medical marijuana

Dr. Jake opens new office near Santa Barbara, CA

Dr. Jake opens new office near Santa Barbara, CA

Dr. Jake is happy to announce the opening of his new office in Santa Barbara county, California.  The new office is located just north of Santa Barbara in Goleta, CA.  Dr. Felice is proud to be sharing his office with David Bearman, M.D., one of the most clinically knowledgeable physicians in the U.S. in the field of medicinal marijuana.

Office address:  7394 Calle Real, Suite C, Goleta, CA 93117

 

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RIP medical marijuana

RIP medical marijuana

Washington states medical marijuana collectives are officially closed, leaving many patient’s only option to be state licensed recreational stores for their medical needs. My patients report that the price of their medicine has tripled, and that selection is scant to nonexistent, especially for medical strains.
It is the sickest and poorest of patients that are harmed most of by this new change. One of my biggest fears for patients is that they are now being forced onto the black market to obtain affordable medicine illegally.

“I need clean medicine, and I’m going to do whatever I have to do to save my child’s life,” says the mother of Madalin Holt age 3, whose life was saved by cannabis. “That’s really what this is about. I’m saving my child when the medical community gave up on her. They were out of options. I found an option, and I’m not going to let my child die because a few people in the legislature decided to strip us of our rights. I know what I’m doing is right.” From The Stranger

I also have serious concerns that new pesticide testing regulations are inadequate, and that pesticide laden cannabis is now being smoked by patients all over Washington state. More about pesticides in another post.

This post was inspired by an article Here’s more from The Stranger:

On July 1, Washington State’s medical marijuana dispensaries and collectives officially closed, leaving only state-licensed recreational stores to serve patients. This is a result of the Cannabis Patient Protection Act (SB 5052), which is perhaps the most egregious bit of doublespeak ever. The law does not protect patients. In fact, evidence suggests that it will put the state’s most vulnerable patients at risk.

Both the Washington State Liquor and Cannabis Board and the Washington State Department of Health—the state’s two regulatory agencies that govern the new medical cannabis system—have stated that they believe the only difference between medical and recreational use is the intent of the user. Essentially, that the needs of the medical market can be just as easily served by the recreational market. If only that were true.

Under the new system, the state’s 1,500-plus dispensaries and collective gardens will disappear. To make up for the loss, the state issued just 222 new retail licenses.

That will directly impact patients such as Madeline Holt. She’s three and a half years old and has a terminal genetic disorder that gives her frequent seizures. According to her mother, Meagan Holt, doctors didn’t believe she would live this long.

“I was told on April 10, 2015, to take my child home for one more night before she died,” said Holt. “Then I tried cannabis, and she’s still alive.” Not only is she alive, but her seizures have become less frequent since she started taking cannabis on a daily basis. While Holt says she still gives her daughter conventional drugs to counteract the seizures, cannabis is an essential part of her medical regimen.

“The importance of this medicine is life or death for Maddy,” said Holt. Madeline takes a minimum dose of 90 mg of CBD oil and 40 mg of THC oil to treat neuropathic pain, muscle spasms, and other issues. The oil she takes is a very specific formulation referred to as full extract cannabis oil or FECO. It is prepared by Deep Green Extracts, a medical oil extractor, and donated to Maddy completely free of charge. (The medical cannabis community, despite being portrayed as “99.2 percent a criminal enterprise” by certain lawmakers, was often extremely compassionate.)

The situation is a precarious one, however, and Holt fears that the changes brought about by SB 5052 will threaten it. For one, she’s worried that she won’t be able to find the same products on the recreational market. “When you go into a rec store, you cannot find the oil that Maddy uses,” said Holt. “Patients like her who rely on the medication that is in the dispensaries, it’s not even available. We don’t even have the option to go to recreational.” While medical patients benefit from both THC and CBD in different ways, they’re in particular need of high-CBD products, which can often be in short supply in the recreational market.

“There is no retail cannabis store that could keep a supply of what we need,” said Holt. “I would be in there weekly getting all of the FECO that they have, I’m sure.” While it’s not yet clear whether Holt’s assertion is true, the current climate around CBD seems to support her view.

Although SB 5052 allowed growers to expand their canopy area in order to help meet the new demand of the medical market, it did not require them to actually grow high-CDB product. Last week, I traveled to farms around the state to see how much CBD product is growing, and it wasn’t promising. At Emerald Twist—a farm in Goldendale whose general manger, Jerry Lapora, is a longtime grower from the Oregon medical market—only about 6 percent of its canopy is dedicated to high-CBD cannabis. Lapora said the farm has discussed selling its CBD plants to Seattle-area processor botanicaSEATTLE for full-plant oil extraction, but those plans are in their nascent stage. Indeed, Chris Abbott, a partner at botanicaSEATTLE, said that sourcing was the biggest hurdle to getting new medical products to market.

“We plan to make these medical products,” he said, “but it’s vital that we can source a sufficient amount of pure and clean CBD plant material to serve the patient base. That has proven to be difficult in this market that has largely focused on high numbers of THC.” Indeed, market pressure has made it very difficult for growers to add CBD to their portfolio.

Alex Cooley, the vice president and cofounder of Solstice, which began as a producer/processor of medical cannabis and has transitioned to recreational, had similarly dismal news: “When Solstice was operating its medical facility, 20 percent of the facility was always CBD rich [or CBD pure]. In adult use we have grown less than 2 percent with our partner farms and are about to harvest our first CBD-rich crop in our separate adult-use facility. This summer we have really bet on people wanting CBD since the two systems have been Frankensteined together.” And that’s a big bet. Lapora, of Emerald Twist, said he’s still sitting on his 2015 harvest of CBD. Cooley and others may grow it, but there’s no guarantee the patients will come. Indeed, they may not be able to afford to.

While pot grown and sold through the legal market comes with certain benefits—legality, safety, ostensible purity, et cetera—it’s also more expensive. The requirements of “medically compliant” cannabis—which all higher-dose medical products will have to meet—will inevitably add to the overall cost of production. Although patients are eligible to buy their cannabis free of sales tax, many likely will not get that discount because they are required to sign up for the new patient registry to receive the benefit, and many aren’t doing so for privacy reasons. Even if they do, the sales tax is a mere 9 percent of the cost. The marijuana excise tax, which they are still required to pay, is 37 percent.

“Even when we started looking into cannabis,” Holt said, “the price that it cost to keep up with her medicine was unattainable. We knew we would need a community to surround us to help us. That community is shrinking really fast, and that’s what’s scaring me.”

Holt’s greatest fear is that, due to an inadequate supply of affordable medicine, she’ll be forced to get hers illegally. “It’s not necessarily the day of July 1, it’s what happens after July 1,” she said. “What happens after August when it starts cooling down and everybody starts running out? I’ve heard of people starting to stockpile medicine. I can’t really do that. I can’t afford to do that, so I’m forced into the black market and forced to just hope that I have people who will help us. Another sad reality of our situation is that my child is living on borrowed time, I’m her only caregiver, and I’m living on a fixed income.”

Holt receives her daughter’s medicine for free, but those types of donations will likely become less frequent in the highly regulated, highly taxed recreational market. Deep Green is getting a recreational license, but in order to continue to give free cannabis to Holt, the business would have to either sell it to a retailer at a 100 percent loss so that the retailer could give it away for free or sell it to the retailer at cost so the retailer could take the loss. Given that most legal cannabis businesses are struggling to stay afloat, it’s hard to imagine that even the most noble-hearted ganjapreneur will give away product. Without donations, low-income cannabis patients like Madeline Holt are basically screwed.

While the market could adapt in a variety of interesting ways—fundraising drives for patients, increased cultivation of CBD plants, a legislative fix on taxes, sensible regulatory action—patients are going to suffer in the meantime. In Megan Holt’s case, that means putting herself at risk of criminal prosecution to get necessary medicine for her daughter.

“I need clean medicine, and I’m going to do whatever I have to do to save my child’s life,” Holt told me. “That’s really what this is about. I’m saving my child when the medical community gave up on her. They were out of options. I found an option, and I’m not going to let my child die because a few people in the legislature decided to strip us of our rights. I know what I’m doing is right.”

Yours truly in health, -Dr. Jake

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Low-toxic cannabis helps folks using more dangerous opiate pain killers

Low-toxic cannabis helps folks using more dangerous opiate pain killers

Opioid prescription deathsMedical cannabis not only helps patients using opiate painkillers to get better pain relief, it also helps them reduce their use of this very dangerous type of medication. Cannabis is low toxic, and does not have to cause a head high for patients to experience relief. Also medical cannabis does not have to be smoked and there are plenty of good non-smoking options available for folks who prefer alternative methods to smoking. Low-toxic cannabis is an intelligent low cost option for folks in chronic pain, as it helps patients get off of their far more toxic opiate pain killers.  These facts are supported by sound science.  I have compiled a list of science from peer reviewed journals supporting below the video.  Because of its safety and effectiveness for pain, our legislators have a moral, ethical obligation to make sure that cannabis is legally available to patients who suffer from chronic pain.

More science below to help combat the lack of quality information about medical cannabis in today’s media

One of the big criticisms of proposed cannabis legalization is the idea that legal cannabis might increase teen use.  These claims are not based in science.  The most up to date science from the great states of Washington and Colorado show that teen use rates for cannabis have not increased with cannabis legalization.  Basically, the prohibitionists’ non-scientific argument is that young folks are so dumb that they’ll be tempted to use cannabis unless we spend millions of dollars locking them up and destroying their lives.  Young people have been very effectively messaged that tobacco use is a bad choice without making tobacco illegal and there’s no reason to believe that cannabis would be different in this regard.  Prohibition is not the best tool for informing people about how to make intelligent choices.

120926092633Below are several peer reviewed studies showing that medical cannabis helps opiate pain medications work better

Medical Cannabis Laws and Opioid Analgesic Overdose Mortality in the United States, 1999-2010. JAMA Intern Med. 2014 Aug 25. doi: 10.1001/jamainternmed.2014.4005. [Epub ahead of print] PubMed PMID: 25154332.  “…States allowing the medical use of cannabis have lower rates of deaths resulting from opioid analgesic overdoses than states without such laws”.   

—Did you know that there are 25% fewer overdose deaths from opiate pain killers in states with legal medical cannabis? That’s right folks, the science has been clear for a long time.  And now there’s even more evidence that low-toxic medical cannabis saves lives for folks in chronic pain.  This time it’s the heavy hitting Journal of the American Medical Association stating “states allowing the medical use of cannabis have lower rates of deaths resulting from opioid analgesic overdoses than states without such laws”.  Below are a few more of the many, many, many studies on cannabis and chronic pain:

Cannabis as an Adjunct to or Substitute for Opiates in the Treatment of Chronic Pain, Lucas, P., Journal of Psychoactive Drugs, 44 (2), 125–133, 2012  “When used in conjunction with opiates, cannabinoids lead to a greater cumulative relief of pain, resulting in a reduction in the use of opiates (and associated side-effects)”….

Cannabis in Palliative Medicine: Improving Care and Reducing Opioid-Related Morbidity, Gregory T. Carter, MD, MS1, Aaron M. Flanagan, MD2, Mitchell Earleywine, PhD3, Donald I. Abrams, MD4, Sunil K. Aggarwal, MD, PhD5, and Lester Grinspoon, MD, American Journal of Hospice & Palliative Medicine 000(00) 1-7, 2011  “…long-term drug safety is an important issue in palliative medicine. Opioids may produce significant morbidity. Cannabis is a safer alternative with broad applicability….”

Multicenter, Double-Blind, Randomized, Placebo-Controlled, Parallel-Group Study of the Efficacy, Safety, and Tolerability of THC:CBD Extract and THC Extract in Patients with Intractable Cancer-Related Pain, Johnson, JR, Burnell-Nugent, M, Lossignol, D, Ganae-Motan, ED, Potts, R and Fallon, MT,MB Journal of Pain and Symptom Management Vol. 39 No. 2 February 2010 167-179  “This study shows that THC:CBD extract is efficacious for relief of pain in patients with advanced cancer pain not fully relieved by strong opioids.”

Cannabis as an Adjunct to or Substitute for Opiates in the Treatment of Chronic Pain, Lucas, P., Journal of Psychoactive Drugs, 44 (2), 125–133, 2012  “Novel research suggests that cannabis may be useful in the treatment of problematic substance use. These findings suggest that increasing safe access to medical cannabis may reduce the personal and social harms associated with addiction, particularly in relation to the growing problematic use of pharmaceutical opiates. “

Cannabinoids against pain. Efficacy and strategies to reduce psychoactivity: a clinical perspective.  Karst, M and Wippermann, S (2009).  Expert Opin Investig Drugs, Feb. 18, No. 2,125-133

“There is a growing body of evidence to support the use of medical cannabis as an adjunct to or substitute for prescription opiates in the treatment of chronic pain. When used in conjunction with opiates, cannabinoids lead to a greater cumulative relief of pain, resulting in a reduction in the use of opiates (and associated side-effects) by patients in a clinical setting. Additionally, cannabinoids can prevent the development of tolerance to and withdrawal from opiates, and can even rekindle opiate analgesia after a prior dosage has become ineffective. Novel research suggests that cannabis may be useful in the treatment of problematic substance use. These findings suggest that increasing safe access to medical cannabis may reduce the personal and social harms associated with addiction, particularly in relation to the growing problematic use of pharmaceutical opiates.”

Cannabinoid–Opioid Interaction in Chronic Pain, Abrams, DI, Couey, P, Shade, SB, Kelly, ME and Benowitz, NL, Clinical Pharmacology & Therapeutics, 90 (6) 2011, 844-851  “We therefore concluded that vaporized cannabis augments the analgesic effects of opioids without significantly altering plasma opioid levels. The combination may allow for opioid treatment at lower doses with fewer side effects.”

Multicenter, Double-Blind, Randomized, Placebo-Controlled, Parallel-Group Study of the Efficacy, Safety, and Tolerability of THC:CBD Extract and THC Extract in Patients with Intractable Cancer-Related Pain, Johnson, JR, Burnell-Nugent, M, Lossignol, D, Ganae-Motan, ED, Potts, R and Fallon, MT,MB Journal of Pain and Symptom Management Vol. 39 No. 2 February 2010 167-179  “This study shows that THC:CBD extract is efficacious for relief of pain in patients with advanced cancer pain not fully relieved by strong opioids.”

Patients and Caregivers Report Using Medical Marijuana to Decrease Prescription Narcotics Use, Peters, D.C., Humboldt Journal of Social Relations, 35, 2013, 25-40  “All patients and producers who were taking opiate pain killers claimed they reduced overall drug use, especially opiates, by using medical marijuana. Patients and caregivers also claimed medical marijuana was preferred over opiates, eased withdrawal from opiates, and in some cases was perceived as more effective at relieving pain.”

Cannabinergic Pain Medicine A Concise Clinical Primer and Survey of Randomized-controlled Trial Results, Aggarwal, SK, Clin J Pain  Volume 29, Number 2, February 2013, 162-171  “Cannabis and other cannabinergic medicines’ efficacies for relieving pain have been studied in RCTs, most of which have demonstrated a beneficial effect for this indication, although most trials are short-term. Adverse effects are generally nonserious and well tolerated. Incorporating cannabinergic medicine topics into pain medicine education seems warranted and continuing clinical research and empiric treatment trials are appropriate.”

Cannabinoid-opioid interactions during neuropathic pain and analgesia, Bushlin, I, Rozenfeld, R and Devi, LA, Curr Opin Pharmacol. 2010, 10(1): 80.

Impact of Cannabis Use during Stabilization on Methadone Maintenance Treatment. Scavone JL, Sterling RC, Weinstein SP, Van Bockstaele EJ.  Am J Addict 2013;22(4):344-51.

Cancer PatientBelow are more peer reviewed references demonstrating that medical cannabis helps patients use less of their prescription opiate pain killers

Cannabis not only helps opiate medications work better, it also helps patients use less of this highly toxic class of drugs. There is positive synergy between opiate medications and cannabis.

Cannabinoid–Opioid Interaction in Chronic Pain, Abrams, DI, Couey, P, Shade, SB, Kelly, ME and Benowitz, NL, Clinical Pharmacology & Therapeutics, 90 (6) 2011, 844-851 “We therefore concluded that vaporized cannabis augments the analgesic effects of opioids without significantly altering plasma opioid levels. The combination may allow for opioid treatment at lower doses with fewer side effects.”

Synergistic interactions between cannabinoid and opioid analgesics

Life Sci. 2004 Jan 30;74(11):1317-24. Review. PubMed PMID: 14706563. http://www.ncbi.nlm.nih.gov/pubmed/14706563

Synergy between THC and morphine in the arthritic rat

Eur J Pharmacol. 2007 Jul 12;567(1-2):125-30. Epub
2007 Apr 20. PubMed PMID: 17498686. http://www.ncbi.nlm.nih.gov/pubmed/17498686

Cannabis reduces opiate use in the treatment of non-cancer pain

J Pain Symptom Manage. 2003 Jun;25(6):496-8. PubMed PMID:
12782429.  http://www.ncbi.nlm.nih.gov/pubmed/12782429

Synergistic and additive interactions of the cannabinoid agonist CP55,940 with mu opioid receptor and alpha2-adrenoceptor agonists in acute pain models in mice.

Br J Pharmacol. 2005 Mar;144(6):875-84. PubMed PMID: 15778704; PubMed Central PMCID: PMC1576059. http://www.ncbi.nlm.nih.gov/pubmed/15778704

Cannabinoid-opioid interactions during neuropathic pain and analgesia, Bushlin, I, Rozenfeld, R and Devi, LA, Curr Opin Pharmacol. 2010, 10(1): 80.

Additionally, there is a lot of good science showing synergistic effects between the molecule CBD and THC.

Feel free to comment at CannabisMatrix.com or email me at DrJake@DrJakeFelice if you have any questions regarding these synergistic effects.

Jake w Hatch surf photoBelow is essential data for citizens to consider which puts into perspective the magnitude of the scope of drug toxicities for our citizens, and why low toxic cannabis can be such an excellent option for patients suffering from even mild to moderate chronic pain.  

 No other pain relieving medication is less toxic than cannabis, not even aspirin or Tylenol. If deaths from toxic effects from NSAIDs such as ibuprofen and Aleve were tabulated separately in the National Vital Statistics reports, these drug toxicities would constitute the 15th most common cause of death in the United States. This is why cannabis as medicine can be an excellent choice as a substitute for more toxic pain-killers such as opiates and NSAIDs.

The July 1998 issue of The American Journal of Medicine stated the following: “Conservative calculations estimate that approximately 107,000 patients are hospitalized annually for nonsteroidal anti-inflammatory drug (NSAID)-related gastrointestinal (GI) complications and at least 16,500 NSAID-related deaths occur each year among arthritis patients alone. The figures of all NSAID users would be overwhelming, yet the scope of this problem is generally under-appreciated.”

And again in June 1999 the prestigious New England Journal of Medicine issued a similar statement:  ”It has been estimated conservatively that 16,500 NSAID-related deaths occur among patients with rheumatoid arthritis or osteoarthritis every year in the United States. This figure is similar to the number of deaths from the acquired immunodeficiency syndrome and considerably greater than the number of deaths from multiple myeloma, asthma, cervical cancer, or Hodgkin’s disease.

If deaths from gastrointestinal toxic effects from NSAIDs were tabulated separately in the National Vital Statistics reports, these effects would constitute the 15th most common cause of death in the United States. Yet these toxic effects remain mainly a “silent epidemic,” with many physicians and most patients unaware of the magnitude of the problem. Furthermore the mortality statistics do not include deaths ascribed to the use of over-the-counter NSAIDS.”

A recent study in Therapeutics and Clinical Risk Management notes that the number of deaths and hospitalizations from GI bleeding due to NSAIDs has remained unchanged since the 1999 study.  Again, medical cannabis has never killed a single patient.

Yours truly,

-Dr. Jake Felice

Seattle, WA

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Patients say ‘yes’ to cannabis for MS

Patients say ‘yes’ to cannabis for MS

The science supporting the use of cannabis for Multiple Sclerosis (MS) is absolutely compelling.  Click here for a list of peer reviewed scientific references.

Patients everywhere should have the right to access the best medicine for their illness.  As of now, 20 states now have medical cannabis laws for patients who need safe non-toxic cannabis for their health conditions.

This video highlights the inspirational story of Gary Cooper, an MS patient.  His story, more than all of the scientific evidence referenced above makes a compelling case for the use of low-toxic medical cannabis.

Gary states about cannabis:  “It takes away my discomfort, it enhances my very being.”

Multiple Sclerosis is an autoimmune disease in which the body’s own immune system attacks the central nervous system causing inflammation, muscle spasm and loss of motor coordination, as well as muscle weakness.  Over years, the disease progresses, and MS patients can become permanently disabled.  Multiple sclerosis is typically a progressive disease and it can be fatal.  Medical cannabis can be very helpful for MS.  According to the US National Multiple Sclerosis Society, 200 people are diagnosed every week with MS in the United States, and it most frequently targets those 20 to 40 years of age.  Multiple Sclerosis is particularly prevalent in the Pacific Northwest.

My patients with MS find remarkable benefits from it’s low toxic properties.  I hope that you enjoyed this post, please feel free to comment as I’d love to hear from you.  In health,  -Dr. Jake Felice

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Topical cannabis is effective for skin conditions

Topical cannabis is effective for skin conditions

I can say that I have personally seen amazing results with patients using topical cannabis for skin conditions such as eczema, psoriasis, sunburn and poison ivy rashes and more.  Here is some new scientific data supporting what we already see is true clinically, namely that cannabis topicals can provide low toxic relief to patients with both chronic and acute skin conditions.  -Dr. Jake Felice

From TheJointBlog

A new study, recently published online in the British Journal of Pharmacology, details how cannabinoids can play a role in the treatment of skin diseases.

Researchers looked at the impact of phytocannabinoids (plant-derived cannabinoids, rather than synthetic counterparts) on epigenetic regulation of skin differentiation genes.

The study found that both cannabidiol (CBD) and cannabigerol (CBG), “significantly reduced the expression of all genes tested via increased DNA methylation for keratin 10 gene”.

The CBD was found to reduce keratin 10 mRNA through stimulating type-1 cannabinoid (CB1) receptors, while the CBG was found to act through a secondary method that did not engage the CB1 or CB2 receptors of keratinocytes (HaCaT cells). It was also revealed that cannabidiol increased global DNA methylation levels.

The study concludes that cannabis could act as a primary treatment for epidermal ailments:

“These findings identify the phytocannabinoids cannabidiol and cannabigerol as transcriptional repressors that can control cell proliferation and differentiation, suggesting (especially for cannabidiol) a possible exploitation as lead compounds to be used in the development of novel therapeutics for skin diseases.”

This report was conducted by researchers at the University of Teramo, the Campus Bio-Medico University and the Santa Lucia Foundation, all located in Italy.

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Ohio: Legislation introduced to legalize medical use of cannabis

Ohio: Legislation introduced to legalize medical use of cannabis

Folks you can make history by voting on this measure by entering your zip code and filling out the form here.  So express yourself and go fill out this form.

From NORML:

Representative Robert F. Hagan (D-Youngstown) has introduced legislation, House Bill 153, to protect patients who engage in physician authorized marijuana therapy.

House Bill 153 would allow patients with a physician’s recommendation to possess up to two hundred grams of usable marijuana and grow up to twelve mature marijuana plants. You can read the full text of the measure here.

According to a May 2013 Fox News nationwide telephone poll of 1,110 adults, 85 percent of Americans favor allowing doctors to authorize specified amounts of marijuana for patients suffering from serious illnesses.

Since 1996, eighteen states and the District of Columbia have approved legislation allowing for the use of cannabis therapy by qualified patients.

NORML will continue to update you in the coming weeks as this proposal moves forward. You can get further information on this measure from Ohio NORML here.

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