MULTIPURPOSE MGZ
OunceMag.com WINTER 2017
1
Arkansas Will Set the Standard for Medical Cannabis Research They say that a magazine is a living and breathing thing. They say print is dying. So why would we create a magazine? Simple. We believe Arkansas will set the standard for medical cannabis research around the world. This magazine is packed with articles written by real doctors, real researchers, real medical professionals, real experts, and real patients with real stories. These stories are meant to be shared. We encourage you to read this magazine cover-to-cover and discover the truth about cannabis that should have been told to us decades ago. When you’re finished with this magazine, pass it around. Give it to your doctor. Spark the conversation.
CREATIVE DIRECTOR Shannon Anderson shannon@ouncemag.com EDITORIAL Corey Hunt corey@ouncemag.com Courtney Boze courtney@ouncemag.com Anna Robnett anna@ouncemag.com
CONTRIBUTORS Angela Bacca • Joe Goldstrich MD, FACC David Bearman, MD • Tammy Post, DO Josh Whittingham, PharmD Garyn Angel ADVERTISING (860) 420-2693 sales@ouncemag.com Ounce Magazine LLC PO BOX 4002 Fort Smith, AR 72914 Photography:
COVER: NELSON RAMIREZ • MORNINGCOFFEEPRODUCTIONS.COM
Corey Hunt, Editor-in-chief
2
OunceMag.com WINTER 2017
CONTENTS NEW TECHNOLOGY HELPS PATIENTS MAXIMIZE COST & SAFETY… HOLIDAY GUIDE PAGE 14
04
HOW TO GET LEGAL IN ARKANSAS
06
Now that it's your constitutional right to have safe and legal access to medical cannabis, here's how to start the process.
08 F E AT U R E
19
BECOMING A CANNABIS NURSE IN ARKANSAS
15
Discover why a nurse of more than 10 years finally came around on the science of medical cannabis.
CANNABIS IS SAFE & THE DEA KNOWS IT! Former DEA Spokeswoman exposes the big secret of drug enforcement.
NO-COST MEDICAL EVALUATIONS FOR LOWINCOME CANNABIS PATIENTS
DR. OZ APOLOGIZES FOR HIS ROLE IN THE OPIOID EPIDEMIC More doctors than ever are discussing medical cannabis as an exit drug to opioids.
30
States with legal cannabis laws have 25% fewer opioidrelated deaths.¹
TERPENE OF THE MONTH: PINENE A key feature in many popular cleaning solvents, but it also has healing properties.
drugpolicyeducation.org #JustTheFacts Ounce is the first magazine in Arkansas to focus on medical cannabis patients, industry, and legislation. Printed in full color and delivered old school. Distributed in retail shops, medical clinics, and events throughout the state. For subscription information please visit www.ouncemag.com.
1October 2014 Medical Cannabis Laws & Opioid Analgesic Overdose Mortality in the United States, 1999-2010, Marcus A. Bachhuber et. Al. ( JAMA Intern Med.)
OunceMag.com WINTER 2017
3
It’s now your constitutional right to have safe & legal access to medical cannabis…
HOW TO GET LEGAL IN ARKANSAS
4
3
1
2
PATIENT APPLICATION
PHYSICIAN CERTIFICATION
TALK TO YOUR DOCTOR
Print and complete the Medical Marijuana Registry Patient Application. Find the link at: OunceMag.com/GetLegal
Print the Medical Marijuana Physician Written Certification. Find the link at: OunceMag.com/GetLegal
Schedule an appointment with your MD or DO and present the Physician Written Certification for your doctor to complete and sign. This is NOT a prescription.
IF YOU HAVE ANY QUESTIONS, YOU MAY CALL THE ARKANSAS DEPARTMENT OF HEALTH DIRECTLY AT 501-682-4982.
CURRENT LIST OF QUALIFYING CONDITIONS Cancer
Ulcerative Colitis
Peripheral Neuropathy
Glaucoma
PTSD
Intractable Pain
HIV+/AIDS
Severe Arthritis
Severe Nausea
Hepatitis C
Fibromyalgia
Seizures
ALS
Alzheimer’s Disease
Tourette’s Syndrome
Cachexia or Wasting Syndrome
Severe and Persistent Muscle Spasms
Crohn’s Disease
Look for our next issue which will feature an article on how DPEG, the Drug Policy Education Group of Arkansas, plans to petition the State to add qualifying conditions.
4
5
REGISTER & UPLOAD YOUR DOCUMENTS
WAIT FOR YOUR CONFIRMATION
Register on the ADH website. Upload your signed certification, MMJ registry application and Arkansas driver’s license (or Arkansas issued photo ID), using your cell-phone camera or a document scanner. You will need a credit or debit card to pay the $50 annual fee online.
Your snail-mail confirmation will arrive after the state accepts your documents. Patient ID cards will be printed from the ADH website immediately and activated one month prior to dispensaries opening. Cards must be renewed on a yearly basis.
OUNCE MAGAZINE
HOW TO BECOME A CAREGIVER It’s just as easy to become a caregiver. Find out more at: OunceMag.com/GetLegal
OunceMag.com WINTER 2017
5
NO-COST MEDICAL EVALUATIONS
For Low Income Cannabis Patients BY COURTNEY BOZE
As the stigma slowly melts away, cannabis remains federally illegal. Insurance companies fearful of repercussions are not covering medical cannabis. Doctors in these insurance networks are refusing to recommend this medicine for fear of being shut out of the network.
Bulldozer Health wants you to “Take Back Your Health.” Their website is packed with information to help you learn ALL of your health care options, including tips on healthy eating, fun fitness ideas, and more. They also have a huge Alternative Health Provider Network to connect you with a compassionate doctor ready to help find the best treatment for what ails you.
“Health care costs, for many, are challenging enough and are driven through the roof when the full responsibility is placed on the patient.”
FREE MEDICAL CANNABIS EVALUATION IN ARKANSAS
—Wendy Love Edge, Bulldozer Health This unfortunate reality leads to immense anxiety for many patients who may already be suffering debilitating conditions, which leave them unable to work. Without gainful employment, many are not able to cover these exorbitant fees. For patients in Arkansas, Massachusetts, Connecticut, and Rhode Island there is helping hand- Bulldozer Health.
6
OunceMag.com WINTER 2017
In Arkansas, Bulldozer Health has partnered with local physicians to offer free and discounted patient consultations to low-income patients making less than $18,000 annually. These evaluations will be available to patients meeting low-income requirements with a qualifying condition in both Northwest Arkansas and the River Valley. Bulldozer Health also boasts a program that offers patients a $50 waiver for the medical cannabis card from the Arkansas Department of Health. This program gives top priority to terminal cancer patients. Patients can apply for the $50 fee to be paid by Bulldozer Health from funds raised in Arkansas at “Take Back Your Health America” benefit concerts and health fairs. In addition to the cannabis legalization waivers, provider network, and healthy living plans you can find on their website, Bulldozer Health also has fantastic YouTube Channel. There you will find hundreds of educational videos ranging from tips to cope with anxiety to regenerative medicine to going vegan. The host of the Bulldozer Health Show is the founder, Wendy Love Edge.
Wendy’s background is in occupational therapy. She is also an active volunteer, having served as a volunteer health worker in Guatemala and Nicaragua. In 2011, Wendy became gravely ill and was told she needed to get her affairs in order. This strong, amazing woman took matters into her own hands and was able to break free of the chains of pharmaceuticals in late 2013. Since then Wendy has made it her mission to help others from being “bulldozed” by overmedication. Bulldozer Health is a non-profit organization. Donations are tax-deductible. You can become a Bulldozer Health Show patron for as little as one dollar per month.
A PATIENT’S GUIDE:
How to Talk To Your Doctor BY ANGELA BACCA
So you have decided you want to try medical cannabis-- or you want to tell your doctor that you are using it. This could go one of two ways; either the doctor will informally signal their support or they will tell you there is not enough
BE FAMILIAR WITH THE STUDIES YOURSELF
summary of the study’s parameters (what
You may not be a professional medical
tements. Perhaps print some out and have
researcher, or even have familiarity with reading studies, but it is important that you
they are studying and how they plan to do it) plus the results and forward looking stathem with you to share with your doctor, who will have a more critical mind toward
research and suggest you try something
the study’s methodologies and how that
harder instead.
could apply to you personally.
If your doctor is the latter, perhaps it is
DON’T BE COMBATIVE
time to find a new doctor. Doctors are not taught about the en-
If a doctor is unwilling to even listen to
docannabinoid system, nor do many of
you on this issue, fighting with them won’t
them have any formal training whatsoe-
change their mind. Don’t accuse them of
ver with the cannabis plant. But, a doc-
being in big pharma’s pocket or having
tor who hasn’t been living under a rock
ulterior motives (even if you are thinking
the last 20 years (or choosing willful ig-
it), but instead, personalize your message.
norance) will know that cannabis cannot
You will have a much bigger impact if you
kill you and is being found to have more
say something along the lines of, “I find
and more medical applications. If your
it really unfortunate you won’t consider
doctor has not even taken the time to
looking into this as it could significantly
look into this issue his or herself, then
improve my quality of life, and therefore I
you should probably question their ju-
will have to find a new doctor who has my
dgement on the drugs they do recom-
best interests in mind.”
mend in its place. It is important to remember that your doctor cannot turn you in or punish you for being honest about your cannabis use. Your doctor should be able to check for any harmful drug interactions of currently prescribed pharmaceuticals.
BE EXPLICIT
understand why you want to use cannabis for your symptoms. Take a trip to to Pub-
Tell your doctor why you are using
Med or Google Scholar and enter the name
cannabis, how it makes you feel and how
of your condition or symptoms and “can-
it affects your symptoms. Take personal
nabinoid” or “marijuana” or “cannabis."
notes so you can share results with your
Each study will have an “abstract” or short
doctor.
FOR HELP LOCATING A PHYSICIAN VISIT: OUNCEMAG.COM/GETLEGAL OunceMag.com WINTER 2017
7
"I began my college experience at Arkansas State University, obtained my RN diploma at Baptist Health Schools, and finished with my BSN at Arkansas Tech University."
Becoming
A Cannabis Nurse
IN ARKANSAS BY KERRY FELLING, RN, BSN
Kerry inspects genetics at a conference in Portland, Oregon.
8
OunceMag.com WINTER 2017
“Is this plant as dangerous as I had been taught? Or are we overlooking a gift that was created to treat the sick?” “I want to help people.” This was a desire I held even as a young child. I can remember looking through books that taught about human diseases and genetic mutations. I felt empathy for the people and wished I could help them. In high school, Biology and Human Anatomy were subjects I found fascinating. When choosing a profession, nursing was an obvious choice. I always thought I was doing everything I could to help my patients, until recently. In November 2016, the people of Arkansas passed the Medical Marijuana Act. I never had any prior knowledge of how marijuana, which I now only refer to as cannabis, could be beneficial in the human body. I was determined to find answers that would persuade me to argue either for or against the use of medicinal cannabis. My journey had just begun. To lay a foundation of my educational background, I began my college experience at Arkansas State University, obtained my RN diploma at Baptist Health Schools, and finished with my BSN at Arkansas Tech University. Sadly, throughout all of my high school and college biology and nursing courses and countless hours of continuing education, I never learned about the endocannabinoid system (ECS). How can this be? This is part of our bodies that has been completely overlooked for centuries. Now that it has been discovered, shouldn’t it be taught in colleges and universities? Until the ECS is added to our educational curriculum, we, as individuals, must take the initiative to learn all that we can and educate one another. My cannabis education process began by tagging along with my husband, who holds a doctorate in chemistry, to a few Arkansas Cannabis Industry Association (ACIA) seminars and patient forums. Kyle, my husband, was attending these meetings to further his own career and to promote his abilities in cannabis analytical testing. ACIA has been very instrumental in educating the public about the medicinal uses of cannabis. Via ACIA, I have heard many inspirational speakers. One individual that spoke at a CE course I attended was Marcie Cooper, MSN. Marcie taught about the history of cannabis, the ECS, and the connection between the two. At a patient forum, I heard Dr. Uma Dhanabalan and Coltyn Turner speak. Dr. Uma impressed upon me the safety in the use of cannabis as a medicine. She has been successfully practicing medicine without prescribing narcotics for over 7 years. That single fact impressed me greatly. Coltyn, now 17 years old, provided his story of living with Crohn’s disease and how cannabis has assisted him in finding remission of his symptoms that had not been possible with multiple different prescription medications. These individuals furthered my curiosity into the world of medicinal cannabis.
I was interested, but also very confused. My previous thoughts and ideas of cannabis were perplexing me. It had never been a part of my life and I naively thought since it was illegal, it had to be bad for you. In addition, my religious beliefs were in conflict. The belief that one shouldn’t use mind-altering drugs versus my knowledge that all things were created for our use was spinning around in my head. Is this plant as dangerous as I had been taught? Or are we overlooking a gift that was created to treat the sick? In an attempt to clear up more of my questions, I attended the Cannabis Science Conference in Portland, Oregon. This conference hosted Marcie, Dr. Uma, Heather Manus, Julie Monteiro, a panel of pediatric cannabis patients’ parents, and many more. These individuals, with the content they discussed and the testimonies they gave, provided the answers I had been looking for. That cannabis IS a medicine and patients, young and old, desperately need it in their lives. Now that I had made an educated decision that medicinal cannabis is beneficial, I knew I had to be motivated to learn. I sought out, bought, and read books about the topic. Among these were, “The Cannabis Pharmacy” and the “Cannabis Health Index." I quizzed everyone around me that had any level of understanding. I learned that the women that spoke at the Portland conference made up an organization called the Cannabis Nurses’ Network (CNN). The CNN held an educational conference in Las Vegas, Nevada that I was able to attend. Jennie Stormes, RN, MSN and author of the book, “Cannabis Education for Nurses”, utilized her book to create the curriculum that was taught at the conference. My confidence and comprehension greatly increased. I learned that the ECS is a system in the bodies of mammals. The ECS “communicates” with other body systems to maintain homeostasis via CB1 and CB2 receptors. Like our lungs need air to survive, our ECS needs cannabinoids to maintain good health. If the ECS is lacking cannabinoids, it will have an impact on other body systems. This is where cannabis becomes significant. Cannabis contains phytocannabinoids that our ECS uses to function. Due to the interaction of the ECS with all body systems, cannabis can be utilized in many medical diagnoses, in most, if not all systems. Now understanding the physiology of cannabis in the body, I have to familiarize myself with what is being purchased by patients. I felt the best way to accomplish this was to go to a dispensary and ask questions similar to a patient. Patients have many options when selecting products and administration methods. Inhalation, via smoking or vaping, oral consumption of edibles, capsules, tinctures, topical creams or salves, transdermal patches, and vaginal or rectal suppositories are some of the choices that patients have depending upon their need. Assisting patients find
OunceMag.com WINTER 2017
9
the best route and type of cannabis to use is where I believe that healthcare professionals such as: nurses, pharmacists, and physicians will need to be able to assist. If we don’t understand the medication, we cannot help them. Some patients will try one type of medication and if it doesn’t work the first time, or they have an unpleasant experience, they won’t try anything else. It is imperative that we teach them correctly the first time they try the medication. Will we get the correct medication on the first attempt every time? The answer is probably no. Journaling is an important part of a beginning medicinal cannabis user’s routine. Along with educating the patients, our communities need to be instructed as well. In order for the “Woodstock” stigma to be torn down, our citizens need to be taught that medicinal cannabis may not even include the psychoactive part of the plant (THC). The non-psychoactive part of the plant (CBD) may be sufficient to treat some. If THC is needed, small percentages of it can be gradually added to CBD until a therapeutic level is achieved. For the individuals that obtain their medicinal cannabis license, it is important to use your medication responsibly. You can either add to the negative stigma or help tear it down. Dispensaries must also work to rebuild the public’s views of this industry. I have visited a few different dispensaries and they ranged in ability to educate their patients. One dispensary, the bud tender stated he obtained his knowledge about cannabis because he was a “stoner." As a nurse, I was greatly disappointed in his statement. I will encourage my patients to shop at dispensaries that care enough about the patients to train their bud tenders or have educational support readily available. The nicest dispensary I have visited to this point is Oregon’s Finest. The bud tender was very knowledgeable, patient with me as I asked questions, and stated that their business requires that new hires read “The Cannabis Pharmacy” and pass a verbal examination. Other considerations that patients need to be aware of is to chose a dispensary that is clean,
10
OunceMag.com WINTER 2017
has enough business to circulate product, provides adequate safety and privacy while discussing the products, are respectful and are forthcoming with laboratory testing information. If this is a new venture for the patient, they need to visit a few different dispensaries to find the one that suits their needs. Once the dispensary licenses are awarded, I will visit many of them in order to be able to judge for myself which dispensaries I feel are best. In nursing, we are taught that it is acceptable if we do not know the answer to every question. What isn’t acceptable is if we don’t know where to go to find the answers. I have been blessed to come in contact with some fantastic, supportive individuals. As I dive into this new area of nursing, I am sure that I will have to
MORE THAN JUST SMOKE Cannabis topicals are one of the top-selling items on the market. Shown: lotions, rubs, soaks, patches. Infused with THC & CBD.
THEY DO EXIST Every single week in America there is a conference where medical professionals are learning about medical cannabis. Pictured here with Nurse Heather Manus of Nature Nurse. Heather and her team have created products that allow patients to microdose cannabinoids.
ARTISANONE.COM • MULTIMEDIA DESIGN & STRATEGY
turn to these and other resources to continue my learning process. The most important thing I have encountered in this field is encouraging, knowledgeable individuals. I believe that cannabis nurses are aware of the mountain ahead of us, that there are numerous individuals that must be educated for medicinal cannabis to be successful and become available for all that need it. Corey Hunt, Courtney Boze, Marcie Cooper, Heather Manus, and Jennie Stormes patiently answered my questions during my educational growth. Thank you all so much and I hope that you understand that I now can help others because you helped me.
WE KNOW HOW TO GET YOUR ATTENTION‌ AND KEEP IT.
OunceMag.com WINTER 2017
11
This Doctor
Says Marinol Isn’t Medical Cannabis BY DAVID BEARMAN, MD
David Bearman, MD is one of the most clinically knowledgeable physicians in the U.S. in the field of medicinal cannabis. He has spent 40 years working in substance and drug abuse treatment and prevention programs. Dr. Bearman was a pioneer in the free and community clinic movement. His career includes public health, administrative medicine, provision of primary care, pain management and cannabinology.
For years, some law enforcement sources—many of who should know better—have referred to Marinol as prescription marijuana. Marinol® (dronabinol) is synthetic THC, it is not prescription marijuana. As you will see, that assertion is wrong by about 511 chemicals. Marinol is THC; just one of many chemical compounds found in cannabis, synthesized and mixed in sesame seed oil. Cannabis is a plant, and like other plants, it contains hundreds of active chemical compounds. Plants are complex, a tomato contains about 380 different molecules, coffee has roughly 880 and cannabis—512. Of these 512, 80-100 are cannabinoids like THC and CBD. The rest are compounds such as terpenes and flavonoids. Both cannabinoids and terpenes are known to have medical implications.
WHY PATIENTS NEED WHOLE PLANT CANNABIS: THE ENTOURAGE EFFECT An important concept with cannabis is the entourage effect. This is the combined effect of all the therapeutic constituents of the plant acting in concert synergistically to address many symptoms in one. With Marinol, there is no entourage effect because hundreds of chemicals are missing. Just to be entirely fair, Marinol does have therapeutic value and I prescribe it. I tell my patients, however, that it is not as effective as cannabis and is more expensive. It’s only effective for conditions that require THC. Marijuana-like products may be available by prescription, but it’s not prescription marijuana. SOMTHING: adiatiorum delessint mollic to explit ditassimus excest, omnis sum que repe nis rest alitiumer
12
OunceMag.com WINTER 2017
WHAT ARE CANNABINOIDS? Cannabinoids are essentially 21-carbon molecules which can block or stimulate the body’s own endocannabinoid receptors. Many of these cannabinoids, including THC, have therapeutic value. Here are some examples: THC (Tetrahydrocannabinol) is, among other things, an analgesic (pain killer), anti-inflammatory, neuroprotectant, antiemetic and muscle relaxant. When THC is heated through cooking or burning, it is converted to delta-9 THC, the psychotropic compound responsible for the “high”, or euphoric effects. When the molecule is obtained in its acid form through juiced raw cannabis it is non-psychotropic and not intoxicating. As THC ages it degrades into cannabinol (CBN). CBN (Cannabinol) is a mild psychotropic that may stimulate bone growth. It is anesthetic, anti-convulsive, analgesic and anti-anxiety. It often has the effect of putting patients to sleep. CBD (Cannabidiol) is non-psychotropic and relieves anxiety, convulsions, depression, inflammation and nausea. It is a sedative, sleep aid and muscle relaxant that is being studied for the treatment of epilepsy. CBC (Cannabichromene) is an anti-inflammatory, analgesic, anti-anxiety, anti-depressant, neuroprotective, anti-proliferative and treats acid reflux. It has been extracted for use in various cannabis topicals for its anti-inflammatory effects. CBG (Cannabigerol) is an analgesic, muscle relaxant, anti-erythemic (reduces redness) analgesic, anti-proliferative (stops the growth of malignant cells) and digestive aid. Researchers and patients are looking at it in the treatment of cancer. THCV (Tetrahydrocannabivarin) is an appetite suppressant, anti-bacterial, antiviral and anti-epileptic compound that can also aid memory and calm the user. Researchers and patients are looking into it for the treatment of diabetes and weight loss.
WHAT ARE TERPENES?
“Cannabis is a plant, and like other plants, it contains hundreds of active chemical compounds.” ...
Terpenes are what give different cannabis strains their unique odors. They are odor molecules found in all plants, with each cannabis strain having its own unique blend of terpenes, the terpene profile, usually found in other plants. The terpene profile is often thought of as the strain’s “fingerprint” or unique genetic identifier. Terpenes are ubiquitous in citrus fruit. They are also found in pepper, pine trees, lavender and other plants. There are no terpenes found in MarinoI, which is just synthetic THC. Here are some examples of cannabis terpenes’ therapeutic activity: Pinene is also found in pine needles and has anti-inflammatory effects in addition to being a bronchodilator, memory aid and Acetylcholinesterase inhibitor. Myrcene is also found in hops and mangoes and is a sedative hypnotic, muscle relaxant, analgesic, anti-inflammatory, Antipsychotic and antispasmodic. Many new cannabis product formulations include added myrcene to combat the anxiety some patients feel using high-THC cannabis. Limonene is found in abundance in many citrus fruits and treats acid reflux, anxiety and depression. It is antifungal and antimicrobial, which is why citrus terpenes are often used in cleaning products. In addition, it is anti-spasmodic, anxiolytic and gastroprotective. Terpinolene is also found in coriander and is an analgesic and digestive aid. Linalool is also found in lavender and is anesthetic, anti-convulsive, anti-anxiety, antineoplastic (prevents tumor development), antipsychotic and an anxiolytic sedative. Caryophyllene is also found in black pepper and is anti-inflammatory, analgesic and protects cells lining in the digestive tract.
OunceMag.com WINTER 2017
13
HOW AN ARKANSAS PHYSICIAN
OVERCAME REEFER MADNESS BY TAMMY POST, DO I once believed marijuana consumed young lives, bridging a gateway into an underworld of destructive behaviors such as insidious narcotics usage and alcoholism, and leaving its victims to be addicted dregs on society. So, how does a doctor who maintained this strict "Just Say No" view of marijuana become an advocate for medical cannabis? My journey started from a very naive and idealistic view of the medical world. My first thoughts of becoming a doctor were formed as a little girl—doctoring my stuffed animals, performing surgery on them, bandaging their boo-boos and kissing them on the foreheads when they were sick. Holes donned their mouths for thermometers and I learned early to use a needle and thread to stitch them. My obsession with tape and bandages left a collection of animal-shaped mummies with glimpses of their little bear and puppy features showing between the wraps. My mother planted these seeds much earlier by investing in medical encyclopedias for my older brothers so that they might pursue the prestigious profession and thus secure her financial retirement privileges. My brothers were a bit of a disappointment in that regard, but somehow the seed found fertile soil in me. My first exposure to cannabis came when my older brother, seeking distraction from the world, tried marijuana. Thanks to “Reefer Madness,” my parents were terrified he would become, at best, a “pot-head” and, at worst, a drug-addicted derelict, hopelessly lost.
I was rarely exposed to any sort of peer pressure to consume drugs and was way too fearful to risk disappointing my parents. Instead, I would model myself as the good girl and become their every expectation. I used judgment and justification against those that imbibed in any sort of alcohol or drugs. (I didn’t even drink wine until I was in my forties!) I watched as some of my classmates fell victim to the world of drugs, but I can honestly say that cannabis was not the gateway for them. In actuality, it was alcohol. The years passed and I continued to join the “War on Weed,” judging and belittling hippies as pot-smoking “losers” who clearly lacked the motivation to contribute to society in any significant way. I avoided parties and chose to study instead. Then a strange thing happened in medical school. I realized my ideals as a healer were quickly squelched by money-mongering pharmaceutical companies.
It is not uncommon for young doctors in medical school to be frazzled over the daunting amount of information they are required to memorize and process. On a day when I was struggling with this feeling, one of my professors told me I was worrying too much. "Just memorize a few medications for blood pressure, antibiotics and the like and you'll make a good living," he said. At first I was relieved, but then I got angry. What the Hell was he saying? Little did I know how true that reality was in the world I was entering—one where doctors prescribe billions of pharmaceuticals every year and practice what I would call “lazy medicine.” What happened to the art of diagnosing and finding the source of the problem? We funnel patients through our offices like cattle, seeing on average forty to sixty patients per day and rolling out those medication prescriptions like glorified legal drug dealers. We are wined and dined by pretty little drug reps. When they can no longer buy us with expensive gifts—like Caribbean cruises, golf trips, Rolex watches or Mont Blanc pens—they use fear tactics to scare us. They tell us we may be sued or held liable for a patient's death when they are prescribed certain medications, like opioids. And yet, the CDC reports that over 100,000 patients die each yearfrom these medications, as prescribed. Those aren't overdoses. Nor are these deaths related to patient CONT’D ON PAGE 29
14
OunceMag.com WINTER 2017
OFFICIAL / SHUTTERSTOCK.COM
Dr. Oz Apologizes for His Role in the Opioid Crisis BY COREY HUNT Dr. Mehmet Oz, better known as “Dr. Oz,” is more than just a TV personality. Dr. Oz has been a professor at the Department of Surgery at Columbia University since 2001. He directs the Cardiovascular Institute and Complementary Medicine Program at New York-Presbyterian Hospital. Dr. Oz has been practicing medicine for over 30 years and has likely prescribed hundreds of thousands of pills to his patients; if not millions. Dr. Oz has finally realized the impact of some of these prescriptions, “For years, we’ve used opiates to treat pain and today we are in the throes of an addiction epidemic.” The opioids Dr. Oz and his colleagues prescribed over the years are the number one killer of adults under 50. Now, Dr. Oz
is apologizing, “I was duped. It’s hard to admit it, but I have to face the facts.” “About twenty years ago, my colleagues and I were sold a bill of goods on a new strategy to treat people suffering from chronic pain. Opioids were the answer, and we were led to believe that not only were they effective, but that they couldn’t be addictive. Unfortunately, it took a national emergency to realize that the quadrupling of opioid prescriptions that resulted from these teachings was actually a problem. Not only are opioids in fact highly addictive, according to the CDC, there is actually little evidence that they are even effective at relieving chronic pain.” In a shocking Change.org petition, Dr. Oz calls on the government to look into
medical cannabis as a solution to the opioid crisis. “I believe medical cannabis could do just that and I’m calling on the federal government to fund the research we need to prove it. Studies already suggest that states with medical cannabis laws have a 25 percent lower mean annual opioid overdose mortality rate compared with states without medical cannabis laws.” At the time of this publication, Dr. Oz has collected over 65,000 signatures on change.org to his petition.
OunceMag.com WINTER 2017
15
The 2017 Holid
SIDEKICK VAPORIZER 7thfloorvapes.com
TIGHT-VAC tightvac.com
SLX GRINDER slxherbgrinders.com
The pe for the pa
These product in Ft. Smith and
16
DIME BAGS dimebags.com
OunceMag.com WINTER 2017
THE LAUNCH BOX Magic-Flight.com
day Catalogue SILVER SURFER VAPORIZER 7thfloorvapes.com
erfect presents atient in your life.
ts can be found at The Looking Glass, Fayetteville or at your local boutique.
46 E. TOWNSHIP ST. FAYETTEVILLE, AR 1602 ROGERS AVE. FORT SMITH, AR
OunceMag.com WINTER 2017
17
Protect Your Growing Business
We provide custom security solutions for your unique requirements. With over 25 years’ experience manufacturing electronic access control systems, we have the partners and resources to ensure you protect your people, building and products. 4 Simple, yet powerful access control systems that exceed state security regulations 4 Biometric and two-factor authentication ensures compliance 4 Complete accountability and tracking with customized reports
Contact us today to find out how we can help you protect your business.
For more information, call us today at 1-800-332-1013 or email sales@access-specialties.com
access-specialties.com
18
OunceMag.com WINTER 2017
FORMER DEA SPOKESWOMAN:
“CANNABIS IS SAFE and the DEA knows it!” BY ANGELA BACCA “Marijuana is safe, we know it is safe.
from football.” Football has always been a
Nelson went home and asked her
It’s our cash cow and we will never give
major part of her life and she has often ca-
then-teenage son if he could find her
up,” Belita Nelson told an audience of doc-
lled well-known players her friends.
marijuana. “Even if the DEA is behind my
tors and nurses at the Marijuana for Medical Professionals Conference in Denver, Colorado in 2016. Nelson says that was the first thing she
THE DEA AGENT & THE DALLAS COWBOYS STAR
name I am not willing to sit here and watch my friend die,” she said. The cannabis helped; he started eating and gaining weight and slept more
learned from her Drug Enforcement Ad-
She says in 2000, two years into her
restfully at night. With new motivation he
ministration (DEA) education coordinator,
tenor at the DEA, a close friend and Da-
started a clean eating and juicing diet to
Paul Villaescusa, when she was hired in
llas football player was diagnosed with
complement the marijuana therapy and
the Dallas office in April 1998.
stage-4 lung cancer. She watched him go
lived an additional nine years.
“I was having fun, I was very good at
through three rounds of chemotherapy
Nelson says she even grew the can-
my propagandist job—I was the chief pro-
and deteriorate from 340 to 140 pounds.
nabis herself so that she knew it was safe
pagandist for the DEA,” she said.
She says he could no longer eat or sleep
and not smuggled from Mexico.
Nelson represented the DEA in the international media from 1998 to 2004. She did regular appearances on
and was miserable.
LEAVING THE DEA FREE & CLEAR
the talk show circuit, including
In 2004, Nelson resigned from
the Oprah Winfrey show and Ni-
the DEA. She had been investiga-
ghtline, espousing the dangers of
ting the heroin epidemic in Plano,
cannabis. Today she advocates for
Texas and learned that addicts who
its medical use, specifically in the
turned to cannabis were having a
treatment of chronic traumatic en-
higher success rate getting off opia-
cephalopathy (CTE) in professional
tes using it. She chose to resign.
football players through an orga-
“[When they hired me] they for-
nization she founded: The Gridiron
got to get me to sign a confidentia-
Cannabis Foundation.
lity agreement—and boy did I know
Belita Nelson grew up in what
the dirt. They called me in and said
she calls a “Texas Football Family."
‘name your price, $10,000 a mon-
Her father loved the Dallas Cow-
th? $20,000? What do you want
boys and taught her “life lessons
Belita?’” CONT’D ON NEXT PAGE
OunceMag.com WINTER 2017
19
IMAGE: KIM SIDWELL
PRE-CERTIFICATIONS FOR MEDICAL MARIJUANA IN ARKANSAS To make an appointment, email HELP@AMEDICINALPURPOSE.ORG
Former DEA spokeswoman, Belita Nelson, speaking out against prohibition and corruption.
She said she left the office screaming, “You know this is safe
Facebook.com/AMedicinalPurpose
and you are keeping it from people who are sick! I am not taking your money and you better worry about what I am going to say!” Nelson relocated to Colorado with little idea what she would
AMEDICINALPURPOSE.ORG
do next, but quickly found a place in the state’s burgeoning medical cannabis industry. She started testifying in support of medical cannabis, citing her official role at the DEA as expertise. “Gradually, I came out of my shell and that dark place I had been because of what I had experience and what I had seen…AMP If Ounce Ad.indd you think the DEA are the good guys, they are not. They are really not. We are talking corruption on steroids.”
STAYING OUT OF THE SHADOWS In 2014, with a longtime friend and former Denver Broncos player Rick Upchurch, Nelson began to advocate for cannabis as part of the treatment of CTE—a brain disease caused by repeated trauma that has killed many former NFL players or led them to take their own lives. Based on their studies, they put together a plan for alternative and holistic treatments for CTE, including medical cannabis. Together they designed a program and have recently purchased property in Colorado to host former NFL players and their families to provide these alternative therapies and see if they can stop brain degeneration. Together, Upchurch and Nelson are hoping to prove the efficacy of cannabis in treating CTE so that the National Football League (NFL) agrees to allow its use among players. At the end of her presentation, Nelson appealed directed to the crowd at the Marijuana for Medical Professionals conference, “There is so much work to do here and I honestly never thought I would see us get where we are. This is a very special time—get excited about this, understand we aren’t just doing it for fun— we are changing history folks. Be a part of this, help me change history—let’s see what this plant can do.”
20
OunceMag.com WINTER 2017
1
10/30/17 5:06 PM
HERE’S WHY
A CARDIOLOGIST TOOK A SECOND LOOK
at Cannabis
It was 2012, and I had recently turned 74. I had retired from a satisfying career in preventive cardiology, nutrition, integrative medicine, and clinical lipidology. I was bored and depressed. Still fit and able to think clearly, what was I to do with the rest of my life? All my medical licenses except for California and Missouri were now inactive. I saw an ad for a job in Pomona, California, to work in a medical marijuana clinic. I wasn’t exactly sure what this entailed, so I investigated and found that it was a job providing recommendations for the use of medical marijuana, which had been legal in California since 1996. I thought this might provide relief from my doldrums and malaise, so I signed on. I saw about 25 patients a day— mostly young men with purported low back pain who were looking for a legal way to smoke marijuana. There were a few interesting patients who told me how cannabis relieved their migraine headaches,1 Crohn’s disease,2 low back pain,3 glaucoma,4 multiple sclerosis spasms,5 and insomnia.6 One woman was looking for cannabis to relieve the side effects of chemotherapy.7 Some, but not all the applicants, brought medical records documenting their diagnosis. I lasted six days because providing the recommendation without supporting medical records, a requirement of the Cali-
IMAGE: DAVID SYGALL
BY JOE D. GOLDSTRICH, MD, FACC
Dr. Joe is all smiles.
fornia medical board, was too stressful for me. I was fortunate enough to find other interesting work as the medical director of a nutritional supplement company. I remembered those interesting medical marijuana patients and continued to follow the medical marijuana job opportunities in California. In late 2013, I saw an ad for a medical marijuana clinic in Oakland, California. This clinic was part of a group of clinics
belonging to Jean Talleyrand, MD, founder and president of MediCann. Dr. Talleyrand advertised that his clinics were “highly professional, ethical…founded and run by physicians.” I flew to California and spent three days seeing patients with Dr. Talleyrand. I was impressed with his professionalism and extensive experience with MediCann in providing medical marijuana recommendations to more than 300,000 California patients. I signed on again, and over the next nine months interviewed close to 3,000 patients seeking a recommendation for medical cannabis.8 During this period of time, my list of medical conditions for which patients found cannabis useful grew to include attention deficit hyperactivity disorder,9 asthma,10 anxiety,11 seizures,12 depression,13 post-traumatic stress disorder,14 erectile dysfunction,15 and cancer.16 (Regarding cancer, cannabis not only provided relief from chemotherapy but also appeared to treat the tumor—more on this later.) It gradually dawned on me that while I had been providing the legal mechanism for patients to use medical cannabis to treat their medical condition, I had little to no firsthand knowledge or experience in guiding patients on using cannabis to treat their conditions. It was then that I decided to become a bona fide cannabinologist.
CONT’D ON NEXT PAGE
OunceMag.com WINTER 2017
21
MORE TO LEARN In 2014, I joined the Society of Cannabis Clinicians,17 a professional society devoted to the exploration and investigation of medical and scientific applications of cannabis medicine. Shortly after joining, Mara Gordon, a layperson who had been making cannabis oil for medical purposes, spoke to the society. She had been advising patients on how to use cannabis medicinally for several years. In September 2014, while attending a continuing medical education program on medical cannabis in Denver, Colorado, I heard Mara present again. Mara was supplying medical cannabis oil to really sick people – people with cancer, people who were deemed incurable after exhausting traditional medical therapy. She had supplied medical cannabis to hundreds of patients over several years and had more experience in advising patients on the use of medical cannabis than anyone else that I had encountered. I asked Mara to teach me what she knew about the use of medical cannabis—to let me learn from her experience. This was not an easy thing for a physician to do, but I was willing to do whatever was needed to gain this knowledge. That was the spring of 2015. Most of the patients I have consulted on have had cancer. I have followed the tumor markers and radiologic scans. Some tumors have shrunk and even disappeared, some have stopped growing, and some have continued to grow unabated. Cannabis is not an oncologic panacea, but I’ve seen enough success to remain cautiously optimistic about the role of cannabis in the treatment of cancer.1 In a nutshell, here are some of the most important things I have learned about the use of cannabis in the treatment of cancer: Cannabis may work synergistically with chemotherapy18 and radiation.19 Cannabis may induce autophagy and subsequent apoptosis resulting in programmed cancer cell death.20 Tumor ID-1 gene expression facilitates cancer cell growth, survival, and metastases.21 Cannabidiol (CBD), a non- psychoactive cannabinoid, expresses antitumor acti-
22
OunceMag.com WINTER 2017
vity22 in part through inhibition and down regulation of ID-1 expression.23 How can this information be used to formulate a therapeutic protocol to treat patients? Many people envision the medical cannabis patient as someone who sits around the house smoking a joint all day long. That’s not usually the case. Smoking might be an effective way to prevent a migraine headache or deal with a flare-up of chronic pain, but for most chronic diseases a concentrated form of cannabis is necessary and is best delivered by the transmucosal route. Accurate laboratory testing of the cannabis material is mandatory. This testing would include not only the percentage of the cannabinoids present in the material (i.e. THC, CBD) but also the absence of pesticides and toxic solvents and the presence of the full cannabinoid and terpene profile so as to take advantage of the entourage effect.24 Once the percentage of the cannabinoids are known, a prescription can be formulated in terms of milligrams of THC and/or CBD. Typical prescriptions for cancer patients will contain from 50 to 300 mg per day of THC and, depending on the status of the ID-1 gene for their particular tumor, from 50 to 300 mg per day of CBD. Specific strains, over and above their THC and CBD con- tent, are chosen for their secondary effects (i.e. wakefulness, appetite stimulation, sleep). Most patients are seeking to avoid the psychoactivity associated with THC, and for that reason it is of paramount importance to start with extremely low doses (i.e. 1 to 5 mg) of THC and build up slowly, taking advantage of the known tolerance that develops with continued THC use. CBD, having little psychoactivity,1 can usually be advanced more quickly. That’s what I have learned so far. My experience convinces me that cannabis should be removed from its schedule 1 status so placebo controlled, double-blind studies can be carried out. Only then will we realize the full potential of this remarkable medicine.
REFERENCES 1 Baron EP. Comprehensive review of medicinal marijuana, cannabinoids, and therapeutic implications in medicine and headache: what a long strange trip it’s been. Headache 2015; 55(6):885-916. 2 Schicho R, Storr M. Cannabis finds its way into treatment of Crohn’s disease. Pharmacology 2014; 93(1-2):1-3. 3 Eisenberg E, Ogintz M, Almog S. The pharmacokinetics, efficacy, safety, and ease of use of a novel portable metered-dose cannabis inhaler in patients with chronic neuropathic pain: a phase 1a study. J Pain Palliat Care Pharmacother 2014; 28(3):216-25. 4 Sun X, Xu CS, Chadha N, Chen A, Liu J. Marijuana for glaucoma: a recipe for disaster or treatment? Yale J Biol Med 2015; 88(3):265-9. 5 Pryce G, Baker D. Endocannabinoids in multiple sclerosis and amyotrophic lateral sclerosis. Handb Exp Pharmacol 2015; 231:213-31. 6 Belendiuk KA, Babson KA, Vandrey R, Bonn-Miller MO. Cannabis species and cannabinoid concentration preference among sleep- disturbed medicinal cannabis users. Addict Behav 2015; 50:178-81. 7 Smith LA, Azariah F, Lavender VTC, Stoner NS, Bettiol S. Cannabinoids for nausea and vomiting in adults with cancer receiving chemotherapy. Cochrane Database Syst Rev 2015; 11:CD009464. 8 Thompson M. The mysterious history of “marijuana.” NPR.org. Available at: http://www.npr.org/ sections/codeswitch/2013/07/14/201981025/the-mysterioushistory-of-marijuana (accessed on January 2, 2016). 9 Hadland SE, Knight JR, Harris SK. Medical marijuana: review of the science and implications for developmental-behavioral pediatric practice. J Dev Behav Pediatr 2015; 36(2):115-23. 10 Tashkin DP, Shapiro BJ, Lee YE, Harper CE. Effects of smoked marijuana in experimentally induced asthma. Am Rev Respir Dis 1975; 112(3):377-86. 11 Korem N, Zer-Aviv TM, Ganon Elazar E, Abush H, Akirav I. Targeting the endocannabinoid system to treat anxiety-related disorders. J Basic Clin Physiol Pharmacol 2015. 12 Devinsky O, Marsh E, Friedman D, et al. Cannabidiol in patients with treatment-resistant epilepsy: an open-label interventional trial. Lancet Neurol 2015; 4422(15):379-8. 13 Hillard CJ, Liu Q. Endocannabinoid signaling in the etiology and treatment of major depressive illness. Curr Pharm Des 2014; 20(23):3795-811. 14 Betthauser K, Pilz J, Vollmer LE. Use and effects of cannabinoids in military veterans with posttraumatic stress disorder. Am J Health Syst Pharm 2015; 72(15):1279-84. 15 Chauhan NS, Sharma V, Dixit VK, Thakur M. A review on plants used for improvement of sexual performance and virility. BioMed Res Int 2014; 2014:868062. 16 Giuliano M. Cannabinoid- associated cell death mechanisms in tumor models (Review). Int J Oncol, May 2012. 17 Society of Cannabis Clinicians. http://cannabisclinicians.org/ (accessed on January 2, 2016). 18 Torres S, Lorente M, Rodríguez- Fornés F, et al. A combined preclinical therapy of cannabinoids and temozolomide against glioma. Mol Cancer Ther 2011; 10(1):90-103. 19 Scott KA, Dalgleish AG, Liu WM. The combination of cannabidiol and ∆9-tetrahydrocannabinol enhances the anticancer effects of radiation in an orthotopic murine glioma model. Mol Cancer Ther 2014; 13(12):2955-67. 20 Salazar M, Carracedo A, Salanueva IJ, et al. Cannabinoid action induces autophagy-mediated cell death through stimulation of ER stress in human glioma cells. J Clin Invest 2009; 119(5):135972. 21 Ling M-T, Wang X, Zhang X, Wong Y-C. The multiple roles of Id-1 in cancer progression. Differ Res Biol Divers 2006; 74(910):481-7. 22 McAllister SD, Soroceanu L, Desprez P-Y. The antitumor activity of plant-derived non-psychoactive cannabinoids. J Neuroimmune Pharmacol 2015; 10(2):255-67. 23 McAllister SD, Murase R, Christian RT, et al. Pathways mediating the effects of cannabidiol on the reduction of breast cancer cell proliferation, invasion, and metastasis. Breast Cancer Res Treat 2011; 129(1):37-47. 24 Russo EB. Taming THC: potential cannabis synergy and phytocannabinoid-terpenoid entourage effects. Br J Pharmacol. 2011;163(7): 1344-64.
LIMITING SIDE EFFECTS & INTERACTIONS
LOW & SLOW BY JOSH WINNINGHAM, PHARMD Medical cannabis is a non-toxic, non-lethal, and natural means for symptom relief. Despite the general safety of cannabis as medicine, patients still need to understand potential side effects and interactions of medical cannabis. Studies have shown that slower consumption at lower doses has a marked reduction in adverse events while also improving the therapeutic efficacy of medical cannabis.1 A “low and slow” dosing protocol, starting with low THC and higher CBD content and utilizing quarterly cannabis detoxes, is the most appropriate protocol for most medical cannabis patients. Discussing side effects of medical cannabis requires nuance, because what is negatively perceived for one condition may be seen as beneficial for another. The varied phytochemical makeup of a specific strain can also alter the perceived effect. Potential adverse effects of cannabis have been described in several reports.2,3,4 Common side effects include the following: • Dry mouth (often referred to as “cotton mouth”) • Dry and/or red eyes • Increased appetite (often referred to as the “munchies”) • Unexpected increase in unfocused energy • Increased sedation or lethargy The same appetite, energy, and sleep effects can be beneficial depending on condition symptom relief desired. If a patient is suffering from insomnia, the central nervous system depressive effects of cannabis can induce sleep. If a patient has been diagnosed with cachexia, the appeti-
te stimulation becomes a beneficial effect. These side effects tend to resolve within one to four hours. Increased dosage amount and/or concentration can produce varied effect. For example, the same medical cannabis product at a low level can have anxiety relieving effects while at a high level can increase or amplify anxiety. Acute adverse side effects attributed to consuming too much cannabis (overdose) include: • Panic • Paranoia • Hallucinations • Heart palpitations • Shortness of breath • Nausea • Cold sweats
• Shaking or trembling • Extreme lethargy/sedation resulting in immobilization These effects are more commonly seen in high THC medical cannabis products compared to low-to-no THC products. If acute adverse effects are experienced, there are steps that can be taken to alleviate the symptoms. It is important to remain calm and know the feelings will usually pass within 2-12 hours. Recommendations for working through the feelings of being overmedicated include: • Drink plenty of fluids • Eat a healthy snack such as whole fruit, which will increase possible low blood sugar • Take a warm shower • Go for a walk • Take a nap, or go to bed • Refrain from driving or operating heavy machinery while under the influence • Cannabidiol (CBD) can alleviate some of the physiological effects associated with cannabis toxicity5 (though it does not reduce the psychotropic feeling of being high.6) These effects can be very uncomfortable, but, it is important to note, cannabis alone cannot cause a fatal overdose.7 Endocannabinoid receptors are not found in abundance in the parts of the brain that support vital functioning such as respiration and circulation. Most illicit drugs that cause fatal overdoses affect these areas. Pharmaceutical medications that cause fatal overdoses affect these areas, or can CONT’D ON NEXT PAGE
OunceMag.com WINTER 2017
23
be combinations of drugs that can include things like acetaminophen, which, taken in excess, can cause liver failure. Cannabis has shown to be both non-lethal and non-toxic. Longitudinal studies of chronic adverse effects are not prevalent and have resulted in a variety of opposing conclusions.8 No long-term negative side effects are currently associated with intermittent or low-to-moderate cannabis use. In general, there are concerns about long-term effects on brain development and memory in adolescents who are heavy cannabis users. Adults who are heavy cannabis users seem to have higher chances of developing anomic aphasia, or a problem with word recall. Regular users of inhaled cannabis have a higher risk of chronic bronchitis and impaired respiratory function. Cannabis’ relationship to heart conditions may very well not be causal, but rather correlate to enhancing cardiovascular issues related to an existing condition.9 Patients with pre-existing mental health conditions and their health care providers should be mindful of the benefit v. risk analysis of medical cannabis use when determining the best treatment strategies. Statistically, cannabis has a 6-10 percent addiction rate.10 This is a lower addiction rate than tobacco, alcohol, and some prescription drugs, but nonetheless should be a consideration when evaluating the appropriateness of therapy for individual patients.
REFERENCES 1 Russo E. B., Mead A. P., Sulak D. (2015). Current status and future of cannabis research, in Clinical Researcher. 58–63. 10.14524/CR-15-0004 2 Hall W, Solowij N. Adverse effects of cannabis. Lancet 1998;352:1611-6. 3 Ashton CH. Adverse effects of cannabis and cannabinoids. Br J Anaesth 1999;83:637-49. 4 Handbook of Cannabis Roger Pertwee (ed.) Published in print: 2014 Published Online: January 2015 Publisher: Oxford University Press DOI: 10.1093/ 5 Karniol IG, Shirakawa I, Kasinski N, Pfeferman A, Carlini EA. Cannabidiol interferes with the effects of delta 9-tetrahydrocannabinol in man. Eur J Pharmacol 1974;28(1):172–7. 6 Lemberger L, Dalton B, Martz R, Rodda B, Forney R. Clinical studies on the interaction of psychopharmacologic agents with marihuana. Ann NY Acad Sci 1976;281: 219–28. 7 The Report of the National Commission on Marihuana and Drug Abuse. Acute Effects of Marihuana. Retrieved September 15, 2017, from http://druglibrary.net/schaffer/Library/studies/nc/nc1e.htm 8 Volkow ND, Baler RD, Compton WM, Weiss SRB. Adverse Health Effects of Marijuana Use. The New England journal of medicine. 2014;370(23):2219-2227. doi:10.1056/NEJMra1402309. 9 Ibid., 47. 10 Anthony, James C.,Warner, Lynn A.,Kessler, Ronald C. Comparative epidemiology of dependence on tobacco, alcohol, controlled substances, and inhalants: Basic findings from the National Comorbidity Survey. Experimental and Clinical Psychopharmacology, Vol 2(3), Aug 1994, 244-268
READY TO ADVERTISE IN OUNCE ?
(860) 420-2693 24
OunceMag.com WINTER 2017
OunceMag.com WINTER 2017
25
Blurring the Lines
Can Food be Medicine? BY GARYN ANGEL The line between food and medicine has always been a blurry one. Herbs and spices commonly used today as flavoring in American kitchens were once hailed as the cornerstones of medicine around the world. The general practice in regions embracing “western” medicine is to separate the two (hence the directive “Take this medicine with food.") The exception is when doctors throw their hands in the air and give that resigned prescription, “diet and exercise.”
BEYOND DIET & EXERCISE That’s not to say diet and exercise aren’t critical—they’re arguably the most important health factors that we can directly control. But the watered-down phrase has too often become the point at which the conversation ends. Nowadays the recommendation of a particular type of diet or herbal regimen is simply noted as an “alternative” treatment, secondary to the barrage of pills and potions pushed on us by physicians and by the pharmaceutical corporations that pull the strings. Dietary medicine, however, is far from alternative. Regionally common foods like ginger, apple cider vinegar, and turmeric have a long history of success worldwide for both prevention and treatment of some of the most serious illnesses known to man. And as technology advances, so does our ability to harness the medicinal properties of everyday plants like these.
CONSIDER NATURAL BOTANICALS Consider cannabis, for example, one of the most controversial plants on the
planet. This natural botanical has been consumed medicinally via smoking and ingestion for thousands of years. Though it is commonly considered a “recreational drug” these days, a good time is not all it has to offer. When ingested in any of a number of forms, the cannabis plant can often benefit the body to an extent that puts prescription drugs to shame. Patients with legal access to cannabis reduce their consumption of conventional pharmaceuticals, according to a demographic review of patient characteristics published online in the Journal of Psychoactive Drugs. In its raw, unheated form, juiced cannabis confers powerful neuroprotective, antioxidant, and anti-inflammatory effects. The phytocannabinoids from carefully chosen strains can even be extracted into potent, concentrated oils. These can alleviate symptoms of conditions ranging from eczema and diabetes to epilepsy, cancer, and beyond.
TAKE IT EASY In the past, extracting the active compounds from cannabis and other plants was tedious and inconsistent. That was before a new kitchen device infused with digital technology came along a few years ago to streamline the process. The botanical extractor, or “MagicalButter machine”, is a unique countertop appliance that takes all the labor, mess, guesswork, and unwanted aromas out of producing
SAVE $30 TODAY ON YOUR OWN MAGICAL BUTTER MACHINE. USE COUPON CODE OUNCEMAG AT MAGICALBUTTER.COM
your own batch of medicine from the plant. It’s easy, too: You toss in your herb and some butter or oil, and press a couple of buttons. With a MagicalButter machine, you can blend the best benefits of your favorite herb into your daily diet—without spending a tedious day hunched over a burner, stirring endlessly in the chemistry lab that was your kitchen, dodging boiling grease rockets from the stovetop. Suddenly, everything from cannabis-infused tomato soup to oil is at the touch of a button. Long gone are the days of sticks and lumps in your cannabutter. Thousands of years ago, Hippocrates himself—the father of modern medicine—said, “Let medicine be thy food and let food be thy medicine.” In our time, thanks to advances in technology and science, the distinction between the two will become even more blurry. Diet and exercise are the answer for robust health. Hopefully, western medicine will soon catch up with the rest of the world and accept them as not the end of the conversation, but the beginning.
OunceMag.com WINTER 2017
27
28
OunceMag.com WINTER 2017
REEFER MADNESS cont'd from page 14
abuse. Those deaths are patients using their medicine, as prescribed by their physician within the guidelines set by the Physician's Drug Reference. If 100,000 people died in a bombing or natural disaster, we would be calling in the troops or Special Forces or something. We'd call for government action or intervention. Yet this quiet poison rains on us and like a thief in the night takes our loved ones. During my residency, a pharmaceutical representative talked to our group about Marinol, an expensive, synthetic version of THC. That is the psychoactive ingredient in cannabis or, as I say, “catnip for humans.” This, we were told, was an acceptable prescription choice—legal and a perfect option for patients who were dying anyway. They would be unlikely to care about possible addiction and would benefit from a medicine capable of treating the symptoms of intractable nausea or cachexia (wasting syndrome associated with weight loss and loss of appetite) that are so often the side effect of chemotherapy. With this information and the assurance that it was acceptable—and more importantly legal—I began prescribing Marinol when indicated. Too often, though, my patients could not afford it. The medicine can range between $300 to $1,000 per month even with insurance. For almost twenty years I have known of the benefits of medical cannabis and shared that knowledge with my patients. What I didn’t know is that the plant is so diverse in its healing. It has anti-cancer and anti-disease properties. It alleviates symptoms and has treatment potentials for psychological impairment. I was also moved to study medicine by my father whose lifelong battle with grand mal seizures was a daily struggle. His intractable status epilepticus episodes were deadly—and they happened frequently, varying from three a day to thousands.The seizure medications were not only ineffec-
“What I didn't know is that [cannabis] is so diverse in its healing. ” ... tive, I believe, they eventually caused his cancer, a rare form of lymphoma known to be a side effect of his medications. Had we known about the benefits of cannabis, they might have made a tremendous difference for him. The funny thing is it was probably right under his nose—with my older, hippy brother. Although smoking whatever my brother had on hand, might not have helped Dad. He may have needed a strain with a specific THC to CBD ratio. Today we know a lot more about medical cannabis, the types of different strains, or chemovars, and the active compunds. Through ongoing research, we can create treatment plans to match many diseases and symptoms. Personally, I have a cannabis story, too. As a child, I had many health issues—chronic fatigue, arthritis, headaches and abdominal complaints. I largely attribute this to poor eating habits, lack of good nutrition and the extreme stress in our home due to
my father’s illnesses. I thought it was normal to hurt. Normal to live with constant headaches and abdominal pain. Normal to have menstrual cycles that lasted two weeks with hormonal fluctuations that caused many female emotional flares. Normal to feel tired. I wanted so much for my life. My ambitions were stifled by my pain and fatigue so often. One day, I made a decision to change my diet and that’s how I got through medical school and residency. I continued to struggle with hormone issues though and sought out alternative healers to help me better understand the way the human body works and how to utilize available options in our environment that God gave us. Then I learned about natural hormone therapy and it changed my life. Our bodies produce hormones which drive nearly every process in them. These systems can be triggered by external plant hormones. In a similar way, the body also has a cannabinoid system that runs alongside the hormonal one—and it can be triggered by external plant-based cannabinoids, too! (Cannabinoids happen to be found in many plants, including cannabis.) My early judgments against cannabis were based on propaganda and fear. My journey to understanding how to be a healer led me to alternative hormones, nutritional therapy, exercise, stress reduction— and cannabis. Now I have a whole new set of tools in my “little black bag” that I can use to help heal and alleviate suffering. It’s time for physicians to dispel the myths of the past and uncover the properties of cannabis and how it interacts with the human endocannabinoid system. A growing body of science shows a clear understanding of the possibilities of this plant in our modern society.
OunceMag.com WINTER 2017
29
TERPENE OF THE MONTH
Pinene
α-Pinene Effects: Pain, Inflammation, Energy, Calming, Focus, Uplifting β-Pinene Effects: Pain, Inflammation, Energy, Focus
BY COURTNEY BOZE
Patients just getting started with medical cannabis may be familiar with cannabis components such as “CBD” or “THC.” These are just two of many, many pieces that lend healing properties to this medicinal herb. Cannabis also contains terpenes. Terpenes are the essential oils found inside plants. In cannabis, terpenes are buried in the crystalline trichomes. They offer potent aromas, as well as, a bounty of medicinal benefits. Terpenes are why some patients may favor different varieties of cannabis to others. The Entourage Effect1 shows cannabinoids work synergistically and are more effective when they are combined. Terpenes play a huge role in the Entourage Effect by enhancing the therapeutic value of the herb. This issue, we’re focusing on pinene (α-pinene and β-pinene). Found in pine trees, alpha-pinene is Earth’s most abundant terpene.2 A research study from 2010 shows flowers high in alpha-pinene were repellent to insects.3 Alpha-pinene and beta-pinene may also be found in Rosemary, Turpentine, and Allspice. You can experience the effects of Pinene through the ancient Japanese practice
30
OunceMag.com WINTER 2017
of Forest Bathing.5 The activity, which has been seen to decrease stress and lower blood pressure, is simply enjoying a leisurely stroll through the nearest forest. Pinene has considerable health benefits including memory aid,6 anti-inflammatory,7 antimicrobial.8 A 2015 study9 suggests α-pinene can effectively suppress tumor growth. Next time you visit a medical cannabis dispensary, ask to see products that are high in pinene.
REFERENCES 1 Ben-Shabet, 1998 https://www.ncbi.nlm.nih.gov/pubmed/9721036 2 Noma Y, Asakawa Y. Biotransformation of monoterpenoids by microorganisms, insects, and mammals. In: Baser KHC, Buchbauer G, editors. Handbook of Essential Oils: Science,
Technology, and Applications.Boca Raton, FL: CRC Press; 2010. pp. 585–736. 3 https://www.ncbi.nlm.nih.gov/pubmed/19729299 4 Perry NS, Houghton PJ, Theobald A, Jenner P, Perry EK. In-vitro inhibition of human erythrocyte acetylcholinesterase by salvia lavandulaefolia essential oil and constituent terpenes. J Pharm Pharmacol. 2000;52:895–902. 5 https://en.wikipedia.org/wiki/Pinene 6 Gil ML, Jimenez J, Ocete MA, Zarzuelo A, Cabo MM. Comparative study of different essential oils of Bupleurum gibraltaricum Lamarck. Pharmazie. 1989;44:284–287. 7 Raman A, Weir U, Bloomfield SF. Antimicrobial effects of teatree oil and its major components on Staphylococcus aureus, Staph. epidermidis and Propionibacterium acnes. Lett Appl Microbiol. 1995;21:242–245. 8 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4669986/ 9 http://www.sciencedirect.com/science/article/pii/ S1347861315000110
OunceMag.com WINTER 2017
31
32
OunceMag.com WINTER 2017
SPONSORED IN PART BY OUNCE MAGAZINE