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Year of the Nurse

Featuring Eloise Theisen

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Eloise Theisen is the president of the American Cannabis Nurses’ Association (ACNA). She has been a nurse for 20 years and a cannabis nurse for six years. With the focus on healthcare workers during the pandemic of COVID-19, GRAM felt talking to a cannabis nurse about COVID-19 issues would benefit our readers.

The number one challenge across the country is rapid change and uncertainty. This uncertainty is no different for the cannabis industry. “One of the challenges we’re seeing in the industry right now are these rapid changes that are coming out around deeming cannabis as an essential business in some states and not others; requiring adult-use states to now only supply cannabis to medical patients again. I think we’re seeing the industry–as a whole–is in jeopardy in terms of being able to sustain and weather this storm because of the fact we don’t qualify for any of the business stimulus relief at the federal level because we’re federally illegal still. So we have all these challenges as an industry that I am concerned about how, eventually, the ripple effect comes to patients. If manufacturers can’t weather this storm, if dispensaries and growers can’t weather this storm, who’s going to be there for patients when we start to come out of this?” Eloise said. 

A challenge for healthcare providers is providing the opportunity for cannabis as an alternative to opioids. Eloise said, “The way that the laws are set up, you have to go in and physically get your prescription refilled. And with all the practices trying to limit patients coming in, some of these chronic pain patients on opioid prescriptions are having a hard time getting their prescriptions refilled. So it’s a good time to explore cannabis as a medicine, as either an alternative to their pain medication or something they can use in conjunction, which may allow them to spare some of the dosages.”

Eloise highlighted the extreme variations happening across the healthcare industry that she sees through ACNA. “What we’re seeing right now is there are hotspots in need of healthcare professionals, but outside of that, we’re seeing layoffs, furloughs, and places closing down because the ERs aren’t at capacity or the hospitals aren’t at capacity. So there’s a real interesting extreme happening in healthcare where we’re either in crisis mode like in New York City, Michigan, Chicago, or you’re getting laid off.” One of the things ACNA is working on is a position statement on post-traumatic stress. Eloise anticipates a “huge increase in that diagnosis from the frontlines, first responders. So we want to get out there and get the states to list PTSD as a qualifying condition because not all states do.”

Eloise addressed the various concerns floating around about using cannabis in these times. “I think a lot of people are nervous about inhaling cannabis right now because there’s been some mixed reports, some clickbait, fear-mongering articles coming out. A lot of those articles, they’re using information based on tobacco studies and not cannabis studies.”

“We do have legitimate research to show that cannabis is effective for things like anxiety, chronic pain, and insomnia, and those are three major conditions or symptoms that people are struggling with right now,” she said. “I would say if you’re new to cannabis, inhalation is not the route you should choose to start until COVID settles in. If you’re a long-term cannabis user and you’re having any respiratory distress or any type of respiratory symptoms like a cough or shortness of breath, you should stop, contact your healthcare provider. Know that there are other options out there.”

It is important to note that cannabis is not a treatment for COVID-19. The ACNA came out with a statement1 addressing cannabis or CBD products being marketed as a cure or treatment for COVID-19. Eloise said, “I think it’s essential for patients to know that the FDA says there’s no coronavirus treatment or cure, and what we know about cannabis and immunity is mixed. So if you’re seeing people making claims about how cannabis or CBD can improve your immune system to fight COVID, you should be suspicious of those claims, and they haven’t been founded in science.”

If you are trying to save money on cannabis or hemp-based CBD products, you are probably sacrificing quality and putting yourself at risk. Eloise said, “Right now, because people have limited income, they may be turning to the grey market to try to save some money, and there’s concern about what’s in those products in terms of mold and pesticides.”

One frustrating aspect of the current environment is that in the race to find a treatment and develop a vaccine for coronavirus, doctors and scientists are basing decisions on extremely small subject groups. “The gold standard of the double-blind, randomized placebo trials, that the healthcare community requires or requests for any type of treatment has been getting a lot of pushback with cannabis, and here we are seeing very small sample sizes with coronavirus and different treatments. And you understand, people are desperate. They’re theorizing how COVID is behaving in the body and what mechanism of action and trying to find the right medication for it. But we see mixed results. Even The New England Journal of Medicine published and basically said there’s not enough evidence to support that hydroxychloroquine and azithromycin are effective treatments for COVID right now.2 Yet we have our current leadership out there promoting this treatment [which has] devastating side effects. It can be toxic to the heart, among other things. It’s this double standard that we’re experiencing right now. I would love to see some leniency or some opportunities open up for cannabis,” Eloise said. “You’re reading about shortages in the hospitals for the different things we need to treat patients, not just with personal protective equipment, but now medication. It’s like if there was ever a time for cannabis, now is it.”

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Testing Requirements for Medical Marijuana

Part 1 of 4 Part Series

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State by state, when rules and regulations are written for medical marijuana one very important area is often overlooked – testing. The need for testing cannabis seems like a no brainer. However, when most states launch their medical marijuana programs the parameters for testing are not always laid out. It often takes additional laws being written to mandate testing. The regulation of pesticides on cannabis, including the difficulty of setting specific residue limits is not the only thing that needs to be considered. Solvent residues, microbes, and heavy metals each pose regulatory challenges of their own. Another hot topic regarding testing is terpenes. It is not mandatory to test for terpenes and from what science is teaching us, we should all be paying close attention to which terpenes are in the cannabis strains we are consuming.

This article is the first in a series focused on the various needs for testing cannabis. Each article will cover the need for testing and why, as well as a call to action so that you can feel educated and empowered to make your voice heard wherever you live. Cannabis consumers are not just healthy adults. In most states, medical marijuana programs are legalized before recreational laws are even considered. This means that consumers consist of all age groups with various types of illnesses and conditions, and everyone is entitled to clean medicine.

The need for testing cannabis seems like a no brainer.

Third party testing is required in all states to show the amount of THC and CBD the marijuana cultivars possess. But, testing for pesticides, terpenes, and anything else varies from state to state. Regulations for testing are vital, and laboratory analysis is the bare minimum for medical cannabis facilities. A medical marijuana treatment center must retain all records of testing, as well as the samples, for a minimum of nine months (depending on the state.) Then, if a sample does not meet the set legal standards, the treatment center must recall all other products from the same batch.

Pesticides are used in the growing of cannabis for pests, insect infestations, mites, and more. Cannabis crops are very expensive, and the fastest and most inexpensive solution for bug problems is often to spray the crops down with chemicals. 33 states now have medical marijuana in the US, and they all have different rules and regulations surrounding pesticides. A major cause for this could be the fact that pesticide use in agriculture is regulated by the U.S. Environmental Protection Agency (EPA) and overseen by state and local governments. But, the federal government considers cannabis an illegal drug.1 Therefore, the EPA has not approved any pesticides for use on the plant, nor has the agency provided any indication of the level of residues on cannabis products—if any—that could be considered safe. 

Each state has had to create new laws and executive orders. Colorado for example, passed Amendment 20 in 2000 legalizing medical marijuana. But, their emergency rules for testing for pesticides took place in 2015 when the Governor issued an executive order directing Colorado state agencies to address the threat to public safety posed by marijuana contaminated by pesticides. By March of 2016, the Colorado Department of Agriculture passed rules and regulations for the Pesticide Applicators Act to apply to cannabis as well.3

Now, 20 years after medical marijuana was legalized, the state of Colorado maintains a very thorough list of which pesticides can be used on growing cannabis. The list is now up to 46 pages.4 Whenever the list is updated, notifications are sent out to all cannabis businesses and anyone registered on the list to receive updates. This streamlined process took years for the state of Colorado to fully develop. This type of list is something every state should implement.  Another example is Washington state. Five years into their recreational cannabis program, they are still working on laws related to pesticides used on recreational cannabis. Currently, their medical cannabis testing requirements for pesticides are simply to detect the general presence of any pesticides prohibited by the Washington State Department of Agriculture.

Regulations for testing are vital.

Florida is an agricultural state. Many crops are exported from the state and many pesticides are already in use for these large scale crops. The difference is—we don’t smoke strawberries or oranges. Some pesticides are deemed safe to be eaten if the produce is thoroughly washed off before eating. We don’t wash our cannabis. Instead we add fire to it when consumed through a pipe or a joint, or we add solvents to it to turn it into concentrates, or we cook with it to become edibles. None of these methods of usage have been studied for the pesticides in question. This can lead to people becoming sick after consumption if the plants are not properly flushed. 

Florida created emergency rule 64ER20 in January 2020 requiring that testing results  be reported accurately to three significant figures as the concentration in milligrams per kilogram, dry-weight for any test reported in parts per million (ppm,) and to three (3) significant figures as the concentration in micrograms per kilogram dry-weight for any test reported in parts per billion (ppb).5 They also provided a list of some 67 agricultural agents used in the growing process and what the testing parameters are for each chemical. This is a great step in the right direction.

Now you may be wondering, “What are they testing for in my state, or how can I make sure we have testing for pesticides?” The first place you can check, is the website your state has created for their medical marijuana program. You can find this by searching “medical marijuana Washington” or whatever state you live in. In Florida, the Department of Health created the OMMU (Office of Medical Marijuana Use) to be the official source of all things cannabis.6 They are responsible for writing and implementing the department’s rules for medical marijuana, overseeing the statewide Medical Marijuana Use Registry, and licensing Florida businesses to cultivate, process, and dispense medical marijuana to qualified patients. 

You can also try reaching out to cannabis organizations currently fighting for your rights as patients, such as Americans for Safe Access. The mission of Americans for Safe Access (ASA) is to ensure safe and legal access to cannabis (marijuana) for therapeutic use and research.7 There are also groups like the National Organization for the Reform of Marijuana Laws (NORML) working towards cannabis legalization as a whole. NORML has chapters in almost every state working towards broadening the conversation surrounding the cannabis plant.8

There are steps you can take to feel empowered and make your voice heard. 

Follow these 4 steps to empowerment…

1. Reach out to your legislators
If you don’t know who they are, that is okay. Our government has made it incredibly easy to find out exactly who represents you at the local, state, and federal levels. By visiting the site www.usa.gov and clicking on the tab at the top of the screen that says “Government Agencies and Elected Officials,” you will then see the question pop up that says,
“How do I contact my elected officials?” Simply click on that and away you go.9

Pro-tip: Do your homework before you write a letter to your representative. What does that mean? It means to research them and their opinions of things, especially the issue you are contacting them about. Follow the Ten Commandments of speaking with lawmakers and you will do great.

2. Get involved
Whether you are a keyboard warrior or you are better at walking the halls of your state Capitol or medical cannabis business offices. Become proactive and interactive with your elected officials. Don’t just send emails, try calling their offices too. Remember, if you call, have a plan of what you want to say.

3. Interact digitally
In addition to platforms like Facebook and Instagram increasing the amount of interaction politicians make, Twitter remains the place where most are active daily. Consider making an account to interact and read their opinion on current events. 

4. Attend town hall meetings
Your representatives will hold local Town Hall events where the public is encouraged to attend and voice concerns. You can usually find when and where these events are going to take place on your representative’s website. If you do not see any upcoming events listed, call their office and ask their assistant. They will be happy to provide an engaged citizen with the information.


The Ten Commandments for Speaking with Lawmakers

  1. Thou shalt not lie to thy legislators.
  2. Thou shalt not forget to thank thy legislators for their help.
  3. Thou shalt not ignore thy legislators between sessions. 
  4. Thou shalt not be hypercritical of thy legislator’s voting on any bill.
  5. Thou shalt not hesitate to praise thy legislators publicly for their good works.
  6. Thou shalt not insist thy legislators desert their party on important party policy.
  7. Thou shalt not fail to recognize the importance of thy legislator’s office.
  8. Thou shalt not forget thy legislators too hath problems and sometimes needeth assistance in their day.
  9. Thou shalt not become completely partisan.
  10. Thou shalt not nitpick.

Do your homework on the office you will visit:

  • Familiarize yourself with your representative’s position or votes on relevant issues.
  • It is nice if there is something you can thank them for right from the start.

Greeting

  • A warm greeting is a great ice breaker.
  • Begin your meeting by thanking your representative for his/her time.
  • Introduce yourself and all members in your group and state why you have requested a
  • meeting or why you are stopping by their office. 
  • Identify your association and no more than three priority issues.

Stay on Message

  • Be professional, but assertive.
  • Be brief. Representatives appreciate it when you get to the point and respect their time.
  • Ask for something; be specific.
  • Never make up information or ‘guess.’
  • It is best to say, “I need to get back to you.” Other than making up an answer.
  • Encourage a conversation. Ask questions of the staff.

Tips for After the Meeting

  • Take notes to help you remember what was accomplished.
  • Find the answers to questions you were unable to answer during your meeting and follow up with them like you said you would.
  • Send a thank you note and other relevant information when you get home/back to your office.

Sources:

1. Seltenrich, N. Environmental Health Perspectives. April 25, 2019. doi: 10.1289/EHP5265

2. https://www.safeaccessnow.org/amendment_20_to_colorado_s_state_constitutionnew  “Amendment 20 To Colorado’s Constitution” Americans for Safe Access.” 

3. https://www.colorado.gov/pacific/agplants/pesticide-use-cannabis-production-information  “Pesticide Use in Cannabis Production” Colorado Department of Agriculture.

4. https://drive.google.com/file/d/1upPu4MArl5Wcdy0eOgP7fkgFDTTSmQo0/view  “Pesticides allowed for use in cannabis production.” Colorado. 

5. https://www.flrules.org/gateway/ruleNo.asp?id=64ER20-9  Florida Department of Health. Emergency Rule for 2020, 64ER20-9.

6. https://knowthefactsmmj.com/  OMMU, Office of Medical Marijuana, Florida. 

7. https://www.safeaccessnow.org/   Americans for Safe Access.

8. https://norml.org/chapters   NORML (National Organization for the Reform of Marijuana Laws) “How to find a chapter near you.”

9. https://www.usa.gov/elected-officials  “How to contact your elected officials.”

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ValidVet

Dr. Zac Pilossoph

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Pet owners can agree, there is nothing more frightening than when your fur baby can’t communicate what is wrong. The way of the world is different at this time. Not all veterinarians are keeping regular office hours during this pandemic, and, in turn, this can make things very difficult and expensive. A trip to the emergency vet can be quite costly. Since the ER staff likely does not know your pet’s history, they will have to perform extra tests out of necessity and this can compound the stress and anxiety. 

Last weekend, I found myself in that exact situation. My regular veterinarian could not get my poor pup in until almost a week later. When I called the emergency room, the nurse on the phone warned me it would be around $400 to start, not including any medications he may need. My jaw dropped, and I felt incredibly trapped. My 15 year old Maltese, Jude, was suffering. His tiny body was trembling from head to toe uncontrollably, accompanied by episodes of panting that made him appear like he was in a lot of pain. 

Since Jude has a history of arthritis and neurological pain, I thought I would try using one of his pain pills and giving him another dose of his CBD oil. The nurse in me said, ok, he’s got 20 minutes; if he is not better, I will spend whatever they ask just to make him feel better. Then I remembered this amazing veterinarian who I had met at a conference the year prior. His name is Dr. Zac Pilossoph. I took a 60 second video of Jude’s symptoms and sent it to him with an attached message asking for his advice. He immediately responded and asked if I could call him. 

Within seconds of being on our call, he sent me the link to his new veterinarian service he is offering in response to the current crisis in our world. He explained to me, “With Validvet, it is not my goal to take business from people’s regular vets, or from the ER’s if the pets really need those facilities. My goal is to be in between those two options, for moments like right now, where you know you need assistance, but it might not be emergency room assistance.” 

Dr. Zac watched the video and asked several questions about Jude’s condition. I told him what medications I had already given Jude, and his first suggestion pleased and shocked me at the same time. He asked if Jude had a CBD oil I felt comfortable increasing his dose with and giving him more. I had to confess that I had intuitively done so just moments before calling him. Expecting to be scolded, my heart melted when instead he complimented my actions and for trusting my intuition. As we spoke I began to notice that his trembling was beginning to cease and so was his panting. Finally after 20 minutes on the phone, Jude was resting comfortably. 

Dr. Zac was able to rule out certain conditions because the CBD oil was 100% effective at calming his symptoms. The service he has created offering telehealth consults for pets is one of the best things that I have seen come out of this pandemic. It is a game changer for anyone out there stuck in that space of “should we go to the ER or can we wait till next week?” If you find yourself concerned about your furry loved one, it is easy to schedule a call or video appointment with Dr. Zac for a digital health and wellness consultation by visiting his website:
http://validvet.org/


VALIDVET.ORG

97-ValidVet or 978-254-3838
[email protected]

10% of sales are donated to Global Strays, an animal welfare non-profit organization, which supports and empowers animal rescuers worldwide.

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Amy Dawn Bourlon-Hilterbran

An American Medical Refugee Family

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Amy has a family of three sons, Austin, Nathaniel, and Freeman, and her husband, Jason. Five years ago, her family moved from their home in Oklahoma to Colorado in an attempt to save her son’s life. “Austin has been on cannabis medicine for 5 years now. In 2012, the doctors gave him two years to live because of the damage the pharmaceuticals had done. He is still alive almost 8 years later, no longer has kidney or liver damage and lives almost seizure free because of his daily medical cannabis regimen.” Even though Austin has lived longer than they were told and has gained some quality of life, the family has encountered many challenges along their journey.

“We were giving up everything on the hope and prayer that a plant would save our son. It cost us friends; we had threats from strangers, online bullying…we couldn’t believe it. All we were trying to do was save our son. We were doing what we thought any parent would do: whatever it takes to save our child. We had a lot of doubters–us included. We had no idea if it would work. We didn’t believe wholeheartedly in the plant then, like we do now. Now, we KNOW. Now, we tell people, ‘cannabis saved our son’s life’ because it has. Not only does it prevent seizures, it stops them when he does have a breakthrough seizure. Cannabis saved our son’s life after a decade of  varying pharmaceuticals couldn’t.”

My thoughts on cannabis now are simple: end prohibition; let the cannabis plant save lives and positively impact our world.

Amy has consumed cannabis throughout her life. However, her husband does not consume cannabis and is a former fireman. She says, “We have a unique household dynamic. It wasn’t until my research on cannabis and its potential use for seizures that I considered it ‘medicine.’ My thoughts prior to that were simple. It’s a plant and man’s law should never outlaw God’s creation. I also thought it was a great injustice to our veterans to force them to choose pills over a plant after serving our country. When I started researching cannabis as a medicine, I learned very quickly that it had medicinal value and certainly should be a legal, accessible option for anyone who needs it. So I have fought for the end of cannabis prohibition every day since.”

“Austin is doing amazing. He will never escape his disease, Dravet Syndrome, the catastrophic form of epilepsy. Before cannabis, Austin was on numerous pharmaceuticals that never stopped his seizures, had hideous side effects, and did damage to his organs.” The family was able to wean him off pharmaceuticals. “It took us 10 months, and some of the withdrawals were dangerous, but THC drops helped him make it through. We also utilize THC solely when stopping his seizures, either through drops, suppositories, or intranasal spray.”

“His success has come from utilizing the whole plant (a higher THC strain), THCa, THC, and CBN for his dystonia. Doctors initially were skeptical. We were in Children’s Hospital with Austin on life support after a cold sent him into seizures and the local hospital administered Ativan and refused to let me give him his cannabis. By the time we were transported to Children’s, Austin had a collapsed lung, the other full of fluid, unresponsive with his vitals crashing, and the doctors were preparing us for the worst.

I can remember being in the room, hearing doctors talking about which pharmaceutical to give him next to try and stop the seizures, and I screamed, ‘You’re going to kill my son – PLEASE STOP – PLEASE STOP – he was recently weaned off pharmaceuticals after a decade of daily use, his heart can’t take anymore, his body can’t take anymore – if you do this, my son will die.’ I was literally begging for my son’s life. Thank God the doctors listened (my husband and I are both licensed medical professionals), and they intubated him, giving him more time to get the Ativan out of his system. We worked hand-in-hand with the hospital leaders and board to get official policy for administration of cannabis medicine accepted. I was able to administer Austin’s cannabis medicine to him, in front of doctors, neurologists, nurses, and they were able to see–before their own eyes–when I would administer his cannabis, that it would stop his seizures. They saw firsthand that after 2 days with his cannabis medicine, Austin was able to be removed from the machines and breathe on his own, after pharmaceuticals had not helped him but caused him harm. We didn’t just change hospital policy, we changed hearts and minds and have had the respect and support from them ever since. Before cannabis, Austin was on varying pharmaceuticals, and still would have hundreds of seizures every day, in addition to the hideous pharmaceutical side effects. Now that Austin is a cannabis patient, he is no longer on pharmaceuticals that were shutting down his organs, his kidneys and liver have completely recovered, and we live with days, weeks, sometimes months with NO seizures at all.”

Now the entire family utilizes hemp products for wellness. She says both her other sons previously had seizures but have not had any at all since starting cannabis. She also uses her own organically grown cannabis medicine and gifts legal amounts to veterans and local cancer patients in need. “I am a cancer survivor (cervical), had seizures, and also utilize cannabis for PTSD and pain. Additionally, we make whole plant suppositories from high-THC cannabis, and I use hemp and CBD to make my own lotions and salves for our family and AMR (American Medical Refugees) patients. Our dogs also enjoy homemade hemp treats.”

Amy was part of a public service ad that was rejected air time during the 2019 Super Bowl. She says, “At first, it was disappointing, but when the ad went uber viral across the globe in minutes, we knew that our message and our family’s story was making an impact far greater than we had ever dreamed. People all over the world, billions of people, were learning that cannabis IS a medicine and that it saved our son’s life.” To help share education and awareness, Amy started a social media campaign to share the message about patent number 6630507 that the U.S. government holds on cannabinoids. “There are numerous patents that prove cannabis is medicinal and should be removed from the Controlled Substances Act, but this patent, which is held by several different arms of the U.S. government, also proves that cannabis is nontoxic and nonlethal in its natural form.”

His success has come from utilizing the whole plant (a higher THC strain), THCa, THC, and CBN for his dystonia. 

Amy and her husband founded the non-profit American Medical Refugees. “AMR hosts monthly events that are free to cannabis patients and their families who have relocated from another state or country to legally access medicine.” Amy’s experience as a medical refugee has driven her mission to help others. “People don’t realize that AMR families are moving out of desperation, many have been told by doctors there is nothing more that can be done (our family was one of those). Many of these patients, these children, are terminal, are fighting–literally–to stay alive another day.”

Amy continues to share her story and education. She founded Millennium Grown, which primarily hosted events for AMR, veterans, and the VIP’s of the cannabis industry, but also produced the world premiere showing of the documentary “The Legend of 420” in Denver. She is now producing a multi-state rollout of expos, starting with the Oklahoma Cannabis Expo, March 22-24, 2020 in Oklahoma City. Amy says she is collaborating with the hemp and cannabis industries’ finest to bring an interactive, invaluable resource for patients, entrepreneurs, and investors alike. “To bring the OCE to our home state is truly one of the greatest honors of my life.” 

Amy says she and her husband have both changed their minds. “He didn’t think marijuana should be legal at all, now he sees it as a medicine and a nonlethal recreational option. As a fireman, he saw first hand the destruction of the opioid epidemic and has done a complete 180 on where he stands about the cannabis plant. In his mind–and in fact–it is a safer option than most if not all the prescribed drugs, nicotine, and alcohol. My thoughts on cannabis now are simple: end prohibition; let the cannabis plant save lives and positively impact our world. In addition to its use as medicine and food, there are so many uses for it industrially, so many potentials as it requires less water to grow, is stronger, and more sustainable than cotton. I believe in my heart that cannabis, hemp, marijuana, weed, ganja, pot–whatever you want to call it–I believe that the potential in this plant could save lives, help our planet, and bring healthier, happier moments to people across the globe. I believe it in my soul, I live it daily.”

www.americanmedicalrefugees.com
www.oklahomacannabisexpo.com

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