Cannabis Politics, Science and Healing – O’Shaunessy’s


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O’Shaughnessy’s | The Journal of Cannabis in Clinical Practice

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Medicine is an endlessly evolving field. My patients deserve better. We have such limited tools.

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One medication has been excluded from study and from native use and understanding for decades. Libraries, seeds, plants, doctors, and lives have been destroyed. Cannabinoid receptors have been found in creatures as old as algae. You have more in your body than any other type. Think immune system and cardiovascular system and bone. Bone. Too bad we know nothing about it.

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I will give you several examples, below, why this journal is important. Laws are being written behind closed doors. Lawmakers are blocking enormous cost effective progress in medicine, not least of which is the ability to use a plant for stress and relaxation that your body has never been able to do without its help. What they are doing.

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Disclaimer: I have written recommendations for cannabis for fewer than 10 patients in 41 years of medicine. Cannabis is one of the world’s oldest and most valuable medications. There are people who should not use cannabis, especially a risk for those with mood disorder, cardiac arrhythmias, heart attack, stroke.

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O’Shaunessy’s is not a fluff journal for medicine or politics. It’s been a brutal fight for people who want to or need to use cannabis for its many benefits. Brutal for many doctors, for hospice patients, for anyone with medical needs who want a choice to use a plant rather than synthetic drugs, and those who want a different way to relax and enjoy time away from work without having to use alcohol. And for those who cannot afford more. Heaven forbid you should not grow to help others, even if they are too old or disabled to do it themselves.

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O’Shaunessy’s has several new articles on CBD, including how Senator Mitch McConnell got DEA to allow Kentucky farmers to grow hemp [high CBD].

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As lawmakers prepare the latest restrictions on use of medical cannabis behind closed doors, restrictions may prevent the best known California cannabis doctors from practicing. Those are the ones with most to teach after  years of clinical experience caring for patients with this ancient medication that has been used as well for spiritual purposes, creativity and relaxation.

270-member Society of Cannabis Clinicians protests aspects of the guidelines

Fred Gardner’s journal O’Shaughnessy’s has carried in-depth coverage of the most important issues for years.

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Fred reports on the laws and lawmakers who look at high volume cannabis practices. They should also look at high volume psychiatry. It’s required of psychiatrists at university clinics to dispense 2 to 5 or more antipsychotic drugs to psychotic patients —-one complex patient every 10 minutes.  Volume psychiatry mills. That is the standard for disabled patients who cannot afford more, a place to monitor and refill pills. Psychiatrists who have no choice or just starting in practice work there, high volume with the most dangerous drugs to the most dangerous unstable population we have. Toxic drugs in complex combinations on unstable patients. Next patient every 10 minutes.

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Why should a person who has anxiety not be able to choose – with a physician of their choice, especially a physician who is familiar with or at least not close minded – to test if cannabis helps better than Xanax . Especially when Xanax is known to cause Alzheimer’s disease, depression, addiction, and potential  overdose.

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Consider, if pain causes anxiety, is it better for a patient who is prescribed an opioid for chronic pain to add Xanax that increases risk of overdose? or cannabis that is also anti-inflammatory and can be used to help sleep when pain is too severe?

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Which would be better after major surgery: an opioid that causes inflammation and suppresses respiration or cannabis that reduces inflammation and pain? Don’t worry, we will never be allowed to test it in hospital, but people are known to sneak in canisters of tea or milk and patients need less opioid so their lungs and brains are not sedated, they can breathe, breathe much more deeply thus lower risk of pneumonia.

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Conundrum

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Consider, if you had failed spine surgery and cannabis gave some relief from spasm and pain and insomnia but nothing else had helped. It took years of hard work every month with pain specialists, nothing else worked. Genetic testing confirms. One patient had double mastectomy and later surgery for oophorectomy with no opioids — they simply didn’t work. What if, in your case, there’s a bad history of alcoholism that destroyed your family. You don’t want to risk opioid addiction but you need big surgery. You cannot get pre-operative clearance for cannabis from your cardiologist even though it is the only thing that helps you. Families risk cardiovascular problems when they sneak it in to hospital — we’ve all heard those stories for decades.

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And no, absolutely do not think I am advising you to take cannabis. That is likely against the law, just like it is against the law to tell a patient where to purchase cannabis safely, at respected sources in ratios of CBD to THC. I do not advise you to take cannabis to hospital, just because that was legal in Israel years ago, as long as conditions were met. Some people choose not to take opioids for hospice or near death.

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Would you rather live in an ICU doped up on opioids and Valium on a respirator or surreptiously taking cannabis when cardiologists do not know what is causing the cardiac arrhythmia —- cardiovascular potential, think THC.

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O’Shaunessy’s covers new dangers that lie ahead for doctors who prescribe. Story from O’Shaughnessy’s, below, on behind the scenes maneuvering of lawmakers.

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And rays of hope, like CBD for epilepsy in children, Fred interviews the team from GW Pharmaceuticals, UCSF, NYU Medical School, and presents the data from neurology meetings.

From the CBD article:

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proved beneficial in animal studies —and
for which Epidiolex [GW Pharmacuetical’s CBD] has been given orphan
drug status— is Neonatal Hypoxic-
Ischemic Encephatopathy, or NHIE (brain
damage caused by oxygen deprivation during
delivery).

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“In neonatal hypoxic-ischemia,” says
GW chairman Geoffrey Guy, MD, “you’ve
got an underlying inflammatory process
which is massively exaggerated by excitotoxicity
after each seizure, which is setting
up the next seizure in a way. It’s not enough
to treat just the seizures without treating
the underlying inflammatory encephalitis
and the damage to neuroplasticity.
“Children’s brains are very plastic and
can usually work around issues, but if
you’re having continuing seizures and
continuing inflammation, that ability will
be dampened. We’re hoping from the preclinical
work that cannabidiol will address
a number of these different issues, not just

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“There is evidence that the Federation of State Medical Boards is a shill for Big PhRMA. Starting in the 1990s, the FSMB, with funding from opioid manufacturers, pushed less restrictive prescribing guidelines that contributed to the current epidemic of addiction and death by overdose.”

Story from O’Shaughnessy’s, below

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How Senator Mitch McConnell got DEA to allow Kentucky farmers to grow hemp [high CBD]. They now lead the nation in producing CBD yet in California, DEA was allowed to raid and destroy the entire production of CBD capsules from California, one day after showing its high standards to city officials. CBD can stop one type of epileptic seizures in some children who have hundreds of seizures per day: Charlotte’s Web. Story from O’Shaughnessy’s.

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The little I know of cannabis, I owe to the instantly helpful, amazing Fred Gardner, who founded O’Shaughnessy’s. Thank you for your help, your investigative work, your connections, your life’s work, Fred. Wikipedia forgot to mention he was in medical school.

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Wikipedia says

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Fred Gardner is an American political organizer and author best known for his opposition to the Vietnam War and his writings about the medical mariijuana movement in the United States.

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Gardner received his bachelor’s degree from Harvard in 1963. He has been an editor at Scientific American, a private detective, a songwriter, an author, a freelance journalist, one of the credited screenwriters for Zabriskie Point directed by Michelangelo Antonioni, the owner of Variety Home Video, the editor of Synapse (the UCSF Medical Center student newspaper), and Public Information Officer for the San Francisco District Attorney’s office under Terence Hallinan.

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In the fall of 1967 Gardner, with Donna Mickleson and Deborah Rossman, started a coffeehouse in Columbia, South Carolina, that became a hang-out for GIs, an alternative USO called the UFO (United Freedom Organization). Gardner covered the court martial of 27 GIs charged with mutiny at the Presidio of San Francisco in October 1968 and wrote a book about the case, The Unlawful Concert, published by Viking in 1970 and reissued by Gryphon Press in 2005.

In April 1970, Gardner worked as a stage manager for Free The Army (FTA) with actors Jane Fonda and Donald Sutherland. This travelling road show for soldiers was meant to counter USO shows put on by Bob Hope. Gardner is a frequent contributor to CounterPunch. He is a long-time contributor to the Anderson Valley Advertiser.

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In 2003, Gardner launched O’Shaughnessy’s Journal of Cannabis in Clinical Practice, a journal in which doctors of the Society of Cannabis Clinicians, monitoring cannabis use by patients could share their findings and observations, and be kept abreast of relevant scientific and political developments. Martin A. Lee has been associate editor since 2009.

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Gardner currently lives in Alameda, California with his wife Marci. He has six sons and a daughter.

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The journal is doing important investigative journalism, to name just a few from :

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O’Shaunessy’s Winter 2015/2016 Print Edition

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CBDiaryHow we broke the cannabidiol story —and the ongoing ramifications.

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Off-Topic is the context in which marijuana prohibition exists —a vast terrain full of contradictions and treacherous peaks and canyons where “Cannabis activists” are told by “Reform leaders” not to stray.

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Going digital is still new for O’Shaunessy’s:

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A Work in Progress

Building this site
in plain sight
we cite Bertolt Brecht—

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“And please make
my curtain half-height, don’t cut the stage off.
Let the spectators leaning back
notice the busy preparations being made
so ingeniously for them, a metallic moon
comes swinging down, a shingle roof
is carried in; don’t show them too much
but show them something. And let them observe
that this is not magic but
work, my friends.”

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 From O’Shaunessy’s Winter 2015/16 issue on CBD

CBD is the non psychoactive cannabinoid in the plant that has at least 86 cannabinoids. It blocks THC

“Many farmers are doing ‘dual harvest,’Boucher explained. “If you’re growing for fiber, are you going to throw that CBD in
the flowers away? If you grow hemp for
seeds, why throw that CBD away? That’s
money for the farmer.”
Boucher credits Senators Mitch McConnell
and Rand Paul and Kentucky Ag Commissioner
James Comer for intervening
in 2014 when the Drug Enforcement Administration
confiscated seeds before they
could reach hemp farmers. David Bronner,
head of Dr. Bronner’s Magic Soap Company,
paid for the lawyers who got the crucial
injunction that ended the confiscation.
“McConnell made them back down last
year and this year the DEA didn’t interfere
at all,” says Boucher. “They were helpful,
in fact.”

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It was politically shrewd of McConnell,
the Senate Republican leader (and faithful
shill for the mine owners) to support the
hemp industry because he was facing a
serious challenge from a Democrat in November
2014. According to an observer of
Kentucky politics, “He would go to town
meetings and rallies, and the first question
—the first three questions— would always
be about hemp. And he’s like, ‘Wait a second,
this is a litmus test for the farmers.
If this is what they want, I’ve got to get behind this.”

behind this.’ And it was funny,
after about the second or third
rally he would say ‘Watch this,
I bet you the first question is
going to be about hemp.’ And
of course it always was.”
Kentucky farmers made
three times more per acre
growing hemp in 2015 than
growing tobacco (which used
to be government-subsidized),
according to Boucher; and 10
times more than they would
have growing corn.

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He said hemp companies were paying
“anywhere from $1,800 a ton, dry
weight—that’s barrel-bottom price—for
the top 2.5 feet of their plants.”
Companies purchasing hemp stalks plan
to make a wide range of products, from
horse bedding to fine textiles. CannaVest
donated seeds to the Growing Warriors, a
veterans group that is making American
flags from hemp. “They process it the oldtime
way,” Boucher says. “They watered
down the fibers, use an old hemp brake,
take the fiber to hand weavers.”
Boucher expects to be scaling up in the
period ahead. He foresees a market of 40
to 50 million Americans for cannabis, and
a large subset looking for CBD. CannaVest
will make tinctures and capsules marketed
as nutritional products, depending on directives
(or signals) from the DEA. “That’s
where everything’s kind of in limbo,” he
adds.

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Boucher says there are misconceptions
about the warnings sent by the FDA earlier
this year to companies that made claims attributing
curative properties to CBD, and
lied on their labels about how much CBD
their products contained. The warning was
not a blanket injunction against distribution
of CBD-rich oil, according to Boucher,
but an outing of companies making false
claims. And CannaVest was blameless.

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We sell to hundreds of different companies,
and some of those third parties were
making claims. When we sell to people, we
specifically tell them in the sales agreement
that you cannot make claims and we

 

The war on cannabis clinicians

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By Fred Gardner  July 22, 2016   The low-intensity war on cannabis clinicians —part of a long-range containment and rollback effort planned by top industry and government strategists after California voters legalized marijuana for medical use in 1996— has been heating up..

 

The Federation of State Medical Boards (FSMB) is now pushing guidelines that could result in cannabis clinicians being investigated based on the number of patients they’ve approved and/or number of plants authorized. The FSMB guidelines, when adopted by state boards, could also result in physicians who medicate with cannabis losing their licenses based on an assumption of impairment! [O’Shaunessy’s covered past cases of doctors who won cases brought against them by the Medical Board of California.]

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Some state medical boards and departments of public health already have adopted guidelines restricting cannabis approvals. Colorado suspended the licenses of four physicians alleged to have authorized too many patients to grow too many plants. Here is John Ingold’s report in the Denver Post.

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Next week the Medical Board of California (MBC) meets in San Francisco and one agenda item has Executive Director Kimberly Kirchmeyer leading a “Discussion on the Process to Revise the Statement on Marijuana for Medical Purposes, Marijuana Recommendations Guidelines, and a Policy on Physician Use of Marijuana.” Linked to the agenda item on the MBC’s website is the state board’s existing policy statement on “Marijuana for Medical Purposes” and the more restrictive “Model Guidelines for the Recommendation of Marijuana in Patient Care” proposed by the FSMB.

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Steve Robinson, MD, has drafted a letter to the FSMB in which the 270-member Society of Cannabis Clinicians protests aspects of the guidelines. The letter will also go to JAMA, which ran an op-ed setting forth the FSMB guidelines. Dr. Robinson thinks the Medical Board of California is on the verge of adopting the FSMB guidelines at its upcoming meeting. Kirchmeyer reassured me in an interview that next week’s procedure is just one small step towards that goal.

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The Federation of State Medical Boards is a non-profit organization consisting of one physician —Humayun Chaudhry, president and CEO — plus a staff of 180 headquartered in Euless, Texas, plus a small  Washington, DC office for their lobbyists.

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There is evidence that the Federation of State Medical Boards is a shill for Big PhRMA. Starting in the 1990s, the FSMB, with funding from opioid manufacturers, pushed less restrictive prescribing guidelines that contributed to the current epidemic of addiction and death by overdose.

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As of the 1990s, the prevailing wisdom was that opioids are highly addictive and should be prescribed only for cancer pain and short-term severe pain. But the makers of synthetic opioids such as Oxycontin (Purdue Pharma), Duragesic (Johnson & Johnson) and Percocet (Endo) had begun funding studies that minimized the risk of addiction when their drugs were used to treat longterm, non-cancer pain such as back and neck pain.

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By 2004 the Federation of State Medical Boards was pushing guidelines that encouraged a more lenient approach to opioid prescribing.  In 2012 John Fauber blew the whistle on the FSMB in the Milwaukee Journal Sentinel/MedPage. The relevance of   Fauber’s expose to the current campaign against cannabis clinicians is striking. He wrote:

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The Federation of State Medical Boards, often develops guidelines that serve as the basis for model policies with the stated goal of improving medical practice —but after its guideline for the use of opioids to treat chronic pain patients was adopted as a model policy, it asked Purdue Pharmaceuticals for $100,000 to help pay for printing and distribution that policy to 700,000 practicing doctors.

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That $100,000 was just a small downpayment on the $3.1 million that the Federation’s foundation estimated it would cost for its campaign to get out the word about “safe” use of opioid analgesics in treatment of chronic pain…

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Why the FSMB would turn to a pharmaceutical company to underwrite the cost of producing and distributing a book about its opioid prescribing policy — and why the FSMB undertook developing such a policy in the first place — is part of a much larger story that has unfolded over the last decade, culminating with the Centers for Disease Control and Prevention’s stark warning about spiraling risk of death from prescription painkillers.

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An FSMB spokesperson said there were many reasons for it to codify a position on the prescribing of opioids, and among those reasons was a project supported by the Robert Wood Johnson Foundation to seek some common ground in the treatment of chronic pain.

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[Fauber had previously reported on the University of Wisconsin Pain & Policy Studies Group receiving $2.5 million from opioid manufacturers between 1999 and 2010, starting with a $693,000 grant from the Robert Wood Johnson Foundation in ’99.]

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    •    The RWJ-funded project started with an advisory committee that recruited several pain experts who had ties to makers of opioids — a core group that included J. David Hadd

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continued

 

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The material on this site is for informational purposes only.

It is not a substitute for medical advice, diagnosis or treatment

provided by a qualified health care provider.

Relevant comments are welcome.

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2 Responses to “Cannabis Politics, Science and Healing – O’Shaunessy’s”

  1. PZ Says:

    Dronabinol has been legal in all 50 states since 1988 as a Schedule C by FDA and Schedule A by DEA. DEA changed its position in 1999 going with Schedule C. This means that pharm companies and proceed with their research or at least have a clear path.

    • Nancy Sajben MD Says:

      I have prescribed for many who had cancer and many with HIV/AIDS. Not one person benefited and never found anyone who liked it, not even those with AIDS who used cannabis.


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