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Is Cannabis Right for You?

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Is Cannabis Right for You?. Dr. Nick Salamie PharmD, RPh. Cannabis Prohibition. Henry Jacob Anslinger US Drug Czar 1930-1962 Major Role in War on Cannabis Spread False Information Marihuana Tax Act of 1937 Implemented an Excise Tax Destroyed Hemp Industry Opposed by AMA Richard Nixon

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Is Cannabis Right for You?

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  1. Is Cannabis Right for You? Dr. Nick Salamie PharmD, RPh

  2. Cannabis Prohibition • Henry Jacob Anslinger • US Drug Czar 1930-1962 • Major Role in War on Cannabis • Spread False Information • Marihuana Tax Act of 1937 • Implemented an Excise Tax • Destroyed Hemp Industry • Opposed by AMA • Richard Nixon • “War on Drugs” • 1973 DEA Creation

  3. Facts • No deaths from Cannabis ever! • ~44 deaths from RX Opioids a day • Does NOT cause respiratory depression • Used as a Medicine for 1000s of years

  4. Current Laws • Federally Illegal • Schedule I • Same level as heroin, LSD, Meth • Alcohol NOT scheduled • Cocaine schedule II • Medical Cannabis • 33 States • District of Columbia • 4 U.S. Territories • Recreational Cannabis • 10 States • District of Columbia • Northern Mariana Islands • Illinois Laws • Medical Only • 41 Qualifying Conditions

  5. AIDS • Alzheimer’s Disease • ALS • Arnold-Chiari Malformation • TBI and Post-Concussion Syndrome • Cancer • Cachexia • Causalgia • Chronic Inflammatory Demyelinating Polyneuropathy • CRPS • Crohn’s Disease • Dystonia • Fibromyalgia • Fibrous Dysplasia • Glaucoma • Hepatitis • HIV • Hydrocephalus • Interstitial Cystitis • Lupus • MS • Muscular Dystrophy • Myasthenia Gravis • Myoclonus • Nail-Patella Syndrome • Neurofibromatosis • Parkinson’s • PTSD • Reflex Sympthetic Dystrophy RSD • Residual Limb Pain • RA • Seizures • Sjogren’s Syndrome • Spinal Cord Disease • Spinal Cord Injury • Spinalcerebellar Ataxia • Syringomyelia • Tarlov Cysts • Terminal Illness Prognosis • Tourette’s Syndrome

  6. Non-Qualifying Conditions • Arthritis • Chronic Fatigue Syndrome • Depression • Diabetes • Insomnia • Migraine and Headache • Nausea and Vomiting • Neuropathy • Osteoporosis • Pain • Sexual Dysfunction

  7. Endocannabinoid System • Found in all animals • CB1 and CB2 receptors • Located all over body • Anandamide and 2-AG • Balance In the body • Pain Modulation • Phytocannabinoids as treatment • THC • CBD

  8. Endocannabinoid System • Alzheimer's Disease • Regulates Memory • Phytocannabinoids as treatment • THC • CBD • Endocannabinoid Deficiency? • Possibly Underlying Cause of Idiopathic Conditions

  9. THC • One of the major therapeutic cannabinoids • Beyond the psychoactivity (High) • Anti-inflammatory • Analgesic • Neuroprotective • Increased Potency via Gastrointestinal absorption • Side Effects • Anxiety • Dizziness • Rapid Heartbeat • Go LOW and SLOW!

  10. CBD • Second most prevalent therapeutic cannabinoid • NO prevalent psychoactivity (High) • Eliminates some of THC’s adverse effects • Sedation • Hunger • Therapeutic value • Anti-inflammatory • Anti-convulsant • Anxiolytic • Side effects • Headache • Diarrhea • Agitation • Sedation • CBD more effective with THC: “Power Couple” • Hemp vs. Whole Plant CBD

  11. First PDI Visit • Goals • Increase Quality of Life • Drug Interactions • Assess Patients Cannabis Experience • No or little cannabis experience • Intermediate cannabis experience • Advanced Cannabis Experience • Tapering Strategy if Necessary • Product selection and initial strategy • Minimum Effective Dose • Follow Up

  12. Dosage Forms • Inhalation • Combustion • Vaporization • Ingestible • Edibles • Oils (RSO) • Tablets/Capsules • Sublingual/Buccal/Oromucosal • Topical • Transdermal

  13. Recent News • “Medical pot: Elixir for the elderly?” • By Dennis Thompson • Dr. Laszlo Mechtler • Senior Researcher • 204 patients • Over 75 years old • Pain • 7 of 10 patients experienced symptom relief

  14. Getting Your Cannabis Card • Formal Diagnosis of 1 of the 41 qualifying conditions • Completion of Physician Written Certification Form by a Licensed Physician • Fingerprint/Background Check • Completion of Online Registration and and Payment • Provisional Registration

  15. Resources • Backes, Michael, et al. Cannabis Pharmacy: the Practical Guide to Medical Marijuana. Black Dog & Leventhal Publishers, 2017. • “Harry J. Anslinger.” Wikipedia, Wikimedia Foundation, 20 Mar. 2019, en.wikipedia.org/wiki/Harry_J._Anslinger. • Jenison, David. “Was Harry Anslinger a Racist?” PRØHBTD, prohbtd.com/was-harry-anslinger-a-racist. • “Marihuana Tax Act of 1937.” Wikipedia, Wikimedia Foundation, 11 Mar. 2019, en.wikipedia.org/wiki/Marihuana_Tax_Act_of_1937. • Russo, Ethan B., and Jahan Marcu. “Cannabis Pharmacology: The Usual Suspects and a Few Promising Leads.” Cannabinoid Pharmacology Advances in Pharmacology, 2017, pp. 67–134., doi:10.1016/bs.apha.2017.03.004. • Salamie, Nicholas PharmD, RPh. “Alzheimer’s Disease and the Alternative to Opioids Act.” Powerpoint File. • Thompson, Dennis. “Medical Pot: Elixir for the Elderly.” Chicago Tribune, 27 Mar. 2019. • “War on Drugs.” Wikipedia, Wikimedia Foundation, 22 Mar. 2019, en.wikipedia.org/wiki/War_on_drugs.

  16. Questions

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