On January 1, 2020, recreational cannabis use became legal in Illinois. More than 80,000 people in Illinois are registered in the state’s medical cannabis program. Surprisingly, many of their doctors don’t know how to talk with them about their medical cannabis use.
As a health sciences researcher, I have a recommendation that is both practical and profound: Physicians can learn first-hand from their own patients how and why they use medical cannabis, and the legalization of recreational cannabis may make them more comfortable discussing its usage overall.
Nationwide, physicians too rarely discuss cannabis use with their patients living with chronic conditions, such as chronic pain, cancer, multiple sclerosis, epilepsy, fibromyalgia, and Crohn’s disease—all conditions with symptoms that evidence shows cannabis may effectively treat. Why don’t physicians talk with their patients about cannabis use? Research from states with longer histories of legalized medical cannabis shows that many physicians do not communicate with patients regarding their medical cannabis use for a variety of reasons.
First, physicians aren’t well trained in cannabis’ medical applications. Unlike the endocrine or cardiovascular systems, the endocannabinoid system—comprised of receptors which bond with the compounds THC and CBD found in cannabis—is not taught in medical school.
I’ve been a proponent of marijuana legalization since I heard about it in high school. I lived in the UK in the 1970s when it was not easily available! So I was a legalization proponent before I’d ever touched the stuff. Nearly four decades later, it’s legal in many states, Canada and Uruguay and most — but by no means all — of the drug war hysteria is recognized for the idiocy it is. But while anyone who’s got stone and had the munchies knows that pot is a good appetite enhancer and antiemetic, there are now a bunch of claims being made about cannabidiol (CBD). So I thought we’d explore them. We’re including a video from ZdoggMD which gives a balanced view of the (appalling lack of) data so far, and an article from Donna Shields, co-founder of the Holistic Cannabis Academy. Donna, as you may guess, thinks it’s pretty useful. And while you think this may still be on the edge, a CBD company called Sagely Naturals won the recent G4A contest held by old world big Pharma company Bayer—Matthew Holt
It’s come onto the healthcare scene like a rocket yet most people don’t really understand what cannabidiol (CBD) is, how to use it and the results one can expect. Here’s a primer on the basics you need to know.
Do you know about the endocannabinoid system
We all have an endocannabinoid system; a network of receptors throughout the body whose job is to maintain homeostasis and well-being for all our organs. Like a master control system. And while our bodies make their own cannabinoids, life, through stress, toxins, poor diet and illness, has a way of depleting the in-house supply or making those receptors “less receptive”. This is when adding cannabinoids, such as CBD, can be a helpful boost.
Marijuana vs Hemp
The mother plant, called Cannabis sativa, can be cultivated to grow marijuana (the plant containing THC, CBD, and other cannabinoid compounds) or hemp, a crop with many uses from food products to building materials. Hemp also contains CBD (cannabidiol), but less than 0.3% THC. CBD is just one of over 80 different cannabinoid compounds found in both marijuana and hemp. Hemp-derived CBD products are available at retail stores and online; while marijuana-derived CBD products are available cannabis dispensary stores.
My wife calls them “hand-me-ups”… things we inherit from our kids. My ex-fashionable shirt that my son wore in college.Our semi-vegetarian diet my daughter adopted in high school. The dog at my feet that came visiting for the weekend, three years ago.
Our lives are enhanced and modified by the most unexpected of teachers, our children. The mentoring of our progeny keeps those of graying years at least partially youthful. Still, I was astonished to hear this week, the words, “Dad, you need to starting doing drugs.”
The “dad” being addressed is 93 years old and has advancing cancer. He is tired, nauseas, anxious and sleeps poorly. Though he likely has a number of months to live, he has become withdrawn. Despite my usual medical brew, his incapacitating symptoms are without palliation.
Dad is miserable. Enter his daughter with the solution. The “drug” she is talking about is the treatment de jour, marijuana.
How did this happen? We raise our kids to be good, honest, mature citizens; we drive them to soccer, suffer through years of homework (do you remember dioramas?), and do the whole college obsessive-compulsive tour thing. In addition, above all, we beg our offspring to stay away from pot, pills and addictive mind-altering potions.
Now they turn on us, pushing ganja in our time of need. How did we go wrong? Actually, it is we that missed a great opportunity.
50% of Americans have inhaled marijuana at some point in their lives. More than 25 million of our neighbors have used it within the last year. Those that imbibe are of a decidedly younger demographic. The oldest citizens, especially those of the Greatest Generation, are much less likely to have experience with cannabis.
Fortunately, once again, youth presents the solution.
Believe me, I’ve heard all the pot jokes, and some of them are true. Public support for legalizing marijuana use is at an all-time high. Some state-level marijuana laws are going up in smoke. And yes, Washington and Colorado are embarking on a historic joint venture.
Puns aside, discussions about marijuana legalization are getting serious. In November, voters in Colorado and Washington made the unprecedented decision to allow commercial production, distribution and possession of marijuana for nonmedical purposes. Not even the Netherlands goes that far.
Policymakers in both states are confronting some new and tricky issues that have never been addressed. For them, and for anyone else thinking about changing their pot laws, here are seven key decision areas that will shape the costs and benefits of marijuana legalization:
1. Production. Where will legal pot be grown — outdoors on commercial farms, inside in confined growing spaces, or somewhere in between? RAND research has found that legalizing marijuana could make it dramatically cheaper to produce — first because producers will no longer have to operate covertly, and second because suppliers won’t need to be compensated for running the risks of getting arrested or assaulted. After lawmakers decide how it will be grown, production costs will be shaped by the number of producers and other regulations such as product testing.
2. Profit motive. If there is a commercial pot industry, businesses will have strong incentives to create and maintain the heavy users who use most of the pot. To get a sense of what this could look like, look no further than the alcohol and tobacco industries, which have found ingenious ways to hook and reel in heavy users. So will private companies be allowed to enter the pot market, or will states limit it to home producers, non-profit groups or cooperatives? If a state insisted on having a monopoly on pot production, it could rake in a decent amount revenue — but for now, that possibility seems far off in the United States since marijuana remains illegal under federal law.
3. Promotion. Will states try to limit or counter advertisements in the communities and stores that sell marijuana? U.S. jurisprudence against curtailing what’s known as “commercial free speech” could make it tough to regulate the promotion of pot. While a state monopoly system could help control promotion, those advertisements you see for state lotteries should give you pause.