Happy 4th! A Promise to Evolve
Considering that the Russian-Ukrainian war, misaligned SCOTUS decisions, and an insurrection are the dominant topics in the news, I will highlight this holiday with a promise to evolve with more compassionate and responsible access to Cannabis
I’ll start by paraphrasing a story by Will Fritz of the NY Cannabis Insider titled, “Another medical marijuana patient describes ongoing problems with price, service, and access”. The story is part of an ongoing series that elevates the voices of NY’s Medical Cannabis patients.
Shortly after New York legalized recreational Cannabis, patients and advocates began sounding the alarm about the state’s handling of medical Cannabis, alleging NY’s medical program was being left to rot while regulators focused instead on the adult-use market.
Christopher, a 25-year-old medical Cannabis patient from Long Island uses Cannabis to treat PTSD. Christopher says he has trouble getting accurate and helpful information from “budtenders” at medical Cannabis dispensaries. When asking for recommendations on what products he can use to best treat his condition, he says he’s often met with little more than a shrug.
“It’s like going to CVS, but the people at the pharmacy are like the people at the checkout. In New York it’s like, they’re just here to sell the stuff,” says Christopher. “You’re working with medical patients who rely on this medication — there should be a level of professionalism.”
He has also encountered privacy issues at his main dispensary, where his PTSD is plainly labeled on the outside of the package when he purchases products. “They’ll put your issue on your package, right on display for everyone,” says Christopher.
Christopher also complains that it’s difficult to find affordable dispensaries. He has visited other states where the pricing is significantly cheaper. “When I went to Maine, I was able to get a full gram cartridge for like, $15.”
“The same product,” he says, “would be as much as $100 more at his usual dispensary in New York.
Christopher acknowledges that it makes some sense that a state with a higher cost of living in general is going to have more expensive medical Cannabis than in states where it is less expensive to live. Still, the difference seems outrages.
“Is it $100 difference?” says Christopher. “I don’t think so.”
Like other patients, Christopher also complains about delays and problems with the Office of Cannabis Management, especially regarding the fact that home cultivation has not been adopted.
“It’s crazy that you still can’t grow your own,” says Christopher. “What’s the OCM going to do, they’re going to break into my garage and take it?”
High prices, less accessible products, and a lack of professionalism are all issues that are ongoing in the Cannabis industry. The re-introducing of Cannabis as a viable and valuable commodity started with compassion and an action to help others. A Cannabis users community and industry started the movement to legalization. Law makers did not initiate regulatory changes, the people did. With supplies at a surplus, it’s up to the people to drop prices through industry practices. Education is accessible and professionalism is an attitude that are not costly. For the sake of the suffering who inspired us to re-introduce Cannabis to the world, it’s up to the people through community and industry to evolve to a better place
Planting a Seed
It’s been more than 25 years since Californian’s passed Prop 215. Today, even states like Texas and Georgia have enacted compassionate use laws. That’s right compassion. That’s how it all started. People who were dying with overwhelming sickness needed help. Modern pharmaceutical drugs were not successful, their side effects causing more problems than they solved. We have evidence of an opiate crisis. We have intractable nausea and vomiting from Cancer chemotherapy. There are people anxious or depressed after traumatic life experiences or unable to sleep and addicted to sleeping pills. All these problems are addressed by allowing people to grow Cannabis, a plant that humans have cultivated for thousands of years.
Today I learned that the Humboldt County Director of Planning and Building ordered a deputy sheriff to tear down the personal garden of one of my patients. He is sick and needs medicine. An annual report from DEA’s Domestic Cannabis Eradication/Suppression Program says that the agency confiscated more than 5.5 million Cannabis plants and arrested approximately 6,600 people over Cannabis in 2021. That’s a 22% increase in the number of confiscated plants and a 32% increase in the number of people arrested.
It’s both funny and sad when you think about. Humanity prides itself on having large brains and being the thinking animal. If we are so thoughtful, why do we prohibit or control the cultivation of a plant that we find useful? Somewhere in the forest, animals with much smaller brains are shaking their heads and laughing at the same time.
You might think of having a personal garden. The idea of enjoying sweet fruit and crisp vegetables from your own garden does not cause fear or panic. But, if you think of incorporating Cannabis into your garden, you must pull out the rule book and worry about your neighbors. How many plants are OK? What, I can’t just grow what I want or need?
“At a time when the overwhelming majority of voters support legalization, and when more and more states—and even members of Congress—are moving toward this direction, it is troubling to see federal agents and their local partners reversing course and reinvigorating their marijuana (Cannabis)-related enforcement activities,” says Paul Armentano, deputy director of NORML
Northern California is notorious for its stance against Cannabis prohibition. People are either from there or have moved there to cultivate Cannabis. They escaped up winding mountainous roads and disappeared among the redwoods to grow the weed. Elected officials looked the other way or sometimes even participated in Cannabis cultivation. With the repeal of prohibition, one might expect the inhabitants of northern California to be dancing in the streets. But ignorance and greed persist and the war on Cannabis continues.
Cannabis is a plant that grows easily for the benefit of humans. We are thankful to have powerful medicines, strong fibers, and nutritious oils from such a wonderful plant. Those elected officials and henchman-like law officers that continue to insist on controlling the cultivation and restricting sharing of this earthly bounty for power and gain must go. The war on Cannabis continues and the personal Cannabis gardener is the foot soldier. In health or in defiance, put a Cannabis plant in your garden today and signify that any attempt to obstruct and dominate over the planting of a seed will never succeed.
A recent study by investigators at the University of New Mexico, Department of Psychology, reveals that Cannabis users prioritize Empathy, Moral Fairness, and Moral Harmlessness. The study, titled “Cannabis Consumption and Prosociality”, was published in Nature Scientific Reports. “Prosociality” refers to the intentional act of advancing the well-being of others.
Previous studies have suggested an association between Cannabis use and antisocial behavior. For example, a study of people with a criminal history of aggression proposes that their Cannabis use is a predictor of their aggressive behavior. Another study of men arrested for domestic violence links Cannabis use to future violence. These studies describe the behavior of lawless and disruptive Cannabis users. However, they don’t lend insight to Cannabis use among healthy populations.
In response, psychologists decided to evaluate healthy Cannabis users. They measured the traits of 146 young adults between the ages of 18 and 25 using validated social psychology scales. Participants’ urine was tested for THC and they were asked if they had recently used Cannabis. Approximately half of the participants had recently used Cannabis. Those with THC in their urine had higher “prosocial” scores compared the THC-free cohort. THC positive females scored higher on measures of aggression and THC positive males scored higher on measures of agreeableness. It's important to note that the study found no difference in measurements of anger, trust of others, emotional stability, openness, principles of respecting authority, and preserving the concept of purity.
The authors explain that Cannabis is often consumed to reduce feelings of anger and aggression. Animal and human studies have shown that, unlike alcohol, Cannabis intoxication results in a decrease in aggressive behaviors. Observational studies indicate that Cannabis users are less irritable, agitated, and stressed. With increasing access to Cannabis, it’s important to understand what happens to Cannabis use in healthy populations.
This study consisted of undergraduate students at University of New Mexico. These students were without chronic health conditions. They also likely have similar social environments. A study of this population explains an association of Cannabis use for a specific group of people. Nevertheless, the results add to growing evidence that Cannabis use can add benefit to healthy populations. Similar studies can be applied to other healthy populations.
Toke and Run
This story is by Sean Teehan from NY Cannabis Insider
On the morning of the 2005 Rochester Marathon, Brian Lane considered not showing up for the race. Juggling his job with the U.S. Postal Service, raising two children, and going through a divorce took the wind out of his sails, and running a long-distance race felt like a chore. But people were expecting him to be there, so he dragged himself out of bed, took four heavy bong rips and made his way to the starting line.
Lane ran the 26-mile race with a time of 3:11:23, finishing 16 out of 658 runners and qualifying for his first Boston Marathon.
Lane is owner and compliance officer at Rochester based hemp processing company NOWAVE and host of Hempthlethics, a podcast about incorporating Cannabis into exercise.
“I think it’s the most under talked about niche,” Lane told NY Cannabis Insider.
A subset of users some call “cannathletes” are becoming increasingly visible.
In a University of Colorado survey of 600 Cannabis users, 80% reported using Cannabis before, during, and after workouts. “Everyone who is a regular Cannabis user that I have brought onto my show, they’re all active,” says Lane. “There’s nobody sitting on their couches doing nothing.” Lane’s long-term goal is to release a line of products that cater to the cannathletic market.
Cannabis companies currently serving the athletic market include Offfield, which makes gummies, soft drinks, and other products that include THC. Another is WannaFit, who makes products that are infused with THCv
Josiah Hesse, author of the book Runner’s High, dives deep into how both elite athletes and weekend warriors use Cannabis. “The market for it is endless,” says Hesse. “There’s no demographic that Cannabis doesn’t reach, young people, old people, all races, all political affiliations, all economic backgrounds.”
Dr. Ethan Russo agrees. “Some uses of Cannabis in conjunction with exercise already have pretty strong scientific backing. THC and CBD have pain killing and anti-inflammatory effects that can help following a workout. However, the idea that Cannabis can help people during a workout is more nuanced.” He recounts his own experience of skiing under the influence of Cannabis. “Being able to key into the rhythm is a benefit,” says Russo.
I really like this idea of combining Cannabis and athletics. I usually consult patients who are using Cannabis for chronic pain or other illness. It’s refreshing to know Cannabis is also used for wellness activities like workouts. Cannabis is not always about the party and we don’t have to wait and get sick before using Cannabis. Using Cannabis for wellness is proactive. I also think the Cannabis industry should promote their own Cannabis athletic events. We could raise awareness for elite athletes like Sha’Carri Richardson, the sprinter who was banned from the Tokyo Olympics. Athletic events are a good way to highlight the positive aspects of Cannabis use.
Cannabis Farmer's Market
Cannabis consumers would be able to buy directly from cultivators at farmers markets, just like they do for produce, under approved legislation, AB 2691, by the California state Assembly. The state Committee on Business and Profession recently approved the bill, which now has to clear the Assembly Appropriations Committee and the full Assembly Chamber and then go through the Senate before reaching the governor’s desk.
Cultivators have had financial challenges since passage of Prop 64, the Control, Regulate and Tax Adult Use of Marijuana Act. Wholesale prices farmers receive for outdoor grown Cannabis averaged $488 per pound according to research from Cannabis Benchmarks. This is a 55% drop from 15 months earlier.
Kristen Callahan, owner of Magic Meadows Farms in Middletown in Lake County is quoted by the Sacramento Bee, “This is an important first step that will help our cash flow by being able to sell directly at farmer’s markets.”
Several dozen farmers that showed up for the committee vote were pleased. They see the direct sales as a beginning of Cannabis tourism in California. Visitors could sample different varieties of Cannabis, similar to what they do at a winery
The bill’s opponents are dispensary owners, who are concerned about competition. Another of the bill’s opponents, Assemblyman Phillip Chen, states, “As I represent Orange County, there will be an over saturation of these retailers in my communities.” The bill sponsor, Assemblyman Jim Wood, D-Santa Rosa, countered that the legislation was about, “giving the little guy a chance.”
The farmers insist that allowing consumers to sample their product at farmers markets will only promote Cannabis, benefiting all the Cannabis consuming community. Farmers can show their products currently at farmer’s markets, but the system doesn’t allow them to make a direct sale. Consumers must go to another booth at the market and buy Cannabis products from a licensed retail operator.
"I think it's super, super awesome and I like that they're kind of getting rid of that guilt or that dark cloud that they have around the whole weed industry,” Davis resident Crystal Molina said.
Since recreational cannabis was legalized in California the morning of January 1, 2018, there have been only three outdoor events in San Francisco with legal cannabis sales. And all three were in Golden Gate Park — Outside Lands 2019, Outside Lands 2021, and the 2022 4/20 Hippie Hill celebration from two weeks ago
According to SFiST, Permit applications have been submitted to bring legal cannabis sales to Carnaval SF on May 28-29, and there’s a high likelihood that Carnaval will be the first California street fair with legal, regulated cannabis use.
As if California Medical Cannabis patients didn’t suffer enough. Apparently, other states have not learned from California’s mistakes. The headline from Ganjapreneur by TG Branfalt is “Medical Cannabis Strained by Adult-Use Sales in New Mexico”
New Mexico medical Cannabis patients are expressing frustration. Increased demand from adult-use sales is straining the New Mexico Cannabis supply. On April 1st, licensed Cannabis dispensaries in New Mexico started adult use sales one year after legislators passed an adult use legalization bill. The roll-out was expected to be gradual since many producers and retailers were building out their operations or just getting municipal approval. The expectation didn’t account for consumers. The state Cannabis Control Division says New Mexico sold over $8 million in adult use Cannabis in just two weeks after legalization. KOB 4 Eyewitness news reports that, despite the large sales, medical Cannabis demand remains high.
Stephanie K, a long-time medical Cannabis patient says, “They’re telling us we should keep our cards (Referring to medical Cannabis identity cards) even though it’s recreational. For what reason? What perks are we getting? We don’t get to get in line in front of anybody, we don’t get to pay less, we don’t get better weed. No, we get nothing.”
Some New Mexico Cannabis retailers have tried to look out for patients. Ellie Besancon, Executive Director of Green Goods, wants to create separate display cases for recreational products and medical products. But she feels patients still have a frustration level. They already know what they want and the lines are long.
MJBiz Daily reports that Texans may be playing a role in consuming New Mexico Cannabis. “Our studies show that 40% to 42% of all adult-use cannabis will be derived from out-of-state purchases, particularly Texas,” says Duke Rodriguez, CEO of the state’s largest cannabis company
California went through its own growing pains after enacting adult-use Cannabis laws. In California, consumer prices remain high despite a supply glut. A significantly large percentage of Cannabis sales are believed to remain in traditional markets. On the East Coast, New York, New Jersey, and Connecticut will be selling adult use Cannabis soon. As of April 21st, New Jersey has already started. Can they learn from the issues western states are experiencing or will medical Cannabis patients suffer similar access issues?
Medical patients typically have a different need and urgency for Cannabis. "I don't do it to party. I don't do it to go out and dance. I don't get high. I don't laugh. I do it because it makes my pain go away,” said Stefanie. now that adult-use has arrived, the shops are only concerned about “money, the dollars.”
Once again, it seems to me that legislators have forgotten about COMPASSION for patients for the money. What do you think?
This story was published in Ganjapreneur on March 8, 2022, by TG Branfalt.
Their headline is “Few Parents know about CBD use in Children”
A recent poll by the University of Michigan’s Mott Children’s Hospital sampled 1,992 parents with at least one child between the age 3-18. Most parents polled (80%) either did not know much about CBD use in children or never heard of it prior to the poll. I might have stopped the poll right there. Apparently, it is of some value to the authors to ask parents about something they don’t know much about.
Seventeen percent of parents reported knowing something about CBD and children. Only three percent said they knew a lot.
Despite not knowing about CBD, 73% of parents optimistically thought CBD might be a good option for children when other medications don’t work. The factors that are important to parents in deciding whether to give CBD to children are its side effects. 83% thought CBD products should be regulated by the FDA, and about three quarters say CBD for children should require a doctor’s prescription.
About one third thought taking CBD is basically the same as using marijuana. (By marijuana, I assume they mean Cannabis with more than 0.3% THC.)
Most (93%) parents have never given or considered giving their child a CBD product.
2% have given their child a CBD product, while 4% have considered giving CBD to their child; 1% say their child has used CBD without their permission.
Among the small percentage of parents who have given or considered giving CBD to their children, the most common reasons included anxiety (51%), sleep problems (40%), ADHD (33%), muscle pain (20%), autism (19%), and to make their child feel better in general (13%).
This poll highlights the limited knowledge that most parents have about CBD and children.
Parents might do anything for a sick child, especially when other medications are not working.
Would you give a sick child CBD? Would you give THC?
Cannabinoid Acids and Covid
Lauren Robertson of Cannabis Scientist recently interviewed Dr. Richard van Breemen about his research on cannabinoids and their ability to block cell entry of Sars-CoV-2.
“It’s been amazing!” says Dr. van Breemen. “All these years we’ve been doing research…” “… but very rarely does a project catch on so globally.” He boasts, “We are currently on 402,000 views for the paper.”
“As you might imagine, people were excited. Very excited.” Ms. Robertson writes about the discovery. “In fact, you may recall reading headlines that claimed smoking weed stops COVID-19. These claims were outlandish – but where there’s smoke, there’s fire (sometimes).”
Dr. van Breemen’s research focused specifically on the role of cannabinoid acids – CBD-A, CBG-A, and THC-A. These are ingredients found, mostly, in the raw plant. And though smoking the flower won’t do much, dietary supplements like raw Cannabis smoothies could be effective.
Van Breemen’s research team used a technique called Affinity Mass Spectrometry to discover that the three cannabinoids inhibited the virus’ spike protein. Then they combined CBD-A and CBG-A with the live virus and found that it blocked the infection of cells.
“I expected some pushback,” said Dr. van Breemen. “But, people really haven’t been criticizing it. I’ve even had phone calls from people to say thank you because they now understand why they didn’t get sick after attending a gathering where everyone else got Covid.”
Dr. van Breemen has been interested in studying natural products as a source for drugs his entire career. He works at the Global Hemp Innovation center at Oregon State University. He got the idea to study Cannabis and Covid-19 after noticing a pattern that the top 10 states with the lowest Covid death rates were all states that had legalized Cannabis His wife, an epidemiologist, pointed out that this pattern had too many confounding variables and that he couldn’t draw any conclusions with confidence. . He also knew that studying Covid would keep his lab open during the pandemic.
During his study, Dr. van Breeman was surprised to find that only the three cannabinoids bound to the spike protein and that the decarboxylated CBD and CBG did not. He pointed out that the lab could only get a small amount of THC-A, not enough to do the live virus test. To get enough THC-A he would have had to apply for a special license.
“Every successful experiment brings up new questions,” says Dr. van Breemen. “There are so many experiments we’d love to do. We are only constrained by regulations and funding.”
I liked this story because it reminds me that there is a lot more to Cannabis than any of us might imagine and that it’s more than just smoking a good “dube”.
By Jean Talleyrand, M.D. and John S. Abrams, Ph. D.
In times of crisis it is customary to “sound the alarm”. However, an alarm with solution is significantly more effective and worthwhile than an alarm alone.
The worldwide effect of COVID-19 is alarming. In the U.S., over 20% of the tested population has contracted the virus. As COVID-19 and likewise SARS produce acute respiratory symptoms, it is often mistakenly assumed that people with chronic obstructive pulmonary disease (COPD) are at higher risk for contracting the infection. Data on the prevalence of COVID-19 and SARS infection shows a lower percentage of infection in people with COPD compared to the general population.1 However, common sense prevails. Despite the lower prevalence of disease there is a five-fold increase in severe outcome in those patients with COPD who have contracted the virus.2
Smoking Cannabis alone has not been associated with an increased risk of developing COPD.3 However, smoking both tobacco and Cannabis is associated with an increased risk or respiratory symptoms and COPD.4 Dr. Jeffrey Block, Executive Board Member of the American Society of Cannabis Medicine suggests that in this time of crisis safer alternative methods of using Cannabis are likely to “save lives”. Historically, Cannabis tincture and Cannabis water decoction formulations have been reported effective ways of using Cannabis.5,6 As well; modern state regulatory standards allow Cannabis to be available in capsules and gummies with incremental doses of 2.5mg, 5 mg, and 10 mg of THC. Additionally, there is growing recognition of the efficacy of the other major cannabinoids in Cannabis, THCA, CBD, and CBDA, all of which demonstrate therapeutic potential without psychoactivity.
Medical Cannabis use is a recently developing clinical practice. Due to the Controlled Substances Act, years of Cannabis prohibition have impeded medical understanding of the therapeutic benefits of Cannabis active ingredients. A March 2020 review of clinicaltrials.gov identifies 106 completed Cannabis clinical studies. Seventy studies (66%) involve Cannabis
1 Halpin, DG et al. Do Chronic Respiratory Diseases or their Treatment Affect the Risk of SARS-COV-2 Infection? The Lancet Respiratory Medicine Comment 2020 Apr 03
2 Lippi G et al. Chronic Obstructive Pulmonary Disease is Associated with Severe Coronavirus Disease 2019 (COVID-19). Respiratory Medicine 2020 Mar 24
3 Tashkin, D. Does Smoking Marijuana Increase the Risk of Chronic Obstructive Pulmonary Disease? Canadian Medical Association Journal 2009 Apr 14; 180(8); 797-798
4 Tan WC et al. Marijuana and Chronic Obstructive Pulmonary Lung Disease: A Population Based Study. Canadian Medical Association Journal 2009; 180(8); 814-820
5 Bridgeman, M et al. Medical Cannabis: History, Pharmacology and Implications for the Acute Care Setting, Pharmacy & Therapeutics 2017 Mar; 42(3); 180-188
6 Boekhout van Solinge, Tim (1996), Ganja in Jamaica. Amsterdams Drug Tijdschrift, nr 2, December 1996, pp. 11-14.
Abuse, Cannabis Use Disorder, Cannabis Withdrawal and Substance Use Disorder.7 The National Institute on Drug Abuse (NIDA) advances science on the causes and consequences of drug abuse and addiction. NIDA has actively funded the majority of Cannabis research during prohibition, which has left an imbalance of information on the cumulative effects of Cannabis.
Dr. Nora Volkow, director of NIDA, identifies persons with addictions and drug abuse as vulnerable to poor outcomes from COVID-19. Indeed, persons with addiction are well known to have comorbid behaviors, which makes them vulnerable to illness.8 However, the tide has turned in regards to Cannabis use. Cannabis can no longer be considered just an illicit drug.
It is increasingly appreciated that the Endocannabinoid system (ECS) plays a key role in shaping the direction of the immune response. Cannabinoids (such as THC and CBD present in Cannabis products) may be differentially influencing the overall type of immune effector function 9,10. This can result from a push more towards a cell-mediated virus-killing effector function, or towards a protective or neutralizing antibody response. In this era of the COVID- 19 pandemic, it is key that we understand the Cannabinoid tools that we currently have at our disposal.
The “medicalization” of Cannabis allows access to products with identified active ingredients and recommends guidance to their use by physicians. In this time of crisis when infection, stress, anxiety, and insomnia are at increasing prevalence, the responsible use of Cannabis presents a solution for consideration.
Jean Talleyrand, M.D. is Chief Medical Officer of MediCann, a medical Cannabis education organization and the Clinical Endocannabinoid System Consortium, a research organization
John S. Abrams, Ph.D. is Chief Science Officer of the Clinical Endocannabinoid System Consortium, a research organization
7 Talleyrand, J. Review of Completed Cannabis Studies with Results (clinicaltrials.gov). The Clinical Endocannabinoid System Consortium www.thecesc.org; 2020 Mar.
8 Miller, NS et al. Comorbid Cigarette and Alcohol Addiction. Journal of Addictive Disease. 1998; 17(1); 55-66
9 Yuan M1, Kiertscher SM, Cheng Q, Zoumalan R, Tashkin DP, Roth MD. Delta 9- Tetrahydrocannabinol regulates Th1/Th2 cytokine balance in activated human T cells. Neuroimmunol. 2002 Dec;133(1-2):124-31.
10 Nichols, James M. and Kaplan, Barbara L.F. Immune Responses Regulated by Cannabidiol. Cannabis and Cannabinoid Research Vol. 5, No. 1 ReviewsOpen AccessOpen Access license
Jean Talleyrand, M.D.,