the most ancient documented form of this type of therapy is found in the healing traditions of China.

Grounded in Taoist beliefs and principles, Chinese herbal therapy incorporates the use of many different types of herbs in treating the sick. In some cases, a single herb is used in the therapeutic treatment and in some cases several herbs are combined in order to prepare medicine for a specific ailment. One of the advantages of herbal therapies in general is that the use of herbs helps to provide the body with essential nutrients that may be lacking in the daily diet. Usually when the body does not receive sufficient nutrition, various types of aches, pains, and emotional disorders begin to appear. By using herbs to restore a nutritional balance, the body is equipped with what it needs to overcome illness and restore health. Natural herbal therapy can take many forms.

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Teas and tinctures are among the most common approaches. Both are efficient ways to quickly introduce nutrients into the body, and may provide quick relief. One noted example is the claim made for a simple tea made with cayenne powder and hot water which is said to ease both the pain and the damage that can be the result of a heart attack within a matter of few minutes. Dried herbs are also a common tool in the practice of herbal therapy.

Herbal aromatherapy is a specialized type of herbal therapy that utilizes herbs to restore the balance between the body and the mind. The process involves simmering fresh or dried herbs in water to release the scent. For example, simmering lavender helps to calm the nerves after a tiring day and may also be effective in easing the after effects of an anxiety.

Traditional Medicine: Curanderos- In Latin America, Curanderos specialize in treating illness through the use of supernatural forces, herbal remedies and other natural medicines. (A Curandero is a type of traditional folk healer).

Energy Healing Therapy: It involves the channeling of healing energy through the hands of a practitioner into the clientâ&#x20AC;&#x2122;s body to restore a normal energy balance and, thus, health. It has been used to treat a wide variety of health problems, and is often used in conjunction with other alternative and conventional medical treatments21.

Espiritista: An Espiritista is a traditional healer who assesses a patientâ&#x20AC;&#x2122;s condition and recommends herbs or religious amulets so as to improve physical or mental health or to help overcome an individual personal problem.

Feldenkreis: Feldenkreis is a movement therapy which utilizes a method of education in physical coordination and movement. Practitioners use verbal guidance and light touch to teach the method through one-on-one lessons and group classes. Their main aim is to help the person become more aware of how ones body moves through space and to improve physical functioning.

Guided Imagery: It involves a series of relaxation techniques followed by the visualization of detailed images, which are usually calm and peaceful in nature. During treatment, the individual will visualize their body free of the specific problem or condition. Sessions are, typically 20â&#x20AC;&#x201C;30 minutes in length, and are practiced several times a week.

Hierbero: A Hierbero or Yerbera is a traditional healer or practitioner with knowledge of the medicinal qualities of plants.

Statistical Data of CAM Users:

background and helps to treat him in a unique manner which is not only efficient but also quite effective. In fact, the holistic approach is the need of the hour and people have started recognizing its benefits and have started turning their attention towards this approach which has started coming to the lime light. It would not be long before CAM emerges as an equivalent to any of the treatment forms in practice today.

REFERENCES :

FIGURE 1: CAM USE BY U.S. ADULTS AND CHILDREN

Figure1 depicts that the various alternative practices among people gets popularized. If we analyze the modern super multi specialized hospitals, we can observe the practice of holistic medicine which indicates the growing interest of alternative practices among the public.

Who uses CAM most: People of all backgrounds use CAM22. However, CAM use among adults is greater among women and those with higher levels of education and higher incomes.

1.

Elion R A, Cohen C: Expert column- Use of complementary medicine by patients with HIV: Full sail into uncharted waters, Medscape General Medicine 2000;2 (3).

2.

Soren Soren V: The open source protocol of clinical holistic medicine. J Alternative Med Res 2009, 129-44.

3.

http://en.wikipedia.org/wiki/Acupuncture

4.

http://en.wikipedia.org/wiki/Ayurveda

5.

http://www.biofeedbacktherapy.net/

6.

http://www.holisticonline.com/chelation/hol_chelation.htm

7.

http://en.wikipedia.org/wiki/Chiropractic

8.

http://www.stress-relief-exercises.com/deep-breathing-exercises.html

9.

http://www.merck.com/mmhe/sec25/ch302/ch302d.html

10.

http://www.energymedicine.in/

11.

http://www.reiki.org/faq/whatisreiki.html

12.

http://www.lifepositive.com/body/energy-healing/ reiki/reiki.asp

13.

http://en.wikipedia.org/wiki/Hypnosis

14.

http://en.wikipedia.org/wiki/Massage http://altmedicine.about.com/od/therapiesfrometol/a/hydro therapy.htm

15.

16.

17.

CAM Therapies used the most: Non-vitamin and non-mineral natural products are the most commonly used CAM therapy among adults. Use has increased for several therapies, including deep breathing exercises, meditation, yoga, massage, pressing, rubbing, and moving muscles and other soft tissues of the body, primarily by using the hands and fingers. The aim is to increase the flow of blood and oxygen to the massaged area.

CONCLUSION: Holistic medicine is a combination of conventional and alternative therapy. Holistic living is an art of living in harmony with nature and deals with a concern for the whole universe.

Thus it takes into account an individualâ&#x20AC;&#x2122;s physical, spiritual, nutritional and even social

18.

19.

20.

http://en.wikipedia.org/wiki/Hydrotherapy Steven Kayne: Homoeopathy in sports medicine. British Homeopathic journal 1992;142-147 Gibbons E : Can aromatherapy replace pre-medication? Br J Theatre Nurs 1998; 34-36 Buchbauer G, et al: Therapeutic Properties of essential oils and fragrances, ACS Symposium Series 1993;Vol.525:159-165

21.

http://www.wisegeek.com/what-is-herbal-therapy.htm John A : Why patients use alternative medicine.

JAMA1998;279:1548-1553.

22.

http://nccam.nih.gov/health/whatiscam/

HOLISTIC MEDICINE: STEPPING STONES OF NEW LIFE IN MODERN MEDICINE Jiny Varghese et al., IJPSR, 2010; Vol. 1 (10): 1-10

Contributing Authors:

K. Jiny Varghese Amrita School of Pharmacy, Amrita Vishwa Vidyapeetham University, AIMS Healthcare Campus, AIMS Ponekkara P.O., Kochi, Kerala, India

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What is Holistic Nursing?

Marcie Cooper RN, MSN, ADS, AHN-BC

American Holistic Nurses Association Vision (AHNA): Our vision is a world in which nursing nurtures wholeness and inspires peace and healing.

Holistic Nursing can be defined as “all nursing practice that has healing the whole person as its goal” and takes a “mind-body-spirit-emotion-environment” approach to self and patient care. (Klebanoff, 2013). It is important to note that the nurses’ self-care is a key component of this caring process, and that the concept of interconnectedness is a pillar in Holistic Nursing. Barbara Dossey, PhD, RN, AHN-BC, FAAN, HWNC-BC is one of the founding members of the American Holistic Nurses Association (AHNA) and a renowned speaker and holistic nursing theorist who explains the concepts of interconnectedness in her Theory of Integral Nursing.

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Holistic nursing practice is included (embraced) and transcended (goes beyond) in this integral process. (dosseydossey.com)

(Image from dosseydossy.com)

The use of Complementary and Alternative Medicine is another pillar of Holistic Nursing. Many complementary and Alternative therapies are utilized in part because they frequently intertwine with components of "mindbody-spirit-emotion-environment" healing and acknowledge as meaningful components that which allopathic medicine fail to recognize. Patients are seeking healing on a deeper level than they once did, and this has been part of the paradigm shift witnessed over the last 20 years or so.

Caring Healing Interventions: nontraditional therapies that can interface with traditional medical and surgical therapies; may be used as complements to conventional treatments.

The American Holistic Nurses Association was founded in 1980 by a pioneering group of nurses who saw the need to refocus nursing care and healing on wholeness. Practice as a Holistic Nurse has since gained acceptance as a specialty and nurses with Associate Degrees through Advanced Practice can all sit for their level of practice to receive Board Certification through the American Holistic Nurses Credentialing Cooperation (AHNCC). These exams are accredited by the Accreditation Board for Specialty Nursing Certification (ABSNC) and recognized by the American Nursing Credentialing Center (ANCC). (ahncc.org) Healing: the process of bringing together aspects of oneself, body-mind-spirit, at deeper levels of inner knowing leading toward integration and balance with each aspect having equal importance and value; can lead to more complex levels of personal understanding and meaning; may be synchronous but not synonymous with curing.

The National Center for Complementary and Integrative Health, formerly known as the National Center for Complementary and Alternative Medicine (NCCAM) and also the Office of Alternative Medicine is part of the National Institute of Health, is the governmental arm of health which seeks to research and identify the benefits and effectiveness of holistic therapies and to determine best practice. Research into holistic modalities and outcomes have led to some amazing findings and adjustments to how and what patient care is provided. Many healthcare organizations, Nursing and Medical Schools, Hospitals and Point of Care facilities have latched on to "Holism" as a way to reflect their vision of patient care and standards and can be seen in companies mission statements and philosophy. Knowing that a holistic approach can improve patient outcomes and satisfaction may be the driving force for this inclusion.

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Intention: the conscious awareness of being in the present moment to help facilitate the healing process; a volitional act of love.

Holistic Nursing offers support, empowerment, and personalized treatment options to patients as they embark on their own healing journey. Incorporating therapies that are holistic in nature such as mindfulness and meditation, acupuncture or acupressure, aromatherapy, pet therapy, music and art therapy, massage, reiki, mindful nutrition, and herbs can help empower patients and give them more control over their treatment and focus their specific goals. Cannabis Therapeutics is fast becoming one of the most common holistic therapies being utilized, although practitioner education on this specific therapy is not near as common as the therapy itself. With 43 states and territories now offering full or limited cannabinoid medical cannabis programs, and an estimated 2,299,016 registered cannabis patients as of March 2017, (MPP.org) understanding Cannabis Therapeutics as a practitioner is becoming as important as utilizing a holistic approach. This actually makes sense being that there is no whole without considering the Endocannabinoid System. Just like Holistic Nurses come from every practice of nursing, such as oncology, pain management, or hospice and Palliative care, Cannabis Nurses too are coming from every practice. Cannabis Nursing and Holistic Nursing are complementary to each other and incorporate the same philosophies and goals.

Holistic Nurse: a nurse who recognizes and integrates body-mind-spirit principles and modalities in daily life and clinical practice; one who creates a healing space within herself/himself that allows the nurse to be an instrument of healing for the purpose of helping another feel safe and more in harmony; one who shares authenticity of unconditional presence that helps to remove the barriers to the healing process.

In summary, the advancement of Holistic Nursing has been decades in the making and is still a work in progress. Cannabis Nursing is advancing at a pace that could be comparable in many ways. Acceptance, education, and comprehensive availability of Cannabis Therapeutics are all needed to continue on the trajectory of improved patient care. As with many holistic modalities, continued research on the effects of cannabis for specific disease process and with the wide range of varieties, preparations, ratios and dosages are needed to determine best practice. Even with this information, Cannabis Therapeutics is still likely to remain highly individualized with the patient controlling the treatment. In the meantime, education on both holistic Nursing and Cannabis Therapeutics can help nurses assist those patients who are leading the way and healing themselves. Organizations such as The Holistic Cannabis Network and The American Holistic Nurses Association, are helping to combine the two by engaging nurses in the opportunity to acquire both nursing skills and specialties together.

From the American Holistic Nurses Association Position Statement: Position on the Role of Nurses in the Practice of Complementary & Integrative Health Approaches (CIHA) June 2016 The American Holistic Nursesâ&#x20AC;&#x2122; Association (AHNA) is a professional specialty nursing association dedicated to the promotion of holism and healing. The AHNA believes that nurses enter therapeutic partnerships with clients, their families, and their communities to serve as facilitators in the healing process. This partnership begins with being mindfully aware and fully present in all interactions at work and in life. The holistic nursing care process supported by AHNA is one in which nurses abide by the following commitments: ď&#x201A;ˇ Acquire and maintain current knowledge and competency in holistic nursing practice. This may include integrating complementary and integrative therapies into that nursing practice. ď&#x201A;ˇ Provide care and guidance to persons through nursing interventions and therapies consistent with evidencebased research findings and other sound evidence.

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 Embrace a professional code of ethics and healing that seeks to preserve wholeness and dignity of self and others.  Engage in self-care.  Develop continual growth and personal awareness of his or her own unique capacity to serve as an instrument of healing.  Recognize each person as a whole: Body-Mind-Spirit. Practice mindful presence in all interactions. 

Assess clients holistically, using traditional nursing concepts and incorporating therapeutic communication to identify a broader scope of factors that are potential contributors to increased stress.



Create a plan of care in collaboration with clients and their significant others that is consistent with cultural background, health beliefs, sexual orientation, values, and preferences focusing on health promotion, recovery, restoration, or peaceful dying while maintaining an optimal level of personal independence for as long as possible. (AHNA.Org)

Attention: Nurse Marcie Cooper RN, MSN, ADS, AHN-BC, along with Nurse Heather Manus, RN, RM/T and Nurse Julie (Juhlzie) Monteiro RN, BSK will be presenting The Endocannabinoid Connections Workshop at the 37th Annual American Holistic Nurses Association Annual Conference, 21st Century Holistic Nursing: Reshaping Health and Wellness to be held June 5-10th, 2017 in Rancho Mirage, CA on Saturday from 10:00AM-12:30PM. Resources: Certification Overview. (n.d.). Retrieved April 20, 2017, from http://www.ahncc.org/certification/ Frisch, N. C., Dossey, B. M., Guzzetta, C. E., & Quinn, J. A. (2000). AHNA standards of holistic nursing practice: guidelines for caring and healing. Gaithersburg, MD: Aspen.

Kebanoff, N. A. (2013, October). Holistic nursing: Focusing on the whole person. Retrieved April 20, 2017, from https://www.americannursetoday.com/holistic-nursing-focusing-on-the-whole-person/ Position on the Role of Nurses in the Practice of Complementary & Integrative Health Approaches (CIHA).

(2016, June). Retrieved April 20, 2017, from http://www.ahna.org/LinkClick.aspx?fileticket=jphhexmIrNA% 3d&portalid=66 Project, M. P. (2017, March 6). Marijuana Policy Project | We Change Laws. Retrieved April 20, 2017, from https://www.mpp.org/issues/medical-marijuana/state-by-state-medical-marijuana-laws/medical-marijuanapatient-numbers/ (n.d.). Retrieved April 20, 2017, from http://www.dosseydossey.com/barbara/tin.html 0Dy June CANNABISNURSESMAGAZINE.COM

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Celebrate Cinco De Mayo All Month with GreAt MexicAn treAtS

A true Sign thAt Summer iS ALmOSt here.

To LeArn More AbouT

ASpArAGuS SAlSA

CooK With hErB

INGREDIENTS â&#x20AC;˘ 1 pound fresh asparagus, trimmed and cut into 1/2-inch pieces â&#x20AC;˘ 1 cup chopped seeded tomatoes â&#x20AC;˘ 1/2 cup finely chopped onion â&#x20AC;˘ 1 small jalapeno pepper, seeded and finely chopped â&#x20AC;˘ 1 tablespoon minced fresh cilantro â&#x20AC;˘ 1 garlic clove, minced â&#x20AC;˘ Âź cup THC olive oil â&#x20AC;˘ 1 teaspoon cider vinegar â&#x20AC;˘ 1/4 teaspoon salt â&#x20AC;˘ Tortilla chips

CHef Herb &

go To www.cookwithherb.com

AvocAdo Fruit SAlAd INGREDIENTS â&#x20AC;˘ 3 medium ripe avocados, pitted and peeled â&#x20AC;˘ 2 tablespoons lemon juice â&#x20AC;˘ 1/2 cup plain yogurt â&#x20AC;˘ 2 tablespoons honey â&#x20AC;˘ 1/8 cup THC olive oil â&#x20AC;˘ 1 teaspoon grated lemon peel â&#x20AC;˘ 1 medium apple, chopped â&#x20AC;˘ 1 medium firm banana, cut into 1/4-inch slices â&#x20AC;˘ 1 cup halved seedless grapes â&#x20AC;˘ 1 can (11 ounces) mandarin oranges, drained

DIRECTIONS Place asparagus in a large saucepan; add 1/2 in. of water. Bring to a boil. Reduce heat; cover and simmer for 2 minutes. Drain and rinse in cold water.

In a large bowl, combine the asparagus, tomatoes, onion, jalapeno, cilantro, garlic, THC olive oil, vinegar and salt. Cover and refrigerate for at least 4 hours, stirring several times. Serve with tortilla chips.

cAlico cheeSe dip

INGREDIENTS DIRECTIONS â&#x20AC;˘ 4 cups (16 ounces) shredded Monterey Jack cheese Cut avocados into chunks; Place in a large bowl; drizzle with lemon juice â&#x20AC;˘ 1 can (4 ounces) chopped green chilies and toss to coat. Drain, reserving the lemon juice; set avocados aside. â&#x20AC;˘ 1 can (2-1/4 ounces) sliced ripe olives, drained â&#x20AC;˘ 4 green onions, sliced For dressing, in a small bowl, combine the yogurt, honey, THC olive oil, lemon peel and reserved lemon juice. In another large bowl, toss the â&#x20AC;˘ 3 medium tomatoes, seeded and diced â&#x20AC;˘ 1/2 cup minced fresh parsley apple, banana, grapes, oranges and avocados. Serve with dressing. â&#x20AC;˘ Âź cup THC olive oil â&#x20AC;˘ Âź cup white vinegar â&#x20AC;˘ Tortilla chips DIRECTIONS

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In a large bowl, beat together the cheese, chilies, olives, onions, tomatoes and parsley until blended.

Prepare salad dressing mix THC olive oil and white vinegar; pour over cheese mixture and mix well. Serve immediately with tortilla chips.

corn breAd INGREDIENTS â&#x20AC;˘ 1 cup THC butter, melted â&#x20AC;˘ 1 cup white sugar â&#x20AC;˘ 4 eggs â&#x20AC;˘ 1 (15 ounce) can cream-style corn â&#x20AC;˘ 1/2 (4 ounce) can chopped green chile peppers, drained â&#x20AC;˘ 1/2 cup shredded Monterey Jack cheese â&#x20AC;˘ 1/2 cup shredded Cheddar cheese â&#x20AC;˘ 1 cup all-purpose flour â&#x20AC;˘ 1 cup yellow cornmeal â&#x20AC;˘ 4 teaspoons baking powder â&#x20AC;˘ Âź teaspoon salt DIRECTIONS Preheat oven to 300 degrees F (150 degrees C). Lightly grease a 9x13 inch baking dish.

In a large bowl, beat together THC butter and sugar. Beat in eggs one at a time. Blend in cream corn, chiles, Monterey Jack and Cheddar cheese.

In a separate bowl, stir together flour, cornmeal, baking powder and salt. Add flour mixture to corn mixture; stir until smooth. Pour batter into prepared pan.

lime juice. Chill the lime juice and scallops all day or overnight until scallops are opaque (you cannot see through them).

Empty 1/2 of the lime juice from the bowl. Add tomatoes, green onions, celery, green bell pepper, parsley, black pepper, THC olive oil, and cilantro to the scallop mixture. Stir gently. Serve this dish in fancy glasses with a slice of lime hanging over the rim for effect.

elote

(MExiCAn Corn-on-thE-CoB) INGREDIENTS â&#x20AC;˘ 4 ears corn, shucked â&#x20AC;˘ Âź cup melted THC butter â&#x20AC;˘ Âź cup mayonnaise â&#x20AC;˘ 1/2 cup grated cotija cheese â&#x20AC;˘ 4 wedges lime (optional) DIRECTIONS Preheat an outdoor grill for medium-high heat.

Grill corn until hot and lightly charred all over, 7 to 10 minutes, depending on the temperature of the grill. Roll the ears in melted THC butter, then spread evenly with mayonnaise. Sprinkle with cotija cheese and serve with a lime wedge.

MexicAn rice

INGREDIENTS â&#x20AC;˘ 1 pound bay scallops â&#x20AC;˘ 8 limes, juiced â&#x20AC;˘ 2 tomatoes, diced â&#x20AC;˘ 5 green onions, minced â&#x20AC;˘ 2 stalks celery, sliced â&#x20AC;˘ 1/2 green bell pepper, minced â&#x20AC;˘ 1/2 cup chopped fresh parsley â&#x20AC;˘ freshly ground black pepper â&#x20AC;˘ 1/8 cup THC olive oil â&#x20AC;˘ 1/8 cup chopped fresh cilantro

INGREDIENTS â&#x20AC;˘ 5 tablespoon THC olive oil â&#x20AC;˘ 1 teaspoon ground turmeric â&#x20AC;˘ 1 teaspoon garlic powder â&#x20AC;˘ 1/2 teaspoon ground cumin â&#x20AC;˘ 1/2 teaspoon ground coriander seed â&#x20AC;˘ 2 teaspoons paprika â&#x20AC;˘ 1 pinch red pepper flakes â&#x20AC;˘ 1 pinch cayenne pepper â&#x20AC;˘ 3 green onions â&#x20AC;˘ 1 green bell pepper, chopped â&#x20AC;˘ 1 cup pre-cooked corn kernels â&#x20AC;˘ 2 small tomatoes, diced â&#x20AC;˘ Âź cup ketchup â&#x20AC;˘ 2 cups cooked rice â&#x20AC;˘ salt to taste

DIRECTIONS Rinse scallops and place in a medium sized bowl. Pour lime juice over the scallops. The scallops should be completely immersed in the

DIRECTIONS Heat THC olive oil in a wok-style pan with turmeric, garlic powder, cumin, coriander, paprika, chili flakes, and cayenne pepper. Add

Bake in preheated oven for 1 hour, until a toothpick inserted into center of the pan comes out clean.

ScAllop ceviche

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the green onions and the green peppers; saute 1 to 2 minutes over medium-high heat.

â&#x20AC;˘ 1 cup chopped almonds â&#x20AC;˘ 1/2 cup confectionersâ&#x20AC;&#x2122; sugar

Add corn and tomatoes and saute until tomatoes release their juices.

Add ketchup and stir until mixed.

DIRECTIONS In a medium bowl, cream the THC butter and sugar. Stir in vanilla and water. Add the flour and almonds, mix until blended. Cover and chill for 3 hours.

Add rice and stir until heated thoroughly. Salt to taste.

bAjA couScouS INGREDIENTS â&#x20AC;˘ 1 cup couscous â&#x20AC;˘ 1/2 teaspoon ground cumin â&#x20AC;˘ 1 teaspoon salt, or to taste â&#x20AC;˘ 1 Âź cups boiling water â&#x20AC;˘ 1 clove unpeeled garlic â&#x20AC;˘ 1 (15 ounce) can black beans, rinsed and drained â&#x20AC;˘ 1 cup canned whole kernel corn, drained â&#x20AC;˘ 1/2 cup finely chopped red onion â&#x20AC;˘ Âź cup chopped fresh cilantro â&#x20AC;˘ 1 jalapeno pepper, minced â&#x20AC;˘ 1/3 cup THC olive oil â&#x20AC;˘ 3 tablespoons fresh lime juice, or to taste DIRECTIONS Combine the couscous, cumin, and salt in a large bowl. Stir in the boiling water and seal with plastic wrap. Set aside for 10 minutes.

While waiting for the couscous, cook the unpeeled garlic clove in a small skillet over medium-high heat until toasted and the skin has turned golden-brown. Peel the garlic and mince. Stir the garlic into the couscous along with the black beans, corn, onion, cilantro, jalapeno pepper, THC olive oil, and lime juice. Serve warm or allow to cool.

SiMple South-oF-the-border cookieS Ingredients â&#x20AC;˘ 1 cup THC butter â&#x20AC;˘ 1/2 cup white sugar â&#x20AC;˘ 2 teaspoons vanilla extract â&#x20AC;˘ 2 teaspoons water â&#x20AC;˘ 2 cups all-purpose flour

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Preheat oven to 325 degrees.

Shape dough into balls or crescents. Place on an unprepared cookie sheet and bake for 15 to 20 minutes in the preheated oven.

Remove from pan to cool on wire racks. When cookies are cool, roll in confectionersâ&#x20AC;&#x2122; sugar. Store at room temperature in an airtight container.

cinnAMon cookieS INGREDIENTS â&#x20AC;˘ 1 cup THC butter â&#x20AC;˘ 1/2 cup confectionersâ&#x20AC;&#x2122; sugar â&#x20AC;˘ 1/2 teaspoon ground cinnamon â&#x20AC;˘ Âź teaspoon salt â&#x20AC;˘ 1 teaspoon vanilla extract â&#x20AC;˘ 1 1/2 cups all-purpose flour â&#x20AC;˘ 1 cup confectionersâ&#x20AC;&#x2122; sugar â&#x20AC;˘ 1 teaspoon ground cinnamon DIRECTIONS Preheat oven to 350 degrees F (175 degrees C). Grease cookie sheets.

In a medium bowl, cream together 1/2 cup confectionersâ&#x20AC;&#x2122; sugar and THC butter until smooth. Stir in vanilla. Combine flour, salt, and 1/2 teaspoon of cinnamon; stir into the creamed mixture to form a stiff dough. Shape dough into 1-inch balls. Mix together 1 cup confectionersâ&#x20AC;&#x2122; sugar and 1 teaspoon cinnamon; roll balls in cinnamon mixture.

Bake for 15 to 20 minutes in preheated oven, or until nicely browned. Cool cookies on wire racks.

Image: http://healingthebody.ca

Smoothies are an easy and enjoyable way to get in all the essential nutrients you require for optimum health and vitality

issues, once you've added enough apple juice and ginger juice to achieved the desired taste.

blueberries: Although already mentioned above, blueberries on their own represent a very powerful anti-oxidant, only exceeded by goji berries.

They also contain considerable quantities of Vits A and B, as well as copper (a very effective immune builder), iron, which promotes immunity by raising hemoglobin counts and thereby increasing oxygen levels in the bloodstream.

Take what's in season, and locally and organically-grown, preferably, and juice up a bowlful of green leaves. You can make a variety of smoothies and hot drinks from this base. for cold winter days requiring more body fuel, and which enter the body slowly, offering a major energy boost over an extended period of hours, rather than a short-term high followed rapidly with another low.

RECIPE: Juice a tub of blueberries and a tub of pomegranate seeds. If out of season, frozen will do. Once again, ginger will give your juice a zing and apple will help balance out any acidity on the tongue. Yoghurt or soya alternative will give you the base for a smoothie, while the hot drink version uses simple hot water. Some lemon juice (a few drops, fresh) will help balance out all the flavours. For a hot drink, add hot water to your juiced ingredients. For something wildly unusual, try blueberries and avocado blitzed together for a crazy but tasty smoothie. You can also add a protein mix to your juice/smoothie and use it as your breakfast on the move.

beets:

Rich in Vit C, beets have plenty of carbs

RECIPE: Add pawpaw (papaya) and ginger juice to your juiced beets (cooked or raw, cooked being sweeter but not as rich in nutrients) for a great smoothie. You can mix and match your favourite fruits, greens or even sprouts to whip up one of a variety of drinks, to which add some fresh lemon juice (again just a few drops for taste), some apple juiced to sweeten if necessary, carrots, also for sweetness and an earthy tang, and providing some beta carotene, plus hot water to dilute and to taste.

Put together, or used as you choose, any of the above recipes and ingredients will help you and your family get through the winter with plenty of energy and the minimal of sniffles. O

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Why U.S. Doctors Love Opioids and Hate Marijuana for Chronic Pain

The opioid epidemic is well documented, yet physicians still are wary about whether cannabinoids are better options for chronic pain.

Neither is a perfect solution.

By: Daniel Clauw, M.D. June 23, 2016 Chronic pain is a tremendous public health problem. The Institute of Medicine estimates chronic pain affects 100 million Americans at an annual cost of $600 billion. Its report notes that evidence based-medicine does not support many of the diagnostic studies (like imaging) and interventions (like injections and surgery) commonly used for chronic pain.

But the rampant use of opioids to treat chronic pain stands out as the least defensible and most harmful of our maltreatments.

Many U.S. physicians remain resistant to this, though, I would argue other options should be considered.

Here's why.

Opioids: Minimal Evidence of Efficacy

Many meta-analyses have found little evidence that this class of drugs is effective for the treatment of chronic pain. Of course, we all know of individual patients who experience significant relief of their pain and improvements in function with chronic opioid therapy. But for every one of these patients we know there are many more who are not helped or are harmed by opioids.

More than 14,000 Americans died in 2014 from unintentional overdose of prescription opioids, making this the leading cause of death among younger individuals in many states, according to the Centers for Disease Control and Prevention. Countless others continue to take opioids not because they have meaningful pain and functional improvement, but because they enjoy feeling numbed, or simply have not been presented with more appropriate and helpful therapeutic options. Unfortunately, it is far faster and easier to give a patient an opioid than to work through the complex issues often present in chronic pain patients.

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As physicians begin to realize the problems with prescribing opioids for individuals with chronic pain, an increasingly common route to opioid addiction and death is the initial prescription of opioids for acute pain after a surgical or dental procedure or ER visit.

At present, this is almost a uniquely U.S. problem. We constitute less than 5 percent of the world’s population, and we consume 80 percent of the world’s opioid supply.

The Push for Marijuana for Pain Meanwhile in the U.S., there has been a movement toward legalizing or decriminalizing the use of cannabis for the treatment of chronic pain and other conditions.

Medical marijuana and [Recreational] laws are now in effect in over [43] states and the District of Columbia.

Medical marijuana advocates have used scientific data and compelling patient vignettes to show legitimate uses of cannabinoids, especially for conditions such as chronic pain, epilepsy and post-traumatic stress disorder, which are notoriously difficult to treat with our standard therapies.

Although the lay public has moved rapidly toward accepting cannabis decriminalization or legalization, the medical community does not generally share this enthusiasm for cannabinoids. Notwithstanding the legal issues (cannabis is still a Schedule I drug that cannot be prescribed), there are other legitimate issues that preclude acceptance by physicians. Even if we could prescribe cannabis, we have no idea what strength or dose to use, or which route of administration is most effective,

Weighing the Risks and Benefits of Both Treatments Most regulatory agencies, such as the Food and Drug Administration, evaluate potential therapies based on benefit versus risk, at both the level of the individual patient and the general public health. If one compares the benefits of opioids versus cannabinoids for chronic pain, the least contentious assessment would be to call it a tie.

Both classes of drugs are at best modestly effective and work well only in a small subset of patients. Both work in a similar manner to dissociate individuals from the sensory unpleasantness of pain rather than treat the root cause of pain. Opioids may be more effective in pain related to peripheral inflammation or damage, and cannabinoids more effective for neuropathic and centralized pain conditions such as fibromyalgia.

But there are not nearly enough good studies with either class of drug to enable us to say this with certainty. In other therapeutic areas, one would not even consider using any class of drug with such modest benefits. But in the chronic pain field, all of our pharmacological therapies have at best modest effect sizes.

Although the benefits of these two classes of drugs might be comparable, the risks are not.

Questioning the Physician Preference for Opioids Although a current analysis of the benefit/risk profile of these two classes seems to favor cannabinoids. U.S. physicians greatly favor opioids. Much of this distorted perception can be traced back to the 1960s or earlier.

Opioids were considered effective for chronic pain, and thus opioids in use at that time were placed on the list of compounds considered effective by the FDA.

inevitably lead to “death, debauchery or hopeless insanity”. We need to adjust our perceptions about these two classes of drugs based on current evidence.

There is no excuse for the common practice in U.S. pain clinics to liberally prescribe opioids while doing drug screens and discharging patients if they test positive for a cannabinoid (THC).

There is also no excuse for pharmaceutical companies to continue to market opioids as though they work broadly for chronic pain when we know there is no evidence they have efficacy for common conditions such as fibromyalgia.

It also makes no sense that cannabis is still a Schedule I drug when extracts or synthetic forms of cannabinoids are generally Schedule III. Rescheduling cannabis would enable physicians who are interested in trying to help their patients find an appropriate formulation and dose of a cannabinoid to do so.

Finally, neither opioids nor cannabinoids should be used as first-, second- or third-line therapies for pain, as there are almost always many much more effective and safer drug and nondrug therapies. We can and should do better for our patients.

Any of these older opioids (and even newer opioids) now get a broad label implying they work well for any type of chronic pain, even if they are shown to be effective for only a single chronic pain condition.

Meanwhile, in part because there has been scant research on the potential benefits of cannabinoids, many U.S. physicians are stuck back in a Reefer Madness era of cannabinoid knowledge, where cannabis will 0Dy June CANNABISNURSESMAGAZINE.COM

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Cannabis Science Pre-Conference Workshops: 2017

Canna Boot Camp & Healthcare Professionals Workshop We are hosting our Full-Day Pre-Conference Workshops in Exhibit Halls A & B at the Portland Oregon Convention Center | Monday, August 28th, 2017

Register online at: www.CannabisScienceConference.com

Exhibit Hall B

Exhibit Hall A

2nd Annual CANNA BOOT CAMP Covers everything from Cultivation, Pre-Processing, Sample Prep, Analytical Testing, Extraction and Edibles Manufacturing. Companies join forces to demonstrate techniques, instruments and technologies to share their experiences. In one day you can get a full understanding of many aspects of the cannabis industry and analytical testing & extraction.

HEALTHCARE PROFESSIONALS WORKSHOP We welcome Cannabis Nurses Network to our team providing certificate courses taught by Cannabis Nurse Network Experts and Professionals covering the eCS, Methods of Administration, Terpenes & Aromatherapy, Ending Prohibition- Our Ethnobiological Right, Incorporating Cannabis into Practice, and Bridging the gap to our Healthcare stytem with Workshop!

(FB): Cannabis Nurses Network

A great opportunity to network with

2016 Educational Achievement Award Heather Manus RN Cannabis Nurses Magazine

Resources

Recommended Books

Cannabis: Evolution an Ethnobotany

is a comprehensive, interdisciplinary exploration of the natural origins and early evolution of this famous plant, highlighting its historic role in the development of human societies.

Cannabis has long been prized for the strong and durable fiber in its stalks, its edible and oil-rich seeds, and the psychoactive and medicinal compounds produced by its female flowers. The culturally valuable and often irreplaceable goods derived from cannabis deeply influenced the commercial, medical, ritual, and religious practices of cultures throughout the ages, and human desire for these commodities directed the evolution of the plant toward its contemporary varieties. As interest in cannabis grows and public debate over its many uses rises, this book will help us understand why humanity continues to rely on this plant and adapts it to suit our needs.

The Handbook of Cannabis Therapeutics: From Bench to Bedside (Haworth Series in Integrative Healing)

The Handbook of Cannabis Therapeutics: From Bench to Bedside sets aside the condemnation and hysteria of society’s view of cannabis to concentrate on the medically sound aspects of cannabis therapeutics.

The world’s foremost experts provide a reasoned, thoroughly researched overview of the controversial subject of cannabis, from its history as a medicine through its latest therapeutic uses. The latest studies on the botany, history, biochemistry, pharmacology, toxicology, clinical use for various illnesses such as AIDS, epilepsy, and multiple sclerosis, and side effects of marijuana are all examined and discussed in depth.

Cannabis, one of humanity’s first domesticated plants, has been utilized for spiritual, therapeutic, recreational and even punitive reasons for thousands of years. Humans have excellent practical knowledge of the uses of cannabis, yet limited understanding of its sociocultural consequences, past or present, due to its widespread prohibition.

In Cannabis, Chris Duvall explores the cultural history and geography of humanity’s most widely distributed crop, which supplies both hemp and marijuana. This book focuses on the plant’s currently most valuable product, the psychoactive drug marijuana, and at the same time provides a global view of the plant, with coverage of little-studied regions including Africa and Australia.

Handbook of Cannabis Truly global in scope and with contributions from leading researchers around the world, The Handbook of Cannabis is the definitive resource on this fascinating drug. Combining scientific perspectives and clinical applications, it covers a vast array of topics, from why over the centuries cannabis has been used as a medicine, through the regulations facing those wishing to selfadminister cannabis or provide cannabis-based medicines, to the chemical structure of its many constituents and the rapidly growing group of synthetic cannabinoids that are currently being used for 'legal highs'.

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Nursing Conferences

2017

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11th National Clinical Conference on Cannabis Therapeutics Patients Out of Time ~ Cannabis: Protecting Patients and Reducing Harm May 18th - 20th, 2017 | Berkley, CA

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+VOF $POGFSFODFT AHNA's 37th Annual Conference-Workshop: Endocannabinoid Connections (June 10th 10:30AM-12Noon) June 5-10th, 2017 | Rancho Mirage, CA 7DNH 1RWH www.ahna.org/conference United Patients Group Presents: "Cannabis- A Clinical Focus" June 2-3, 2017 | Linthicum Heights, MD www.UnitedPatientsGroup.com

"VHVTU $POGFSFODFT Pre-Conference Courses & Workshop for Health Care Professionals - Cannabis Nurses Network August 28th, 2017 | Portland, OR (In conjunction with the Cannabis Science Conference & Bootcamp) (FB): Cannabis Nurses Network | www.CannabisScienceConference.com Cannabis Science Conference 2017 August 28th-30th, 2017 | Portland, OR wwww.CannabisScienceConference.com

2FWREHU &RQIHUHQFHV Cannabis Nurses Magazine 2-Year Anniversary & Awards Ceremony | October 7th, 2017 Cannabis Nurses Network: Health & Wellness Courses & Events| Three Day Event!

October 5th -8th, 2017 | Las Vegas, NV (FB): Cannabis Nurses Network | www.CannabisNursesMagazine.com

Stay Tuned

!

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