04/29/12 Amanda Reiman

Program
Cultural Baggage Radio Show

Reports from Patients out of Time Conference on Cannabis Therapeutics in Tucson with Dr. Amanda Reiman, ALS patient Cath Jordan & Federally supplied cannabis patient Irvin Rosenfeld

Audio file

Transcript

Cultural Baggage / April 29, 2012

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Broadcasting on the Drug Truth Network, this is Cultural Baggage.

“It’s not only inhumane, it is really fundamentally Un-American.”

“No more! Drug War!” “No more! Drug War!”
“No more! Drug War!” “No more! Drug War!”

DEAN BECKER: My Name is Dean Becker. I don’t condone or encourage the use of any drugs, legal or illegal. I report the unvarnished truth about the pharmaceutical, banking, prison and judicial nightmare that feeds on Eternal Drug War.

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DEAN BECKER: Welcome to this edition of Cultural Baggage. Today I’m reporting from Tucson, Arizona where I’m attending the Patients Out of Time conference dealing with the subject of cannabis. Every other year Patients Out of Time sponsors this major conference with doctors and scientists, nurses and other practitioners to talk about cannabis and its use as a medicine and the science which indicates more and more maladies, more and more conditions can, in fact, be treated positively with cannabis.

First up we’re going to hear from Dr. Amanda Reiman. She’s with the Berkeley Patients Group.

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AMANDA REIMAN: Today what I’m talking about is cannabis as an exit drug. So we are very familiar with the gateway theory and now we’re learning more about how individuals are using cannabis to move out of the addictions that they have found with other substances. So that’s what I’m going to be talking about today. I’m looking at the use of cannabis as an exit drug, treatment versus substitute.

So first I want to give a little bit of a context. You know right now in that cannabis industry and in the movement we are experiencing a bit of a mixed message. We do have this umbrella of therapeutic but underneath that we’re seeing two camps emerging. One that’s talking about cannabis more as a recreational, wellness model - a nutritional, dietary supplement as you will. And another group that’s talking about it more as an actual cure for various disease states.

So what this does for the public, at least, and for those individuals who are in society trying to find answers to their medical questions, is that it sends a bit of a mixed message. Then on top of this we have, of course, the Schedule I barrier which prevents us from doing research with human beings with whole plant medicine. And then we also have this moral, philosophical viewpoint of deontology where the belief is that the behavior of ingesting illicit substances is bad regardless of the consequences.

So this ends up with drug policies that treat all illicit drugs as if the consequences of their use is the same even though we know that is not true. This has also stifled the conversation about how to move forward and apply cannabis in a clinical setting with human beings.

So we’re seeing this continuum of cannabis. On one side we have wellness and on one side we have cure. What I’m going to talk about today is that in the context of drug addiction treatment we are seeing individuals utilize both ends of these continuums in order to treat their addiction and to reduce their use of other substances.

Something else we’re seeing is that dispensaries are kind of in the middle of all of this because there’s not a lot of education for M.D.s around how to talk about cannabis in clinical practice you see a lot of individuals coming to dispensaries asking questions about clinical applications - asking questions about different conditions that cannabis might be used for and how they can choose the correct medicine for them.

So dispensaries are put in the position of almost being that catalyst of health care services. So they also really need to know how cannabis can be utilized in this way so that they can give better information to their patients.

On the wellness side we have things like the raw plant, life enhancement, natural remedies and maintaining balance in the body. And on the curative side, which we’ve heard a lot about at this conference, we have the endocannabinoid system, we have research on receptor activity – curative properties of cannabinoids but also, in the end, maintaining balance.

When we look at why patients use medical cannabis we see that very naturally their behavior is covering both ends of the spectrum. So this is data from 200 randomly selected charts from MediCann. There were individuals that were coming to renew their medical cannabis recommendations in California.

68.9% of them were using cannabis as a substitute for prescription drugs. 81.1% report cannabis as being very effective. 22.8% said that they needed to use more cannabis over time but of those almost 86% were able to reduce their cannabis use when they wanted to.

So this is how we’re kind of seeing the patient population utilizing cannabis and in terms of why they’re using it. This shouldn’t be anything new. We’ve seen a lot of research supporting that the most popular reasons for patients using, at least in the state of California, are pain relief, sleep, relaxation and a prescription drug substitute. These may be thought of in more of the natural remedy/wellness end of the cannabis spectrum but then you also see things like anti-diarrhea, anti-itching, preventing seizure, preventing involuntary movement and this speaks a lot more toward the curative model. We’re talking about the impact of the taking in cannabinoids on the signaling and the endocannabinoid system.

So what I want to present today is this idea of cannabis as a treatment for addiction. So kind of given this context there are these mixed messages, kind of under this auspice of Schedule I and deontology and given that the medical cannabis patient population is already utilizing cannabis both to treat symptoms of an illness but also to treat the illness itself. It stands to reason that we can apply this model to various clinical applications such as addiction.

So in this model we’re really looking at a holistic health model – a combination of wellness, biology and complimentary and alternative medicine. When we talk about wellness we are talking about substitution. We’re talking about the mind-body connection and we’re talking about harm reduction. Ways to encourage a mind-body connection so that individuals have more of a control over their own behaviors.

When we talk about complimentary and alternative medicine we are talking about introducing techniques such as massage, acupuncture, chiropractic care, meditation and other herbs into this treatment as well.

And then, finally, on the biological side you have things we’ve been hearing more about at this conference such as Greg was mentioning – the ability of cannabinoids to block receptors in the brain responsible for sending signals for craving.

And then, again, you have dispensaries there in the middle. Now one of the amazing things about many dispensaries is that they’ve already adopted this model. Berkeley Patients Group, for example, we offer massage and chiropractic and acupuncture free of charge for our patients. Other dispensaries have meditation programs. They do bring research into patients so that they can learn about the endocannabinoid system and the different functions that it has. And they have harm reduction classes and harm reduction education for patients as well.

So we are seeing this model being exhibited in dispensaries which makes it an amazing venue for studying the use of cannabis as a treatment for addiction.

So the study that I’m going to be speaking on today is actually “hot off the presses” you could say. I just analyzed these results last week and I’m really excited to be bringing them to you today.

So there’s a dispensary in San Francisco called Spark. It’s a phenomenal, phenomenal dispensary. In addition to having a wide variety of medicines and cannabis-infused products for their patients they have a whole host of alternative health classes and programs free of charge such as Chinese herbal medicine, consultations, massage, acupuncture. They work with local harm reduction centers in San Francisco. It’s a really good example of an institution that’s able to bring this model together.

I helped them conduct a study. They had been offering meditation for some time now taught by this wonderful woman whose a Buddhist monk in conjunction with a Chinese herbal alternative medicine center in San Francisco. They wanted to know if this program was doing anything.

You know they had patients come and do the meditation. Afterwards they would say, “Oh, I feel great.” And “That was wonderful.” But they wanted to know is it really doing anything for these individuals in terms of changing their behavior.

So we decided to design a study. We recruited 8 medical cannabis patients from a local harm reduction center who were actively using methamphetamine and participating in harm reduction. There were 6 men and 2 women. Of the 8, 5 were active meth users at intake and 3 of them were former users at intake.

They participated in 6 one hour meditation sessions that were led by this bhuddist monk and were compensated with 2 grams of cannabis per week from the dispensary. They’re all qualified patients and were able to choose whether they wanted to get Indica, Sativa or one gram of each.

Then what we did is administer a standardized scale of mindfulness and drug craving at baseline before and after each meditation session which lasted an hour. We also asked them to keep daily logs of whether they meditated that day and also whether they used alcohol that day, cannabis that day or methamphetamine that day.

So these are the results.

First we conducted baseline interviews with all of the participants to ask them about their drug and alcohol history, especially their history of cannabis and methamphetamine use and their history of meditation. It’s interesting, you know, listening to Greg’s talk, because we talk about this idea of relapse.

When I was interviewing these individuals of the 8 every single one of them related to me the same thing. And that’s when I asked them if they had used cannabis previously to try to stop or reduce their use of methamphetamine. As they were explaining that phenomanum in their own lives each one of them reported the same thing.

“When it’s late and I’ve been up for several days using methamphetamine and I know I should go to sleep and I know I shouldn’t go back out and use more meth but something in my head is telling me to go out and use more meth. If I smoke a joint that voice goes away and I’m able to go to sleep and I’m able to ignore this craving to go use meth and then I wake up the next day and I feel better.”

And each one of them said that. I think that that really speaks to the potential of cannabis to help prevent relapse right in a moment of craving. So that was something really interesting that came up in the baseline interviews.

We did a regression analysis to look at the relationship between total days spent meditating, total days spent using cannabis and reductions in craving scores, increase in mindfulness scores from week 1 to week 6. Days spent meditating did significantly predict a reduction in craving and an increase in mindfulness from week 1 to week 6.

Cannabis use is on its way to being significant. Again, this is a small sample but we definitely did see that those who were using cannabis did enjoy an increase in mindfulness and a decrease in craving.

Most participants used cannabis daily. So we had 8 participants. In a given week most were using cannabis 5, 6, 7 days a week. However, during the study, their amounts of alcohol and methamphetamine use remained extremely low.

So, again, going back to Greg’s talk and thinking about this idea of the gateway theory and does the frequent use of one substance such as cannabis lead to the frequent use of other substances such as alcohol and methamphetamine and what we’re seeing here is that no, that these individuals were maintaining very high levels of cannabis use but were able to maintain reduced use of alcohol and methamphetamine.

So one patient in particular that I wanted to point out because it’s a really remarkable case. He was a 43-year-old male that was using alcohol, cannabis, nicotine and methamphetamine at the start of the study. Throughout the 6 weeks he had consistent reductions in craving and consistent increases in mindfulness. He meditated 6 to 7 days per week throughout the study.

Drinking days per week ranged from 0 to 3 days per week and meth using days per week ranged from 0 to 1 and he used cannabis every day. So I think this is a good example of a more successful case where an individual is able to maintain high levels of cannabis, bring mindfulness into their practice and enjoy reduced levels of the substances that they were trying to avoid.

So what are some implications from a study like this? Again, it’s an extremely small sample. It’s self-report. We didn’t do blood tests on them. We don’t know for sure that what they were telling us was the truth. But these were individuals that were very highly engaged in their own treatment. These were individuals that were visiting harm reduction centers on a very frequent basis and were coming into the dispensary on a very frequent basis.

So what we’re seeing is that a combination of cannabis and mindfulness practice might be effective at reducing the use of other substances such as alcohol and methamphetamine and that there seems to be a dose response relationship and that the more someone was meditating the more they were enjoying the reductions in carving and the increase in mindfulness.

That cannabis assists in the reduction of other substances both through brain signaling and behavioral substitution. So just as individuals were talking about the ability of cannabis to quiet the addictive voice that was telling them to go on and use more methamphetamine they also spoke about the ability of cannabis to help them sleep, to reduce anxiety, to take the edge off withdrawals associated with methamphetamine use and as an aside the ability of cannabis to take the edge off withdrawals also really helps in reducing the risk of relapse because many times individuals will relapse when withdrawals get too intense.

So we’re talking about that mechanism and we’re also talking about a psychoactive substitute. You know, individuals that are seeking to alter their brain chemistry, individuals that are seeking to alter their perceptions who have found that the substances they were using in the past were causing multiple harms in their lives and find that they can get that same satisfaction from a substance that isn’t causing harm in their lives.

So, again, in this model we’re really seeing these two different types of cannabis emerge. We’re seeing the brain signaling model and we’re also seeing kind of the palliative, well-being, quality of life model as well.

We also see that it is possible for those wishing to reduce or stop their drug use to utilize cannabis frequently while reducing or eliminating the use of other substances. One of the issues that a lot of patients have come to me with is that they want to go to NA or AA. So they go because it’s great. It’s everywhere. You can always find a meeting and it’s free. That’s one of the reasons it’s one of the most widely utilized addiction program there is.

But they go in and everyone is talking and it comes out that they’re medical cannabis patients and that’s it. All of the sudden you know, “Goodbye. Come back when you’re sober. We don’t want to deal with someone that’s in denial.”

So it can be really difficult for them to convince people that, “No, I am clean from the substance that I was having such a problem with. This is my medicine. This is what I’m using to stay clean.”

So that stigma is still out there. It’s difficult for that to be accepted in the traditional treatment world which is why you are seeing more and more dispensaries having harm reduction and substance abuse programs held actually in the dispensary so that individuals that are attending already know that that part of their treatment is going to be accepted by those who are providing treatment for them.

The Schedule I status of cannabis use and the deontological framework of drug policies are barriers to discovering the full range of therapeutic benefits. We talk about the Schedule I status a lot but I really wanted to talk more about this moral philosophical framework of deontology because I think it’s something that‘s embraced by drug education such as DARE. I know from myself when I got out of the DARE program I thought that crack, methamphetamine, pot were all the same and were all going to same thing to me and that’s because the focus was on the behavior. The behavior is bad regardless of the consequences. So I would really like to see this come more in our conversations about why we’re having trouble moving past this idea of prohibition to actually talking about a more realistic public health-based regulation of drugs in the U.S.

The active components of cannabis have promise of treating addiction via the body’s messaging system so more as a treatment. I would love to see a severe alcoholic go into the hospital for detox and be given an IV drip with cannabinoids in it to help prevent seizure and to make them feel better. It makes sense to me. So maybe we can work on that after the conference.

.The palliative effects of cannabis can assist in reducing cravings and the chance of relapse while providing a safer psychoactive substitution. So here we’re talking about that wellness model, about keeping the body in balance by introducing cannabinoids into the system instead of other substances.

And that dispensaries can act as a nexus for the provision of both types of cannabis therapy. So I want briefly mention a study that was just published I believe last week in the Harm Reduction Journal that was co-authored by myself and Jennifer Janichek form Harborside Health Center. Where she surveyed 303 patients from Harborside Health Center and found that 40% want more information on harm reduction and 20% would participate in harm reduction and other therapeutic groups if they were offered.

So there is a huge opportunity here to really help individuals that have not found satisfaction with traditional substance abuse programs to invite them into the medical cannabis world and to help provide that holistic health model that seems to be working for those individuals that engage in the use of cannabis as a treatment for addiction.

So thank you and enjoy the rest of the conference.

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DEAN BECKER: As I file this report the conference is still ongoing. There’ll be much more next week as well as on this week’s Century of Lies and 420 reports.

As a side note I wanted to report that when I quit alcohol some 26 and a half years ago I went to AA for about 6 months and then I happen to mention that I used medical marijuana to help me stay sober, safe and sane – they kicked me out, too.

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It’s time to play Name That Drug by Its Side Effects!
Headache, fatigue, nausea, dizziness, irregular pulse, skin discoloration, weakness, amnesia, agitation, loose stools, coughing, taste perversion, tremors, arrhythmia, cardiac failure and death…

{{{ gong }}}

Time’s up!

From Pfizer Laboratories, Caduet, for high blood pressure and high cholesterol.

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DEAN BECKER: Please listen closely…

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DEAN BECKER: OK it’s the first day of the Patients Out of Time conference. I’m here with Cathy Jordon. She’s a story that you need to hear about.

Cathy, tell us about your medical problems, please.

CATHY JORDON: I have ALS, Lou Gehrig’s Disease. I was diagnosed in 1986 when I was 36-years-old.

DEAN BECKER: Now, Cathy, you’ve been very much involved in trying to educate the American people to the benefit of cannabis, have you not?

CATHY JORDON: Yes I have. I’m active because when I realized that it made my disease stop I first told my doctor and he had thought I was delusional. So he suggested a mental ward so I didn’t take anything for about 6 years and then, of course, I was still alive and after being [inaudible] at the last conference I learned that cannabis is [inaudible] and an antioxidant and an anti-inflammatory I presumed that cannabis would be the best [inaudible].

DEAN BECKER: Now you have not let your maladies stand in the way of your progress, so to speak. I met you first about 11, 12 years ago during the Texas Journey for Justice. You and another associate were in your wheelchairs out in front of this caravan, were you not, and participated in the march in Austin and it wore you out pretty good, did it not?

CATHY JORDON: It wore me out but I met a woman, Alice, and I really felt good about it because her husband had ALS and when he passed away she used to sit in bed at night and blow smoke in his face. He said it was the only time that he felt normal.

I yelled at her for years because she felt that she had hastened her husband’s death. I said I would have sat on that bed and blew smoke on his face morning, noon and night.

DEAN BECKER: Speaking of that Journey for Justice in Texas. I remember that we made a trip around the State House and I saw you were very, very tired. You could barely speak and there was a joint that got passed around. What happens to you when you enjoy a bit of cannabis?

CATHY JORDON: Actually I hide this [inaudible] because the summer is so hot that my arms were twisting. I rarely smoked out in public especially in the Austin Courthouse. But I was beginning to have muscular problems so I had to medicate or I would not have been able to speak.

DEAN BECKER: It was that moment when I saw the change in you that, indeed, cannabis can be an immediate benefit and especially to people with severe maladies like yourself.

CATHY JORDON: I appreciate that but don’t remember that far back. But, yes, it is a medicine. I have been working with the ALS Association and trying to get the message out there for patients to be their own advocates.

DEAN BECKER: Alright, once again, we’ve been speaking with Cathy Jordon – a hero in my book.

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DEAN BECKER: And speaking of heroes, long-time listeners of the Drug Truth Network know of our next guest from his many visits to our shows. We’re here in Tucson attending the Patients Out of Time conference on cannabis and we have one of the four surviving, federally-supplied medical marijuana patients, Mr. Irv Rosenfeld.

IRVIN ROSENFELD: It’s good to see so many people here learning about the benefits of medical cannabis and to think that Bob Randall helped start this in the 70s it makes me feel really good and I have Bob looking down upon us and smiling.

DEAN BECKER: Yeah and I gained a lot from the couple of presentations we’ve seen thus far but they’re not going to translate to radio very well. Could you give kind of a summation of what you’ve heard.

IRVIN ROSENFELD: What I heard today is that if you smoke cannabis it helps beneficially for your medical conditions or for your overall standard of living in benefit to how we want to survive, that the human body needs it and that it’s important for us.

DEAN BECKER: Yeah, a lot of talk about endocannabinoids and how it’s beneficial for us and a whole host of other diseases and maladies, right?

IRVIN ROSENFELD: That’s very true. And daily living. It’s how the body needs it and how it’s important to us.

DEAN BECKER: We’re outside the conference, outside the building for a moment and you’re sitting here smoking some government-supplied cannabis, correct?

IRVIN ROSENFELD: That is correct. I smoke 10 to 12 cannabis cigarettes a day supplied to me by the federal government and they’ve been supplied to me for over 29 years.

DEAN BECKER: And, again, you’re one of 4 people in America that can do this legally, correct?

IRVIN ROSENFELD: That is true. I’m not breaking any law because I’m under federal guidelines so therefor state laws don’t affect me and, again, this conference shows that I’ve been right as far as it works for me and that people need this. This conference is proof of that.

DEAN BECKER: You are author of a great book, “My Medicine.” It talks about how the hoops you had to jump through and how the process whereby you became legal, right?

IRVIN ROSENFELD: That’s very true. It took me 10 years of fighting the federal government, arguing or educating and it just proved out that what I knew 40 years ago is true.

Again, I’m not a doctor, I’m not a scientist – all I know is that I take my medicine and it helps. This is the scientist here are proving and saying why it helps medically.

DEAN BECKER: Do you want to point folks to your website?

IRVIN ROSENFELD: To order my book and learn more about medical cannabis is http://mymedicinethebook.com You can order an autographed copy of my book and learn the whole history of medical cannabis in this country as seen through my eyes and, more importantly, learn how a regular person can educate the federal government and be able to provide information where, nationally and internationally, that cannabis works on the body.

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(music)

DEAN BECKER: Ladies and gentlemen, this is the Abolitionist Moment.

Prohibition is an awful flop. We like it.

It can’t stop what it’s meant to stop. We like it.

It’s left a trail of graft and slime. It don’t prohibit worth a dime.

It’s filled our land with vice and crime…nevertheless, we’re for it.

Franklin Adams, 1931

Through a willing or silent embrace of drug war we are ensuring more death, disease, crime and addiction.

Some have prospered from a policy of drug prohibition and dare not allow their stance taken to be examined in a new light.

But, for the rest, ignorance and superstition will eventually be forgiven.

What Houston has done, in the name of drug war, will never be forgotten.

Please visit http://endprohibition.org Do it for the children.

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DEAN BECKER: That was the sound of my little portable recorder going into the trash. I hope you will do your part soon to end the madness of drug war. And, as always, I remind you that because of prohibition you don’t know what’s in that bag. Please, be careful.

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DEAN BECKER: To the Drug Truth Network listeners around the world, this is Dean Becker for Cultural Baggage and the Unvarnished Truth.

This show produced at the Pacifica Studios of KPFT Houston.

Tap dancing… on the edge… of an abyss.

Transcript provided by: Jo-D Harrison, R.I.P. Billy Ray Harrison who passed away on September 6, 2003 after fighting ALS for 5 years :(