Endocannabinoids Emerge Out of the Shadows - Ed Glick
The Seventh National Clinical Conference on Cannabis Therapeutics met in Tucson, Arizona on April 26-28, 2012. As is customary with this series of conferences, Patients Out of Time brought together a wide variety of clinical, research and experiential presenters who described the expanding universe of endocannabinoid therapeutics. However, this conference became a benchmark in understanding these complex systems. Where previously, underlying mechanisms of action were vaguely understood, today these biochemical pathways have been described in detail. Where previously, researchers (and patients) knew that cannabinoids dampen down excitatory sensory impulses, today they know how this is accomplished. Additionally, research continues to expand the understanding of anti tumor effects of cannabinoids.
Most of the endogenous (anandamide), or exogenous (herbal cannabis), effects are through neuro modulation at the synapse. (Neuro modulation is the activity of a chemical signal which stimulates or dampens the release of neuro transmitters at the space between two nerve cells.) This complicated process acts like a feedback mechanism to the cells pushing them towards homeostasis- or balance. The reason cannabinoids benefit so many different disease states is precisely because this neuromodulation is occurring as a process of homeostatic re-regulation. Since all mammals have evolved the endocannabinoid signaling system over millions of years, the use of cannabis to selectively activate it is nothing short of a profound medical breakthrough-(which patients have been aware of for generations!)
The ocular neuro protective effects of endocannabinoids are also becoming understood and were described by Professor Melanie Kelly of Dalhousie University in Nova Scotia Canada. When nerve cells (neurons) are degraded or inflamed, local endocannabinoid production is increased in that location. Blocking CB1 or CB2 receptor activity increases the susceptibility of that neuron to stroke and trauma. Cannabinoids display neuro protective effects in experimental models of trauma. Again, the activation of cannabinoid receptors (CB1 or CB2) through either endogenous release of anandamide, or through the exogenous use of herbal cannabis, stimulates a return toward homeostasis by decreasing neurological stress and inflammation.
Another researcher, Martin Lee described his research into unlocking the mechanisms of cannabdiol (CBD)- the non-psychoactive cannabinoid. Most readers understand that THC is the cannabinoid in cannabis that is primarily responsible for the euphoria that is prized by recreational users and that was intentionally bred into most strains. What is much less known are the various important effects of the non-psychoactive CBD. Apart from the obvious benefit to some -that it stimulates endocannabinoid signaling without the person getting high -CBD also reduces breast and glioblastoma cell proliferation, may protect neurons against cellular degradation, promotes stem cell neurogenesis (growth), exerts anti psychotic influences, suppresses cardiac arrhythmia, is anti biotic, and has anti-oxidant properties. Interestingly, CBD has little affinity for the cannabinoid receptors, rather it works by activating non cannabinoid receptors and “enhances endocannabinoid tone by inhibiting FAAH…a key endocannabinoid metabolizing enzyme.” FAAH breaks down endocannabinoids, CBD slows the degradation and enhances cannabinoid signaling. (Since it’s therapeutic re-discovery in 2009, CBD-rich strains like Cannatonic and Harlequin are being grown specifically for patients who want pain control with less psycho activity.)
In addition to numerous speakers, the Seventh National Clinical Conference on Cannabis Therapeutics was the site for a meeting of the American Cannabis Nurses Association. Founded two years ago, the ACNA is the professional organization for nurses and others who are interested in the unique interaction of nurses and cannabis patients. Nurses all over the country are caring for and in contact with cannabis patients and have little understanding or awareness of its mechanism of action or of the many complex legal issues presented by the Federal governments ongoing war on cannabis patients. How should a nurse counsel a patient about safe use of cannabis? Nursing as a specialty is concerned with the provision of direct patient care, and the subspecialty of cannabis nursing lends itself to this role.
The conference was also attended by a number of physicians, some of whom participated in the first credentialing seminar hosted by the American Academy of Cannabinoid Medicine. This seminar provided physicians with advanced practice certification.
The conference and the venue were enhanced by the sponsorship of the Arizona Center for Integrative Medicine in Tucson. Dr Andrew Weil, author of From Chocolate to Morphine spoke to the gathering exhorting participants to take control of this issue, rather than let it be continually framed by drug war proponents and conservative media. He described the huge education gap of clinicians and the “deep-rooted irrationality” surrounding cannabis. His talk ranged over the limitations of conventional pharmaceutical treatments, contrasting the risk/benefit relationship of cannabis.
The Seventh National Clinical Conference on Cannabis Therapeutics was well attended by over 250 participants, and was held at Loews Ventana Canyon Resort, in the canyons north of Tucson. This spectacular setting was matched by the culinary offerings created by the Loews Chef, who offered many dishes created with hemp.
The field of cannabinoid research has been hampered for decades by overreliance on the single-molecule profit-based health care industry of America. As Dr. Weil pointed out, this accounts for much of the obstruction, insanity, and senselessness of the continuing federal prohibition on cannabis. The very fact that millions of patients can “dispense” with their muscle relaxants, opiates, sedatives and tranquilizers by using a safe and powerful remedy must make pharmaceutical industry accountants break into a cold sweat. Nevertheless, as this conference showed, the re-integration of cannabis into the Pharmacopoeia is now inevitable, and the legal prohibitions are destined to fall like dead leaves on a tree.
The Seventh National Clinical Conference on Cannabis Therapeutics marked, for the first time, the emergence of cannabinoid science from a poorly understood complex process into an increasingly cohesive body of clinical and experiential wisdom which represents the last new frontier of conventional medical advancement. This is, of course, something millions of patients have known for centuries. Their cumulative experience has precipitated this beginning revolution in medical care. Patients are, after all, the leaders here.
Patients Out Of Time (www.medicalcannabis.com)
American Cannabis Nurses Association (www.cannabisnurse.org)
American Academy of Cannabinoid Medicine (www.aacmsite.org)
Arizona Center for Integrative Medicine (www.Integrativemedicine.arizona.edu)
AN OPEN LETTER TO PRESIDENT OBAMA - Dr. David Bearman
Dear President Obama,
When it comes to Drug Policy Reform and your campaign promises of Hope and Change, we, the American people, have been had. You are obviously a smart, articulate person. When you ran you made it clear – or it seemed clear at the time – that you were committed to drug policy reform. From where I sit that hasn’t happened.
Before I criticize your disappointing failure in this realm, let me say thank you for all that you have accomplished:
Pulling us back from the abyss of the great recession
Getting the U.S. out of a needless, senseless war in Iraq
Health care reform
Developing an exit strategy for Afghanistan
Abolishing “Don’t Ask Don’t Tell”
Championing women’s reproductive rights
Supporting fairness in U.S. tax policy
Definitively dealing with Osama bin Laden
There are an impressive list of accomplishments. They took hard work, intelligence and political courage. This makes it all the more baffling that you have done little or nothing to address our dismally failed drug policy. This is in the face of the majority of Americans supporting drug policy reform. You have notable conservatives such as Dr. Ron Paul, George Will and Judge James Gray calling for and recognizing the need for drug policy reform. Last June we had a distinguished Global Commission calling for drastic change in drug policy. A week later former President Carter seconded that conclusion. We have Mexico and other South American governments calling for and implementing reform. Spain and Portugal have reformed their drug laws with positive results.
Then we have you at the recent Hemisphere Conference saying that we will not alter our current, constitution bending, expensive, wrong headed reliance on the criminal justice system to “treat” substance abuse. Now we have the local outrage of blocking access to the ill and infirm of this safe (per DEA), effective medication (liquid cannabis, Satiivex, is approved for sale in at least ten countries) by raiding cannabis dispensaries in Santa Barbara.
Syndicated columnist Debra Saunders recently wrote, “Mr. Obama may talk up having a dialogue on legalization and decriminalization, but his newly announced strategy proclaims, ‘Legalization of drugs will not be considered in this approach.’” It is time to realize that we have been going down the wrong track on this matter since 1914. The drug issue has been used as a tool to expand federal power at the expense of states rights.
What is even more disappointing, Mr. President, is your hypocrisy and flip-flopping on this issue. You yourself used marijuana and cocaine and became President. Mr. Bush used cocaine and alcohol and became president. Mr. Gore admits he smoked cannabis for several years and he became U.S. Senator from Tennessee and Vice President of the U.S. Newt Gingrich smoked marijuana and became Speaker of the House. Some citizens might say we’d have been better off if you were all arrested and jailed like low income Black or Hispanic substance abusers. I don’t agree and my guess is you don’t either.
When it comes to the medicinal aspects of cannabis you have turned your back on the health benefits of cannabis and cannabinoids. You have not respected state laws as you said you would. No, you sided with two conservative Justices Anton Scalia and Anthony Kennedy, who have repeatedly trumpeted their support of states rights, and the four moderate associate justices (sometimes mistakenly referred to as liberals) who turned their back on their support of states rights in the Gonzalez v. Raich case.
The late Chief Justice Rehnquist and Justices O’Connor and Thomas supported states rights and wrote two ringing dissents recognizing that the 9th and 10th amendments and the 1925 Lindner decision give the constitutional authority to regulate the practice of medicine to the individual states.
I recently delivered a presentation at SBCC about how we got to our current dysfunctional drug policy to a class on deviant behavior. It got me thinking; is it deviate behavior to ignore the results of over 20,000 studies and 5,000 years of medical use? Is it deviant to treat a medical issue with a criminal justice approach? Is it deviant for you to say you would follow the science and then have your director of the DEA block the study of cannabis medicine by an eminent botanical medicine expert, Dr. Lyle Craker, of University of Massachusetts.
George Will wrote that our drug policy
“…has consequences: More Americans are imprisoned for drug offenses or drug-related probation and parole violations than for property crimes. And although America spends five times more jailing drug dealers than it did 30 years ago, the prices of cocaine and heroin are 80 to 90 percent lower than 30 years ago.
Your administration has followed the lead of your recent predecessors George H.W. Bush, Bill Clinton and George W. Bush and blocked or discouraged research on a substance that has been shown in animal studies to cure cancer and a substance that is used by tens of thousands of our courageous war veterans to treat PTSD. Your drug czar has ignored the distinguished American Academy of Cannabinoid Medicine’s request for a meeting to educate him on the endocannabinoid system and the therapeutic applications for cannabinoids. Your administration forced the National Cancer Institute (NCI) to take down from their website the fact that doctors believe that cannabis has anti-cancer properties.
A $200 transaction can cost society $100,000 for a three-year sentence. And imprisoning large numbers of dealers produces an army of people who, emerging from prison with blighted employment prospects, can only deal drugs. Which is why, although a few years ago Washington D.C. dealers earned an average of $30 an hour, today they earn less than the federal minimum wage ($7.25).”
As a physician who has recommended cannabis for treatment of PTSD, phantom limb pain, ankylosing spondylitis, nausea and decreased appetite from cancer, seizures, migraines, cyclical vomiting syndrome, analgesia, depression, and many other serious, debilitating illnesses – and as a citizen who understands that clinical application of science - I am disappointed.
With 20 billion in the federal budget for controlling drugs (that we admit), tens of billions spent on incarceration, loss of productivity, tax revenue and harming children by destroying families by arresting and jailing parents, by walking away from potential billions in tax dollars; the majority of Americans, and the vast majority of youth, believes you are wrong and that you lied to us. You are a fantastic wordsmith and I suspect you could come up with a dazzling retort to this letter. Based on your track record, why should we believe you?
The governors of Washington, Vermont and Rhode Island have all petitioned you to reschedule cannabis to schedule II. This is consistent with the 1988 findings of the DEA, consistent with the position of the AMA, consistent with a conservative reading of the Controlled Substances Act, and plan just the right medical, political and humanitarian action to take. Follow the science and have compassion for the ill and infirm. We had medicinal cannabis available in pharmacies from 1854-1942. It is well past time to return to that policy.
I only hope that by your deeds not your rhetoric that, should you receive a second term, you fulfill your promise to follow the science, to respect state laws and to give us changes that will give we the American people hope for sanity on this issue.
Alabama: Considering a medical marijuana law.
HB642 - The Michael Phillips Compassionate Care Act of Alabama
Arkansas: Considering a medical marijuana law.
Connecticut: Passed a medical marijuana law.
Florida: Medical marijuana petition drive underway.
Idaho: Considering a medical marijuana law.
Illinois: Considering a medical marijuana law.
Bill Status of SB1381
Indiana: Considering a medical marijuana law.
Iowa: Considering a medical marijuana law.
Kansas: Medical marijuana petition drive underway.
Marijuana Bill Reaches House
Cannabis Compassion and Care Act
Maryland: Considering a medical marijuana law.
Bill Status of SB 627
Massachusetts: Considering a medical marijuana law.
Minnesota: Considering a medical marijuana law.
Missouri: Considering a medical marijuana law.
HOUSE BILL NO. 1670 - An Act relating to the use of marijuana for medicinal purposes
Cottleville Mayor Don Yarber hopes Missouri legislature passes medical marijuana law
New Hampshire: Considering a medical marijuana law.
New York: Considering a medical marijuana law.
North Carolina: Considering a medical marijuana law.
North Carolina Medical Cannabis Act
Ohio: Considering a medical marijuana law.
Pennsylvania: Considering a medical marijuana law.
South Carolina: Considering a medical marijuana law.
South Dakota: Medical marijuana petition drive underway.
Tennessee: Considering a medical marijuana law.
Texas: Considering a medical marijuana law.
Wisconsin: Considering a medical marijuana law.
The Jacki Rickert Medical Marijuana Act
Featured Recipe - Cooking Means Cash by Jay R. Cavanaugh, PhD
A good friend of mine (no less than the driver of the Canny Bus) has written me many times saying that our recipes look wonderful but who can afford them? She’s not alone. Most folks don’t cook. They don’t have the time, the energy, and, they think, the money.
Talk about cash. What about fast foods, "convenience" foods, and "prepared" foods? We all know that fast food is not cheap. A lot of times it isn’t even fast. Most folks buy their drive-thru junk on their way to their by-pass operation. Now, don’t get me wrong, occasionally, junk is a treat. More often it’s a down payment on future funeral plans. Convenience can mean just about anything short of digesting the food for you (although it some times looks like that).
More sinister, however, is the growing trend of "prepared" foods at the market. Sure, I want to eat something that’s been sitting in a steam table for three days. Pass. About the only affordable already made food for you is Jack in the Box two for .99 cents tacos. For three or four dollars (not counting the Pepsi) one can just about overdose. No family is getting out of that drive-thru lane for less than a ten spot. For my family you have to at least break a twenty. As you’ll soon learn, for the far less money, the same time, and less hassle, you could be having the meal of a lifetime. Remember:
- The more "prepared" or "convenient a food is, the more cost per serving. When they actually have to even heat the food up for you, it’s terribly expensive. The mark-up on supermarket prepared salads (a classic "convenience" food) rivals that of the best cannabis. "Frozen entrees" are another wallet buster.
- The only way "prepared" food can possibly be affordable is to either cut down on portions or, more likely, use inferior ingredients. Just what are "cheese products" anyway?
- "Prepared" foods are simply military rations in camouflage packaging.
- Fast, prepared, or convenient, you are paying top dollar for food lacking in nutrition, taste, and health.
Smart shopping and home cooking translates directly into tasty meals filled with nutrition that are fun to make. It also translates over time into big time cash savings. How much cash? Check out this typical comparison. Time of fast food was 30 minutes, same as home cooking. Nutrition didn’t even compare. Taste? Well you decide. Cash? Keep it in your pocket and leave the car in the driveway!
Meal for four at Carl’s Jr.
Typical burger evening
Meal for four at home
Green Peril and Green Garlic Toasted for All
(4) "Restaurant" burgers
(4) Super fries
(4) Large Pepsi’s
(4) "Super Star" cookies
1/4 cup olive oil
1/4 cup white wine
1/2 mini tub
3 cloves of garlic
3 medium shallots
1/3 cup Pecarrino
(Better bud butter) est.
1/2 liter Chardonnay
1 loaf fresh French bread
That’s a savings of $11 for just one meal. Say you’re cheap at Carl’s and leave the cookies out. There’s still a savings of $6. Do this every day and you end up with nearly $2,000 a year in extra cash just for substituting home cooking for "convenience" one meal a day.
These savings don’t even begin to count how much is saved from the co-pay on your CAT scan, ECG, and blood tests.
Have you tried "Green Peril" or "Green Garlic Toasted"? These and many more recipes are all on our AAMC website: http://www.letfreedomgrow.com
Future articles will have tips on shopping, portion control, and other ways to save even more cash. Most of the recipes are relatively easy. They all have been taste tested and are guaranteed tasty.