Nurse ed­u­cates the pub­lic on the health ben­e­fits of cannabis

Honolulu Star-Advertiser - - VIEWS & VOICES - By Vicki Viotti

Wendy Gib­son, cannabis nurse, first be­came in­ter­ested in the med­i­cal mar­i­juana field by tak­ing the op­po­nent’s side. Granted, it was just an aca­demic ex­er­cise — it was an as­signed de­bate in nurs­ing school — but it stuck with her. To win the de­bate, she threw out a few stock ar­gu­ments about po­ten­tial risks to pa­tients. That was back in 2005. Gib­son, 55, did not be­lieve those ar­gu­ments then — through her 20 years in health care, in­clud­ing four years as a med­i­cal-sur­gi­cal nurse — and cer­tainly not now.

As the field or­ga­nizer for both the Drug Pol­icy Fo­rum of Hawaii and one of its projects, the Med­i­cal Cannabis Coali­tion of Hawaii, she spends much of her time work­ing to ed­u­cate peo­ple about cannabis.

That’s the pre­ferred term, she said, adding that mar­i­juana was a deroga­tory slang that at­tached in the 1930s, when there was an in­dus­trial crack­down on what had been folk medicine through­out his­tory. Gib­son was among the speak­ers at last week­end’s Hawaii Cannabis Expo, as the state ramps up for its first dis­pen­saries. She’s do­ing other talks at 3 and 5 p.m. Thurs­day at 1188 Bishop St. (de­tails are avail­able via email, info@mc­chi.org).

“I have to ac­knowl­edge, there are peo­ple who overuse and overdo it, and are very much look­ing for­ward to le­gal­iza­tion,” Gib­son said. “But the pri­mary in­tent is to get medicine to our pa­tients that’s tested and la­beled so we know what it is and can dose it.”

QUES­TION: Why is cannabis needed as med­i­ca­tion for pain, nau­sea and other ail­ments? AN­SWER: Cannabis is one of the most ef­fec­tive and safest medicines avail­able — es­pe­cially when com­pared to opi­oid pain medicines. It tar­gets the mech­a­nisms in the body that con­trol pain and nau­sea.

Q: What is its ad­van­tage over other treat­ments?

A: Some of the ac­tive in­gre­di­ents in cannabis, the cannabi­noids, are sim­i­lar to the chem­i­cals our own body makes to heal. These en­do­cannabi­noids are well-tol­er­ated chem­i­cals, very ef­fec­tive and non-toxic to any of our or­gans, in­clud­ing the liver. This is unique among medicines.

With whole-plant medicine the many chem­i­cals in the plant work syn­er­gis­ti­cally to pro­duce the de­sired ef­fects and serve to buf­fer the side ef­fects of oth­ers. … Most of the side ef­fects are usu­ally pre­dictable, min­i­mal, eas­ily treated, and they di­min­ish over time as the pa­tient de­vel­ops a tol­er­ance.

Q: What would you con­sider its lim­i­ta­tions as a med­i­ca­tion?

A: Like any med­i­ca­tion on the mar­ket, it doesn’t work well for ev­ery­one. We need to see the chem­i­cal com­po­si­tions … to best help pa­tients find the right medicine, de­liv­ery sys­tem and dose. Once lab-tested medicine is avail­able in our dis­pen­saries, dos­ing will be­come more pre­cise. Ideally, we would team up with phar­ma­cists for cus­tom com­pound­ing.

One of the big­gest lim­it­ing fac­tors is the lack of ed­u­ca­tion about our en­do­cannabi­noid sys­tem in med­i­cal schools, nurs­ing and phar­macy schools. Add to that the stigma that re­sulted from our mis­guided war on drugs, and there is a lack of ac­cep­tance in al­lo­pathic medicine. We say we want per­son­al­ized medicine, but when it comes to cannabis that goes out the win­dow. Pa­tients are lim­ited by where they can use their medicine. For ex­am­ple, pa­tients who are hos­pi­tal­ized may be de­nied ac­cess to their medicine. Some pa­tients have had to choose be­tween keep­ing their job and us­ing their medicine be­cause of drug test­ing in the work­place.

Q: Are there pa­tients who es­pe­cially would not ben­e­fit?

A: Any hu­man without an en­do­cannabi­noid sys­tem. Truly, ev­ery dis­ease hu­mans suf­fer from in­volves their en­do­cannabi­noid sys­tem. Know­ing the chem­i­cal com­po­si­tion of your medicine is key to get­ting re­sults. If you have qual­ity, in­de­pen­dent lab test­ing of prod­ucts and know the chem­i­cal pro­files pa­tients can get medicine that works for them without un­wanted side ef­fects.

Q: Se­nate Bill 174 would ex­pand the list of ail­ments for which a pa­tient could get cannabis au­tho­riza­tion, in­clud­ing lu­pus, epilepsy, mul­ti­ple scle­ro­sis and autism.

Can you give an ex­am­ple of how cannabis re­lieves symp­toms of these? A: Lu­pus is a dev­as­tat­ing au­toim­mune dis­ease where a pa­tient’s im­mune de­fenses be­gin at­tack­ing their body. This can in­volve lungs, kid­neys, and the brain. Cannabis-based medicines help re­duce the de­struc­tive im­mune re­sponse, re­duce and re­pair the in­flam­ma­tion it causes. Epilepsy: Cannabis is very neu­ro­pro­tec­tive and helps nor­mal­ize the er­ratic elec­tri­cal sig­nals of seizures caused by epilepsy. It does so with a unique neu­ro­trans­mis­sion process called “ret­ro­grade neu­ro­trans­mis­sion.” Mul­ti­ple scle­ro­sis: The most ef­fec­tive medicine known for safe re­lief of spas­tic­ity is a plant based formula, Sa­tivex that com­bines THC and CBD (cannabis com­pounds). In the U.S., cannabis is patented as a neu­ro­pro­tec­tive agent and pos­si­bly slows the pro­gres­sion of this dis­ease. Autism: The autism spec­trum dis­or­der can cause se­vere brain dys­func­tion re­sult­ing in dis­abling symp­toms. Both Dr. Bon­nie Gold­stein and Dr. David Sine — who has teamed up with a phar­ma­cist to cre­ate cus­tom­ized for­mu­las for pe­di­atric pa­tients — say that it calms and nor­mal­izes most pa­tients with ASD.

Q: SB 173 would in­clude ed­i­bles among the forms to be sold. Good idea?

A: Yes. Great idea. Many pa­tients need long-act­ing medicines. In­haled medicines last about three hours. Ed­i­bles can give the long­est-last­ing pain re­lief and en­hance deep sleep, the most heal­ing phase of sleep. I would pre­fer to see healthy ed­i­ble choices rather than sug­ary sweets.

Q: Do you think the ap­peal of ed­i­bles to non-pa­tients such as chil­dren should be a con­cern?

A: Yes, and if ed­i­bles be­come per­mis­si­ble, ev­ery pre­cau­tion will be taken so that it doesn’t have to be a con­cern. Pre­cau­tions will in­clude the stan­dard pa­tient ed­u­ca­tion with la­bel­ing, … and prod­ucts will be sealed in child­proof pack­ag­ing.

Q: Do you think there’s enough progress at reg­u­lat­ing dosage? A: Yes. We know from his­tory. In the U.S., 10-mil­ligram doses of whole plant medicines were sold in phar­ma­cies from 1850 to 1937. Dron­abi­nol (Mari­nol) which is 100 per­cent THC is sold in 2.5, 5 and 10 mg cap­sules. We can cal­cu­late the mil­ligrams from labtested prod­ucts. Once lab tested medicine is avail­able, dos­ing will be­come more pre­cise. Some dis­pen­saries are part­ner­ing with dos­ing ex­perts. We have good data from doc­tors and sci­en­tists, thou­sands of case stud­ies and more than 500 sci­en­tific, pre­clin­i­cal and clin­i­cal stud­ies. We have learned how to start low (with the dose) and go up slowly with the titra­tion — like we do with many other med­i­ca­tions. We can also teach pa­tients how to buf­fer the ef­fects of THC us­ing CBD or Ter­penes — the es­sen­tial oils found in plants. For ex­am­ple, the ter­pene Beta-Caryophyl­lene, found in black pep­per can help re­duce un­wanted side-ef­fects of THC.

Q: Are there dos­ing stan­dards Hawaii can use?

A: Yes, in fact we just brought dos­ing ex­perts to the first CME (con­tin­u­ing med­i­cal ed­u­ca­tion) pro­gram for physi­cians — from Spain and Cal­i­for­nia — to train our doc­tors and nurses. They have been re­search­ing this for years. … We’re hope­ful that dis­pen­saries will col­lect data about which doses and chem­i­cal com­po­si­tions work the best for our now more than 15,000 pa­tients.

Q: How do you an­swer crit­ics who say many med­i­cal mar­i­juana users are just recre­ational users, that all this is just prepa­ra­tion for broader recre­ational distri­bu­tion?

A: Skep­tics likely don’t un­der­stand how the hu­man body pro­duces and uses chem­i­cals sim­i­lar to those in the plant. They sim­ply find it hard to be­lieve that it is ther­a­peu­tic for so many dis­eases. Most pa­tients are try­ing to stay func­tional, and get well — not high. “Recre­ational users” may be self-med­i­cat­ing pain, stress, anx­i­ety, in­som­nia, and more. Adult-use is at least safer than other sub­stances such as opi­oids or al­co­hol in that it does not carry the “side-ef­fect” of death. … Many health-care pro­fes­sion­als (in­clud­ing my­self) feel that cannabis should not be viewed as a gate­way drug but as a po­ten­tial EXIT “drug” from more harm­ful sub­stances. There is a grow­ing body of ev­i­dence that sup­port this idea.


Newspapers in English

Newspapers from USA

© PressReader. All rights reserved.