Author Archives: Michael Catanzaro

Playing in the Fourth Quarter/ Running the Last Lap

Playing in the Fourth Quarter/ Running the Last Lap

May 7, 2021

As an American male, receiving Social Security checks for some time, I am most comfortable with using sports metaphors to describe myself on an actuarial basis: certainly I am in the last quarter of my life. (That acknowledged, my health is very good and genetically I was delt a superb hand: Dad lasted until 88 and Mom 100, and neither suffered from dementia.) Further, if life is viewed as a game, we are all players, and how we do in the 4th Qt or on the last lap, depends a lot on how we played the first three quarters! Did we avoid tobacco, drink alcoholic beverages in moderation, if at all, keep our weight under control, minimize stress, and so on. If we did, we probably trained as well as we could for playing the last quarter. We still tire faster, and know that ultimately we all lose the game, but some of us are going to enjoy the last quarter mile a lot more than others. 

So much for the personalized preface: what I really want to discuss with my actuarial cohorts is your potential for dementia during the last chapter of your book, and what may make it somewhat easier on you and your family members. This is most germane to me as two male friends of mine (one a very talented Stanford fraternity brother/attorney from the mid 60’s, now about 78, and another chap in a local Sonoma County family that my wife has been close to for over 25 years) and about 82, are both significantly and increasingly impacted by dementia. Both fellows are living at home and assisted by bright, supportive and somewhat younger wives, but by themselves they would already be helpless and hopeless. Neither fellow anticipated this condition and likely are quite flummoxed by it. (Whether this continues into Alzheimer’s disease for each, we do not know for sure, but evidently 70% of people living with dementia (PLWDs the current acronym) wind up with ALZ.

The Dementia Problem

Within the United States, there are at least 5 million people currently living with age-related dementias. As the population increases and ages, these numbers are expected to rise significantly. To put this into perspective, it is estimated that one out of every six women and one out of every ten men, living past the age of 55 will develop dementia. Although there are various forms of dementia, around 70 percent of cases are due to Alzheimer’s. Alzheimer’s disease is the most common form of dementia, accounting for 60-80% of all cases of dementia. By the age of 85 years and older, between 25 and 50 percent of people display symptoms of dementia, more specifically Alzheimer’s.

Early screening is by far the most effective way to help detect Alzheimer’s and other types of dementia. Early detection of dementia may be able to allow intervention to ameliorate or delay the onset of symptoms. While there is currently no cure for dementia, knowing sooner can also allow families to make many important decisions, such as planning for long-term care, and organizing estate affairs.

What this should mean to all of us over 75

Friends of yours, if not in your immediate family, will soon be exhibiting early signs of dementia. Since I am not a health care professional, I am not going to be giving any sort of medical advice regarding geriatric care. But I can share some relevant information I have learned since age 70. First, having spent a lifetime in the top 1% of everything does not mean crap when it comes to dementia; having attended top schools, proving yourself in business or government, or having lead kind and generous lives means nothing if you develop dementia. And as indicated above, if you live to age 85, there is about a one chance in three of getting dementia during the remainder of your life. Clearly this is not a guarantee, but as you get older, the odds get worse.

Secondly, certain things may occur if you or you spouse/partner contract dementia. Even if you have done successful estate planning, you may have no specific plans for dealing with this type of physical ailment. Dementia can be a very severe test of the best of relationships and having a plan in advance would make sense for most. If one of the couple tires of caring for the PLWD impacted, when will they make the decision to get the partner into a health care facility? At present, the average monthly cost of such arrangements is at least $5,625 and substantially over $6,000 is not a top of range cost in nicer urban areas. Will there be the funds available for such care?  (Also many sweet people change personalities radically when dementia hits, and they are no longer the person you loved for years. They may say mean things, act out physically, and worse. If this happens while they are in a health care facility, they may be forced to leave and return home. This can be a horrible situation for an aging spouse or other family member.)  

One drug relief regime for such difficult behavior, as well as various other ailments, is medical marijuana (aka MMJ) or cannabis. Notably the Medical Board of California has listed the following medical conditions for which medical marijuana may be useful:

Pain                                                    Easing nausea/vomiting

Arthritis                                            Appetite stimulant

Cancer                                               Glaucoma

Anxiety                                              Spasticity

Migraines                                          HIV

Or any other illness for which cannabis may provide relief.

On the other hand, for those of us who grew up warned repeatedly since elementary school about Reefer Madness, threatened with criminal prosecution for possession or use of marijuana, not lifetime smokers, and generally turned off by the Stoner Image at any age, suggesting consideration of marijuana/cannabis may be viewed as quite radical. However, far better to become better educated on the subject now rather than later. If you are the one with growing dementia, you will not really be in position to do research; if you are the caregiver or responsible family member, you will likely be stressed with multiple issues. Further, there will certainly be other friends and family members adamantly opposed to any sort of MMJ/cannabis treatments, based only on a lifetime of bad press about a much-maligned herb. 

There is certainly no shortage of stumbling blocks that must overcome if one is determined to do a rigorous study of this new and unusual medicine.

      1. As of May 2021, cannabis remains federally classified as a Controlled Substances Act Schedule I Drug with no medical efficacy with high potential for abuse; this also makes it illegal for a doctor to help a patient obtain such a “dangerous drug.” 
      2. While “medical marijuana” has been legal in CA since 1995, the historical national stigma (and prohibition) against cannabis is still a fact of life. The very limited amount of research available about cannabis has been hampered by strict federal laws and severe restrictions on medical marijuana lab studies.
      3. Complicating the issue is that even in states like CA where medical cannabis is legal, doctors cannot prescribe it while it is illegal; they can only make a recommendation, even for ALZ patients. Care facilities also cannot prescribe drugs; therefore, it ultimately becomes the decision of the relevant family members to request cannabis products. (Fortunately, one CA company has been benefitting by some health care professionals willing to push the limits in this area and more are anticipated.)
      4. The American Alzheimer’s Association www.alz.org   is unsupportive of the use of cannabis, until “randomized, controlled clinical trials are carried out.” http://alz.org/media/documents/cannabis-and-cannabis-derived-products-statement-updated-feb-2020.pdf Nonetheless, while they continue to fund research in numerous areas relating to the disease, it may be they are not researching cannabis at all. Further, colleagues I respect believe their current policies are to recommend ardently against the use of any cannabis regimes.
      5. Not more than 25% of CA dementia sufferers are presently living in care facilities; the balance are chiefly with families or living alone.  Obviously, the patients themselves are not in a condition to evaluate the drug itself and the ability of families to seek adequate information in this area is conjectural.
      6. Even though the country’s medical cannabis designation is what pushed cannabis to legalization, the medical designation for cannabis is now far lower in sales than recreational and an often disregarded segment. Getting practitioners as well as adopters (patients, care providers, facilities) to be on-board with medical cannabis becomes a hurtle when the cannabis industry is thriving on recreational “dabs,” “joints,” “brownies,” and “vape pens.”

In CA there are numerous “store front” retail cannabis dispensaries but few, if any, are staffed with personnel who can advise on cannabis products for the elderly. For this reason, I am now associated with a company that has developed specific products for the elderly and is growing a professional staff of CA regional cannabis concierges that work with families and health care facilities. The Farmacann website (www.farmacann.com ) may be a good first step in expanding your knowledge about geriatric cannabis. 

Returning to my sports analogy, personally I want to play as good a game in the fourth quarter as I can. Yes, I will tire faster, miss more shots, forget some words, repeat some favorite old stories, and do other “old timer” antics like many who came before me. But if certain cannabis drugs can make my life easier, if not also reduce pain, keep me anxiety free, and help me sleep better, or for that of a loved one, I want the drugs available. I do not want others, certainly those without current medical product knowledge and knowledge of our medical conditions, denying me or others beneficial cannabis therapies. To the extent they are involved, I also will need health care facility staff, fellow patients, physicians, and family/caregivers knowledgeable of the benefits of cannabis for those of us who become PLWD. Lastly, I hope many of my actuarial cohort also take the time and learn more now about cannabis; you may be very thankful later that you did. Remember that for all of us the fourth quarter does not last forever, and the last lap is exactly that. Let’s enjoy it as best we can. 

By Dave Jefferson (chronologically in his Fourth Quarter)

Stanford (AB, 1965) GSB (MBA, 1967)

Kenwood, CA 95452

415.342.3141

Improving Access to Cannabis in End of Life Care

Improving Access to Cannabis in End of Life Care

By Chela Fiorini

SB-311 Compassionate Access to Medical Cannabis Act or Ryan’s Law  passed the California Senate in March and was referred to the Assembly. This is a very important bill for patient access in hospitals and anywhere there are federally funded programs like Medicare or Medi-Cal.

Please call and/or write your Assembly Member and Gov. Newsom to urge them to pass this bill that would allow medical cannabis in certain medical facilities for terminally ill patients. This is really important for seniors. 

Last session it passed unanimously in the legislature, but Governor Newsom vetoed it over concerns with conflicting federal policy. We cannot wait to help our loved ones. Call the Governor today. 916-445-2841 Or send him a note https://govapps.gov.ca.gov/gov40mail/ 

Here’s what I wrote: 

“Dear Gov. Newsom –

Writing today to urge you to sign SB-311 Compassionate Access to Medical Cannabis Act or Ryan’s Law (when it comes to your desk) to help all those in hospitals, hospice and even skilled nursing facilities gain access to cannabis medicine. 

Cannabis was the only medicine that ever helped ease my mom’s journey through Alzheimer’s dementia. From the time we started using it until her last breath, cannabis eased the way. 

The Governor of Virginia recently signed a similar piece of legislation. We need you to lead on cannabis normalization and help seniors and others at the end of life have access to the medicines that they wish to use. Please have compassion for those at the end of life and be bold enough to sign this law. 

Sincerely, Chela”

A little background on Ryan’s Law: Former Santee Mayor Jim Bartell’s 42-year-old son, Ryan, was diagnosed with stage 4 pancreatic cancer in early 2018 and died seven weeks later in a hospital bed in Washington State. Their experience inspired them to help craft this law that would give terminal patients a better quality of life. Here is a news story from last session, the first time they tried to pass it. 

https://www.10news.com/news/local-news/san-diego-father-advocates-for-bill-allowing-terminally-ill-patients-to-use-cannabis-in-hospitals 

Connect with me on LinkedIn @CoachChela

Could Cannabis Improve Long Term Brain Health?

Could Cannabis Improve Long Term Brain Health?

By Chela Fiorini

Cannabis herb and leaves with oil extracts in jarsMy mom died with complications from Alzheimer’s and so did my paternal aunt and grandmother. When they were diagnosed the mainstream thought was that there is nothing you can do to slow or stop the progression nor could we prevent it. Now, we know better. We know that we can do many things to fight off the onset of debilitating cognitive decline if we have an early diagnosis. But I say, why wait?

Particularly interested in preventing cognitive decline, I learn from many functional medicine doctors and practice a healthy diet and lifestyle that includes eating vegetables, minimizing starchy carbs, lean toward low glycemic sweets like berries; doing regular moderate exercise; getting quality sleep and managing stress with mindfulness and meditation as well as using cannabis medicine. Two new studies released in March validate my personal working theories. 

In Georgia, a mouse study showed that two weeks of high doses of CBD “…ameliorated the symptoms of AD, and retarded cognitive decline…” Cannabidiol Ameliorates Cognitive Function via Regulation of IL-33 and TREM2 Upregulation in a Murine Model of Alzheimer’s Disease

Also released last month,  a computer simulation employing all atom molecular dynamics simulations showed that “…THC molecules disrupt the amyloid-β protofibril structure by binding strongly to them.” And referenced that “…Δ-tetrahydrocannabinol (THC) is a cannabinoid, which can bind to the receptors in the brain, and has shown promise in reducing the fibril content in many experimental studies…” 

 There is a new drug in the Korean research pipeline showing some hope for Alzheimer’s on the thing that cannabis seems to do, but cannabis is available to Californians and many others right now, and has an established low risk of harm in the low doses that seniors and people living with dementia are using. 

Combining these interesting new findings with Dr. Russo’s Frontiers article, also below, I’m seeing a picture that research should do a hard pivot and look for how cannabis is and can help in dementing illnesses and so many others.  

Hope you enjoy reading the studies, and please share what you’re doing to support your long term brain health in the comments.

Cannabidiol Ameliorates Cognitive Function via Regulation of IL-33 and TREM2 Upregulation in a Murine Model of Alzheimer’s Disease

“Our findings suggest that CBD treatment enhanced IL-33 and TREM2 expression, ameliorated the symptoms of AD, and retarded cognitive decline.”

Destabilization of the Alzheimer’s amyloid-β protofibrils by THC: A molecular dynamics simulation study

[FTA]

“…Alzheimer’s disease is a leading cause of dementia in the elderly population for which there is no cure at present. Deposits of neurotoxic plaques are found in the brains of patients which are composed of fibrils of the amyloid-β peptide. Molecules which can disrupt these fibrils have gained attention as potential therapeutic agents. Δ-tetrahydrocannabidiol (THC) is a cannabinoid, which can bind to the receptors in the brain, and has shown promise in reducing the fibril content in many experimental studies. In our present study, by employing all atom molecular dynamics simulations, we have investigated the mechanism of the interaction of the THC molecules with the amyloid-β protofibrils. Our results show that the THC molecules disrupt the protofibril structure by binding strongly to them. The driving force for the binding was the hydrophobic interactions with the hydrophobic residues in the fibrils. As a result of these interactions, the tight packing of the hydrophobic core of the protofibrils was made loose, and salt bridges, which were important for stability were disrupted. Hydrogen bonds between the chains of the protofibrils which are important for stability were disrupted, as a result of which the β-sheet content was reduced. The destabilization of the protofibrils by the THC molecules leads to the conclusion that THC molecules may be considered for the therapy in treating Alzheimer’s disease.”

Frontiers in Integrative Neuroscience article: Cannabis Therapeutics and the Future of Neurology, a review by Dr. Ethan Russo

[FTA] “…Based on its pharmacology (Russo and Marcu, 2017), cannabis components may provide myriad benefits on target symptoms in this complex disorder:

    • Agitation: THC, CBD, linalool
    • Anxiety: CBD, THC (low dose), linalool
    • Psychosis: CBD
    • Insomnia/Restlessness: THC, linalool
    • Anorexia: THC
    • Aggression: THC, CBD, linalool
    • Depression: THC, limonene, CBD
    • Pain: THC, CBD
    • Memory: alpha-pinene (Russo, 2011; Russo and Marcu, 2017) + THC
    • Neuroprotection: CBD, THC
    • Reduced Aβ plaque formation: THC, CBD, THCA…”

Connect with me on LinkedIn @CoachChela

Why the SAFE Banking Act Must Pass to Expand Legal Cannabis Access to Seniors in Residential Care

Why the SAFE Banking Act Must Pass to Expand Legal Cannabis Access to Seniors in Residential Care

By Dave Coennen

Pass SAFE Cannabis Banking Act Today!

Did you know that buying cannabis is a cash only transaction in the US? Did you know that even cannabis healthcare specialists and educational organizations struggle to find and keep banking and credit card processing? Did you know that there is no cash on hand in residential care facilities for the elderly?

Credit card companies won’t process cannabis related transactions and most banks will not provide services for licensed cannabis businesses. A few credit unions are starting to offer basics, like a checking account and a debit card, but still have no processing for credit cards. They require an armored car service and charge very high rates and fees for oversight and compliance, probably due to the fear they might be considered money laundering for the sale of a “federally controlled substance.”

Despite the “Green Wave” of states legalizing the healing herb for adult use or medical purposes in 2020 and now in 2021, cannabis remains on the Schedule I of drugs in the Controlled Substances Act. This is the Schedule where they put heroin, and other chemicals which are considered to be “drugs with no currently accepted medical use and a high potential for abuse.” The mere fact that cannabis is on this schedule of forbidden substances creates a myriad of issues for the states that have legalized the plant for medical or adult use purposes, not the least of which is financial.

Efforts to remove cannabis completely from the Controlled Substances Act are underway in the House of Representatives in the MORE Act, passed in 2020 and soon to be reintroduced along with a bill in the Senate by Sen. Chuck Schmumer (D) and members of the Cannabis Caucus to achieve the same goal: legalizing cannabis federally.

This is, of course, the ultimate goal; de-scheduling cannabis, a plant that is so beneficial to so many with a relatively low risk of harm and few unwanted side effects. Although the legalization bills being introduced are encouraging, the odds of the MORE Act or some other full cannabis legalization passing at the federal level are slim, needing the support of every Democrat plus ten Republicans as well as Biden’s approval.

The Cannabis Banking Bill: How the SAFE Act Can Help Seniors

After being initially introduced in 2019, the cannabis banking bill, or the Secure and Fair Enforcement (SAFE) Banking Act, has been reintroduced in the House. The proposed law ensures cannabis companies would no longer be prohibited, penalized or discouraged from being provided financial services and was widely celebrated in 2019 with bipartisan support. In fact, the vast majority in Congress voted for it, 321-103. Despite all the support, the SAFE Banking Act languished in the Senate.

With passage in the House extremely likely in 2021, SAFE banking will once again be in the hands of the Senate, now under Democratic control. But the road to passage of the bill is not as clear as one would imagine. Senate banking chair Sherrod Brown recently stated he would like to couple bank access for cannabis businesses with drug sentencing reforms, working in concert with the Judiciary Committee:

“I am willing to look at moving on the SAFE Act, but with it needs to come sentencing reform,” Brown said. “I don’t think we move on legalization the way that Colorado and some other states want us to, unless we really look more seriously at who’s in prison for how long for those kinds of offenses and we don’t do one without the other.” Brown said the sentencing reform he desires would have to go through the Senate Judiciary Committee.

“We’re not going to move without working with the Judiciary Committee on that at the same time,” said Brown.”

It is only because of the outlaws and traditional medicine makers that we have a modern cannabis movement. Legalizing and normalizing cannabis must include ending failed policy and releasing those who made all this possible.

Should cannabis banking pass without addressing the harms of the failed war on drugs? Probably not, but will it? Getting bipartisan support for a criminal justice reform bill on top of banking access for legal cannabis businesses may not be achievable in the current Congress.

Banking alone, however, may get the support of both sides of the aisle. Will that support reach the margin of 60 votes to allow the banking industry a piece of the cannabis pie, solving the cash only safety concerns, as well as expanding access to people living in residential care who don’t have cash to pay for their medicine? Only pressure from their constituents will make them get on board.

Call and write to your Senators and tell them to pass SAFE banking including sentencing reform. In California, Sen. Dianne Feinstein (D) – (202) 224-3841 and Sen. Alex Padilla (D) (202) 224-3553

Follow Dave Coennen @DC420LA on Twitter
www.cannabissavestheworld.us
www.cannabishelpsdementia.com
#freetheplant #freethepeople

NYT: “Lighting Up Later in Life , The number of older adults who use cannabis is on the rise”

New York Times NYT: “Lighting Up Later in Life, The number of older adults who use cannabis is on the rise…” 

In a New York Times article from March 20, “The New Old Age” feature, they focused on the rise of cannabis use among seniors from coast-to-coast in the United States. Along with a reasonably clear picture of why the herbal medicine is being used among the 65+ crowd, the article also includes a healthy dose of caution to the fastest growing segment of the cannabis market – Boomers.

The Farmacann family will recognize one of the Times sources for the piece as one of our recommending health care practitioners in Northern California,  the President of the American Cannabis Nurses Association, an expert in cannabis medicine for seniors, geriatric nurse-practitioner Eloise Theisen of Walnut Creek, CA. Nurse Eloise participated in Farmacann’s webinar ISOLATED ELDERLY: Anxiety & Depression in Seniors Amid COVID, Can Cannabis Medicine Help? where we discussed the very subject included in the NYT article:

FTA:

“…There are no data yet on how the pandemic, with its stress and isolation, affected use among older people. But legal cannabis sales grew by 20 percent last year, according to the National Cannabis Industry Association. Leaf411, a nonprofit, nurse-staffed information hotline, received 50 percent more calls, most from older adults.

Researchers therefore expect the numbers will show greater geriatric use. Mental health surveys of older people last year showed rising anxiety and depression, conditions frequently cited as reasons to try cannabis.

“I’ve definitely seen my patients who were stable returning for tuneups,” said Eloise Theisen, president of the American Cannabis Nurses Association and a geriatric nurse-practitioner in Walnut Creek, Calif. “Their anxiety was worse. Their insomnia was worse.”

“Start Low and Go Slow”

One concern amongst the mainstream medical community with the increase in interest in cannabis medicine by seniors, which is brought up in the article, is something that we’ve learned at Farmacann from clinicians like Eloise Thiesen or geriatric psychiatrist Dr. Phillip Grob: seniors are much more sensitive to THC and other cannabinoids, and that starting slow at very low dosages not only mitigates most, if not all the side effect concerns, such as “dizziness and lightheadedness, and with thinking and perception disorders” but many patients are able to find great benefit from ultra low doses of both CBD and THC.

FTA:

“Older adults generally need less, because their metabolism has slowed,” Ms. [Nurse] Theisen said. That also means that “they can have a delayed onset, so it’s easier to over-consume, especially with products that taste good,” she continued. She urges older adults to consult health care professionals knowledgeable about cannabis — who, she acknowledges, are in short supply…”

As the Boomer generation returns to cannabis from a long hiatus or if exploring the wide rage of benefits for the first time, CBD along with low-dose THC can play an essential role for seniors in addressing a wide variety of health issues including sleep, anxiety, pain reduction or even behavioral issues associated with symptoms of dementia. 

Farmacann has focused their formulations and ratios specifically for seniors and others looking for low dose, pure and potent cannabis medicine. 

Cannabis is associated with blood pressure reduction in older adults & may not cause a cognitive decline in older populations & more researech

Doctor consulting his patientCannabis is associated with blood pressure reduction in older adults & may not cause a cognitive decline in older populations.

 

With today’s fastest growing segment of cannabis users in the US and the world being seniors, concerns over its use in a population at risk for numerous other medical conditions such  cardiovascular disease and hypertension, as well as cannabinoids, most specifically THC, possibly contributing to cognitive decline, is of ongoing concern. 

In January of this year, researchers at Ben-Gurion University in Israel released the results of a first-of-its-kind study in adults 60 and over with hypertension using cannabis therapy either in smoked or oil form. 

According to the abstract: “Medical cannabis use is increasing rapidly in the past several years, with older adults being the fastest growing group. Nevertheless, the evidence for cardiovascular safety of cannabis use is scarce. The aim of this study was to assess the effect of cannabis on blood pressure, heart rate, and metabolic parameters in older adults with hypertension.”

The conclusion of the study: “amongst older adults with hypertension, cannabis treatment for 3 months was associated with a reduction in 24-hours systolic and diastolic blood pressure values with a nadir at 3 hours after cannabis administration”

And as reported here, a recent review in Archives of Clinical Neuropsychology of “multiple studies have indicated that exposure to cannabis may not cause a cognitive decline in older populations.”

FTA – “Six articles reported findings for older populations (three human and three rodent studies), highlighting the paucity of research in this area. Human studies revealed largely null results, likely due to several methodological limitations,” the researchers wrote. “Better-controlled rodent studies indicate that the relationship between [THC] and cognitive function in healthy aging depends on age and level of THC exposure. Extremely low doses of THC improved cognition in very old rodents. Somewhat higher chronic doses improved cognition in moderately aged rodents. No studies examined the effects of cannabidiol (CBD) or high-CBD cannabis on cognition.”

As seniors follow their own paths to cannabis therapy, educating their doctors along the way, it’s important to stay up to date on potential benefits and unwanted effects of cannabis therapy despite the “paucity” of research.

If you want to get really technical on some of the other current research, here are a few studies released last month that may interest you. One on how CBD can help with PTSD from the pandemic; one on how CBD is helping folks with anxiety, stress and sleep; and a third on how cannabis may be a therapeutic agent in glioblastoma. 

https://www.liebertpub.com/doi/10.1089/can.2020.0102 

Could Cannabidiol Be a Treatment for Coronavirus Disease-19-Related Anxiety Disorders?

https://jcannabisresearch.biomedcentral.com/articles/10.1186/s42238-021-00061-5 

Reasons for cannabidiol use: a cross-sectional study of CBD users, focusing on self-perceived stress, anxiety, and sleep problems

https://search.proquest.com/openview/58d8e60e4aa4a7a2ce8b78fb17f6733d/1?pq-origsite=gscholar&cbl=2032536 

Cannabigerol Is a Potential Therapeutic Agent in a Novel Combined Therapy for Glioblastoma

Caregiver Advocacy: Engaging Lawmakers To Expand Access, &  Right to Try Plant Medicine

Caregiver Advocacy: Engaging Lawmakers To Expand Access & the Right to Try Plant Medicine

Remove Cannabis from the CSA Today!

February 19th was the last day for bills to be introduced in the CA Legislature. There are several bills pertinent to California medical cannabis patient access. I’ve written to my Assembly Member and CA Senator and left messages in their offices. Including what I wrote to them, below, for inspiration. 

If any of these issues are important to you or a loved one, please contact your elected reps. Remember, they work for you. Let’s end the failed policy that is also bad for medical cannabis patients. To find your California state representative you can use this website: http://findyourrep.legislature.ca.gov/

In Solidarity,
Chela

AB 527    (Wood D)   Controlled substances: cannabinoids.  

Impacting physicians and medical cannabis patients

MY CONCERNS:

What medical cannabis patients really need is cannabis to be removed for the CSA Schedule I completely, DE-scheduling. It was erroneously put there for political reasons. The science that the  LaGuardia (1930s) & Schafer Commission (1970) presented was ignored and the CSA Schedule I was codified. It’s time for this to stop. 

I would love to see mandated endocannabinoid system education ADDED to this bill.

AB 384    (Kalra D)   Cannabis and cannabis products: animals: veterinary medicine.

Impacting veterinarians and consumers. 

MY CONCERNS:

We all have an endocannabinoid system and plant cannabinoids found in cannabis help to keep it balanced. Medical cannabis users often want their pets to feel better, too. I would love to see mandated endocannabinoid system education ADDED to this bill.

[NO!] AB 1034  (Bloom D)   Commercial cannabis licenses: free cannabis. 

Compassion/patient access.

MY CONCERNS:

Why would anyone want to limit compassion? DO NOT LIMIT COMPASSION PROGRAMS. The modern cannabis movement is alive only because of medicinal cannabis. If anything more compassion and easier access is what’s needed. Do not punish patients and small business owners. Never limit compassion. Especially for microbusinesses. Compassion is often why a microbusiness owner got into cannabis to begin with.

AB 1256  (Quirk D)   Employment discrimination: cannabis screening test.  

Patient access/doctor patient relationship. 

MY CONCERNS:

Many studies are coming out that show medical or “adult use” cannabis reduces the need for opioids. And another study showed places that have access to cannabis have fewer workers compensation claims. If anything, I would loosen the restrictions on this bill. Stop screening for “marijuana” period. 

SB 311    (Hueso D)   Compassionate Access to Medical Cannabis Act or Ryan’s Law. 

Patient access. Dignity in dying.

MY CONCERNS:

But imo, too many barriers to be in alignment with federal law. I had to do this for my own mom. We would have been lost without cannabis on her deathbed. But, as you know, this one Gov. Newsom VETO’d last session over concerns about the Fed. Schedule I. He needs courage. The people want freedom of choice.

SB 519 (Weiner D) Controlled substances: decriminalization of certain hallucinogenic substances.

MY CONCERNS:

End failed policy, allow for sharing and research. Israel is researching how psilocybin and cannabis could help in dementia.

My letter to representatives.

Dear [Elected CA Assembly Member and Senator] – 

As a family caregiver turned advocate for people living with Alzheimer’s & related dementias, I urge you to vote YES for things that support more patient access and freedom, and NO on things that will limit access to cannabis and other potentially life changing plant-and-fungus medicines.  Seniors, especially those in long term care have particular difficulty in accessing safe, tested, legal medicinal cannabis due to current banking laws and the plant’s CSA Schedule I designation, which was not actually based on science (See Shafer and LaGuardia Commission Reports). Doctors still face dire consequences due to the same federal policy. There are many people living with dementia in Northern California who are in long-term care facilities getting this remarkable medicine in low dose capsules in blister pack pill cards, compliant with Title 22, but it is a labor of love that is not easy to sustain. These people need this medicine. And so many others could benefit when policy changes. 

Below are a few bills proposed this session that warrant your support and attention. Please don’t hesitate to call if you would like to discuss any of these further, or if you have advice for me. I know you’re extremely busy, thank you for all you do for people.

Sincerely,

Chela

Benzos, Depression & Alzheimer’s During Pandemic Isolation

Nerd Land: Benzos, Depression & Alzheimer’s During Pandemic Isolation

Benzodiazepines are frequently prescribed to ease anxiety, insomnia and agitation. Anxiety and insomnia are risk factors for developing dementia. 

As one who’s mom, paternal grandmother and aunt all died with complications related to dementia, and one who knows they all suffered with anxiety and insomnia, I am particularly interested in these kinds of stories. Additionally, anxiety has been my ongoing medical issue since I was a kid, really. I sucked my thumb til I was 12 and only stopped after my best friend blabbed it to her boyfriend. 

For a long time, doctors recommended benzodiazepines to treat my anxiety, along with recommending exercise and mindfulness practices. After reading that the FDA-approved, prescription meds I was on could cause sudden seizures, I swore to never take them again and leaned into plant medicine, despite the societal stigma in the early 1990’s. 

Anxiety and isolation related depression are having a devastating impact on our seniors and the people who love them.

Below are some recent stories and research that I found particularly interesting:

Benzodiazepine Use and the Risk of Dementia

[FTA] “…Concluding Thoughts

Available evidence indicates a positive association between the use of benzodiazepines and the development of dementia, although causality cannot be inferred from this data. Despite the lack of evidence proving causality, the association between benzodiazepine use and the development of dementia is a major cause for concern given the prevalence of benzodiazepine use among older adults. The prescription of benzodiazepines to older adults must be carefully reviewed given the lack of data regarding their long-term efficacy and their significant adverse effects including the risk for developing dementia.”

Cannabidiol: A Potential New Alternative for the Treatment of Anxiety, Depression, and Psychotic Disorders

Preliminary clinical trials also support the efficacy of CBD as an anxiolytic, antipsychotic, and antidepressant, and more importantly, a positive risk-benefit profile. These promising results support the development of large-scale studies to further evaluate CBD as a potential new drug for the treatment of these psychiatric disorders.

Alzheimer’s deaths skyrocket as patients’ lives ‘upended’ by pandemic

[FTA] “…In September, Bettie Pitchford, 76, who had been an accomplished quilter, occasional clown for children’s parties, active member of her church and the NAACP and director of special education for the Pontiac School District outside Detroit, became one of thousands of Americans with dementia to die unexpectedly, succumbing not to the infection of COVID-19 but to the way it upended their already off-kilter lives.

Nationally, about 259,250 people with Alzheimer’s or other forms of dementia were expected to die last year, according to the Alzheimer’s Association. Federal data analyzed by the association shows that the number of dementia deaths, at least through the end of November, was 16% higher. More than 38,000 people died unexpectedly…”

Study Finds Older Adults Using Cannabis to Treat Common Health Conditions

“Pain, insomnia and anxiety were the most common reasons for cannabis use and, for the most part, patients reported that cannabis was helping to address these issues, especially with insomnia and pain,” said Christopher Kaufmann, PhD, co-first author of the study and assistant professor in the Division of Geriatrics and Gerontology in the Department of Medicine at UC San Diego.

Pandemic isolation has killed thousands of Alzheimer’s patients while families watch from afar

[fta] “…Overlooked amid America’s war against the coronavirus is this reality: People with dementia are dying not just from the virus but from the very strategy of isolation that’s supposed to protect them. In recent months, doctors have reported increased falls, pulmonary infections, depression and sudden frailty in patients who had been stable for years…”

Believe in Science? Cannabis medicine creates homeostasis in body and mind

Believe in Science? Cannabis medicine creates homeostasis in body and mind

By Chela Fiorini-Coennen

Inner harmony

through balancing chemistry 

healthy happiness

It’s impossible to understand that cannabis is medicine without knowing that our bodies have an Endocannabinoid system (ECS; eCB). A vital system that is maintained by cannabinoids we make on-demand in our bodies. By eating leafy greens and a healthy diet, getting regular exercise, and reducing stress we help balance our ECS. We can also nourish our ECS by consuming phytocannabinoids like those found in cannabis and other plants. Sounds a little like crunchy-granola-hippie-talk, but it’s actually science. The first cannabinoid receptor was discovered in 1988 and further research over the next decade, led to understanding of the network that came to be known as the “endocannabinoid system.” 

All vertebrates have an endocannabinoid system. It’s essential in maintaining balance in our body and brain. Our ECS keeps us steady. If it’s not working properly, we experience dis-ease. 

There are a number of systems in the human body including: the circulatory, digestive and excretory, endocrine, integumentary/exocrine, immune and lymphatic, muscular, nervous, renal and urinary, reproductive, respiratory, skeletal and the endocannabinoid system.

The existence of the ECS is well-established in scientific literature. Although more needs to be learned about it, the existence of the ECS is currently only taught in 10 US medical schools. And in my home state of California, where Medical Cannabis has been legal since 1996, it’s not required for healthcare providers to learn about it at all. What if the nervous system or skeletal system were only taught in a handful of medical schools? Would you be comfortable seeing a doctor that didn’t know about all the systems of the human body? Has your doctor studied the importance and role of the endocannabinoid system?

In her incredibly accessible and illuminating 2020 book, “Cannabis is Medicine,” Dr. Bonni Goldstein writes, “The endocannabinoid system is the most widespread receptor system in the human body. It regulates many of the most important physiologic pathways, including: 

    • Gastrointestinal activity
    • Cardiovascular activity
    • Pain perception
    • Maintenance of bone mass
    • Metabolism control
    • Immune function
    • Inflammatory reactions
    • Inhibition of tumor cells

As you can see, your endocannabinoid system is involved in just about every chemical process in your body!” (p.30)

In a 2013 study published in Cerebrum, Bradley E. Alger, Ph.D. writes, “…Endocannabinoids and their receptors are found throughout the body: in the brain, organs, connective tissues, glands, and immune cells. With its complex actions in our immune system, nervous system, and virtually all of the body’s organs, the endocannabinoids are literally a bridge between body and mind…” 

So, the question is, if most healthcare professionals aren’t getting the complete picture because of outdated policy and lagging professional requirements, how can we get symptom relief or even hope for a cure to so many illusive illnesses? 

World-renowned neurologist, researcher and psychopharmacologist, Dr. Ethan Russo theorized that a deficiency in the endocannabinoid system could be the cause of many hard to treat issues “…that lack objective signs and remain treatment resistant. Foremost among these are migraine, fibromyalgia, and irritable bowel syndrome…with possible common underlying pathophysiology suggests that a clinical endocannabinoid deficiency might characterize their origin…” 

Dr. Russo has also proposed that Alzheimer’s and other intractable conditions may be related to endocannabinoid deficiency. More studies are obviously needed. 

On the subject of Endocannabinoid Deficiency Syndrome, Dr. Goldstein writes, “…Chronic stress, poor diet, poor sleep, and chronic pain have all been shown to negatively impact endocannabinoid system functioning and can lead to endocannabinoid dysfunction…” (p.38)

It’s well established that endocannabinoid dysregulation leads to anxiety, depression and many other disorders. So, be sure to tone your endocannabinoid system. Eat your greens, get regular exercise, quality sleep and reduce stress. Consider cannabinoid therapy if you’re having trouble. Science is real. 

#cannabisismedicine #scienceisreal #endocannabinoidsystem #ecs #cbd #thc

References:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5812699/ CB1 & CB2 Receptor Pharmacology Drs. Allyn C. Howlett and Mary E. Abood

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3997295/#:~:text=Endocannabinoids%2 0and%20their%20receptors%20are,bridge%20between%20body%20and%20mind. Getting High on the Endocannabinoid System Bradley E. Alger, Ph.D.

https://pubmed.ncbi.nlm.nih.gov/28861491/ Clinical Endocannabinoid Deficiency Reconsidered: Current Research Supports the Theory in Migraine, Fibromyalgia, Irritable Bowel, and Other Treatment-Resistant Syndromes by Dr.Ethan B Russo 

https://pubmed.ncbi.nlm.nih.gov/30405366/ Cannabis Therapeutics and the Future of Neurology by Dr.Ethan B Russo 

https://pubmed.ncbi.nlm.nih.gov/21916860/ Endocannabinoid system dysfunction in mood and related disorders by Drs. C H Ashton, P B Moore

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3808114/ Role of Endocannabinoid Signaling in Anxiety and Depression by Drs. Sachin Patel and Cecilia J. Hillard

https://pubmed.ncbi.nlm.nih.gov/22123166/ Contributions of endocannabinoid signaling to psychiatric disorders in humans: genetic and biochemical evidence by Drs. C J Hillard, K M Weinlander, K L Stuhr

https://pubmed.ncbi.nlm.nih.gov/22804774/ The endocannabinoid system and the brain by Drs. Raphael Mechoulam, Linda A Parker

 

Unleash American Ingenuity and Help People with Dementia

Unleash American Ingenuity and Help People with Dementia

“In any civilized society, it is every citizen’s responsibility to obey just laws. But at the same time, it is every citizen’s responsibility to disobey unjust laws.”
– Martin Luther King, Jr.

Remove Cannabis from the CSA Today!

This is an exciting time in the world, to say the least. If we focus, it could be one where we begin to make meaningful progress in our fight to end the suffering of people living with Alzheimer’s and related dementias. It’s time to be bold. In addition to helping millions in relationship with dementia, what we’re proposing has the potential to revitalize the US economy by opening up a brand new industry and unleashing American ingenuity.

Cannabis medicine was the only medicine that ever helped ease the toughest behavioral symptoms of my mom’s (and our family’s) nearly decade-long journey through Alzheimer’s, but it was illegal for her to get it in the nursing facility she moved to because cannabis remains on the Controlled Substances Act (CSA) Schedule I of Drugs. 

The most restrictive drug schedule in the US is reserved for drugs that are known to have:

    • – no currently accepted medical treatment use in the U.S. 
    • – a lack of accepted safety for use under medical supervision 
    • – high potential for abuse 

Cannabis does not fit this definition, yet it remains on the CSA:

    • – cannabis is medically legal in 41 US states and territories. 
    • – cannabis therapeutics have never been proven to result in serious harm, nor death
    • – a “high potential for abuse” is not a scientifically proven claim about cannabis

It’s time to simply remove cannabis from the Controlled Substances Act to allow patients to maintain access to this relatively harmless plant while science catches up with what is happening in practice in more than 2/3rds of states. The President has the power to do this by Executive Order. 

The Science

In Northern California , Upstate NY and in  Florida, there are care facilities currently using cannabis medicine for their residents. But most care facilities are too afraid to use a “Schedule I substance” because they risk losing funding and licensure. Additionally, cannabis science is only taught in ten medical schools and there are no legal requirements for medical professionals to learn about this valuable tool. Not even in California. 

There are studies that show the potential benefits of medical cannabis, but due to the CSA, it is very, very difficult to research. Despite this, there are enough studies that show how beneficial cannabis is for people living with dementia for two review articles and a US Department of Health patent:

Frontiers in Integrative Neuroscience review article: “Cannabis Therapeutics and the Future of Neurology” by Dr. Ethan Russo 

[FTA] “…Initial trials of herbal cannabis for AD have begun sporadically, with a more focused effort in a California nursing home (Hergenrather, 2017). Patients were treated with a variety of preparations: THC-predominant (2.5–30 mg/dose), CBD predominant, and THCA, mainly in tinctures and confections. Marked benefit was reported on neuroleptic drug sparing, decreased agitation, increased appetite, aggression, sleep quality, objective mood, nursing care demands, self-mutilation and pain control.

Based on its pharmacology (Russo and Marcu, 2017), cannabis components may provide myriad benefits on target symptoms in this complex disorder:

    • Agitation: THC, CBD, linalool
    • Anxiety: CBD, THC (low dose), linalool
    • Psychosis: CBD
    • Insomnia/Restlessness: THC, linalool
    • Anorexia: THC
    • Aggression: THC, CBD, linalool
    • Depression: THC, limonene, CBD
    • Pain: THC, CBD
    • Memory: alpha-pinene (Russo, 2011; Russo and Marcu, 2017) + THC
    • Neuroprotection: CBD, THC
    • Reduced Aβ plaque formation: THC, CBD, THCA

Thus, an extract of a Type II chemovar of cannabis (THC/CBD) with a sufficient pinene fraction would seem to be an excellent candidate for clinical trials (Lewis et al., 2018).

Journal of Pharmacopuncture “A Review on Studies of Marijuana for Alzheimer’s Disease – Focusing on CBD, THC” by Korean research Drs. Kim, Yang, Yook

[FTA] “…These results implied that the CBD components of cannabis might be useful to treat and prevent AD because CBD components could suppress the main causal factors of AD. Moreover, it was suggested that using CBD and THC together could be more useful than using CBD or THC alone…”

US Patent 6630507B1 – Cannabinoids as antioxidants and neuroprotectants

From the US Department of Health Patent: “…The cannabinoids are found to have particular application as neuroprotectants, for example in limiting neurological damage following ischemic insults, such as stroke and trauma, or in the treatment of neurodegenerative diseases, such as Alzheimer’s disease, Parkinson’s disease and HIV dementia…”

The MORE Act + Social Justice

Passed in the House of Representatives in November 2020 and sponsored in the Senate by Vice President (elect) Harris, though not taken up by McConnell, The MORE Act would completely remove cannabis from the Federal Schedule I of Drugs. This would allow those who are currently benefiting from cannabis medicine in 35 States, to continue to do so while the relevant research studies and science can catch up with what’s happening in daily practice. By now, we all know that cannabis was not placed on the CSA Schedule I because of science, it was put there for racist, political reasons. It’s time to finally undo this generations-old wrong.

Green Future

The clean, renewable cannabis-hemp plant can replace dirty fossil fuel petroleum to make plastics, oil and gas. Hemp can replace trees for paper and biomass. Hemp can be building materials. Hemp is also an excellent source of nutrition and it’s a bioaccumulator that can clean the soil. Hemp can literally save the world, but it must be completely removed from the CSA to allow development. We must be bold in ways we never have been before.

The question is: will President Biden be bold enough to cut through the red-tape and sign an Executive Order to remove cannabis from the CSA? Or is he going to let people suffer needlessly while the congress further argues over out-dated, racist, prohibitionist policy? 

There is nothing like a new industry to inspire hope and deliver relief to millions of Americans in this exceptionally difficult time. There is nothing like cannabis medicine for people living with dementia. Let all dementia sufferers have access to this life-changing plant. De-schedule cannabis today.

Chela Fiorini-Coennen, Farmacann Education & Outreach

#BeBold #CannabisHelpsDementia #dementia #care #economy #hemp