Cannabis for Cancer Harm Reduction

By Janna Champagne, BCMH, DMCS, BSN, RN (Ret.)

Over the past decade, my primary focus has been assisting both consumers and medical practitioners in understanding the most effective application of medical cannabis to optimize health outcomes. Among the thousands of patients I’ve had the privilege to educate, a significant portion were individuals grappling with cancer. The outcomes many of them experienced were surprisingly positive, and it’s clear that cannabis is a powerful harm reduction tool for cancer.

Despite enduring stigma, cannabis stands as a solution for alleviating cancer symptoms. Moreover, case studies and research outcomes alike provide evidence that cannabis may also harbor anti-cancer properties. Notably, compared to conventional treatments like chemotherapy and radiation, a natural approach incorporating cannabis may offer comparable benefits, while sparing patients from mainstream cancer treatment’s life-threatening side effects. While this article isn’t intended as medical advice, it aims to provide educational insights for those intrigued by the potential of cannabis in reducing harm as a cancer intervention.

A cancer diagnosis can be profoundly distressing for patients and their loved ones, often triggering a frantic search for answers. Throughout my tenure serving patients, cancer is the most common basis for patient’s seeking this modality. Through this firsthand experience, I’ve witnessed the transformative impact of a well-informed, personalized approach to medical cannabis therapy. Key factors for success include ensuring optimal cannabis product quality (1), and adopting a holistic strategy encompassing dietary improvements, stress management, and other pertinent factors.

At its core, cancer represents a breakdown in the body’s immune system, allowing cancer cells to proliferate unchecked. Contrary to common misconception, everyone harbors cancer cells in their body daily, resulting in cancer diagnosis only when the immune system’s response is lacking. Cannabis potentially offers benefits through its documented immune-balancing properties (2). Additionally, cannabis can be targeted to mitigate the side effects of conventional cancer treatments, or used more intensively as an anti-cancer regimen.

Among the cannabinoids, Cannabidiol (CBD) emerges as a frontrunner in cancer treatment due to its non-intoxicating nature and widespread accessibility. CBD has garnered research support for its ability to impede cancer growth and spread by blocking the GPR55 pathway (3), which cancer cells rely on for proliferation. Notably, CBD’s non-intoxicating nature allows patients to maintain functionality, often enhancing their overall quality of life. However, CBD and other forms of cannabis may entail interactions with pharmaceuticals, and warrants guidance from competent medical professionals.

Tetrahydrocannabinol (THC) exerts intoxicating effects and entails legal access restrictions in certain regions, yet may seek it as a cancer treatment for its ability to induce apoptosis or “natural cell death” in cancer cells, which we initially discovered in 1972 research (4). However, caution is advised, particularly in hormone-driven cancers, where THC intake may exacerbate hormone levels and potentially fuel cancer growth (5).

Additional cannabinoids, such as non-intoxicating raw or acid forms, offer immune support through potent anti-inflammatory properties (6). For instance, CBDa has shown promise in alleviating nausea and supporting breast cancer treatment (7). CBDa is also evidence-based for improving nausea, providing a tool to mitigate this common side effect of chemotherapy (8). CBG represent another widely available option for targeting cancer, boasting legal status in the US and many foreign countries (9).

Unity Formulas too offers targeted CBD Hemp tinctures, many of which provide support for common cancer-related symptoms like pain, anxiety, depression, and sleep disturbances (10). Unity Formulas offers free nurse guidance to consumers, and 20% of coupon code: RETJACH2. For more intensive needs, paid cancer consultations are available through Integrated Holistic Care, which may be helpful to tailor product recommendations to your individual needs (11). Given the urgency of addressing cancer, swift and targeted intervention offers the best chance at optimal outcomes.

Many patients have reported symptom relief and even achieved No Evidence of Disease (NED) status through cannabis use in cancer treatment. Healthcare professionals are duty-bound to navigate the myriad treatment options available to cancer patients, employing an objective risk-benefit analysis. With its unparalleled safety profile and beneficial side effects, cannabis emerges as a clear harm reduction tool for enhancing cancer patient outcomes.

References:

1. FLOW Criteria for Optimal Therapeutic Quality Cannabis:  https://www.cannabisnurseapproved.com/post/four-criteria-for-assuring-cannabis-is-medical-quality
2. Cancer immune balancing: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7173676/
3. CBD blocks GPR55 https://medium.com/@mary_c_biles/gpr55-the-cancer-promoting-endocannabinoid-receptor-and-how-cbd-might-block-it-dc5cd354f10b
4. 1972 THC Cancer Apoptosis Study:  https://ntp.niehs.nih.gov/sites/default/files/ntp/htdocs/lt_rpts/tr446.pdf
5. THC Hormone Driven Cancer Contraindication: https://www.researchgate.net/publication/336281388_Breast_Cancer_and_Cannabis_Cautions_and_Considerations_when_Recommending_Medicinal_Cannabis_for_Patients_with_Breast_Cancer_Potential_benefits_and_risks_of_managing_Breast_Cancer_Symptoms_and_Treatmen).   
6. Acidic Cannabinoids Reduce Inflammation:  https://pubmed.ncbi.nlm.nih.gov/35910331/#:~:text=operated%20Calcium%20Entry-,Acidic%20Cannabinoids%20Suppress%20Proinflammatory%20Cytokine%20Release%20by%20Blocking%20Store%2Doperated,Function%20(Oxf).
7. CBDa for Breast Cancer: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4009504/
8. CBDa for Nausea:  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3596650/#:~:text=Conclusions%20and%20Implications,attenuate%20conditioned%20gaping%20in%20rats.
9. CBG/CBC Anti-Cancer Properties:  https://www.healtheuropa.com/cannabinoids-cbc-and-cbg-exhibit-anti-tumour-properties-on-cancer-cells/97058/
10. Unity formulas CBD Hemp Tinctures – free nurse guidance – 20% off coupon code RETJACH2:   www.unityformulas.com
11. Integrated Holistic Care – paid cancer consultations: www.integratedholisticcare.com

OSBN Official Testimony

Urging Adoption of Cannabis Nursing Practice Guidelines

Public Forum, 9/21/2023

By Janna Champagne, DMCS, BSN, RN (Ret.)

www.jannachampagne.com

Thank you, Director Prusak, and esteemed board members, for inviting me to testify today. My name is Janna Champagne, and I retired my RN license last year, after nearly a decade of serving medical cannabis patients in Oregon. 

My journey into nursing specialization of Cannabinoid Therapeutics was not my planned career trajectory, and instead this was an organic path impelled by my own health crisis in 2012.  Prior to that, I held high-level nursing positions in acute and critical care at Asante Regional Hospital in Medford. I was also in graduate school when my health necessitated that I drop out, just a few credits shy of completing my Master’s degree to become a Nurse Practitioner. 

My introduction to cannabis as medicine occurred shortly thereafter, as a patient who happened to be a nurse, seeking alternatives to manage my chronic pain.  I discovered OMMP certification as a safe alternative to opioids, a choice driven by the science verifying that cannabis reduces opioid reliance (1), combined with the well-documented risks associated with opioid use (2).   My cannabis results surpassed all expectations, by managing my pain effectively, while also promoting systemic homeostasis, and eventually resolving my functional limitations.  The research confirms what I experienced, and cannabis is evidence-based for providing deeper balancing benefits, as explained by over 35,000 reputable and statistically valid journal articles (3).   My remarkable health outcomes prompted me to delve deep into cannabis research, where I finally learned the Cannabinoid Science that was absent in my BSN curricula at OHSU.  Today I share some of my profound findings.

Historically, cannabis was mainstream medicine in the US until 1937, with thousands of preparations made by hundreds of producers in our pharmacopeia.  This changed when cannabis became financially inaccessible to most due to targeted taxes on “Marihuana.”  The American Medical Association (AMA) opposed the Marihuana Tax Act, and physicians were confused by the new terminology, not realizing that “marihuana” was, in fact, cannabis (4, 5).  Sudden lack of access to cannabis ushered in our medical reliance on synthetic pharmaceuticals to ease patient’s symptoms.  Prior to 1937, Cannabis was used by humans around the globe for over 5,000 years to enhance human health, without a single death or adverse effect.  As such, cannabis is well-established as a safe and effective remedy for use across the lifespan, reflecting its unparalleled safety profile (5).   

Scientific evidence also suggests that cannabis improves EndoCannabinoid Deficiency, which is linked with many chronic illnesses (6).  Supplementing with cannabis flower can seamlessly replenish these endogenous vital nutrients, thereby promoting systemic homeostasis, by objectively improving biomarkers associated with EC Deficiency (7).   Yes, you heard me correctly – our bodies produce vital nutrients called EndoCannabinoids, which share structural form and functional roles with phytocannabinoids from the cannabis flower.   I’ve provided numerous citations with my written testimony for those of you interested in exploring this fascinating human system (8).  

Today, I urge the OSBN to provide practice guidelines and support nurses serving cannabis patients, with whom they will inevitably interact, considering our legal accessibility spanning 25 years in Oregon.  Further, in 2021, HB3369 was passed, allowing Nurse Practitioners to certify patients for OMMP, and specifying that nurses are allowed to discuss cannabis with their patients (9).   However, OSBN has yet to release an Interpretative Statement for HB3369, nor adopt nursing scope of practice guidelines as required by ORS 678.150. 

I’ve provided links to the NCSBN (10) and ACNA (11) guidelines for nursing care of medical cannabis patients, which serve as templates for legal states creating scope guidelines for this specialty.  As these documents reveal, nurses are uniquely qualified to support cannabis patients, by providing evidence-based education, facilitating a well-informed approach, and reducing risk factors – with the primary consideration being pharmaceutical interactions.  Absent competent medical cannabis education, patients are forced to rely upon less reputable resources, which jeopardizes their chance at optimal outcomes, and increases risk of Cannabis Use Disorder, Cannabis Hyperemesis Syndrome, and other preventable adverse effects (12).   Unfortunately, OR nurses choosing an ethical approach, and discussing cannabis with patients per HB3369, must still operate in a licensure gray area.  

As per our foundational medical ethics, nurses must provide informed consent, protect patient autonomy, and assist patients in objectively evaluating their treatment options (13).  This simply isn’t the reality in Oregon, and I encourage you to explore my in depth and fully-cited articles on this subject (14, 15).  Oregon’s need for improvement is also independently reflected in the 2022 Americans for Safe Access (ASA) State of the States report, which awarded Oregon a grade of only 54% on our handling of cannabis patient’s needs (16).  

After regaining my health and function, I started serving cannabis patients as a grower/caregiver, nurse educator, and individual consultant.   Currently, I am a university professor educating integrative and functional medicine degree students of Medical Cannabinoid Science – as such, I have a unique perspective on this topic.   My personal health experience, combined with those of thousands of patients I have served, reflect that cannabis is a powerful harm reduction tool.  When patients are privy to competent guidance allowing an optimal medical approach, they commonly experience reduced reliance on pharmaceuticals, with improved quality of life and function.  (12). 

I am here to offer my support and expertise with the goal of improving cannabis-inclusive care in Oregon that meets our ethical nursing standards. Having witnessed the discriminatory treatment of this patient cohort, my oath and ethics compel me to advocate for change.    I’m happy to answer any questions. 

References:

1. Nguyen T, Li Y, Greene D, Stancliff S, Quackenbush N. (2023).   Changes in prescribed opioid dosages among patients receiving medical cannabis for chronic pain, New York State, 2017-2019. JAMA Netw Open 6(1).  Retrieved from:  https://jamanetwork.com/journals/jamanetworkopen/article-abstract/2800813
2. Wang, et al (2023).   Predictors of fatal and non-fatal overdose following prescription of opioids for chronic pain:   A systematic review and meta-analysis of observational studies.  Lancet 3(1).   Retrieved from:  https://papers.ssrn.com/sol3/papers.cfm?abstract_id=4374583

            References (Cont.):

3. NORML (2020).  Record number of scientific papers published in 2020 about cannabis.   Retrieved from:  https://norml.org/blog/2020/12/16/record-number-of-scientific-papers-published-in-2020-about-cannabis/

4. Wikipedia (2023).  Marihuana Tax Act of 1937.   Retrieved online at:  https://en.wikipedia.org/wiki/Marihuana_Tax_Act_of_1937#:~:text=The%20American%20Medical%20Association%20(AMA,and%20medical%20cannabis%20cultivation%2Fmanufacturing.

5. Bridgeman MB, Abazia DT. Medicinal Cannabis: History, Pharmacology, And Implications for the Acute Care Setting. P T. 2017 Mar;42(3).  Retrieved online at:  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5312634/

6. Russo E. B. (2016). Clinical Endocannabinoid Deficiency reconsidered: current research supports the theory in migraine, fibromyalgia, irritable bowel, and other treatment-resistant syndromes. Cannabis and cannabinoid research, 1(1), 154–165.   Retrieved from:    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5576607/
7. Siani-Rose M, Cox S, Goldstein B, Abrams D, Taylor M, Kurek I. Cannabis-Responsive Biomarkers: A Pharmacometabolomics-Based Application to Evaluate the Impact of Medical Cannabis Treatment on Children with Autism Spectrum Disorder. Cannabis Cannabinoid Res. 2023 Feb;8(1):126-137.   Retrieved from: https://pubmed.ncbi.nlm.nih.gov/34874191/
8. Devane WA, Hanus L, Breuer A, Pertwee RG, Stevenson LA, Griffin G, Gibson D, Mandelbaum A, Etinger A, Mechoulam R. Isolation and structure of a brain constituent that binds to the cannabinoid receptor. Science. 1992 Dec 18;258(5090):1946-9. Retrieved from: https://pubmed.ncbi.nlm.nih.gov/1470919/
9. HB3369 (2021).   Oregon Legislative Assembly.   Retrieved from:   https://olis.oregonlegislature.gov/liz/2021R1/Downloads/MeasureDocument/HB3369/Enrolled
10. Koch, G. (2019).  The NCSBN National Nursing Guidelines for Medical Marijuana.   OSBN Sentinel, August 2019.  Retrieved online at:  https://www.oregon.gov/osbn/Documents/Sentinel_2019_August.pdf
11. Clark, C., et all (2019).   ACNA Scope and standards of practice for cannabis nurses.    American Cannabis Nurses Association.   Retrieved online at:  https://www.cannabisnurses.org/assets/docs/2019_RN_APRN%20Cannabis%20Scope%20and%20Standards%20WEBSITE.pdf
12. Temple, L., Lampert, S., Ewigman, B. (2019). Barriers to achieving optimal success with medical cannabis: opportunities for quality improvement. The Journal of Alternative and Complementary Medicine. Retrieved from: https://www.liebertpub.com/doi/10.1089/acm.2018.0250

13.   ATrain Education – Medical Professional Code of Ethics (2021). Retrieved from: https://www.atrainceu.com/content/2-professional-codes-ethics
14. Champagne, J. (2022).  The demise of medical cannabis in Oregon.  Retrieved from:  https://integratedholisticcare.wordpress.com/2022/05/12/the-demise-of-medical-cannabis-in-oregon/
15. Champagne, J. (2022).   Mission: Educate and advocate.   Retrieved from: https://wordpress.com/post/integratedholisticcare.wordpress.com/484

Americans for Safe Access (2021).   2021 State of the States Report, p. 96.   Retrieved online at:  https://american-safe-access.s3.amazonaws.com/sos2021/StateoftheStates21_Web2.22.pdf

Mission: Advocate and Educate

By Janna Champagne, DMCS, BSN, RN (Ret.)

Introduction:

As detailed in my article, Demise of Medical Cannabis in Oregon, our medical cannabis program, known as OMMP (Oregon Medical Marijuana Program), has been in existence for over two decades, yet it is failing to adequately serve vulnerable patients. This failure is primarily due to a lack of understanding among medical professionals regarding the science behind cannabis, which supports its therapeutic applications and potential for harm reduction. This article delves into the various barriers that hinder the acceptance and utilization of cannabis in medical practice.

Misconceptions about Federal Schedule I Classification:

One of the significant deterrents for medical professionals is the federal Schedule I classification of cannabis. Many mistakenly believe that cannabis, particularly THC, meets the criteria for this classification, which justifies strict accessibility restrictions. These criteria include being harmful, addictive, and having no accepted medical use (1). However, the reality contradicts these assumptions.

Cannabis’s Exceptional Safety Profile:

Contrary to popular belief, cannabis boasts an impeccable safety profile, with thousands of years of historical use without a single recorded case of harm to patients (2). It’s ironic that the same government allowing widespread access to opioids, which statistically claim lives every 18 minutes, restricts access to cannabis, a safer and effective alternative for pain management. Research from states with medical cannabis programs even shows a decrease in opioid-related deaths, underscoring the potential for cannabis to mitigate the current opioid crisis (3).

Comparative Harm and Addiction Potential:

Scientific research supports that cannabis is less physically addictive and less harmful than common substances like sugar, coffee, and cigarettes, all of which are freely available nationwide (4). Moreover, there is a substantial body of research endorsing cannabis’s medical applications, with the federal government itself holding multiple patents for cannabis as medicine (5, 6).

Long-Standing Legal Battles:

As far back as 1988, federal DEA judges have ruled in favor of removing cannabis from Schedule I placement, given the overwhelming objective evidence contradicting this classification (7). Despite this, cannabis remains under federal Schedule I restriction, preventing access for patients who could benefit. The delay in rectifying this situation can likely be attributed to political and financial interests.

The Pharmaceutical Industry’s Role:

Cannabis presents competition to pharmaceutical profits. Many patients who find success with medical cannabis therapy reduce their reliance on pharmaceuticals, making it a perceived threat to the pharmaceutical industry. Pharmaceutical lobbyists are the leading contributors to politicians, surpassing even the oil and gas industry (8), which may explain the persistence of federal restrictions on cannabis despite the majority of the country supporting medical cannabis use (9)

Barriers for Medical Professionals:

Becoming a medical cannabis practitioner involves overcoming significant barriers. In Oregon, our medical licensing boards are notoriously discriminatory toward practitioners serving patients seeking cannabis therapy(11, 12). Ethical practitioners committed to helping cannabis patients must navigate the fear of potential licensure consequences for prioritizing patient care (10).

Licensing Boards’ Resistance to Change:

Oregon’s licensing boards have also failed to adopt guidelines for licensees working with medical cannabis patients, forcing ethical practitioners into a gray area. This situation persists despite 24 years of legal patient access to medical cannabis in the state (10). The reluctance of these boards to adapt and support practitioners is a major contributor to our failure to provide competent care to cannabis patients..

Advocating for Change:

Medical professionals play a crucial role in ensuring that cannabis patients achieve their health goals and experience optimal therapeutic outcomes (13). It is high time that we advocate for change so that medical practitioners can fulfill their ethical duty to serve cannabis patients without prejudice or discrimination.

Conclusion:

Oregon’s medical cannabis program, like many others across the country, faces significant challenges. Overcoming the barriers to acceptance and utilization of cannabis in medical practice is essential to providing vulnerable patients with the care they deserve. It is incumbent upon the medical community, licensing boards, and policymakers to reevaluate their stance on medical cannabis and prioritize patient well-being over political or financial interests.

​References:

1. 21 US Code 812 – Federal schedule of controlled substances.   Retrieved online at: https://www.law.cornell.edu/uscode/text/21/812  
2. Americans for Safe Access (2021). Patient’s history of medical cannabis.   Retrieved from: https://www.safeaccessnow.org/patients_history_of_medical_cannabis
3. Hsu G, Kovács B. Association between county level cannabis dispensary counts and opioid related mortality rates in the United States: panel data study  BMJ  2021;  372 :m4957 doi:10.1136/bmj.m4957  Retrieved from:  https://www.bmj.com/content/372/bmj.m4957  
4. Mic.com (2021).  5 substances that are far more addictive than marijuana — that are legal.   Retrieved from:  https://www.mic.com/articles/137800/5-substances-that-are-far-more-addictive-than-marijuana-that-are-legal
5. NORML.org (2020).  Record number of scientific papers published in 2020 About cannabis.  Retrieved from:  https://norml.org/blog/2020/12/16/record-number-of-scientific-papers-published-in-2020-about-cannabis/  
6. US Patent # 6630507 Retrieved from: https://pubchem.ncbi.nlm.nih.gov/patent/US-6630507-B1
7. NORML.org (2013).  25 years ago: DEA’s own administrative law judge ruled cannabis should be reclassified under federal law.   Retrieved from:  https://norml.org/news/2013/09/05/25-years-ago-dea-s-own-administrative-law-judge-ruled-cannabis-should-be-reclassified-under-federal-law/  
8. Kennedy, Robert F. (2015).  Vermont legislature testimony, retrieved from: legislature.vermont.gov/Documents/2016/WorkGroups/House%20Health%20Care/Bills/H.98/Witness%20Testimony/H.98~Robert%20Kennedy~Testimony%20of%20Robert%20F.%20Kennedy%20Jr.~5-5-2015.pdf
9. NORML.org (2021).  Poll of Americans support of legalizing marijuana.  Retrieved from:  https://norml.org/marijuana/library/surveys-polls/ 
10. Stutsman, E. (2016).  Marijuana, the practice of medicine, and the Oregon Medical Board.  Retrieved from:  https://elistutsman.com/2016/07/marijuana-the-practice-of-medicine-and-the-oregon-medical-board/
11. OMB Board Action Report (2016).   Brian Lane Dossey, MD investigation for furnishing OMMP certification to a qualifying minor:                                  https://www.oregon.gov/omb/BoardActions/May%2016,%202016%20-%20June%2015,%202016.pdf
12. OMB Board Action Report (2019).  Brian Land Dossey MD forced retirement of medical license (cannabis specialty physician):                           https://www.oregon.gov/omb/BoardActions/September%2016,%202016%20-%20October%2015,%202016.pdf
13. Temple, L., Lampert, S., Ewigman, B. (2019). Barriers to achieving optimal success with medical cannabis: opportunities for quality improvement. The Journal of Alternative and Complementary Medicine.Jan 2019, 5-7.http://doi.org/10.1089/acm.2018.0250  Retrieved from:  https://www.liebertpub.com/doi/10.1089/acm.2018.0250

The Demise of Medical Cannabis in Oregon

By Janna Champagne, DMCS, BSN, RN (Ret.)

In 1998, Oregon took a pioneering step by becoming the second state in the United States to legalize access to medical cannabis through the Oregon Medical Marijuana Program (OMMP). However, the current state of medical cannabis protocols in Oregon is falling short of meeting the needs of patients in alignment with medical ethics, leaving many patients with no choice but to access cannabis through the recreational market, with its higher taxes. Astonishingly, the top three reasons for recreational cannabis purchases in Oregon are pain relief, anxiety management, and sleep improvement, all of which are fundamentally medical needs.

Given Oregon’s status as a haven for “cannabis refugees” and a trailblazer in national cannabis legalization, one would expect the OMMP to be a shining example of a well-functioning medical cannabis program. Unfortunately, the reality is quite the opposite, as our current regulations and barriers to ethical patient treatment serve as a cautionary tale for states looking to establish their medical cannabis programs.

The 2021 State of the States report by Americans for Safe Access paints a bleak picture, rating Oregon’s medical cannabis program at a mere 54.43% overall, with a score of only 50/100 for patient rights and civil protections and 45/100 for affordability (1). Considering our 25-year history as a legal medical cannabis state, these scores are far from commendable. It’s clear that Oregon has significant issues to address to uphold its legacy as a cannabis trailblazer and provide compassionate care to patients.

As a now-retired nurse and an OMMP patient since 2014, I bring a unique perspective to this issue. Over nearly a decade, I have navigated the complexities of being an OMMP patient, grower, and cannabis-specialty nurse pioneer, driven by my commitment to educate patients, find solutions to their barriers, and address their unmet needs.

Becoming a legal medical cannabis patient in Oregon entails meeting specific health criteria and obtaining current documentation from a primary physician, and OMMP certification often requires a separate, uninsured doctor appointment costing an average of $250 (2). While I eventually found a primary care physician willing to provide my OMMP certification, most PCPs are unwilling to facilitate this process, making it unaffordable for many patients.

Moreover, the OMMP certification process typically involves brief interactions, lasting less than 15 minutes, between patients and doctors, resulting in little more than a signature on a form. This approach does not align with conventional medical practices, where patients receive detailed prescriptions with dosing, timing, and administration instructions. Instead, cannabis patients are left to seek guidance from dispensary budtenders, who often lack specialized medical knowledge.

In contrast to this suboptimal approach, patients should receive evidence-based education, product recommendations, and comprehensive screenings, including evaluations for potential pharmaceutical interactions. Competent medical care for cannabis patients meeting ethical standards of informed consent and patient autonomy is associated with better therapeutic outcomes and reduced risk factors (3).

Oregon’s current methods undermine cannabis patients’ basic needs, also violating foundational medical ethics that prohibit discrimination (4). This leads patients to experiment with multiple products while facing numerous barriers in achieving their desired health goals, a modifiable risk for adverse effects (3). Further, OR medical facility licensing policy is in breach of ORS ORS443.014, which protects patient access to cananbis in a medical setting (7) .

Compounding this issue, medical doctors and nurses do not receive formal training in the science supporting the therapeutic potential of cannabis, even though this intricate regulatory system was discovered 30 years ago, in 1992 (5). This lack of cannabis science education has given rise to pervasive stigma and misconceptions within the medical community, impeding their ability to provide unbiased support to cannabis patients. Healthcare providers who stumble upon the therapeutic promise of cannabis must independently seek out knowledge and education in this field.

Adding complexity to the matter, many practitioners dismiss cannabis as a cure-all, misconstruing it as a mere panacea. They fail to grasp that cannabis activates our Endocannabinoid System, contributing to balance and homeostasis in every other bodily system. Moreover, medical professionals often overlook the connection between chronic illnesses and Endocannabinoid Deficiency, as elucidated by Dr Ethan Russo, MD, in 2004. EndoCannabinoid Deficiency is a contributing factor to the root cause of many chronic diseases, further supporting the overwhelming evidence that cannabis holds potential for diverse medical uses, as it seamlessly addresses a vital nutrient deficiency linked to numerous ailments (6).

Those healthcare practitioners who engage in objective scientific education on cannabis quickly realize that the prevailing stigma and unjustifiable restrictions on medical cannabis do not hold up to scrutiny. These courageous individuals disregard the risks associated with operating in a “gray area,” a necessity to ensure competent and ethical treatment of cannabis patients. It is imperative that medical professionals in legal cannabis states familiarize themselves with and critically review the extensive body of over 35,000 valid research articles, which present compelling evidence supporting cannabis as a safe and effective therapy, also guiding an optimal and well informed approach that may benefit a multitude of conditions. Furthermore, cannabis emerges as a valuable tool for harm reduction in various medical contexts.

In conclusion, it is high time that medical professionals in Oregon and beyond embrace a more enlightened perspective on cannabis. Comprehensive education and a nuanced understanding of cannabis science are prerequisites to provide the highest standard of care for patients who choose this therapeutic option. It is incumbent upon the healthcare community to shed outdated misconceptions, embrace the evidence, and prioritize the well-being of their patients.

References:

1. Americans for Safe Access (2021). 2021 State of the States Report. Retrieved from: https://american-safe-access.s3.amazonaws.com/sos2021/StateoftheStates21_Web2.22.pdf
2. OMMP Qualifying Conditions (2021). Retrieved from: https://www.oregon.gov/oha/ph/diseasesconditions/chronicdisease/medicalmarijuanaprogram/pages/physicians.aspx
3. Temple, L., Lampert, S., Ewigman, B. (2019). Barriers to achieving optimal success with medical cannabis: opportunities for quality improvement. The Journal of Alternative and Complementary Medicine. Retrieved from: https://www.liebertpub.com/doi/10.1089/acm.2018.0250
4. ATrain Education – Medical Professional Code of Ethics (2021). Retrieved from: https://www.atrainceu.com/content/2-professional-codes-ethics
5. Devane WA, Hanus L, Breuer A, Pertwee RG, Stevenson LA, Griffin G, Gibson D, Mandelbaum A, Etinger A, Mechoulam R. Isolation and structure of a brain constituent that binds to the cannabinoid receptor. Science. 1992 Dec 18;258(5090):1946-9. Retrieved from: https://pubmed.ncbi.nlm.nih.gov/1470919/
6. Russo E. B. (2016). Clinical Endocannabinoid Deficiency reconsidered: current research supports the theory in migraine, fibromyalgia, irritable bowel, and other treatment-resistant syndromes. Cannabis and cannabinoid research, 1(1), 154–165. Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5576607/
7. Oregon Medical Marijuana Program. OMMP additional caregiver attestation Form (2020. Retrieved online at: https://sharedsystems.dhsoha.state.or.us/DHSForms/Served/le2585.pdf

Cannabis for Autism Harm Reduction

By Janna Champagne, BSN, RN, Autism Mom

Tens of thousands of parents in the US choose to administer cannabis to their child with Autism, a seemingly risky prospect considering the complex legalities of medical cannabis, and potential scrutiny by punitive regulations. I’m one of those parents using cannabis to treat my daughter with Autism, and I can personally vouch for the angst and hope that often follows this decision. Fear often strikes while parents maneuver dark gray areas, in an attempt to improve our Autism children’s overall existence. In many of these cases, the benefits outweigh any hesitations, and cannabis wins as the preferred treatment approach.

As a holistic nurse focused on natural alternatives to pharma, residing in a cannabis-legal state, learning about medical cannabis therapy was a logical decision for me. Cannabis quickly became a major life passion, after sparing my teen daughter with Autism from mandated out-of-home placement, due to a sudden onset behavioral crisis with puberty onset. Safety concerns arose with her high-level behaviors, including self-injury, aggressive attacks, and property destruction, and I can attest that there’s nothing more helpless than watching your child suffer to the extent of injuring themselves and others in a blind rage.

Since witnessing the life-improving results in my own child with Autism, I have personally educated thousands of cannabis patients with a goal of optimizing their therapeutic outcomes. For most of my Autism clients, cannabis has provided safe and effective symptom relief, and eased many family’s crisis situations. As an added bonus, many have replaced potentially harmful mental health pharmaceuticals, thereby alleviating their extreme side effects. When parents learn that cannabis, used as medicine for thousands of years, has an unsurpassed safety profile, and mild if any side effects, it’s often the far more appealing option.

Currently only two pharmaceuticals are FDA approved for Autism, both Antipsychotics named Abilify and Risperdone. In addition, many pharmaceuticals are prescribed as off-label use, including antidepressants (SSRI’s), Anxiolytics/Benzos (Ativan), Stimulants (Ritalin, Adderall), and Anticonvulsants (Lamictal). The mainstream pharmaceutical approach is risky, especially considering these drugs are not approved for use in children, and we have no clue what the long-term effects may be. The declared pharmaceutical side effects are bad enough, with potential to threaten quality of life (male breast development, extrapyramidal symptoms) or even be life threatening (suicidal ideation, NMS, SJS) (1, 2).

In addition to positive patient outcomes, and desirable safety profile, the research also supports cannabis as an optimal approach for treating Autism. Endocannabinoid System (ECS) Deficiency is a condition termed by Dr Ethan Russo, MD which clearly contributes to Autism (3). ECS Deficiency means the body is unable to produce enough endocannabinoids, and is lacking these vital nutrients responsible for promoting a state of optimal health balance (aka homeostasis). In addition to producing endocannabinoids, our ECS has receptors to uptake endocannabinoids throughout our bodies. In response to an imbalance, the ECS will produce extra endocananbinoids, and receptor activation intelligently rebalances whatever is out of skew (4). Additionally, a recent research study reflects that supplementation with cannabis shifts biomarkers associated with Autism towards neurotypical baseline (13).

This balancing influence targets some important areas for treating Autism, such as neurotransmitter balance, immune modulation, and decreasing inflammation (5, 6, 7, 8). Amazingly, when our bodies can’t produce enough endocannabinoids to remain in balance, phytocannabinoids from the cannabis plant seamlessly and safely replace the deficient endocannabinoids. Since one contributor to Autism is EndoCannabinoid Deficiency, this may help explain why cannabis is a highly effective therapeutic option (9, 10), by targeting root imbalances. In addition, cannabis may relieve common symptoms of Autism, incuding anxiety (11), pain (12), and inflammation (13).

I hope this article helps expand your paradigm on the important topic of cannabis for Autism harm reduction, and I hope you will join me in advocating for improved legal access and expanded use of cannabis for Autism families in need. Our mission at 501c3 Autism Safe Haven is creating cannabis-inclusive Autism care resources, so those benefitting from cannabis supplementation are accommodated as our medical ethics require. For more information or to support our mission, please visit: www.autismsafehaven.org

To learn more about Janna and her roles in the medical cannabis industry, please visit: www.jannachampagne.com

References

1. Adverse Drug and Supplement Reactions, Autism Research Institute. Retrieved online at: https://www.autism.org/adverse-drug-reactions/
2. Medical Marijuana vs. Traditional Pharmaceuticals (2016). Medicinal Marijuana Association, retrieved online at: http://www.medicinalmarijuanaassociation.com/medical-marijuana-blog/infographic-medical-marijuana-vs.-traditional-pharmaceuticals
3. Russo, Ethan (2008) Clinical endocannabinoid deficiency (CECD): can this concept explain therapeutic benefits of cannabis in migraine, fibromyalgia, irritable bowel syndrome and other treatment-resistant conditions? Neuro Endocrinol Lett. 2008 Apr;29(2):192-200.​.Retrieved online at: https://pubmed.ncbi.nlm.nih.gov/18404144/
4. Dilja, D., Krueger, N. (2013) Evidence for a common endocannabinoid-related pathomechanism in autism spectrum disorders. Neuron: 78(3):408–410. Retrieved online at: https://pubmed.ncbi.nlm.nih.gov/23664608/
5. Carbone E, Manduca A, Cacchione C, Vicari S, Trezza V. Healing autism spectrum disorder with cannabinoids: a neuroinflammatory story. Neurosci Biobehav Rev. 2021 Feb;121:128-143. Retrieved online at: https://pubmed.ncbi.nlm.nih.gov/33358985/
6. Chalystha Yie Qin Lee, Ashley E. Franks, Elisa L. Hill-Yardin (2020). Autism-associated synaptic mutations impact the gut-brain axis in mice. Brain, Behavior, and Immunity, Volume 88, Pages 275-282. Retrieved online at: https://www.sciencedirect.com/science/article/pii/S0889159120300714
7. Brigida AL, Schultz S, Cascone M, Antonucci N, Siniscalco D. (2017). Endocannabinoid signal dysregulation in Autism Spectrum Disorders: A correlation link between inflammatory state and neuro-immune alterations. International Journal of Molecular Sciences, 18(7):1425. https://doi.org/10.3390/ijms18071425
8. Nichold, J., Kaplan, B., (2020). Immune responses regulated by cannabidiol. Cannabis and Cannabinoid Research, 5(1), retrieved online at: https://doi.org/10.1089/can.2018.0073
9. Chakrabarti, B., Persico, A., and Battista, N.(2015). Endocannabinoid signaling in autism. Neurotherapeutics, 12(4): 837–847. Retrieved from: https://pubmed.ncbi.nlm.nih.gov/26216231/
10. Campos, A., et al (2017). Plastic and neuroprotective mechanisms involved in the therapeutic effects of cannabidiol in psychiatric disorders. Frontiers in Pharmacology, 8:269. Retrieved online at: https://www.frontiersin.org/articles/10.3389/fphar.2017.00269/full
11. Zan Ameringen M, Zhang J, Patterson B, Turna J. (2020). The role of cannabis in treating anxiety: an update. Curr Opin Psychiatry, 33(1):1-7. Retrieved online at: https://pubmed.ncbi.nlm.nih.gov/31688192/
12. Finn DP, Haroutounian S, Hohmann AG, Krane E, Soliman N, Rice ASC. Cannabinoids, the endocannabinoid system, and pain: a review of preclinical studies. Pain. 2021 Jul 1;162(Suppl 1):S5-S25. Retrieved online at: https://pubmed.ncbi.nlm.nih.gov/33729211/
13. Li H, Kong W, Chambers CR, et al. The non-psychoactive phytocannabinoid cannabidiol (CBD) attenuates pro-inflammatory mediators, T cell infiltration, and thermal sensitivity following spinal cord injury in mice. Cell Immunol. 2018;329:1-9. Retrieved online at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6447028/
14. Siani-Rose M, Cox S, Goldstein B, Abrams D, Taylor M, Kurek I. Cannabis-Responsive Biomarkers: A Pharmacometabolomics-Based Application to Evaluate the Impact of Medical Cannabis Treatment on Children with Autism Spectrum Disorder. Cannabis Cannabinoid Res. 2023 Feb;8(1):126-137.   Retrieved from: https://pubmed.ncbi.nlm.nih.gov/34874191/

5 Simple Tips for Improved Winter Health

by Janna Champagne, BSN, RN

In the winter, boosting your health can make the difference between chronic bouts of illness and staying well. The fall and winter months can be especially hard on our health, between the weather shifts, having less sunlight exposure, and the holiday stress. The following are 5 simple tips for supporting optimal wellness:
1. Support Your Lymph System: Our lymph system is like a drain that helps to remove waste and balance the immune system. Daily care of the lymphatic system helps the body work better and keeps the immune system operating the way it should. Consider the following supports:
a. Daily Detox Tea Recipe (and it tastes amazing!): https://draxe.com/recipe/secret-detox-drink/
b. Daily Rebounding Session: https://www.wellbeingjournal.com/rebounding-good-for-the-lymph-system/

2. Limit Incoming Toxins: Our immune system functions best when we limit our exposure to environmental toxins. Toxins can contribute to inflammation and suppress our immune system, making us more vulnerable to infection and illness. Consider the following strategies to limit environmental toxin exposure:
a. Consume Primarily Organic foods
b. Use personal products that are free of parabens, sulfates, or synthetic perfumes. For healthier scented products, look for those with essential oils in the ingredients, or purchase unscented and add your own favorite essential oil or blend.
c. Filtered Water: Depending on where you live, water may have high levels of contaminants. Using filtered water can make a big difference, both in drinking/cooking and in the bath/shower. Filter prices vary, and even the most affordable options are worth the investment.

3. Stress Management: The holidays often create extra levels of stress, for various reasons. Stress is a major factor in illness, so it’s important to seek strategies to alleviate stress during the more chaotic times. To better stress management, the first step is to be aware of its impact. We often can’t control the external sources of stress, but we can learn to control our own response. The next time you feel stressed, try to notice the tension in your body and make a conscious decision to decrease that response. Practice stress-relieving strategies that appeal to you, whether it’s deep breathing, meditation/prayer, or something like exercise or reading. Find what is meaningful, and what works best for you, and use it at every opportunity.

4. Consider Cannabis Supplementation: CBD is a non-intoxicating component of cannabis that has far-reaching immune benefits supported by research, including balancing the immune system, decreasing inflammation, and killing bacteria as strong as MRSA. Not all cannabis formulations are equal for medical use and knowing what to purchase can be confusing. Here’s our blog article on optimal cannabis formulations for guidance on choosing the best product options (we don’t benefit from ANY product sales): http://www.integratedholisticcare.com/blog

5. Emergency Response: If you start to feel sick despite your efforts to stay well, there are immediate interventions that may help to reduce the length and severity of illness. At the first sign of a cold/flu, taking supplements like Vitamin D3, Vitamin C, Zinc, and Virastop enzymes can offer a substantial immune boost. Other options include medicinal teas (Yogi is a reputable brand), and food-sourced support like Elderberry syrup or Echinacea lozenges. Most importantly, listen to your body. Winter is the season we are supposed to slow down. So try to honor the times you feel extra rest is needed, or shorten your to-do list if possible. You’ll feel better in the long run.

All of us at Integrated Holistic Care wish you all the best wellness possible this winter solstice, and hope the above suggestions are helpful for optimizing your health!

http://www.integratedholisticcare.com

Four Criteria for Assuring Cannabis is Medical Quality

By Janna Champagne, BSN, RN

As a holistic nurse who specializes in application of medical cannabis therapy, knowing which formulations are optimal for targeting patient’s health goals comes with the territory. After years of working with clients using a variety of cannabis products, I began noticing a trend: that different extraction and production methods exert very different results. This prompted intensive research into different types of cannabis formulations, which led to creation of the following optimal criteria for medical cannabis products. Please know I do not benefit from the sales of any products, so my perspective is completely objective and without profit-bias or personal gain.

In order to understand these criteria, it’s helpful to know a bit about the Endocannabinoid System (ECS). Many people, including fellow medical professionals, have never heard about this master control system in our bodies, much thanks to our recent cannabis prohibition in the US. Now that cannabis is becoming more readily accessible, we are researching and learning that it contains vital nutrients needed to support optimal health balance. Cannabinoids found in the cannabis plant, such as THC and CBD, attach with ECS receptors in our bodies, which promotes internal homeostasis or balance. We know that the underlying cause of disease is imbalance, so this balancing “Entourage Effect” or synergy of cannabis can be profoundly therapeutic for improving the root cause of symptoms (4).

Following are the FLOW criteria, all of which my nurses and I deem important for safe and effective medical cannabis use. We educate these criteria to every client we serve, since our goal is ensuring that cannabis patients find the highest-quality medical products available.

Flower-Derived: The most potent spectrum of cannabinoids and synergistic components is found in formulations derived from cannabis flower. Since industrial hemp is sparse in flowers, often producers source oil from less optimal parts of the industrial hemp plant, such as the stalks and stems. While industrial hemp has many applicable uses, including textiles, bioaccumulation (cleans soil), building materials like Hempcrete, when it comes to medicinal potency, industrial hemp leaves a lot to be desired (9).

To clarify, many CBD producers have a USDA hemp license allowing them to legally produce and distribute hemp throughout the United States, because their cannabis flower products meet the federal hemp regulations (by containing less than 0.3% THC). There is a new term called “Medical Hemp” being coined by optimal CBD oil producers, to differentiate their products derived from high CBD cannabis flower qualifying as hemp, the best choice for medical use. Medical hemp products have the added convenience of shipping legally anywhere in the United States. However, clients still need to be aware of their local laws on hemp CBD, since some states don’t recognize federal CBD hemp regulations.

Lab tested: Oregon is one of a few states that are fortunate in this regard, as they require every product on a dispensary shelf to be lab tested by a state-certified facility. Lab testing is important to know cannabinoid content, potency or strength, and (as already mentioned) to rule out contamination with toxins. Lab testing allows clients to consistently dose with improved accuracy, which is important when using cannabis for health purposes. Labs are the only conclusive method for knowing exactly what’s in a formulation, without reliance on strain name (which may not be accurate) to know which components are present.

Terpene lab results reflecting the cannabis strain’s essential oil profile are not as commonly available. When available, having this information is optimal to predict a cannabis product’s therapeutic benefits, and the terpene profile is also used to determine whether a product is categorized as sativa (energizing) or indica (sedating) (11).

Organic: This may seem like an obvious requirement, for those who understand the harm that toxins may cause. Unfortunately, USDA Organic certification is not yet available for cannabis farming/processing, so we rely on labs to rule out any toxic pesticide, fertilizer, mold, or heavy metal contamination. We know, especially when working with already sick patients, that adding toxic exposure may be harmful to their health, and could potentially negate any benefit received from cannabis otherwise. The recent theory linking Cannabis Hyperemesis Syndrome, or excessive nausea, vomiting and abdominal upset, with Neem pesticide toxicity (same symptoms) further supports the importance of using lab testing to ensure product is clear of toxins, and verified safe for medical use (10).

Whole Plant: Products concentrating the cannabis flower without altering the contents are the best options when the patients goal is improved health status. Cannabis formulations extracted using food grade ethanol or infusion methods are preferred to meet these criteria. Whole plant formulations conserve and contain the 500+ flower-derived cannabis ingredients, most of all of which remain intact in the final product.  In comparison, CO2 processing nets around a dozen compounds (isolate cannabinoids + terpenes), and isolate contains only one compound (one cannabinoid).   Research supports that the Gestalt theory applies to cannabis therapeutic outcomes:  The whole is truly greater than the sum of its parts (2).

Cannabis is a very complex plant, containing over 140 cannabinoids, 200 terpenes (essential oils), bioflavonoids, chlorophyll, essential fatty acids, and antioxidants (1).  Research supports that synergy between all of the 500+ compounds enhances the “Entourage Effect” experienced by the consumer, defined as the ability of cannabis to promote homeostasis.   Many of the new and popular cannabis extraction methods in today’s cannabis industry, such as CO2 extraction, isolation, or fractionation, remove many of these ingredients contributing to the Entourage Effect (8).

It’s the balancing effect (homeostasis) that we specifically seek when the patient’s goal is improved medical outcomes that reach beyond superficial symptom management (4). Research comparing the efficacy of whole plant cannabis formulations with isolates clearly reflects that isolates, with or without added terpenes, aren’t as effective for exerting the balance we seek for optimal medical outcomes.    Research comparing whole plant formulations with isolate reflects the broader spectrum works as well or better at 20-25% of the dose of isolate or co2 extraction, thereby improving health outcomes for less cost to the patient.    Research also reflects that isolate and co2 extractions exert a bell curve response, narrowing the therapeutic dosing range, and risking little to no benefits with intensive dosing as indicated for serious conditions such as cancer (2, 3, 6).

There is a lot of confusion around choosing the best cannabis products, and the intent of this article is to guide medically-focused cannabis patients and ensure they understand which qualities to seek when purchasing cannabis products. We encourage anyone who is new to cannabis, suffering from a complex medical condition, or taking pharmaceutical medications to seek individualized consultation and education from a qualified medical professional for a targeted care plan. Using an individualized approach with medical guidance further reduces possible risk factors, allowing clients to gain the most benefit from their medical cannabis therapy. To find out more about our services, please visit: http://www.integratedholisticcare.com

References:
1. Echo (2017). Other compounds in cannabis. Retrieved from: https://echoconnection.org/other-compounds-in-cannabis-terpenes-chlorophyll-etc/
2. Blasco-Benito (2017). Appraising the entourage effect. Retrieved from: https://www.ncbi.nlm.nih.gov/labs/pubmed/29940172-appraising-the-entourage-effect-antitumor-action-of-a-pure-cannabinoid-versus-a-botanical-drug-preparation-in-preclinical-models-of-breast-cancer/
3. Pamplona (2018). Potential clinical benefits of CBD-rich Cannabis extracts over purified CBD in treatment-resistant epilepsy: observational data meta-analysis. Retrieved from: https://www.biorxiv.org/content/biorxiv/early/2017/11/01/212662.full.pdf
4. Russo, E. (2001). Cannabis and cannabis extracts: greater than the sum of their parts? British Journal of Pharmacology. Retrieved from: http://cannabis-med.org/data/pdf/2001-03-04-7.pdf
5. Echo (2017). Major and minor cannabinoids in cannabis. Retrieved from: https://echoconnection.org/a-look-at-the-major-and-minor-cannabinoids-found-in-cannabis/
6. Gallily (2015). Overcoming the Bell-Shaped Dose-Response of Cannabidiol by Using Cannabis Extract Enriched in Cannabidiol. Retrieved from: http://www.scirp.org/Journal/PaperInformation.aspx?PaperID=53912#.VP4EIildXvY
7. Fundacion Canna (2017) Cannabis bioflavonoids. Retrieved from: http://www.fundacion-canna.es/en/flavonoids
8. Echo (2017). CBD Alcohol or CO2 Extraction. Retrieved at: http://www.cbd-hemp-oil-drops.com/articles/57-cbd-alcohol-or-co2-extraction
9. Price, M (2015). The difference between hemp and cannabis. Medical Jane. Retrieved online at: https://www.medicaljane.com/2015/01/14/the-differences-between-hemp-and-cannabis/
10. Mishra, A., & Dave, N. (2013). Neem oil poisoning: Case report of an adult with toxic encephalopathy. Indian Journal of Critical Care Medicine : Peer-Reviewed, Official Publication of Indian Society of Critical Care Medicine, 17(5), 321–322. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3841499/
11. Cannabis Safety Institute (2014). Standards for cannabis testing laboratories. Retrieved online at: http://cannabissafetyinstitute.org/wp-content/uploads/2015/01/Standards-for-Cannabis-Testing-Laboratories.pdf

Rationale for Genetically Guided Cannabis Therapy

Rationale for Genetically Guided Cannabis Therapy

By Janna Champagne, BSN, RN

I was first introduced to the topic of epigenetics in 2008 at a business conference in Florida, and as a medical professional I was immediately intrigued. Epigenetics is defined as the environmental impact on gene expression, which explains how genes can be influenced to alter our genetic health expression, like an on/off switch. Depending on exposures, environmental interaction with genes may result in positive or negative impacts on our health. Pretty exciting, since this exemplifies that our overall health is not determined solely based on what our parents contributed. Instead, we as individuals have the ability to positively affect our inherited risk factors for familial diseases (1).

Correctly applied Nutrigenomics (genetically-individualized nutrition) is a positive environmental factor with the potential to improve genetic predisposition to illness, by slowing or halting many contributors to disease (1). This supports what we’ve known for a long time: that given what it needs, the body can balance and heal itself.

Over the years of helping clients optimize their health through nutrigenomics and other alternatives to pharma, I’ve seen some amazing results ie: successful weaning off harmful pharmaceuticals (with physician oversight), and reversals of difficult to treat conditions like cancer and autoimmune. My knowledge of genetics has since crossed over another area of passion: medical cannabis therapy.

Contrary to it’s abhorrent social reputation in the last century, cannabis is proving to be a source of vital nutrients needed to maintain balance in the body, and is therefore a perfect compliment to almost any nutrigenomic regimen. Of course, unique varieties of cannabis exert varying effects on individuals, an issue that may be resolved through a new process allowing for genetic guidance of cannabis therapy.

As you may have already guessed, genetically guided cannabis is very cutting edge, and a bit complex. It’s the overlap of several emerging sciences: the endocannabinoid system, human genetics, cannabis genetics, and botany are all in the mix. If this intrigues you, then you’re definitely a kindred cannabis nerd.

Here’s a little background info: All humans have a master control Endocannabinoid System (ECS), which is so important that it’s widely argued that life would not be possible without its balancing influence (1). The ECS produces endocannabinoids that interact with our body’s receptors, and when activated they promote balance throughout the body systems. (4)

Since the role of the ECS is homeostasis or balance, and the underlying cause of most chronic illness is some sort of imbalance, it makes sense that endocannabinoid deficiency (lacking what’s needed to maintain homeostasis) is linked to chronic illness (5). Since plant derived phytocannabinoids exactly mimic our internally-made endocannabinoids, cannabis supplementation can help fill the EC deficiency gap, and promote the balance necessary to recover health. (3)

This explains how medical cannabis therapy may benefit those suffering chronic illness, and many report cannabis is more effective than pharmaceuticals sans the dangerous side effects. Cannabis is very safe overall, and since it promotes underlying body balance it’s also potentially curative for many diseases. (3) Very few pharmaceuticals exert a curative effect, making cannabis a far superior intervention for chronic illness.

Endocannabinoid deficiency is especially prevalent in today’s society, thanks to nearly a century of cannabis prohibition. This epidemic is the result human ECS pathway mutations/inability to produce ample endocannabinoids, combined with lacking availability/intake of phytocannabinoids. (5)

Every individual has a unique genetic profile, and mutations may reflect predisposition to ECS deficiency, along with many other contributors to imbalance. The cannabis plant contains many medicinal components, including 140+ phytocannabinoids and 200+ terpenes, thereby providing a broad spectrum of the components needed to fill an individual’s ECS deficiency profile (4).

Assessing an individual’s genetics specific to the Endocannabinoid System (including other system pathways that overlap) can help to guide cannabis therapy, which is proving useful to decrease the “trial and error” phase upon starting cannabis, and also provide more consistently positive health outcomes. There are several pathways assessed to determine which cannabis components might best fit an individual’s needs, and genes considered include those from the following pathways (6):

-Serotonin/Dopamine and GABA/Glutamate -Neurotransmitter pathways (cannabinoid profiling, terpene guidance) 9

-Vitamin d3/gcmaf (ECS receptors affected) 10

-Choline pathways (mutation predispose ECS deficiency) 11

-Immune system pathways (for targeted cannabinoid therapy) 12

-AKT1/Schizophrenia predisposition-only known contraindication to THC (13)

-Methylation pathways (addressing mutations mitigates risk factors) 7

and many more…

 

The process of genetic screening is especially important in pediatric applications of cannabis therapy, because methylation pathway mutations predispose neurodevelopmental risks with child/adolescent use of cannabis (7). Methylation mutations are linked to chronic illness, by contributing to harmful systemic inflammation, and dysfunction in both the immune system and detoxification (8). The main reason most seek cannabis therapy for a minor child is chronic illness, making this is a common consideration for children who may benefit from cannabis therapy.

TO BE VERY CLEAR: This doesn’t mean that children and adolescents (even with methylation mutations) shouldn’t use medical cannabis when it’s indicated. Instead this supports that methylation should be optimized with targeted supplementation (nutrigenomics) to mitigate this risk factor.

Genetics are important, but it’s equally imperative to work with a medical professional that understands the basis of an individual’s condition(s), plus other unique cannabis considerations such as medication interactions, etiology of symptoms, and lifespan risk factors. Mitigating as many contributing factors as possible, balancing risk vs benefit, and assessing client goals as a holistic process reinforces optimal medical outcomes. Luckily there are knowledgeable practitioners available to assess genetic cannabis risk factors, and optimize health further through nutrigenomics.

In addition to screening genetics to improve cannabis therapy, full genome assessment and applied nutrigenomics may help address other pathway mutations implicated in chronic illness. My favorite analogy to describe the potential of combining nutrigenomics and cannabis therapy is a sink that’s overflowing with imbalances, thereby causing chronic illness symptoms. Starting cannabis therapy helps the body start balancing, and can be likened to taking the plug out of the drain in this overflowing sink scenario. Applied nutrigenomics can slow or turn off the running faucet. This is a powerful duo for chronic illness indeed.

My hope is to spread knowledge about this very pertinent issue, so that patients and medical professionals alike are aware of the power of using human genetics to guide cannabis therapy. I truly believe this approach represents the future of medical cannabis, and offers a viable option for comprehensive healing of the widespread chronic illness found in our society today.

For more information about genetically guided therapy and nutrigenomics assessment, please visit our website at: http://www.integratedholisticcare.com

 

 

 

References

1. Watters, E.(2008) DNA is not destiny. Accessed online at: http://www.geneimprint.com/media/pdfs/1162334912_fulltext.pdf

2. Piomeli, Daniele (2002). The molecular logic of endocannabinoid signaling. Nature Reviews Neuroscience 4, 873-884 (November 2003). https://www.nature.com/nrn/journal/v4/n11/full/nrn1247.html

3. Department of Chemistry, Kennesaw State University, 1000 Chastain Road, Kennesaw, GA 30144, USA (2002). Endocannabinoid structure-activity relationships for interaction at the cannabinoid receptors. Prostaglandins Leukot Essent Fatty Acids. 2002 Feb-Mar;66(2-3):143-60. https://www.ncbi.nlm.nih.gov/pubmed/12052032

4. Grant, I., & Cahn, B. R. (2005). Cannabis and endocannabinoid modulators: Therapeutic promises and challenges. Clinical Neuroscience Research, 5(2-4), 185–199. http://doi.org/10.1016/j.cnr.2005.08.015

5. Smith, SC, Wagner, MS(2014). Clinical endocannabinoid deficiency (CECD) revisited: can this concept explain the therapeutic benefits of cannabis in migraine, fibromyalgia, irritable bowel syndrome and other treatment-resistant conditions? Neuro Endocrinol Lett. 2014;35(3):198-201. https://www.ncbi.nlm.nih.gov/pubmed/24977967

6. DiMarzo, V., Lutz. B.(2014). Genetic dissection of the endocannabinoid system and how it changed our knowledge of cannabinoid pharmacology and mammalian physiology. http://onlinelibrary.wiley.com/doi/10.1002/9781118451281.ch4/summary

7.Neuroscience & Biobehavioral Reviews. High times for cannabis: Epigenetic imprint and its legacy on brain and behavior. Neuroscience & Biobehavioral Reviews, May 12, 2017. http://www.sciencedirect.com/science/article/pii/S0149763417300659

8. Lertratanangkoon K, Wu CJ, Savaraj N, Thomas ML. Alterations of DNA methylation by glutathione depletion. Cancer Lett. 1997 Dec 9;120(2):149-56. https://www.ncbi.nlm.nih.gov/pubmed/9461031

9. Sammit, S., Owen, MJ, Evand, J., et al (1995). Cannabis, COMT and psychotic experiences. Br J Psychiatry. 2011 Nov;199(5):380-5. https://www.ncbi.nlm.nih.gov/pubmed/21947654

10. Siniscalco, D., Bradstreet, J., et al (2014). The in vitro GcMAF effects on endocannabinoid system transcriptionomics, receptor formation, and cell activity of autism-derived macrophages. Journal of Neuroinflammation 2014, 11:78. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3996516/

11. Basavarajappa, B. S. (2007). Neuropharmacology of the Endocannabinoid Signaling System-Molecular Mechanisms, Biological Actions and Synaptic Plasticity. Current Neuropharmacology, 5(2), 81–97.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2139910/
12. Cabral GA1, Staab A.(2005). Cannabis effects on the immune system. Handb Exp Pharmacol. 2005;(168):385-423. https://www.ncbi.nlm.nih.gov/pubmed/16596782

13. DiForti, M., et al (2012). Confirmation that the AKT1 (rs2494732) genotype influences the risk of psychosis in cannabis users. Biol Psychiatry. 2012 Nov 15;72(10):811-6. https://www.ncbi.nlm.nih.gov/pubmed/22831980

 

Cannabis For Autism: A Holistic Nurse’s Perspective

by Nurse Janna Champagne, RN, BSN,  Holistic Nurse & Warrior ASD Mama

In the Autism Parent community, word spreads FAST. If you’ve been paying attention, you’ve surely heard the stories about seemingly miraculous results from a parent who discovered cannabis for their ASD child. I’m one of those parents, and can personally vouch for the extreme positive potential of this most controversial herb. *Disclaimer: Legally accessed and administered*

As a holistic nurse focused on natural alternatives to pharma, residing in a cannabis-legal state, learning how best to apply medical cannabis therapy was a logical decision for me. Cannabis quickly became a major life passion, as this amazing plant was integral in saving my own ASD teen daughter from out-of-home placement. I thought of doing what many consider unthinkable (foster placement), due to safety concerns when my daughter suffered a major puberty crisis, with high-level behaviors including self-injury, aggressive rages, and property destruction. I can attest: there’s nothing more helpless than watching your child suffer to the extent of injuring themselves and others in a blind rage.

The trauma of puberty crisis is experienced by an estimated 50% of Autism families, and is therefore an exceedingly common presentation during many a child’s coming-of-age (1). Having been there myself, I completely empathize and offer hope of resolution upon connecting with kindred ASD parents. After recovering my own daughter from her ASD puberty crisis, my resulting passion turned our trauma into purpose: to help other families.

I’ve since personally guided many ASD parents through optimal application of cannabis therapy. For most it has provided safe and effective relief, and eased their family crisis. As an added bonus, many using cannabis have successfully weaned off harmful mental health pharmaceutical medications, some of which have permanent side effects (google extra-pyramidal symptoms, not a good scenario). *Disclaimer: I highly recommend medical oversight for pharmaceutical weaning.*

The only shame of this process is how many parents don’t consider cannabis therapy until every other option to manage their ASD child is completely exhausted. No judgment by the way. It’s lack of education about cannabis that prevents consideration of this safe and effective option. Now that word is spreading, many parents are using cannabis as a crisis prevention strategy (sometimes well before puberty) and the ASD biomed treatment addage “the earlier the better” certainly seems to apply.

I want to be clear that the goal of medical cannabis use for ASD isn’t for parents to get their kids “high” to mellow them out. Instead, the goal is to improve internal balance and optimize function, through individualized microdosing and experimenting to find the “sweet spot” titration. The experimentation process is needed because individual cannabinoid needs vary greatly. With successful medicinal cannabis titration, even with use of psychotropic components such as THC, a “high” is rarely discernable.

Now for the science supporting cannabis therapy for Autism. First and Foremost: Endocannabinoid Deficiency Predisposes Autism (2). Read that a few times and let it sink in for a minute. For those who are brand new to the Endocannabinoid system (ECS), think of it as the motherboard that manages the interactions within and between our body’s organ systems. The role of the endocannabinoid system is homeostasis (maintaining balance) throughout the rest of the body. In response to an imbalance, the ECS will intelligently rebalance what’s out of skew. This includes some important areas for treating ASD such as neurotransmitter balance, immune modulation, and mitigating inflammation (3). In fact, one cause of ASD is genetic Endocannabinoid System receptor mutations which lead to ECS deficiency (4). The cannabis plant has the most prolific source of phytocannabinoids available to supplement what is lacking in the ECS of those with ASD. This explains why cannabis can have such a profoundly positive impact as an intervention for Autism.

So, how exactly does cannabis benefit one with Autism? Well, let’s start with symptom management. Cannabis is very effective at minimizing or completely stopping extreme Autism behaviors before, during, or after puberty. The anxiolytic (5), pain-relieving (6), and anti-inflammatory (7) effects of cannabis seem to come in particularly handy for managing Autism behaviors. In addition, cannabis is considered very safe with much milder side effects compared to its pharmaceutical alternatives (8). Hence the symptom management piece that is renowned for alleviating harsh situations in ASD families, even when at or near their breaking point.

In addition to its symptom management efficacy, cannabis also promotes balance of some underlying issues that cause Autism…hence my inclination to call it potentially “curative”. Biomedical ASD 101: Autism is caused by a combination of genetic and environmental impacts that result in pervasive imbalances, predominantly in the gut, brain, and immune systems (9). When cannabis activates the Endocannabinoid System, the effect includes balancing of all three of these major organ systems gone defunct in ASD. Cannabis is immune modulating (10), neurotransmitter balancing/neuroprotective (11), plus anti-inflammatory to the gut and brain (12), to name a few of the profound curative effects.

Cannabis itself has definitely been one of the “big hitters” in recovering my own ASD daughter, who made more progress in verbal abilities, focus, social, academic, and sensory processing between the ages of 11-17 (post cannabis), than in the biomed-heavy decade prior. If you have a child with Autism who you believe may benefit from cannabis, but are unsure where to begin, I recommend connecting with organizations like Mother’s Advocating Medical Marijuana for Autism (MAMMA), and Whole Plant Access 4 Autism. I also urge you to seriously consider this safe and effective therapy if you have a child with Autism.

For more information about Nurse Janna Champagne, please visit: http://www.jannachampagne.com

Citations:
Ballaban-Gil, K. et al (1996). Longitudinal examination of the behavioral, language, and social changes in a population of adolescents and young adults with autistic disorder. Pediatric Neurology, 15(3):217–223
Chakrabarti, B., Persico, A., and Battista, N.(2015). Endocannabinoid signaling in autism. Neurotherapeutics, 12(4): 837–847.

De Petrocellis, L., Cascio, M. G. and Di Marzo, V. (2004) The endocannabinoid system: a general view and latest additions. British Journal of Pharmacology 141, 765–774.

Dilja, D., Krueger, N. (2013) Evidence for a common endocannabinoid-related pathomechanism in autism spectrum disorders. Neuron: 78(3):408–410.
Blessing, E., Steenkamp, M., Manzanares, J., Marmar, C., (2015). Cannabidiol as a potential treatment for anxiety disorders. Neurotherapeutics: 12(4):825-36.
Russo, E. B. (2008). Cannabinoids in the management of difficult to treat pain. Therapeutics and Clinical Risk Management, 4(1), 245–259.
Nagarkatti, P., Pandey, R., Rieder, S. A., Hegde, V. L., & Nagarkatti, M. (2009). Cannabinoids as novel anti-inflammatory drugs. Future Medicinal Chemistry, 1(7), 1333–1349.
Medical Marijuana vs. Traditional Pharmaceuticals (2016). Medicinal Marijuana Association, accessed online at: http://www.medicinalmarijuanaassociation.com/medical-marijuana-blog/infographic-medical-marijuana-vs.-traditional-pharmaceuticals
Caroline, G., Lopes, S., Silva, P., et al (2011). Pathways underlying the gut-to-brain connection in autism spectrum disorders as future targets for disease management. European Journal of Pharmacology, 668:S70–S80.
Thomas, W., Klein, L., Newton, C., Larsen, K., et al (2003). The cannabinoid system and immune modulation. Journal of Leukocyte Biology. 74(4): 486-496
Hampson, J., Grimald, M., Axelrod, J., Wink, D, (1998). Cannabidiol and tetrahydrocannabinol are neuroprotective antioxidants. National Academy of Medial Sciences, Vol. 95, pp. 8268–8273.

Cannabidiol (CBD) for Autism and Related Immune Disorders

by Janna Champagne, BSN, RN

Cannabidiol (CBD) is a non-intoxicating cannabinoid found in the cannabis plant, and it boasts the broadest therapeutic potential of any other component (1).  CBD is widely known for its vast array of medicinal uses, including relief of anxiety, nausea/vomiting, mental health disorders, inflammation, cancer, AND…(drumroll please)…CBD kills infectious organisms (2).  These facts, combined with CBD being readily available to purchase anywhere in the US (and many other countries), makes supplementation an excellent treatment option for many conditions.

But there’s a catch!   Caution is warranted when administering CBD for Autism or related immune or infectious diseases, and considerations and preparation is often  necessary to prevent the opposite of the desired effect.  Imagine taking CBD and expecting symptom relief, and instead having it worsen Autism behaviors or illness symptoms.  Being a professional cannabis nurse with Autism as one area of specialty, I have witnessed this very reaction on many occasions.  Curiosity prompted me to further research this phenomenon, and now I’m sharing my theory and solutions below.

Fact #1: A major underlying factor for MOST kids with Autism (and related disorders) is chronic infections (3).   Chronic infections result from a combination of factors commonly underlying in Autism, including endocannabinoid deficiency (4), and ECS deficiency contributes to the immune imbalances allowing chronic infections to linger (it’s a vicious cycle)

Fact #2: CBD is the most powerful anti-microbial component in cannabis, making it a therapeutic for killing infections (5).  CBD is especially helpful for remedying immune and infection-related disorders, because killing infections lowers the overall infectious load.   This is a critically important step to recover a struggling immune system from it’s chronic state of overwhelm, as seen in Autism (and other immune disorders).

 Fact #3: Another phenomenon supporting the potential for therapeutic benefit of CBD is research that reflects Autism commonly presents with an increase of CB2 (Cannabis-specific) receptors.  It’s almost like the Endocannabinoid Systems of those with Autism are literally begging for cannabis supplementation (6).  Pretty exciting stuff to this cannabis nerd!

So what’s the problem with giving CBD to someone with Autism or chronic infections?   It’s not so much a problem per se.  It’s the conditions that exist, which if not taken into consideration, may result in worsening of symptoms.  Basically, giving CBD as a first-step intervention without taking any of the appropriate precautions is the equivalent of feeding a starving person Thanksgiving for their very first meal.   It’s going to overwhelm their system and make them feel worse!

One possible issue that arises from giving CBD to a patient with Autism or chronic infections is the die-off effect, also known as a Herxheimer reaction.  Die-off occurs when harmful infections are killed, upon which their cell wall ruptures and they release an influx of toxins into the body.   Of course, the actual killing of harmful infections is a positive therapeutic action.

With Autism and related disorders, die-off may increase illness symptoms when:

1. CBD is dosed too aggressively (detox can’t keep up with die-off)

2: CBD is given without prior optimization of the detoxification pathways.

With proper detox support, the die-off reaction is often much milder, or may even be avoided completely.  Without effective detoxification, die-off toxins add significantly to the already high levels of toxins found in those with ASD (7).  A Herxheimer reaction is known to increase symptom severity, which in Autism often presents as a spike in behaviors, especially in those with impaired communication abilities.

Those who do not understand Herxheimer reactions may incorrectly blame CBD or cannabis for the symptom exacerbation, when the issue is actually caused by inefficient detoxification.   The good news is that detox efficacy can be supported through a variety of interventions, including epson salt baths and activated charcoal administration (8) along with nutrigenomic interventions to optimize the body’s own detoxification pathways. That brings me to another contributing aspect.

Making matters even worse, most children with Autism (70-80%) have MTHFR genetic mutations, which impair glutathione production, so they lack what is arguably the most important antioxidant in the human body (9).   Glutathione deficiency alters many areas of health, with one major impact being decreased ability to detoxify and clear toxins effectively.   So if nutrigenomic detox pathway optimization isn’t completed, combined with a CBD-triggered increase in toxic load from die-off, then boom: Herxheimer misery.  This is best described as feeling like a severe flu, and in some cases the severity may require seeking medical attention…no wonder we see a spike in Autism behaviors!

In summary, CBD has considerable therapeutic potential as an intervention for Autism and related immune disorders, but I recommend taking special consideration of the patient’s detoxification status before starting CBD supplementation.   This helps prevent a severe die-off reaction, and decreases the risk of an adverse event that may discourage use of cbd, however beneficial.

Of course, there are additional considerations for CBD, supporting the wisdom of working with a practitioner who offers an individualized approach to cannabis therapy.  At Integrated Holistic Care, we offer help for those seeking support in managing therapeutic cannabis to treat Autism and beyond.   If you would like more information, or to schedule a consultation, please visit our website at:  www.integratedholisticcare.com

Citations:

1. J Nat Prod. 2008 Aug;71(8):1427-30. doi: 10.1021/np8002673. Epub 2008 Aug 6.

2.  Zhornitsky S, Potvin S. Cannabidiol in Humans—The Quest for Therapeutic Targets. Pharmaceuticals. 2012;5(5):529-552. doi:10.3390/ph5050529.

3. Jepson, Bryan, and Jane Johnson. Changing the course of autism: A scientific approach for parents and physicians. Sentient Publications, 2007.

4.  Siniscalco, D., Sapone, A., Giordano, C. et al. J Autism Dev Disord (2013) 43: 2686. doi:10.1007/s10803-013-1824-9

5. Lone, Tariq Ahmad, and Reyaz Ahmad Lone. “Extraction of cannabinoids from Cannabis sativa L. plant and its potential antimicrobial activity.” Universal Journal of Medicine  1.4 (2012): 51-55.

6.  Siniscalco, D., Sapone, A., Giordano, C. et al. J Autism Dev Disord (2013) 43: 2686. doi:10.1007/s10803-013-1824-9

7.  Grandjean, Philippe et al.  Neurobehavioural effects of developmental toxicity

The Lancet Neurology.  2014; 13(3): 330 – 338

8.  Woeller, Curt MD.  Autism Treatment: Herxheimer reactions and Autism.  Website: http://autismrecoverytreatment.com/autism-treatment-%E2%80%93-herxheimer-reactions-and-autism/

9.  Boris, Marvin, et al. “Association of MTHFR gene variants with autism.” J Am Phys Surg 9.4 (2004): 106-8