1. Medicinal Cannabis Shelly Van Winkle RN
Member, American Cannabis Nurses Association
April 8, 2015

2. Shelly Van Winkle, RN

3. With Eli, Changes

4. Endocannabinoid System, or ECS
Every mammal has an ECS
Newly discovered
Regulates homeostasis of multiple body systems
Most medical schools and nursing schools in the USA do not currently have curriculum in place and are not educating
Explains why so many chronic and critical illnesses throughout the body respond to whole plant medicine
Juiced fresh Cannabis does NOT have any psychoactive component, but is of benefit to the ECS system.
There are Endocannabinoids in breastmilk. I don’t see Congress being able to outlaw production of breastmilk anytime soon.

7. Cannadinoids & Compounds

8. Cannadinoids & Compounds

11. Importance of Whole Plant Medicine, Cannabinoids
Over 100 different cannabinoids, still being discovered.
Synthetic, pharmaceutical medicines such as Marinol, Sativex, seek to isolate out singular compounds of Cannabis.
Synthetic THC is a schedule 3 medicine, however, natural THC is schedule 1. Why?
For several years, breeding selective strains of cannabis focused on increasing percentage of THC and decreasing CBD, for the psychoactive, recreational use of cannabis.
Current research shows that CBD and THC are most effective when they are able to work together in the human brain.

12. A Guide to Cannabinoids

13. Just like opiate receptors, the body has cannabinoid receptors
Just like opiate receptors, the body has cannabinoid receptors. We each have an endocannabinoid system that regulates appetite, pain-sensation, mood, and memory. In fact, the brain's receptors for cannabinoids far outnumber its opiate receptors, perhaps by as much as ten to one.
CB1 receptors are found in the brain and in other organs and tissues such as the eyes, lungs, kidneys, liver and digestive tract.
CB2 receptors are primarily located in tissues associated with immune function, such as the spleen, thymus, tonsils, bone marrow, and white blood cells.

14. Research
Over 33 published controlled clinical trials showed significant benefit. Placebo-controlled trials proving efficacy in treating pain, MS, PTSD, HIV neuropathy, Anorexia, Epilepsy, Leukemia, Brain cancer, Crohn's disease, Parkinson's disease.
University of California established the Center for Medical Cannabis Research (CMCR)
University of Mississippi grows cannabis for researchers, but very difficult to gain approval.
2009 medical journal review 33 trials
UC applied for DEA license, so they can grow and research their own cannabis

15. Treatment Guide

16. Treatment Guide

17. Cancer
1983 Linn Pierson Theraputic Research: THC superior to Dronabinol (synthetic THC)
Studies: cannabis has palliative effects in cancer patients by preventing nausea, vomiting and pain and by stimulating appetite
Anti-Tumor: promotion of apoptosis (programmed cell death) in tumors and by arresting angiogenesis (increased blood vessel production)
1991 Harvard Medical School study revealed that nearly half (44%) of U.S. oncologists were recommending cannabis to their patients as a way of mitigating the side effects of cancer treatments.

18. HIV/AIDS, Hepatitis C, Anorexia
2009 study: significant percentage of those with HIV/AIDS find cannabis effective for anxiety, depression, fatigue, diarrhea, nausea, and peripheral neuropathy.
Neuropathic pain. 1/3 HIV sufferers experience it.
Hepatitis C virus: Organization to Achieve Solutions in Substance-Abuse (OASIS) found that “modest cannabis use may offer symptomatic and virological benefit to some patients undergoing HCV treatment by helping them maintain adherence to the challenging medication regimen.”

19. Chronic Pain
Prescription epidemic: prescriptions for addictive opioid painkillers like OxyContin, Percocet and Vicodin have increased by 300 percent in the last decade. Deaths from overdose are up 400 percent since 1999.
States with medical cannabis programs for chronic pain and other conditions have a 25 percent lower rate of deaths from opioid drug overdose.
Opiates = severe side effects. Cannabis LESS addictive.
If you’ve ever heard someone with MS or neuropathy or Ellers Danlos syndrome describe debilitating pain…
In August of 2014, a big study was published in JAMA

20. Alzheimer’s
Cannabidiol (CBD) a combination of neuroprotective, anti- oxidative and anti-apoptotic effects by inhibiting the release of the toxic beta-amyloid peptide.
THC reduced the agitation common to Alzheimer's sufferers.
THC is also proven effective in combating anorexia or wasting syndrome, a common problem for people with Alzheimer's disease.
Alzheimers is believed to associated with oxidative stress due, in part, to the membrane action of beta-amyloid peptide aggregates.

21. PTSD Study in Neuropsychopharmacology:
synthetic cannabinoids to rats after a traumatic event can prevent behavioral and physiological symptoms of PTSD by triggering changes in brain centers associated with the formation and holding of traumatic memories.
University of Arizona: large clinical trial just begun
Almost all states that have a program include PTSD
Iowa has lost a veteran to suicide this week.
Iowa veteran are leaving the state to move to states where they can obtain medicinal cannabis to treat PTSD, legally. They don’t seek to break the law, they seek relief from the traumas they suffer from.

22. Multiple Sclerosis and Movement disorders
96% of Canadians living with MS believe cannabis is therapeutically useful for relief of chronic pain, spasticity, and depression
Numerous studies have reported improvement in tremor, sexual dysfunction, bowel and bladder dysfunctions, vision dimness, dysfunctions of walking and balance (ataxia), and memory loss, as well as pain and spasticity.
Sativex

23. There IS PEER REVIEWED RESEARCH
There IS PEER REVIEWED RESEARCH. Our legislators are being asked to decide laws regarding medicine, when very few of them have a medical back round. It is very important that the research they use to drive their decisions is up to date, peer reviewed and not done by a politically motivated government agency that has access to questionable sources of cannabis to perform research with. This is a human, ethical issue, a life and death issue for many Iowans and great care and respect must be shown our citizens with the least ability to fight for themselves, with the least amount of voice. Raise your voice and demand the legislators qualify their opinions based on medical facts, not a political line.

24. 23 States + DC
All around Iowa there is legislation—Nebraska and Kansas and south Dakota have bills introduced this year.
There are decriminalization and rescheduling bills rolled out in Iowa this year.

25. 23 States + DC
Laws vary by state.

26. Qualifying Conditions
Here is an example of New Mexico Qualifying conditions. Left column was original list when program started in 2007, right column are conditions that have been added by advisory board.

27. Iowa’s Real Need
Iowa’s Real Faces

28. Thank You
Any questions?