Therapeutic Cannabis:


(Re)discovering the Benefi ts of Marijuana in Integrated Health Care


umans have used cannabis for medicinal, nutritional, sac- ramental and recreational purposes for thousands of years. One of the earliest written references to the therapeutic use of cannabis is found in a 15th century BC Chinese medical text. , and references to the herb are found in texts and artifacts from premodern-era China, India, Egypt, Greece, Persia and other countries. Even in the U.S., cannabis-infused tinctures were widely available from pharmacies until the late 1920’s. Over the past two decades, attitudes toward cannabis in the


H


U.S. have been progressing steadily away from the prohibitionist paradigm of the last 80-plus years. Researchers here and abroad are discovering and disseminating more information about the thera- peutic benefi ts of the plant every day. About 60% of U.S. citizens now live in a state with some form of legal access to medical can- nabis. Increasingly, people are rediscovering cannabis as a safe, natural way to treat illness and restore balance to their lives. Yet stigmas and stereotypes linger, both about the plant and about the people who choose to use it therapeutically. There is also confusion for physicians who appreciate the medicinal potential of cannabis, but have trouble fi tting it neatly into the predominant healthcare paradigm in the U.S. Here, we explore and demystify some of the confusing issues that may make patients and their health care providers hesitant to have honest, scientifi cally in- formed conversations about including cannabis in patient-centered care plans.


Cannabis Catch-22 Currently, patients and health care providers in this country are


trapped in a cannabis Catch-22, due to the fact that marijuana is considered a Schedule I drug under the Controlled Substances Act of 1970. Schedule I substances are deemed to have no medical use even under a doctor’s supervision, and a high potential for abuse. Contrast this with the fact that methamphetamine and cocaine


are both Schedule II drugs which can be prescribed and used with a doctor’s oversight; or with the fact that Marinol, a synthetic pharma- ceutical version of the only psychotropic compound in the canna- bis plant, is listed under Schedule III. Because it is a Schedule I drug, it is diffi cult to obtain approv- als in the U.S. to do research involving cannabis. The resulting lack of peer-reviewed studies from U.S. researchers can give rise to the false impression that there is no scientifi c research happening at


all. In fact, a search of the website PubMed results in over 20,000 studies of the plant and its active compounds, by researchers from around the world.


A Prescription for Confusion Physicians do not write prescriptions for medical cannabis.


(Schedule I drugs cannot be prescribed, as they are deemed to have no medicinal value.) Also, the doctor is not “recommending” can- nabis. Instead, health care providers certify that a patient has one or more of the qualifying conditions in their state. Most states with medical marijuana laws also require that the certifi cation include a statement that the provider will continue to monitor the patient’s health if they do choose to add cannabis as part of their therapy.


Dosage, Potency, and Empowerment Currently, whole-plant medical cannabis is self-titrated; the


patient, rather than the physician, determines the dosing process, frequency, and amount. This challenges the dominant paradigm of traditional Western medicine, by placing the power over these important decisions directly in the hands of the patient. Furthermore, product potency varies from plant to plant, and


while edible preparations are more easily dosed, in Maine there is no current licensing system for testing labs. Lab testing protocols for cannabis are developing rapidly, and soon patients and providers can be assured of the ratios of various active compounds in all the products they receive from a dispensary. It is especially important for providers to understand that pa-


tients’ self-titration of therapeutic cannabis use does not generally constitute a danger. In fact, it promotes patient engagement in their own treatment regimen, makes users more conscious and deliber- ate in how and when they use their medicine, and empowers the patient to take an active role in managing their own health.


Becky DeKeuster, M.Ed is a founder and the current Director of Community & Education of the Wellness Connection of Maine, a not-for-profi t mutual benefi t corporation which operates four of Maine’s eight state-licensed and regulated medical cannabis dispen- saries. For more information, visit www.mainewellness.org, or email info@mainewellness.org. See ad on page 7.


www.EssentialLivingMaine.com 13


Page 1  |  Page 2  |  Page 3  |  Page 4  |  Page 5  |  Page 6  |  Page 7  |  Page 8  |  Page 9  |  Page 10  |  Page 11  |  Page 12  |  Page 13  |  Page 14  |  Page 15  |  Page 16  |  Page 17  |  Page 18  |  Page 19  |  Page 20  |  Page 21  |  Page 22  |  Page 23  |  Page 24  |  Page 25  |  Page 26  |  Page 27  |  Page 28  |  Page 29  |  Page 30  |  Page 31  |  Page 32  |  Page 33  |  Page 34  |  Page 35  |  Page 36