Vol. 5, Number 8
cheryl riley, editor & writer
Dr. David Bearman,
Gradi Jordan, Ed Glick,
Sunil K Aggarwal,
Jim Greig, Joan Bello,
AAMC El Dorado County CA
AAMC Rhode Island
Medical Marijuana advances - Arthur Livermore
It's been a busy month for medical marijuana. We now have 20 States and the District of Columbia with medical marijuana laws. New Hampshire Governor Maggie Hassan signed the bill on July 23rd which will allow patients with serious illnesses to obtain marijuana from four nonprofit, state-licensed alternative treatment centers. Illinois Governor Pat Quinn signed their medical marijuana law on August 1st allowing patients with one of 30 specific medical illnesses such as cancer, AIDS, Alzheimer's disease, Crohn's disease and multiple sclerosis, to obtain approval from a physician to use medical cannabis. Qualifying patients may possess 2.5 ounces obtained from one of 60 "registered dispensing organizations" that will be supplied by 22 "licensed cultivation centers."
New Jersey Governor Chris Christie was confronted by the parents of a young child who needs medical marijuana to treat her epileptic seizures. New Jersey now allows children to use marijuana and the strain of cannabis this young girl needs has been added to their legal strain list.
Dr. Sanjay Gupta got a lot of attention for his apology that he was wrong about marijuana. During his research for a CNN program called "Weed", he found that marijuana really is medicine. He had assumed that the law was based on scientific evidence, but he found that many patients use marijuana to successfully treat their symptoms.
Our AAMC New Mexico director, Bryan Krumm, has filed suit in US District court demanding removal of cannabis from schedule I of the Controlled Substances Act.
For immediate release.
I am Reverend Bryan Krumm, CNP. I am a Psychiatric Nurse Practitioner and I have filed a suit in the US District Court for New Mexico demanding removal of cannabis from schedule I of the Controlled Substances Act. 1:13-cv-00562-RB-LFG. The suit alleges the failure and the futility of the CSA's Administrative Process for scheduling, which is the responsibility of the Attorney General to enforce and which has been delegated to the DEA. These rules were enacted to ensure the safety of the American People.
Tragically, this legal process has been repeatedly violated by the Drug Enforcement Administration, which colludes with the Department of Health and Human Services, National Institutes of Health and National Institute on Drug Abuse in order to maintain the prohibition of Cannabis. Meanwhile, the Attorney General has ignored his responsibility to ensure the DEA acts fairly and legally. I have had a rescheduling petition filed with the DEA for over 3 years and the DEA has failed to respond to my argument, that because Cannabis now has "accepted medical use in the United States" by 20 States and the District of Columbia it is illegal to keep Cannabis in Schedule I. This failure of the administrative process has left me with no other choice than to seek extraordinary relief from the Courts.
In 1988, the DEA refused to remove Cannabis from schedule I of the CSA, in opposition to the recommendation of their own Administrative Law Judge. They cited a lack of "accepted medical use" as their rationale, in spite of overwhelming evidence of the safety and efficacy of Cannabis. There were no State Medical Cannabis Programs at that time. Cannabis now has "accepted medical use" in 20 States and the District of Columbia. The DEA simply looks the other way and continues to insist that "there is no accepted medical use in the United States". The DEA is violating the law by maintaining Schedule I placement of Cannabis in the CSA and in doing so, they have caused the deaths of hundreds of thousands of Americans.
The Defendants demand that more and better research be done while they actively block FDA approved research protocols looking for potential benefits of Cannabis. They claim that the thousands of studies in peer reviewed medical and scientific journals don't meet their level of scrutiny, while they engage in pseudoscience that is often never subjected to peer review. They simply ignore the large number of studies that have been conducted with smoked Cannabis in both the US and abroad, unless it is a study designed to find harm.
However, the issue at hand is not even about the research. It is about "accepted medical use". The quality of the research is clearly adequate for 20 States and the District of Columbia to have accepted the medical use of Cannabis. Therefore Cannabis does not meet the definition of a Schedule I drug which clearly states it can have "no" accepted medical use in the United States. Cannabis cannot legally remain in schedule I of the CSA if it has accepted medical use.
Cannabinoids, substances found in cannabis, activate specific receptors in the body called cannabinoid receptors. These receptors are involved in maintaining homeostasis and regulate many biological systems. Because of this, Cannabis has a broad range of therapeutic value. Because Cannabinoids have little effect on basic life support function, it is virtually impossible to overdose on Cannabis. There has never been a documented overdose death attributable solely to Cannabis. While mild changes in respiratory function can occur from smoking cannabis, we do not see the serious respiratory problems associated with tobacco use. Long term heavy use of cannabis has not been found to have a significant negative impact on overall health, and has been shown to provide significant relief from a great number of ailments.
In my clinical practice, Cannabis has proven to be the only medication consistently effective in treating PTSD. In the United States, 22 veterans suicide every day because there are no legal treatments which are consistently effective in treating PTSD. We have lost more active duty troops to suicide than to enemy fire in Iraq and Afganistan. Certainly the brave men and women who serve our country deserve better than to be denied a safe and effective treatment by appointed bureaucrats who are not held accountable to the American People.
Cannabis also has unique therapeutic value for treating cancer. In cancer, cannabinoids have been shown to induce apoptosis, the normal process of cell death which stops in cancer cells and leads to the development of tumors. Simply stated, cannabis may kill tumors while leaving health cells alone. Cannabis may also inhibit angiogenesis, the process by which tumors take over blood vessels to feed themselves, so cannabinoids starve the tumor. Finally, cannabinoids inhibit metastasis, the spread of the tumor to other areas of the body. Cannabis is far safer than any chemotherapeutic agent but Defendants refuse to allow human studies to be conducted so we can find out if cannabis might help save some of the over half a million Americans projected to die of cancer this year.
Alzheimer's is another disease for which we have no adequate treatments. Cannabis helps to prevent the deposition of amyloid plaques in Alzheimer's. It also shuts down the inflammatory processes which lead to neurodegeneration in Alzheimer's.
In my clinical practice, Cannabis has also proven to be effective in treating depression, anxiety, insomnia, nightmares, irritability, anger, psychosis, mood swings, pain, spasticity, cachexia, and even the core behavioral problems associated with profound Autism. It does so with superior safety and oftentimes greater efficacy than available pharmaceuticals. It is unreasonable, arbitrary and capricious for the DEA to stand between these sufferers and the medication they need to alleviate their symptoms.
As a Vet, I took an oath to defend the Constitution against all enemies, both foreign and domestic. By causing the death of hundreds of thousands of American Citizens, these agencies have proven that they have no respect for the Constitution or the Freedoms the Constitution is designed to protect. That is why I have brought this suit, to demand that these appointed bureaucrats are made to follow the law.
General use of cannabis for PTSD Symptoms - Raphael Mechoulam, Ph.D.
Dr. Mechoulam is the Israeli scientist who identified THC as the psychoactive compound in marijuana, and decades later he discovered the brain's endocannabinoid system and the endogenous neurotransmitter anandamide. He is one of the most respected Israeli neuroscientists and has been a senior advisor to the Israeli government on marijuana policy and the ethics of research with human subjects. He discussed his experiments demonstrating the neuroprotective effects of the endocannabinoid system in mice that have had traumatic injuries to the brain. He believes the neuroprotective effects of marijuana may eventually have applications for other neurological and psychiatric conditions, including Alzheimer's and Parkinson's disease.
Another fascinating discovery, one with implications for PTSD, is that the cannabinoid system is integrally related to memory, specifically to memory extinction. Memory extinction is the normal, healthy process of removing associations from stimuli. Dr. Mechoulam explained that an animal which has been administered an electric shock after a certain noise will eventually forget about the shock after the noise appears alone for a few days. Mice without cannabinoid systems simply never forget - they continue to cringe at the noise indefinitely.
This has implications for patients with PTSD, who respond to stimuli that remind them of their initial trauma even when it is no longer appropriate. By aiding in memory extinction, marijuana could help patients reduce their association between stimuli (perhaps loud noises or stress) and the traumatic situations in their past. Working with Army psychiatrists, Dr. Mechoulam has obtained the necessary approvals for a study on PTSD in Israeli veterans, and hopes to begin the study soon.
The Alternative Medical Journal: General use of cannabis for PTSD Symptoms.
Despite the anecdotal evidence to the contrary, most of the experimental studies that have been conducted so far indicate that by and large the administration of exogenous cannabinoids such as vaporizing therapeutic cannabis may not be the most reliable nor effective means of utilizing the eCB system to treat anxiety and aversive memories such as those formed in PTSD. For reliable and truly effective treatment of these conditions it appears that restricting eCB breakdown by way of FAAH inhibition is the best target discovered so far within the eCB system. (The other eCB targets include the two primary receptors CB1/CB2, vanilloid receptors, eCB reuptake, as well as eCB production.) To this end, Kadmus Pharmaceuticals, Inc. has started to express serious interest in marketing a new FAAH inhibitor they have developed, currently code-named KDS-4103. KDS-4103 appears to have a lot of potential from a pharmacological perspective. Even though it produces analgesic, anxiolitic, and anti-depressant effects it otherwise does not produce a classic cannabis-like effect profile and animals easily discriminate between THC and KDS-4103. All this indicates that KDS-4103 does not produce a “high” like THC and other direct CB1 agonists. KDS-4103 is orally active in mammals and fails to elicit a systemic toxicity even at repeated dosages of 1,500mg/kg body mass. All other available evidence to date also suggests a very high therapeutic margin for KDS-4103. All in all, considering that the kinds of events which usually precipitate PTSD in most individuals often also involve pain, KDS-4103 seems like it may be just about the perfect medication.
So what should all this mean to the individual? Anecdotal evidence says by and large the use of therapeutic cannabis provides a significant improvement in quality of life both for those suffering from this malady and for their family and friends. Whether or not this is taking the fullest advantage possible of the eCB system in the treatment of PTSD is yet to be seen. Mostly the use of cannabis and THC to treat PTSD in humans appears to provide symptomological relief at best. In and of itself, there is nothing wrong with symptomological relief. That's what taking aspirin for a headache, a diuretic for high blood pressure, opiates to control severe pain, or olanzapine for rapid-cycling mania is all about. We do have the potential, however, to do better than just treating symptoms of PTSD via activation of the cannabinoid receptors. With the right combination of extinction/habituation therapy and the judicious administration of a FAAH inhibitor like KDS-4103 we have the potential to actually cure many cases of PTSD. For the time being though, symptomological treatments are all we have for more generalized anxiety and depression disorders.
If an individual were to want to get the most out of using therapeutic cannabis to improve a PTSD condition they should try to use low to moderate doses with as stable a blood level as possible for general anxiety and depression symptoms. Oral cannabis produces more stable blood levels. Since peak levels will produce the most soporific effect, administration of oral cannabis right before bed should produce the most benefits for improving sleep patterns. If the goal is to use cannabis to facilitate extinction of the response to PTSD triggers than small to moderate doses of cannabis vapors should be administered shortly before planned exposure to the trigger. A series of regular extinction sessions will produce better results than a single session. If cannabis appears to make aversion, fear, or aversive memories worse then the dosage should be lowered. If feelings of fear do not improve with lower dose then discontinue use of cannabis as fear-extinction aide.
In light of all evidence currently available, it is striking that the FDA refuses to investigate cannabinoids for the treatment of anxiety disorders like PTSD yet they have approved studies of MDMA, the club drug Ecstasy, for the treatment of PTSD (Doblin, 2002). Even if you do not accept cannabis as the answer itself, it should be hard to accept that by and large we still have not found effective and reliable ways to utilize the eCB system in modern western medicine. After all, the most potent (meaning it takes the least amount to produce a threshold effect) substance know to humans is not LSD as many still assume but is instead a derivative of fentanyl, know as Carfentanil. The threshold dosages for LSD and Carfentanil are 20-30µg (micrograms) and 1µg, respectively (Wikipedia, 2 & 3). This makes Carfentanil 10,000 times more potent than morphine, 100 times more potent than fentanyl, and 20-30 times more potent than LSD. At least up until 2005 and unlike LSD, Carfentanil was(is?) regulated as a Schedule II substance in the US (Erowid). For those that do not know, this means that despite perceived extreme dangers from use or abuse of this drug it is still assumed to have medical value. With the lives and well being of so many veterans AND private citizens at stake, those in the scientific community and police makers alike cannot afford to miss the wake up call. Even a child should be able to see the hypocrisy evident in the relative policies concerning cannabinoids and opiates. It is time to fix this appalling imbalance in our policies concerning the pharmacopia or else be the laughing stock of future generations.
Alabama: Considering a medical marijuana law.
Arkansas: Considering a medical marijuana law.
Idaho: Considering a medical marijuana law.
Illinois: Passed a medical marijuana law.
Indiana: Considering a medical marijuana law.
Iowa: Considering a medical marijuana law.
Maryland: Considering a medical marijuana law.
Minnesota: Considering a medical marijuana law.
Missouri: Considering a medical marijuana law.
New Hampshire: Passed a medical marijuana law.
New York: Considering a medical marijuana law.
North Carolina: Considering a medical marijuana law.
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.
Featured Recipe - Patty Pot Pesto Sauce by Jay R. Cavanaugh, PhD
This wonderful, spicy, yummy, and potent green sauce is inspired by a friendly northern caregiver whose food products (butter, oil, and flour) are the best on the planet. Nancy Wife and I have learned a great deal from this cook extraordinaire. In this recipe you'll learn how to make and use a delicious sauce that features dried sativa flowers. Cannabis oil can be substituted for the flowers but the sauce won't taste nearly as good. The sauce is potent and a little goes a long way so stick to flower power if you can. The "Patty Pot" featured in this recipe is also called California Orange. This Sativa strain is not as strong as "Train Wreck" but is quite respectable in the THC category. In addition, it has a citrus like aroma that is great for cooking.
April 26-28, 2012
Tucson, AZ USA
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