Grass Roots America Magazine - February 2020

PA I N ISSU E

FE BRUA RY 2 0 2 0

GOLNESA GHARACHEDAGHI “D ES TROY TH E TA BOO”

SEBASTIEN COTTE JAGG E R ’S J OU RN E Y

ASHLEY MANTA

TH E C A N N AS E XUA L

CATCHING UP WITH SO PH I E + TR AC Y RYA N

RILEY COTE

TO O L S FO R H E A LI N G

WELCOME PAIN - When I was 26 years old, I was in a car accident in a third world country and was hospitalized for months. I got to know pain for the first time in my life, and it wasn’t my friend. The pain only got worse during my long recovery, and I became increasingly tolerant to pain medicine.

As my doctor increased the amounts and variety of pain medicines, my health slowly and steadily declined.

Several years ago, with the help of a plant medicine scientist, I titrated off all pain medications over a 4 month period. I have lived without suffering through plant-based medicines since. I enjoy meeting people that have traveled the same journey and feel blessed to have a publication to share their stories with you.

In September, I met Golnesa Gharachedaghi in Los Angeles. It was a joy to meet her and see her living without the crippling pain she had been in for so long. I knew her from the Shah’s of Sunset TV program, following her journey to find a diagnosis, to understand her pain. Once she found plant medicines, she decided to help herself. Now, with her own line of products especially formulated for Rheumatoid Arthritis sufferers she can lead a productive life without constant pain holding her down.

- NANCY

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FEBRUARY 2020 GOLNESA GHARACHEDAGHI

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RILEY COTE

22

SEBASTIEN COTTE

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EDUCATION + RESEARCH 6 RESEARCH CORNER

ASHLEY MANTA

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DIS LIST 6 BACK PAIN 3

8 MARIJUANA MINUTE

38 BREAKTHROUGH PAIN

10 CBD

40 CHRONIC PAIN

12 NATURAL PLANT MEDICINES

42 NEUROPATHIC PAIN

14 CATCHING UP WITH SOPHIE

4 4 NIGHTTIME PAIN

+ TRACY RYAN

THE USUAL 6 FITNESS 4

ADDITIONAL ARTICLES 6 CANNABIS FOR CHRONIC PAIN 1

47 OUTDOORS

30 JORDAN’S STORY

48 CULTIVATION 49 CELESTIAL EVENTS 50 COOKING WITH PLANT MEDICINE FEAT. CHOCOLATIER, LAUREN GOCKLEY 53 REFERENCES

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OUR TEAM FOUNDER | EDITORIAL DIRECTOR – Nancy Moss MANAGING EDITOR – Antonio DeRose COPY EDITOR – Dr. Dawn Hayford PRODUCTION | DESIGN – Melissa Morris TECHNOLOGY DIRECTOR – Alex Moss

OPERATIONS – Kara Cave EVENTS – Mirella Hurst SCIENTIFIC RESEARCH – Dr. Matt Jackson, Sarah Moss SOCIAL MEDIA MARKETING – Green House Healthy ADVERTISING – advertising@GetGramNow.com

CONTRIBUTING WRITERS & COLUMNISTS

PHOTOGRAPHERS

Antonio DeRose Ben Owens Curt Robbins Dr. Debra Kimless Heather DeRose

Erick Gibson Evan Duning Photography Jack Shinella Jacqueline Collins

Jordan Person Maggie Slighte Dr. Matt Jackson Meg Sanders

Michelle Martin Maxine Taylor Rachael Carlevale Sarah Moss

Linsey Kelsey Melissa Morris Russell Gearhart

NEW WRITER | CURT ROBBINS is a technical writer, instructional designer, and lecturer and has been developing science-based educational and training content for Fortune 200 enterprise companies for more than 30 years. His clients have included Federal Express, Microsoft, Sun Microsystems, Northrop Grumman, National City Bank, Strainprint Technologies Ltd., the J.M. Smucker Company, and USAA. Robbins began writing about the biochemistry and the science of the various wellness molecules produced by plants such as hemp in 2003. He has since developed more than 600 educational articles about hemp and its various health components, including terpenes, cannabinoids, and the human endocannabinoid system. In 2019, Robbins developed a 50-page white paper regarding the hemp cannabinoid cannabigerol (CBG) that explored a fourth potential species of this unique plant genus.

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DISCLAIMER: This publication is designed as a reference and is made available to the public with the knowledge and understanding that the publisher and the author are not rendering medical, legal or other professional advice. You should not use the information contained in this publication as a substitute for the advice of a licensed medical doctor. You should consult a medical doctor to address any health concerns specific to you. We suggest that you consult a legal professional to assess the legality of any described remedies.

Mention of specific products, companies, or organizations does not imply that the publisher and author of the publication endorse such products, companies, or organizations.

Nothing contained in this publication should be taken as an endorsement for any legislative action.

The author and publisher disclaim any liability whatsoever with respect to any loss, injury, or damage arising out of the use of the information contained in this publication or omission from any information in this publication.

Natural plant medicines and herbs can interact with medications or affect some medical conditions.

You should always check with your prescribing medical doctor before using any of the herbal remedies and natural plant medicines described in this publication.

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RESEARCH CORNER COLLECTED BY MATT JACKSON, PHD

PILLS TO POT: OBSERVATIONAL ANALYSES OF CANNABIS SUBSTITUTION AMONG MEDICAL CANNABIS USERS WITH CHRONIC PAIN

A survey of patients using medical cannabis to manage chronic pain and how medical use is changing prescription drug use, from the University of Michigan Medical School and published in The Journal of Pain in July 2019.

STUDY FACTS

https://www.jpain.org/article/S1526-5900(18)30735-1/fulltext#sec0018

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SURVEY DESIGN: ● Dispensaries and cannabis certification clinics distributed an anonymous, online survey to medical cannabis patients through their databases and social media. ● Researchers asked patients with chronic pain about their health conditions and history using prescription drugs and cannabis. ● 1,321 medical cannabis patients from across the U.S. completed the survey, a nationwide expansion of a smaller 2016 study that surveyed 185 patients in Michigan.1 DEMOGRAPHIC BREAKDOWN: ● On average, patients were 50 years of age, 59% were female, 86% had a college degree, and 49% were married. ● 63% had used medical cannabis for over 1 year, and 62% also used prescription pain medicines. ● 20% were from California, 18% from Maine, 10% from Arizona, and 9% from New Hampshire.

In 2016, researchers surveyed 185 medical cannabis patients with chronic pain who visited one dispensary in Michigan. These patients reported that after starting to use medical cannabis, they decreased their opioid use by 64%.1 In 2019, the researchers expanded the study to a nationwide survey of more than 1,000 medical cannabis patients. They found that medical cannabis patients were decreasing prescription drug use or replacing their prescriptions with cannabis altogether. Patients also reported decreased pain levels and improved overall health.

ALL PATIENTS IN THE STUDY USED MEDICAL CANNABIS FOR CHRONIC PAIN. ● Back pain was most common (58% of patients), followed by migraines (21%), osteoarthritis (20%), and fibromyalgia (15%) ● Patients reported multiple health conditions (4.5 on average), which included conditions besides pain: anxiety (52%), depression (40%), and PTSD (25%).

62% OF MEDICAL CANNABIS PATIENTS ALSO REPORTED USING A PRESCRIPTION DRUG FOR PAIN MANAGEMENT. ● NSAIDs (nonsteroidal anti-inflammatory drugs, such as aspirin) were most common (31% of patients), then opioids (16%), benzodiazepines (13%), and gabapentanoids (12%). ● Patients also used SSRIs (12%) and SNRIs (9%), drugs generally used to treat depression and anxiety.

80% OF PATIENTS REPORTED USING MEDICAL CANNABIS TO REPLACE AN AVERAGE OF TWO PRESCRIPTION DRUGS. ● About 40% of patients stopped using NSAIDs, and another 40% decreased use “a lot.” ● 70–80% stopped using other drugs, including opioids, and 10–20% decreased use “a lot.” ● Patients said cannabis provided better symptom management with fewer side effects. ● Those who substituted prescriptions were also more likely to say that their pain levels decreased or that their overall health improved.

HOW DO THESE RESULTS STACK UP WITH THE REST OF THE SCIENTIFIC EVIDENCE? ● This survey closely matches at least seven surveys and clinical studies from the U.S., Canada, and Israel, all reporting that medical cannabis patients are reducing or stopping opioid use. ● The researchers pointed to additional scientific evidence that indicates that THC and opioids likely work together to increase pain tolerance and that CBD might help reduce opioid cravings. ● Patients can often achieve similar pain relief by supplementing smaller opioid doses with cannabis.

On the heels of the opioid epidemic, patients are reporting astounding success using medical cannabis to moderate or stop their opioid use, all while reporting improved pain management and overall better quality of life.

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EDUCATION + RESEARCH

MEDICAL MINUTE WITH NURSE JORDAN

In this column, our readers have the opportunity to ask our staff nurse anything they want to know about using cannabis plant medicine. She will provide quick and concise answers to big questions. In this issue, we dive into pain of all kinds and why people are turning to cannabis as an alternative treatment or in conjunction with their current therapy.

Pain is often broken down into two categories, acute and chronic. Acute pain tends to last a short period of time, up to 3 months, and is sharp and severe.

Whereas chronic pain can last forever and can be an intense hurt or a constant dull ache. According to a study1 done in early 2019, chronic pain is currently and historically the most common qualifying condition reported by medical cannabis patients.

Currently there are 50 million2 Americans suffering for various reasons. Many suffer in silence, taking countless pharmaceuticals only to feel new compounding symptoms from the use of too many OTC (over-thecounter) or prescription pills. Read on as we explore some commonly asked questions about making the switch to using cannabis for various types of pain.

INHALED CANNABIS REDUCES SELF-REPORTED HEADACHE SEVERITY BY 47.3% AND MIGRAINE SEVERITY BY 49.6%

WHAT ARE THE MOST COMMON REASONS PEOPLE USE CANNABIS FOR PAIN? Pain can come from a variety of things including the common headache. A recent study released in November 2019 by Washington State University showed, “inhaled cannabis reduces self-reported headache severity by 47.3% and migraine severity by 49.6%.�3 This is fantastic news for chronic migraine and headache sufferers. Another common cause of pain is neuropathy, and science is showing great use for cannabis with this type of pain as well. A 2018 study4 by the University of California showed that using cannabis via vaporization or oral delivery was an 8

effective treatment for pain caused by neuropathy.

Another common reason for using cannabis is the daily pain caused by arthritis. One in four adults report they experience pain from arthritis.5 The question of whether or not cannabis is effective for arthritis pain is so common, the organization that represents the voice and needs of those suffering, The Arthritis Foundation, now has a dedicated tab6 on their website offering guidance.

WHAT PRODUCTS OR METHODS OF APPLICATION/CONSUMPTION ARE RECOMMENDED FOR GENERAL PAIN? In my personal opinion, one of the best ways to receive cannabinoid therapy is through our largest organ - the skin, via the use of topicals. We have been offering cannabis massage using topicals in Colorado for six years at Primal Therapeutics, and we have helped thousands of patients feel relief. Using topicals focuses on the health aspect and not the high sometimes associated with using cannabis plant medicine. Infused topicals can be an effective treatment for several types of pain.

Other methods of consumption include smokeables such as using a vapor device or consuming the flower or bud in a joint, bong, or cannabis pipe, or consuming various forms of hash, now commonly called concentrates, for the very high concentration of THC

they possess. A great consumption method can be ingestibles. These products can be purchased in almost all medical cannabis dispensaries in legal states and come as tinctures, capsules, and edibles. CBD manufacturers make these products as well.

Pharmaceuticals, specifically those used for pain come with high addiction rates and countless side effects, including death.7 Cannabis has never caused a death, ever. This means experimenting with the plant in its various forms can cause little detriment. However, on occasion there can be a contraindication for using CBD with certain pharmaceuticals, so it is best to check with your doctor to see if you are on one of those medications.

CAN I RECEIVE THE BENEFIT OF PAIN RELIEF FROM CANNABIS WITHOUT THE HIGH? Absolutely. As mentioned above, topicals are a great option for wanting to receive all the benefits of plant medicine without a psychoactive experience. Another way to use the plant for pain is to work with various cannabinoids. Not all cannabinoids make you feel high. Science has shown us that THC is the part that makes us feel “high.” To avoid that feeling, there are other great ways to use cannabis plant medicine.

Tinctures, edibles, or capsules that are high in CBD with little or no THC may provide exactly the relief you seek.

Experimenting with cannabis plant medicine may provide relief to those suffering. It is important to remember, pain is a general term, and it’s difficult to measure. Everyone has a different pain tolerance and what may cause great distress to one, may feel like a minor ache to another. Judgement should not be felt by those in pain. The feeling is difficult for many to express and communicate to those they love. Be patient with yourself and anyone you know who suffers from pain.

DO YOU HAVE QUESTIONS FOR NURSE JORDAN? Please submit any questions to info@getgramnow.com Your question may be published in an upcoming issue.

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EDUCATION + RESEARCH

CBD + PAIN

BY BEN OWENS

As regulations begin to roll out and the hemp industry continues to legitimize itself, CBD products are more accessible than ever. Not only are CBD products more accessible, but they can now be found in edible, sublingual, and smokable forms. CBD has become an increasingly reliable option for those looking for alternatives to over-the-counter (OTC) and prescription painkillers. For individuals dealing with chronic pain, CBD has anecdotally shown to be effective in reducing or replacing conventional treatment options that often include powerful pharmaceuticals with dangerous long-term side effects, and studies are now backing these claims up.1,2

than their OTC counterparts.3 Due to this increase in strength, there is also an increase in side effects, including developing a tolerance that can lead to abuse and dependency if left unchecked. Individuals suffering from chronic physical and neurological pain often become chronic users of heavy prescription painkillers and are at a much higher risk of abuse and dependence, an issue that has largely led to the opioid epidemic as we now know it. Thankfully, patients are gaining access to alternative treatment options that can improve quality of life without the dangerous side effects of pills.

STUDIES HAVE SHOWN CBD CAN BOTH SIGNIFICANTLY REDUCE OPIOID USE AND IMPROVE QUALITY OF LIFE We are all familiar with the sensation of pain, but sometimes the reason we are in pain isn’t as obvious as the throbbing, sharp sensations we feel in the moment. Pain can be caused by both physical and neurological reasons. Physically, inflammation, irritation, abrasions, and incisions are among the most common reasons we feel pain. Stub our toe and it swells; slice our thumb while cooking and it bleeds and swells. But neurological pain stems from a variety of reasons. According to the Brain and Spine Foundation, “Common causes of neuropathic pain include nerve pressure or nerve damage after surgery or trauma, viral infections, cancer, vascular malformations, alcoholism, neurological conditions such as multiple sclerosis, and metabolic conditions such as diabetes.” CBD has been shown to help with a variety of the symptoms associated with these causes of neuropathic and physical pain, which has lent itself to the possibility of reducing and replacing traditional prescription painkillers.

CONVENTIONAL PAIN TREATMENTS We’ve all had that person in our lives that swears by Tylenol or Ibuprofen. Aside from these OTC solutions, doctors may also prescribe prescription strength painkillers such as opioids that are much stronger 10

CBD & PAIN As society becomes more favorable to CBD and cannabinoid treatments as a whole, we are learning more about the possibilities each compound holds and their ability to help with issues such as chronic or neurological pain. Studies have shown CBD can both significantly reduce opioid use and improve quality of life by reducing chronic pain and improving sleep quality in both patients and animals that were part of the studies.1,2 CBD can be an effective pain treatment due to its anti-inflammatory properties and also due to its ability to combat negative symptoms of diagnosis such as cancer, substance abuse, and multiple sclerosis. In areas where conventional treatments can be replaced or supplemented with CBD regimens, studies are showing a decrease in opioid and painkiller dependence.1,2 CBD can help treat pain and minimize our reliance on substances with often deadly side effects.1 If you’re considering CBD for pain or looking for a supplement to your current pain treatment, talk to your doctor or care provider about cannabinoids such as CBD as well as CBD products containing an entourage of cannabinoids. These products may help improve the quality of life in those impacted by pain.

EDUCATION + RESEARCH

PLANT MEDICINE POWERFUL PLANTS FOR PAIN

BY HEATHER DEROSE

Plant medicines continue their progressive path as a potential solution to the opioid epidemic and providing relief to people across the world. The psychedelic renaissance continues with the FDA granting a Breakthrough Therapy designation to a program to study psilocybin. The Usona Institute is a non-profit, medical research organization looking beyond the traditional treatments for depression. Their goal is to enable and support research with the FDA by registering psilocybin as an approved medicine which would have the ability to treat over 300 million people affected by depression worldwide.1 More states are pushing for decriminalization for plant medicines, and some are pushing for statewide initiatives later this year.

CURCUMIN HAS BEEN STUDIED WIDELY FOR ITS ANTI-INFLAMMATORY, ANTIOXIDANT, ANTICANCER, AND ANTIANDROGENIC EFFECTS In addition to psychedelic plants providing relief for depression and inflammation, other plants, such as turmeric, have powerful properties to reduce inflammation and provide other benefits. Turmeric is a plant related to ginger that is grown throughout India, other parts of Asia, and Central America. It has been used in one of the world’s oldest medical systems, Ayurvedic medicine, for thousands of years and is described as a powerful pain reliever. Ayurvedic medicine applies a natural and holistic approach to physical and mental health and remains one of India’s traditional health care systems.2 Turmeric contains curcuminoids, which studies have found may reduce the number of heart attacks, bypass patients have after 12

surgery, control knee pain from osteoarthritis as well or better than ibuprofen, and reduce the skin irritation that often occurs after radiation treatments for breast cancer patients.3 “Curcumin has been studied widely for its anti-inflammatory, antioxidant, anticancer, and antiandrogenic effects. Curcumin has shown considerable anticancer effects against several different types of cancer, including prostate cancer, breast cancer, colorectal cancer, pancreatic cancer, and head and neck cancer.”4 It is believed to produce its anticancer activity throughout several mechanisms within the body. More studies need to be conducted to evaluate methods of delivery for optimal pain reduction.

However, a study found curcumin to be effective and safe in alleviating symptoms in patients suffering from knee osteoarthritis.5 Similar to tumeric, ginger is another plant that has been found to provide powerful pain relief. A study looked at applying topical ginger treatments. It concluded, “Ginger has the potential to relieve symptoms, improve the overall health, and increase independence of people with chronic osteoarthritis.”6 There are so many natural plant medicines available we can use without a prescription and side effects.

Another study looked at using aromatherapy. It found that the inhalation of essential oils, such as damask rose and lavender, reduced the severity of pain and anxiety after a c-section.7 There are almost 400,000 plant species around the world that humans have coexisted with; the possibilities of their potential are abundant to help provide natural healing options for our world, and these are just a few that help with pain.

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EDUCATION + RESEARCH

CATCHING UP WITH SOPHIE + TRACY RYAN

BY ANTONIO DEROSE

UPDATES ON SOPHIE Sophie spent her first Christmas off chemo treatment since being a newborn! “We are finally off after six years,” her mother Tracy tells us, “She’s been stable for over a year now.

It’s still in there, but currently it is stable and believed to be dead. Now, we have to continue to monitor it and do scans every two and a half to three months. We’re confident that before we ever get too many years away from where we are now that we’re going to have a therapeutic available for her that literally eradicates the disease completely, so we never have to worry about it again.”

GROUNDBREAKING RESEARCH “We’re hopeful to be ready to for planning our human trials in the next six months. The brain cancer discoveries that the team has made are astronomical. I can’t say exactly what level the results are at, but it’s exciting. It would be a nontoxic option for patients because it would be using cells that are naturally indigenous to your body. Everything we discovered thus far, we hope to have published by March 20th. Dr. Jewett has discovered cannabinoids are attacking cancer STEM cells, and chemotherapy and radiation can’t even do that. This cancer STEM cell discovery, Dr. Jewett is calling the biggest discovery in the history of cannabis research and one of the biggest findings this century in cancer research. Sophie has been the most exciting patient in this research because she has shown the highest level of NK cell function as compared to all of the healthy and sick patients Dr. Jewett has tested over the last 30 years.”

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THE SAVING SOPHIE PODCAST “It is on iTunes and all about medical cannabis. We have completed interviews with Julian Marley, Tommy Chong, and Dr. Jennifer Berman that will air in the coming weeks. On each one of these episodes we’re hoping to use them as an amplifier, and an educational tool for people who really want to learn more about cannabis and become more involved in this community. Our interview with Dr. Jewett that digs into our research, where it’s going and where it is today, just launched this week, as well.”

UPCOMING PROJECTS “We are launching the CKSoul cannabis and hemp line in February. CannaKids will become our advocacy and education platform since legalization has brought challenges with having ‘Kids’ in our name. I’m also launching a new pharma company called NKore. We want to be the company bringing Dr. Jewett’s cancer therapeutics through human trials and to market because we know we will do it in a way that is considerate to patients.”

HOW YOU CAN SUPPORT “I’m truly trying to manifest people that can come in and help support these efforts and initiatives that really believe in what we’re doing and want to get in on the ground floor, with the goal of really being a part of this company moving forward. We also need to keep raising philanthropic dollars for Dr. Jewett. We’ve got a lot of work to do before we can get this into the hands of the patients and the more help we can get and the more donations we can get, the faster we can get there.”

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CANNABIS FOR CHRONIC PAIN

BY DR. DEBRA KIMLESS Chronic pain is difficult. The sufferer endeavors to live a normal life but is impeded by pain. It is difficult for their friends and family because they feel powerless, wanting their loved one to feel better and to be an active participant in life. It is just as difficult for their treating physician or health care provider as the current effective FDA approved treatment options are limited.

Traditional therapies are a balancing act of risk versus benefit. We are all very well aware of the opioid epidemic. We are all aware that opioids aren’t FDA approved for chronic pain. But, opioids are still used for chronic pain and to the great peril of patients and their families and friends. Physicians and patients are left with a paucity of options. One such option is the off-label use of prescription medications (technically not FDA approved for the indication of pain) that come with many serious side effects and with unreliable efficacy. Another is the overuse of over-the-counter pain relief medications. Even though they do not require a prescription, these medications also have the risk of serious side effects-like heart attack or stroke. So, what is left?

The answer everyone wants to read is that cannabis is the panacea. Yes, cannabis can be used as a pain reliever, which I will describe shortly. However, nothing is a panacea. Nor should cannabis be the sole treatment. Patients complain they hate it when physicians just throw pills at them. Patients tell me that they hate feeling like a victim. If that is the case, why should patients want cannabis thrown at them? They shouldn’t.

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PAIN

The causes of chronic pain are as varied as the sufferer. Chronic pain itself varies in nature and character--where the symptoms and intensity are in constant flux. However, the common denominator of chronic pain, like many other disease processes, is inflammation.

The adequate treatment of pain will be difficult unless the inflammation is quelled. Inflammation is the cause of most of our chronic diseases, including chronic pain.

So how do we stop inflammation?

It is not simply with a pill, despite what we have been programmed to believe.

TRADITIONAL THERAPIES ARE A BALANCING ACT OF RISK VERSUS BENEFIT We all have the power to break the inflammation cycle. We need to take an active role in our own healthcare and not be the passive recipients of pills. Our lifestyle choices create or reduce inflammation. Lifestyle choices include the foods we eat, exercise, sleep, and even socialization. I focus on food because marketing and disinformation creates confusion about what is considered healthy eating and eating is an essential part of reducing the inflammation and therefore reducing pain. When we eat processed foods, animal products, and oils (oil is highly processed-think of how many kernels of corn it takes to make a bottle of corn oil), we set up our body for inflammation. When we eat whole food, all-plants, no added oils, no processed foods we transform our

internal environment into a healing machine where our immune system is functioning, inflammation is reduced, and pain is reduced. But sometimes lifestyle alone is not enough.

HOW ABOUT CANNABIS? WHERE DOES IT FIT IN? I think about healthcare as a pyramid, where the base of the pyramid consists of the elements of a healthy lifestyle. When pain becomes chronic, then the next step up the pyramid is to discover the root cause, if possible, and then try less invasive pain healing techniques first, such as physical therapy, acupuncture, meditation, massage. If these modalities aren’t sufficient then the next step up the pyramid is herbal remedies, including cannabis.

According to the 2017 National Academies of Science, Engineering, and Medicine, cannabis may be useful for the treatment of chronic pain and with minimal adverse side effects. I have seen successful pain relief in patients using cannabis as well. In my current position as the chief medical officer for a cannabis company in Michigan, I have the honor and privilege of conducting IRB approved clinical trials using standardized low doses of cannabinoids in a rapidly absorbing tablet that is administered under the tongue. I have gathered patient data (soon to be published) that shows a statistically significant improvement in pain from baseline pain scale scores, and with no reported adverse side effects. The side effects that were reported were a statistically significant reduction in anxiety and an overall improvement in sleep quality. These clinical trials are not a one-off as the results are repeatable. This is exciting stuff!

Patients are always inquiring if smoking is the only way to use cannabis, and will they be able to function while taking cannabis?

Cannabis use is not just about smoking, and you don’t have to feel intoxicated or high for it to achieve the desired results. There can be a stepwise approach in its use as well. If a patient has musculo-skeletal pain where the affected area can be touched, then I recommend using a topical application of cannabinoids first. In fact, I call topical cannabis medicines the gateway to understanding cannabis is an effective medicine and without intoxication. If topicals are not enough or the location isn’t accessible to topicals, then I recommend starting with a low dose of cannabis medicine and slowly titrating to effect. Cannabis medicine is different from traditional pharmaceuticals where the pain relief may take a bit longer to take effect, and the reduction of the pain may not be as dense as an opioid. But low dose cannabis allows for full mental functioning as opposed to opioids. Most patients prefer to be functional with their pain reduction and not incapacitated by their medications.

A holistic and comprehensive approach is the best recipe for pain-relieving success. I recommend finding a physician or health care provider who will help guide you in your healing journey with both diet and cannabis medicine.

BE WELL, DR. DEB 17

GOLNESA GHAR ACHEDAGHI

BY JORDAN PERSON

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PAIN

Recently GRAM sat down with Golnesa Gharachedaghi, from the television show, Shahs of Sunset. We discuss why she is becoming a part of the growing cannabis industry with her new business, Wusah, and learn about her personal experience using cannabis for symptoms associated with rheumatoid arthritis (RA).

Many people deal with the pain of RA every day.

There are currently 1.5 million Americans suffering,1 many of whom suffer in silence. The joint tenderness and fatigue is sometimes unbearable. RA is an autoimmune inflammatory condition that causes severe pain, stiffness, swelling and redness to the joints.2 RA can affect other tissues of the body as well, including the eyes, lungs, and heart.

For Golnesa, her symptoms started with her hands.

“Up until my diagnosis, the doctors thought what I had was tendonitis from years of being a gymnast.

I am sure that was because I started as a gymnast at age 3. Doctors considered it to be normal wear and tear.

They began putting steroids into every single tendon in my fingers through injections.

The pain eventually found its way to my shoulders. I went to see an orthopedic doctor and he told me I had bursitis.”

the pharmaceuticals. That was my booster for everything. There were times I received biweekly transfusions as well.”

All of this treatment was still not enough. The inflammation in the tendons of her hands was still too much. “The doctors told me I had too many steroids previously injected into my hand, and the inflammation was so bad, and the tendons were so damaged they had to go in there and scrape it all out.” If trigger finger3 is severe, the finger that is affected can become locked in a bent position. The surgery for trigger finger is called “tenolysis” or “trigger finger release.” Golnesa had this surgery to release the tendon in her hand.

Rheumatoid arthritis patients suffer not only from pain but also from swelling, redness, stiffness or the joints that are affected may misshapen. For Golnesa, all of her fingers were so stiff she could barely straighten them. Before cannabis she would have to use her teeth to open bottles of water for herself.

After 8 or 9 years of medications and then finally requiring surgery for trigger finger, she made the life-changing decision to listen to her holistic minded mother. Her mom had been reading a lot about CBD and its benefits. Five years ago, as she began to read about the plant, she felt that it was still just considered cannabis, “You would hear weed or marijuana or pot and would think, so I am just going to get high. I told my mom no, what would it mean if I went back to this drug?“

IT TOOK TWO YEARS BEFORE I WAS DIAGNOSED WITH RA

The pain then made its way to her knees. Her doctor assumed it was the same issues she was experiencing in her shoulders and began steroid treatment injections to her knees. Finally one doctor had an idea, “The doctor said to me, this has to be something systemic. He sent me to a Rheumatologist. It took two years before I was diagnosed with RA. This was after two years of getting these injections with little to no relief. I remember my fingertips were blue, and I could barely bend my knees. My rings wouldn’t come off my fingers. Two years after injections, finally I understood I had RA in 32 joints in my body.”

“When having an autoimmune condition, your body can build up an immunity to certain medications after a while. So for me, every medication had a lifespan of about 1 1⁄2 years, and then it just stopped working for me. They tried several pharmaceuticals, so many I can’t remember all of their names. The methotrexate was a mild chemo drug that I had to inject into my stomach once a week in conjunction with all of

This was not her first experience with the cannabis plant. Her experience began at a young age, “younger than anyone in my grade, I was about 11.5 the first time I ever smoked pot; my older sister knew it was something that was going to come up, and she wanted my first time to be secured, safe and with her.”

She experimented with the plant over the years but discontinued use in 2005.

That was until her mother found Dr. Allan Frankel. Dr. Frankel has been a doctor of Internal Medicine for 35 years and is a worldwide authority on dosed cannabis. He is the founder of Greenbridge Medical in Santa Monica, California. The clinic claims that 80% of

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the people that come to them have had no previous relationship with cannabis. Dr. Frankel has treated just under 80 conditions using cannabinoid therapy. He provides a customized treatment plan to each patient he sees because he understands the varying needs for each patient, and that plant medicine can require some “tuning.”

Golnesa’s mom made her an appointment with Dr. Frankel. “He really broke it all down for me three and a half years ago. I started with a CBD capsule that was a 5 (CBD):1 (THC) ratio. I was really scared of getting high and that I was going to have a horrible experience, but having the mindset that it was going to help me medically was the significant difference for me. I then went from taking the capsules to buying the flower. As I kept consuming, the THC ratio continued to increase, and after about 8 or 9 months, I noticed my fingers were able to straighten out.”

DR. FRANKEL HAS TREATED JUST UNDER 80 CONDITIONS USING CANNABINOID THERAPY. Even though she began seeing mild results from cannabis, Golnesa continued with conventional medicine, using mild doses of chemo and going to her rheumatologist regularly. After 11 years of treatments, some of those in conjunction with the use of cannabis, a severe situation led to emergency surgery and the loss of both fallopian tubes. “That somehow put my body into some sort of shock. My rheumatologist said he had never seen my body flare that badly before. They put me back on infusions, but this time they used medications that were safe for pregnancy because at that time I was trying to get pregnant and the body must be rid of methotrexate for at least three months before you can attempt pregnancy.”

Golnesa continued using cannabis and was able to get all of her blood levels where they needed to be so she could try IVF again. During this time of trying to heal her body naturally, she started thinking about how much cannabis improved her quality of life. She started to brainstorm ideas for a product line so she could share this type of healing with others. Two years ago she launched the CBD company, Wusah.5

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I am pleased to tell you she shared with us that she is now pregnant.

“I read that CBD vapes were the safest way to consume because its more controlled as far as how much goes into your body while you are pregnant so I was using my Wusah vapes whenever I feel like I am irritable, or like my hands are too much with pain, I would just take a couple puffs. I recently just went three months without consuming. Then, just a few nights ago, I took a few puffs to help with my insomnia”, she tells us about using a CBD vape during her pregnancy.

else. We make sure our CBD oil is really good and broad spectrum.

It’s hard because of what the media and the government is putting out there, I feel like they are doing it to control the market for a lot of people. I can tell you though, at Wusah, we have no byproducts in our vapes.”

Vapes are not the only thing she sells. She says her focus is wellness. The Wusah product line includes capsules, oral sprays, a balm, patches, and drops for your water. Her plan is to stick with what internally is the most medic-

tralia. You really have to dig deep right now because there is a very big dollar sign on this plant.”

Golnesa is an advocate for people suffering from RA. She has worked with the Arthritis Foundation and Children’s Hospital Los Angeles to help support others, particularly children, who suffer from the disease as well as raise money for research to develop a cure. Most recently, she established a nonprofit foundation, Little Warriors, to support children suffering from a variety of autoimmune diseases. “I would love to be able to advocate

EMBRACE THE FACT THAT IT IS NOT A DRUG. DESTROY THE TABOO. “I have been so lucky I have not had any morning sickness, so I have been fine with using CBD only products. Had I been one of those women that did have nausea and they would have wanted to prescribe a medication for that, I would have absolutely just taken a few puffs off of a joint instead.”

inal and to focus more on symptoms, to help people internally.

She says, “Think more like anti-inflammatory, joint pain, and health and wellness.” She wants to put out products that are designed for whatever each individual may need; she feels her cause is to help people internally.

There is currently a lot of controversy surrounding the use of vapes.

Vape pens that contain Vitamin E Acetate or MCT oil have caused severe health issues and in some cases, death. In fact, thousands of deaths have now been reported in the US from the use of adulterated products. Golnesa confidently tells us, “unlike all the stuff going on in the outside media, my vapes do not mix with any outside oils, and I don’t dilute it with anything

“To stay current, I read every single day. I read everything. I receive as many cannabis newsletters from as many publications as I possibly can. I go to every possible convention I can in California and in neighboring states. I constantly educate myself on what’s out there. I tend to follow a lot of what Israel is doing since they are so advanced when it comes to cannabis, as well as some of the information coming out of Aus-

publically for the use of cannabis for RA, and I look forward to it.”

She leaves us with a bit of advice, “My best advice is to educate yourself first, understand all the components of the plant. Read about it. Try it. Ask around. Talk to people. Embrace the fact that it is not a drug. Destroy the taboo.

Educate first and foremost. Don’t believe me, do your own research, read the fucking ingredients, know what you are taking. Research and educate yourself, don’t just trust any product because it says it has CBD in it. Once you fully understand the plant, you will then understand why certain products hitting the market can’t be real.”

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SPIRITUAL PAIN, CANNABIS, + PSILOCYBIN WITH

NOW WHEN I HEAR THE WORD PAIN, I THINK OF DIFFERENT DIMENSIONS OF PAIN. THE MENTAL HEALTH COMPONENT.

After over 250 fights on the ice, 4 years in the NHL, and 7 total surgeries between his nose, eyes, wrist, knee, and even his fingers, the former left winger and enforcer for the Philadelphia Flyers, Riley Cote, is no stranger to physical pain. A longtime consumer of cannabis, since the age of 15, Riley believes cannabis helped him manage more than just the physical pain from the brutal demands of his sport. He also believes it aided him in coping with the mental struggles and anxiety resulting from amping up his nervous system in anticipation of fights before games, and the spiritual aftermath of inflicting pain on others.

“I turned pro at 20 and started fighting. It cranked on this different level of anxiety, as you can imagine.

I mean, performance anxiety, just daily stress and anxiety, but then all of a sudden now you're fighting regularly and preparing to fight the next night. I realized then, it (cannabis) was really helping with my anxiety but then also my sleep, you know, just comes hand in hand. I didn't really identify the anti-inflammatory properties until later on in my career when I started learning about the science behind it.” Riley is now retired from the NHL, but still involved in the sport of hockey on several levels, but with different goals in mind.

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RILEY COTE

BY ANTONIO DEROSE

Since retiring from his professional sports career, Riley has created his new path as a powerful voice of reason and inspiration for healing the body, the mind, and spirit, while also being environmentally conscious. “I’m trying to make a difference,” says Riley, and he’s doing a lot to live up to his word. Riley is the Founder of the Hemp Heals Foundation, a 501(c)3 non-profit promoting cannabis and hemp as a viable renewable resource. He is also a cofounder of another not-for-profit organization called Athletes For Care, where they are dedicated to creating a community where athletes can find support, opportunity, and purpose in life after careers in sports. In addition to his leadership role, he is the organization’s NHL Ambassador, while also sitting on the Pennsylvania Hemp Industries Council board, and his passion for healing is what really inspired him to start his own product company, BodyChek Wellness. A line of hemp-based personal care products with a mission to optimize everyday performance and challenge individuals to rethink the healing process; it’s a brand that reinforces his passion to help individuals discover safe, nontoxic methods for pain management and self healing.

When asked about what comes to mind when hearing the word pain, Riley says, “If you'd asked me this question 10 years ago, I think immediately, I would have thought of physical pain, right?

I mean, just general inflammation, the standard pain most people associate the word with. But I think now when I hear the word pain, I think of different dimensions of pain. The mental health component. It's the emotional pain and the spiritual pain, suffering that people are going through that you can't see. Pain is subjective, but it's very real. And me being a meathead in my former life, I know a lot about physical pain, but I also realize towards the end of my career that there was probably a lot more emotional and spiritual pain going on than physical.” This reflection gave him “a new appreciation for it because pain is a symptom, the red flag that you have to address instead of suppressing it. I think once you address it, whether it's physical, emotional, spiritual, that's when the healing begins.”

PSILOCYBIN IS JUST A TOOL. His journey as a healer began with healing himself, in order to be able to help others, and it started when he was given an opportunity to step down from playing professionally by accepting a coaching position, but his decision wasn’t an easy one. Riley thought, “This is like giving up on my NHL career to begin the coaching. It wasn’t exactly how I envisioned this going down, but I got off the phone, and I just knew where my head was at. I didn’t want to go down to the minors and fight. I knew I was probably going to get sent down the next year the way it was going the past year. I didn’t want to go down there and fight everybody. I was tired of the party. I was tired of just that whole emotional rollercoaster of jacking yourself up and fighting and all the emotional turmoil that comes along with it. So I was almost like, okay, now this is my opportunity to get out of playing but stay in the game.”

It was at this same time Riley realized, “Now this is me, embarking on this quest of holism, find-

23

ing myself, healing and all these things encompass. It wasn't just one thing that I was seeking. As I started reading, I always kept coming back to the cannabis plant, hemp as an industrial resource, mushrooms, Chinese medicine, and these few things kept popping up.”

On top of educating himself about the healing benefits of different plant medicines, Riley tells us, “One of the biggest things that I did, was transitioned from an animal-based protein diet to a plant-based protein diet. I got into the hemp seed, hemp seed protein, and got off all the whey. I wasn’t drinking milk at the time, but I basically eliminated all the dairy and in those moments I realized that it was inflammatory, mucus forming, and acidic, and all these things that were actually working against me. Then I just started to put my head down these different rabbit holes and became extremely passionate with the plants. I mean, how can you not? And then in those moments I also started realizing this different dimension of cannabis as medicine.”

At this point he, “just felt the need to spread the good word, because in between this (cannabis) and mushrooms, in my opinion, they are the only two things that have the ability to save our planet. In the sense of remediation, whether is phytoremediation or micro-remediation, public health, local economics. They help people, but help the environment and economics and well.”

For newcomers wanting to utilize the benefits of these plant based tools, Riley recommends, “I think the most important thing is always being responsible, knowing what you're getting into and respecting the substance. Then having a proper intention with it. You know, what are you trying to accomplish and how are you gonna go about it? What type of delivery system? What is your vision and how you're doing it and are you in a comfortable setting? Setting is important and this goes for both, especially if you've never tried either. Obviously, if you're going to be dipping I THINK THAT'S WHAT WE into psilocybin it's a little NEED TO BE TEACHING, IS bit of a different animal, but being around people RESPONSIBLE, MINDFUL USE, that you trust and being in WHERE WE CAN ACTUALLY a comfortable environment NOT JUST HELP OUR is, in my opinion, probably the most important, espePHYSICAL BODIES AND OUR cially for psilocybin. I feel MINDS, BUT INCREASE THE like both the medicines talk to you more when you're SPIRITUALITY AND LEAN ON quieter. So set and setting, THESE AS SPIRITUAL TOOLS. the level of comfort and just respecting the plants or the fungi is important.”

Riley mentioned mushrooms, and in addition to cannabis, he also believes strongly in the medicinal benefits of psilocybin mushrooms. Whether it’s cannabis or psilocybin, he tells us they are both tools and need to be consumed responsibly. “I think these two things can help because they are coping mechanisms and if you use responsibly and respectfully and mindfully, they're very powerful tools. I think that's what we need to be teaching, is responsible, mindful use, where we can actually not just help our physical bodies and our minds, but increase the spirituality and lean on these as spiritual tools.” When comparing this natural plant medicine

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to other substances, like alcohol, Riley makes an excellent point. “It’s a conscious forming drug versus an unconscious forming drug. I mean, one creates awareness and mindfulness and the more you drink, the more you lose consciousness until you black out.

So, you know, totally polar opposite. So what it actually does to the human brain and spirit, alcohol extracts spirit and essence out of things, plants, people and whatnot, and in my opinion, cannabis and psilocybin, it’s like they inject spirit back in. That's why they help so much with anxiety and depression and a lack of identity.”

Riley shared with us how he’s been consuming psilocybin mushrooms for the past few years, which have grounded him in his spirituality, and path as a healer.

“I feel like the connection component of what mushrooms do is the most important. It really grounds us and reconnects us to the things that matter and puts things into perspective. I think if everyone just tried it once, it would change their perspective on life almost immediately, to some degree. And the beautiful part is, we can always go back and learn more. You know what I mean? That mushrooms are always there to

teach. I think it's a great instrument to use for self-reflection. You know, a lot of people are limited in this bubble, and they know they think that they're on the right path. They’re suppressing their emotions and then they’re all suffering until the mushroom kind of slaps them around a little bit and says listen, you’ve got to change the direction a little bit. It's amazing what they're trying to teach you, but if you can't listen because you're too distracted, you're not going to get the message.”

Mushrooms have “ancient power and wisdom. It's passing through the mushroom to me. I know it sounds deep and almost weird for some people to talk about, but it is what it is.” Riley’s psilocybin practices over the years have included both micro and macro dosing. With “micro I've been going through different phases of trial and error and self-experimentation. I go four days on, with a hundred milligrams with a few other mushrooms in the capsule. Then you go off for four or five days and kind of go through cycles like that.” When it comes to macro dosing, Riley says, “I found myself doing that a lot more, going into that space with different intentions. It’s more about me tapping into those spiritual growth components, tapping into the self, and observing thoughts. Then there's other times where I go into the space more

for creative purposes and just trying to gather ideas and sort out certain things. I really do find that helps with that visionary component.” He does this “maybe once every two months or one and a half months or something like that. And I go deep, you know, five, six grams or so. Usually by myself, and then every now and then I'll bring someone in and go with the intention of helping someone else with it.”

With all this being said, it’s clear, Riley has been on a serious path of healing himself, and sharing his experiences to help others. He wants us all to know, the most important takeaway about everything he’s shared with us, is to “really talk about the emotional and spiritual pain and suffering, because the body reflects mental health. You look around this country, we're not well right? I mean, there’s the obesity crisis, the heroin crisis, and you’ve got a mental health crisis. It’s important to keep pushing this conversation about the emotional and spiritual pain, because that, to me, is a real true crisis. I think cannabis is just a tool. Psilocybin is just a tool. They do certainly help, but I think the bigger component here is, we have to do our work too, right? I mean, it's our job as human beings to be accountable for our own lives and take actions.”

I FEEL LIKE THE CONNECTION COMPONENT OF WHAT MUSHROOMS DO IS THE MOST IMPORTANT.

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One of the most promising aspects of the current global wave of cannabis legalization is the hope for relief it sometimes provides to the desperate parents of extremely sick children. In many cases, conventional drugs and therapies are found to be ineffective, forcing their parents or caregivers to seek alternative avenues of treatment.

One of the alternative therapies frequently investigated is hemp or cannabis. Many patients have demonstrated significant and life-altering relief from special concentrates and oils derived from the cannabis plant.

A slew of anecdotal reports—and an increasing volume of pre-clinical research studies and clinical investigations—has revealed children who suffer neurological disorders, including epilepsy, autism, and mitochondrial disease sometimes experience surprising levels of relief from cannabis or hemp oil.

JAGGER’S JOURNEY

THE COT TE FA MILY S TORY

BY CURT ROBBINS

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Improvements gained from the administration of such plant-based oils include relief from symptoms like seizure activity, loss of motor control, and one of the most common results of any disease, pain. Some caregivers have reported cognitive and motor coordination improvements in sick children who are given cannabis oil, including the onset of speech, basic problem solving skills, and even milestones such as the ability to feed themselves or walk.

The analgesic properties of the various cannabinoids and terpenes produced by cannabis are of obvious appeal to patients and their caregivers due to the commonality of pain in such a wide variety of disease and condition profiles.

One family knows the benefits of cannabinoids so well, they are fighting for legalization in the United States.

Jagger Cotte is a nine-year-old boy living in Georgia who suffers from mitochondrial disease (also called

tients suffer cellular breakdown that results in organ failure.

Jagger’s cognitive and motor skill developmental level is roughly that of a six-month-old infant. He is relegated to a feeding tube, having never been capable of feeding himself. At the age of one, doctors predicted that he would not survive until his fourth birthday.

He was declared terminal and placed on hospice.

mitochondrial disorder), a rare congenital condition that, according to the United Mitochondrial Disease Foundation (UMDF), results from “failures of the mitochondria, specialized compartments present in every cell of the body (except red blood cells).”1 According to the Cleveland Clinic, one in every 5,000 people suffer from a mitochondrial disease. “Each year, about 1,000 to 4,000 children in the United States are born with a mitochondrial disease,” states the organization.2 Due to the sheer number and type of symptoms involved in this disease, including the specific organs involved, it is often mistaken for other ailments.

MANY PATIENTS HAVE DEMONSTRATED SIGNIFICANT AND LIFEALTERING RELIEF FROM SPECIAL CONCENTRATES AND OILS DERIVED FROM THE CANNABIS PLANT. The criticality of mitochondria in the maintenance of human health and wellness cannot be over emphasized. Responsible for “Creating more than 90 percent of the energy needed by the body to sustain life and support organ function,” genetic disturbances to the functionality of this cellular mechanism typically result in a significant impact to human health.

Disturbances to mitochondrial functionality can result in severe impacts to cellular function and energy levels. In severe cases of mitochondrial disease, pa-

His parents refused to give up their efforts to help their child. Their options within the mainstream medical community having been exhausted, the 30-something couple began pursuing alternative treatments and therapies.

Children with neurological disorders such as Jagger’s suffer from a wide range of symptoms, including severe pain (resulting from muscle cramps and other complications, including paralysis), respiratory failure, and reduced mental capacity. The combination of these conditions paints a bleak picture for parents and their loved ones. Few children suffering mitochondrial disease live beyond the age of four.

During an exclusive interview with GRAM, Jagger’s father, Sebastien Cotte, told us, “Before cannabis, Jagger had episodes of cramping where his pain level was so great that he would scream. He’s nonverbal, so he screams when he’s in pain.”

Sebastien explained how these episodes would occur, on average, four to five times a week, with each featuring a duration of between five minutes and one hour. During the episodes, Jagger suffers extreme cramping and high levels of pain. “His legs were so tight and hard, we couldn’t even bend them,” said Sebastien.

He explained how, after beginning to treat Jagger with cannabis, including THC, he and his wife were able to reduce the occurrence of his episodes to only one or two per week. In addition, treatment with cannabis oil resulted in shorter episodes lasting “only a few minutes.”

When asked how cannabis has helped, Sebastien responded that he believes it has saved his son’s life.

“Jagger is alive today because of medical cannabis.

We had to move to Colorado to do it, but we got him started on cannabis right before his fourth birthday.”

Sebastien explained how Jagger remains on hospice and is very frail, but “Cannabis has given him a much better quality of life, which in turn is giving him a longer life.” When queried about the specific benefits gained from Jagger’s consumption of cannabis oil, Sebastien cited significant pain and seizure reduc27

tions. For seizure activity specifically, occurrence has decreased from about a dozen per day to only two to four. “He’s just a happier, more aware kid overall.”

In a heartwarming testimonial endorsement of the efficacy that cannabis has afforded Jagger, Sebastien explained how, for a brief period, Jagger achieved the motor and mental coordination necessary to achieve the simple act of smiling. Unfortunately, the progression of Jagger’s disease now prevents the coordinated muscular expression of which most parents are the daily recipients.

The genesis for the Cotte family’s investigation of the potential benefits of cannabis oil for Jagger was the 2013 CNN documentary Weed hosted by Dr. Sanjay Gupta. The famous investigative news segment, which brought the issue of cannabis efficacy for human diseases center stage, featured a young child suffering debilitating epilepsy and the significant relief gained from the use of a hemp oil containing CBD. The Gupta documentary motivated Sebastien to travel to Denver to learn more about how Jagger might gain life-saving benefits from cannabis or hemp oil.

While in Denver, he spoke with “anyone who would listen,” including cannabis cultivators, dispensary owners, researchers, and other caregivers. Sebastien and his wife were in the desperate position of having exercised all conventional treatments in Georgia. “We were clearly out of options,” he said. “Everything we could do... anything possible... we had done.”

“We were medical refugees, forced to relocate from Atlanta to Denver to obtain legal cannabis oil for our son, Jagger. Our use of cannabis oil resulted in an extension to Jagger’s life, well beyond the predictions of medical professionals,” he continued.

Unfortunately, the high altitudes of Denver were detrimental to Jagger’s respiratory system. Only 13 months after fleeing to the mountainous Centennial State, the Cotte family was forced to return to Georgia. Not merely disruptive and expensive, the relocation more significantly forced the Cotte family to become criminals, purchasing hemp and cannabis oil on the underground market in an effort to decrease their child’s suffering and extend his life.

In 2013, Sebastien and his wife co-founded Georgia's Hope, a group comprised of parents fighting for access to safe, legal medical cannabis for their children. The group has an impressive record of helping pass a number of medical cannabis laws in the state of Georgia, some of which achieved national precedents.

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WE WERE MEDICAL REFUGEES, FORCED TO RELOCATE FROM ATLANTA TO DENVER TO OBTAIN LEGAL CANNABIS OIL FOR OUR SON, JAGGER. “We are the main group responsible for passing the medical cannabis bills in Georgia during the past five years,” said Sebastien during his interview with GRAM. He explained how the group lobbied the state for improvements in how it regulates its medicinal cannabis program. Georgia’s Hope helped write HB 324, the bill that legalized the cultivation and distribution of medical cannabis in Georgia. “The law is officially called the Georgia’s Hope Act. We are very proud of that.”

The couple’s success in improving Georgia’s medical cannabis program has resulted in additional qualifying conditions for participation in the state’s relatively limited system. “We were able to get mitochondrial disease added to the list of qualifying conditions in Georgia in 2015,” said Sebastien, explaining that their effort resulted in the southern state becoming “the first in the country to add mitochondrial disease” to its list of conditions that permit patients to legally possess and consume cannabis medicine.

In addition to their role in Georgia’s Hope, the Cotte family has joined others in the lawsuit against the U.S. federal government on the grounds that cannabis prohibition is unconstitutional. The outcome of this legal effort, which is slowly progressing through the legal system, could have major implications for the parents of children like Jagger nationwide.

Given a terminal diagnosis and put on hospice at the age of only one, Jagger Cotte celebrated his ninth birthday in September 2019. His parents attribute the simple fact that he is alive to his consumption of cannabis oil.

New research, including human trials, will inevitably reveal more about the complex biochemistry behind the interaction of cannabinoids such as CBD and THC with the human endocannabinoid system. As long as children sometimes gain such marked relief— including reductions in pain and seizure activity and improvements in mobility and cognitive function— parents like the Cottes will continue to do whatever is necessary to legally obtain and consume these health-giving molecules.

GUTTED, INSULATED + REBUILT

BY JORDAN PERSON

Throughout my life, writing has always been a form of self-expression. I used journaling to help process life's events beginning at age 10, thanks to some incredible advice. As the years went on, my writing evolved just like I did. Poetry was one of my favorite things to write for a long time, and it always rhymed.

No matter where life took me, as long as I could get out what I was feeling on paper, I could figure out what my next steps were. Until I got sick.

I would try and write, but I was so lost, scared, and in so much pain every single day my attention span did not allow me to. Reading became difficult too. Before I knew it, books, magazines, even articles on my phone were no longer interesting. My mind was so distracted by being in pain and uncomfortable that I could barely verbally communicate what I was experiencing, let alone journal it.

One day I sat down, and the only thing that poured out of me were three words: gutted, insulated, and rebuilt. Those three words described me and the journey I had been experiencing. I wrote them over and over. I didn’t even understand their meaning at the time. Honestly, I may not have understood completely until right now, as I am telling this story for GRAM. This is a journey of barely surviving to thoroughly thriving, all thanks to cannabis plant medicine.

GUTTED. In 2010, the pain I had in my right side had become constant. Doctors ordered so many tests.

I had x-rays, CT scans, upper endoscopy, colonoscopy, pelvic ultrasounds, kidney ultrasounds, blood 30

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tests galore, and so much more. I felt poked and prodded and confused. It seemed like every test they did, they found something--it just wasn’t the cause of the pain. Finally, a test done on my gallbladder called an ejection fraction was completed, and it showed that my gallbladder was not functioning at all. Although I showed zero signs of gallbladder issues, the doctors insisted it was the cause for the pain and made the decision to remove it.

That was just the beginning. During the procedure they found a tumor on the underside of my liver. The size of the tumor pushed my gallbladder out of its way and caused the malfunction of the organ itself.

Several specialists told me the tumor was inoperable.

I made the decision to leave my home state of Florida and head to Colorado as a medical marijuana refugee. I knew the state had a medical program. The 13 pharmaceuticals I was on didn’t help me, but everytime I consumed cannabis, I felt some sort of relief.

Not long after arriving in Colorado, I obtained my medical marijuana card and began consuming the plant in all of its forms; topicals, smokeables, tinctures, capsules, edibles, all of it. The pain in my right side reached an all time high. This time the emergency room doctors in Colorado would find what was causing my pain all along, what all the other agonizing tests had missed--a massive stone in my right kidney. I was prepared for emergency surgery.

That surgery led to another one due to the fact I have two ureters on my right kidney. Stents were placed

and then removed and along with the stent went the stone.

I was finally out of right sided rib pain and was expecting to make a full recovery, that was until my menstrual cycle returned with a vengeance. I had been diagnosed with dysmenorrhea and polycystic ovarian disease years prior, and both conditions began wreaking havoc on my body. The only option I had left was a total abdominal hysterectomy. I was only 29 years old and had to make one of the hardest decisions of my life: my health or the ability to, one day, have a child.

An error was made during the hysterectomy, and my right ureter was sutured down and after four weeks

a short period of time. So, I stepped outside my comfort zone, and I volunteered for a cannabis themed concert being put on for the consumer holiday known as 4/20. That fateful night led to a job offer and before I knew it, I was managing a medical marijuana dispensary. Day by day, I worked to make myself feel whole again.

REBUILT. Days at the dispensary taught me so much, including why so many people were choosing to use medical cannabis. After a year, my body and mind were ready to return to being a nurse or massage therapist, but with everything I learned, there was no way I could go back to working in a hospital. In 2014, out of pure frustration and an effort to combine

THIS IS A JOURNEY OF BARELY SURVIVING TO THOROUGHLY THRIVING, ALL THANKS TO CANNABIS PLANT MEDICINE. I became septic. I ended up in emergency surgery again, but this time to have a nephrostomy tube placed in an effort to save my kidney. After almost seven agonizing months of wearing the tube down my thigh, they repaired my bladder and ureter in a non-refluxing ureteral reimplantation.

I was mad at my body and tired of having surgeries. I felt hollow. So many organs had failed me. I felt gutted. I just wanted to be well. My chart had been submitted to the Porter Hospital in Denver, Colorado.

They had a specialist transfer from Emory University by the name of Dr. Thomas Heffron. He felt he could remove the tumor from my liver. So, in a 7.5 hour operation, they removed the “inoperable tumor.� This started a whole new chapter of my life.

INSULATED. Once the physical pain passed, it became one big mental obstacle. I would need to do so much internal work to come back to who I was, or at least who I wanted to be. I studied herbalism and tried to understand the herbs and plants I had been using that replaced my pharmaceuticals. I took online courses in self healing. I tried to write and journal, but the words would not come out. I sought professional counseling to help me through the roughest patches, and I relied heavily on my friend, cannabis. I studied everything I could about the plant.

I knew that my body could not perform massages or be a nurse for that matter. I went through too much in

everything I had learned, cannabis-infused massage was born. Headlines were quickly made, and Primal Therapeutics took off faster than I could have ever expected. Fellow massage therapists from around the world began reaching out and asking me to teach them.

As of December 2019, I have taught massage therapy in 23 states and in several provinces in Canada and New Zealand. The curriculum I created is called Cannabis Massage 101. Every student remains hungry for more, so I have been working on 102 and plan to release it in 2020. The joy of writing has finally returned, and now my writing has a purpose. A severe fall in 2018 took me away from bodywork and allowed me to focus on creating new products for Primal Healing, the product line I initially created for Primal Therapeutics patients. We now make high CBD products so they can be available to anyone who may need or want them.

I made the transition from barely surviving, to living, to thoroughly thriving all thanks to the cannabis plant.

I could have given up. Instead I chose to dedicate my life to the cannabis plant by furthering its education to the masses. Cannabis saved my life on so many levels. The multitude of surgeries did leave me with some side effects. But, now I use cannabis for the symptoms I experience including daily nausea, pain, and discomfort.

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ASHLEY

“THE CANNASEXUAL”

MANTA

BY HEATHER DEROSE

Ashley Manta, also known as “The CannaSexual,” is on a journey to share information and help others throughout the world. Ashley created the word CannaSexual and trademarked it. It refers to anyone who mindfully and deliberately combines sex and cannabis to deepen intimacy and enhance pleasure, whether solo or partnered. Ashley says, “It has become a lifestyle brand and my professional nickname, ‘The CannaSexual.’ I am a sex and relationship coach, writer, and public speaker. I work with clients (individuals and couples) via Skype, and I work with VIP clients face-to-face. I offer online courses, I speak at colleges, conferences, and retreats, and my first book will be published in the second half of 2020. My mission is to inspire people to see the in32

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nate value in themselves and empower them to ask for what they want. I am having the best sex of my life, and it's a combination of confidence, communication, technique, and enthusiasm. I want that for everyone. Whatever is getting

IT HAS BECOME A LIFESTYLE BRAND + MY PROFESSIONAL NICKNAME, ‘THE CANNASEXUAL in the way of my clients having the best sex of their lives (however they define it). I help them find practical solutions, reframes, and workarounds. My public lectures

are part education and part motivational speeches. Someone, sometime in your life, may have left you thinking that you weren't enough or weren't worthy. I'm here to tell you that you ARE enough, and you are SO worthy.”

Ashley wasn’t always a cannabis consumer and didn’t consume cannabis for the first time until ten years ago, while she was in graduate school working on her Masters degree in Philosophy. “I'd grown up being taught, like most kids of the 80s and 90s, that ‘marijuana’ was bad and so were the people who used it. That belief system was challenged by the fact that most of my grad school cohort and a few of the professors were enthusiastic consumers.

The first time I smoked, I used a

gravity bong (rookie mistake) and got extraordinarily high but in a pleasant way. I sat on a LoveSac and watched Empire Records and contemplated the beauty of the universe. After that, I was fully pro-cannabis.”

uct impacts arousal, desire, and sensation. If you're not interested in feeling high, try using a THCA and/or CBD tincture, which won't cause any intoxication. Likewise, topicals are intoxication free, so try it if you have body aches.”

Now, Ashley consumes cannabis in all forms available. “I smoke, vape, dab, eat edibles, use tinc-

“Anytime someone is thinking of combining sex and cannabis, I encourage them to be mindful of con-

Combining cannabis and sex has been life changing for some. Ashley says, “The exact mechanism hasn't been fully studied. We're so limited on scientific data, especially regarding sexuality and cannabis, but the working theory is that cannabis helps with pain by reducing painful sensations in the nerves and enhancing pleasurable

STOP BUYING INTO THE INDICA/SATIVA MYTH. tures, apply topicals, insert suppositories, and use cannabinoid infused skincare and bath products. Depending on the method of consumption, it helps in different ways. I use CBD suppositories for cramps and to make deep penetration more comfortable during sex. I smoke and dab socially, it helps with my social anxiety. I use tinctures for headaches and body pain. I eat edibles before bed to help me sleep. I love soaking in a tub with a THC and/or CBD bath bomb--Kush Queen is my favorite brand. I use Foria Awaken every time I have sex to enhance sensation.” As you can see, cannabis can be consumed in a variety of ways and Ashley has the knowledge and experience to share with others, which may help improve some aspect of their own life.

For those new and interested in trying cannabis, Ashley offers her advice. “I encourage everyone to start out with miniscule amounts of whatever they're trying. Use a bit, then wait. If you're inhaling, wait 15-20 minutes, if you're ingesting, wait a full two hours. See how you feel, then add more if you choose. I also strongly encourage folks to masturbate after consuming to determine how that prod-

sent. Cannabis is psychoactive, even if some forms are non-intoxicating. Have a conversation with your partner, prior to consuming, about boundaries, fears, and desires. Tell them how you'd like to be taken care of if you over consume, and share with your partner some key things that they might see or hear (lethargic movements, softer speech) if you're in some kind of distress. Additionally, stop buying in to the indica/sativa myth. The effects of a given strain are entirely subjective and largely dependent on personal body chemistry, mindset, environment, tolerance, and amount consumed. Not all sativas make you energetic and not all indicas make you sleepy. We need to develop more nuanced ways of talking about cannabis' effects rather than using vague conversational shorthand.” Keeping in mind that the widely used terms indica and sativa aren’t reliable terms to distinguish the effects a product may have on a person and that each person may react differently to the same product is very important to understand when combining cannabis and intimacy or consuming for any other reason.

People are experiencing less pain when consuming cannabis.

sensations. THC is a vasodilator, meaning it expands blood vessels, bringing more blood flow to the area when applied topically, while CBD has anti-inflammatory properties, which can help with swelling. Vaginal suppositories are helpful because it gets the cannabinoids deeper into the vaginal canal where they can absorb into the vaginal walls, the cervix, and the internal clitoral erectile tissue.

Suppositories can also be inserted anally, which helps reduce discomfort without numbing.” She says, “Sex shouldn't hurt unless you want it to! That was a BDSM joke. Seriously though, as someone who experienced pain with penetration from my first sexual experience in my teens through my late twenties, I have deep empathy for those who experience pain during sex. There are lots of reasons this might be the case, and since I'm not a doctor, I would encourage folks to chat with their healthcare provider to rule out any serious health issues that might be masked by using cannabis for pain relief.”

As more states legalize cannabis and it continues to move mainstream, more studies are being conducted. “Marijuana Use Episodes and Partner Intimacy Ex33

periences: A Daily Report Study” looked at participants over a month and examined whether cannabis consumption periods were associated with couple intimacy. “Although marijuana use has been linked to negative consequences for intimate relationships, emerging literature suggests that under some circumstances it may have positive consequences.

Couples who use substances together report better relationship functioning over time and may experience positive short term outcomes.” The study concludes, “It is also possible that some couples are more likely to experience positive versus negative outcomes. Because the positive effects of marijuana are particularly strong, they are probably more apparent to users than the more modes effect on partner conflict, reinforcing positive marijuana expectancies and encouraging use within the couple.”1 Science will continue studying why and how these positive effects are being seen with cannabis use in couples and are continuing to learn more through research.

I'M HERE TO TELL YOU THAT YOU ARE ENOUGH, AND YOU ARE SO WORTHY.

Next year, Ashley will continue to provide education when she releases her book. “After my book is released, I'll be doing a book tour, which will take me to a bunch of new places that I've been wanting to visit. Plus, I'm going to be traveling internationally to speak at retreats and festivals, and I am really looking forward to finally getting some stamps in my passport! I'm especially looking forward to hosting my first Bodysex retreat after being certified by the founder, iconic feminist Betty Dodson, last summer.

This retreat is designed to help women love their bodies and feel empowered to give themselves pleasure! It's very cannabis friendly--Betty is a big fan of the plant!”

There are so many ways to support Ashley and learn more from her events! Enroll in one of her online courses at ElevatedIntimacy.com, subscribe to her podcast Elevated Intimacy, or hire her to teach at your retreat, festival, or conference! Visit her website, CannaSexual.com, to learn about all of the ways you can interact! She’s taking on a few more elite coaching clients in 2020, so email her to enquire about the enrollment process. You can also follow her on Instagram @CannaSexual or on Twitter @TheCannaSexual.

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PAIN

BACK PAIN + CANNABIS

BY HEATHER DEROSE

DIS-LIST

Pain is the body’s way of alarming something isn’t right. Whether it is because of disease or injury, pain is the most common reason people seek medical assistance.

Pain has many causes and affects everyone differently, which can be problematic to treat. According to the Mayo Clinic, “Back pain is one of the most common reasons people go to the doctor or miss work, and it is a leading cause of disability worldwide. Most people have back pain at least once.”1 Common symptoms of back pain include muscle aches, shooting or stabbing pain, pain that radiates down the legs, pain that worsens with bending, lifting, standing or walking, and pain that improves with reclining. Back pain occurring suddenly, without previous symptoms, and lasting less than six weeks is considered acute back pain and is typically caused by a fall or heavy lifting. Less common is back pain lasting longer than three months, which is considered chronic. Oftentimes, back pain is caused by a muscle ligament or strain, bulging or ruptured discs in the spine, arthritis, skeletal irregularities, and osteoporosis. Developing back pain is more common with older age; lack of exercise, excess weight, diseases such as arthritis and cancer, improper lifting, psychological conditions such as anxiety or depression, and smoking can all increase the risk.

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Although a number of factors are involved with developing back pain, there are measures to help prevent pain occurring such as exercising, maintaining a healthy weight, lifting properly, and quit-

ting smoking cigarettes. To assess back pain, a doctor will examine a patient’s ability to sit, stand, walk, and lift the legs. Other tests including x-ray, MRI or CT scans, blood tests, bone scans, and nerve studies can provide results to learn more about the complex condition, which affects everyone differently and needs to be treated individually.

PERIPHERAL NERVES THAT DETECT PAIN SENSATIONS CONTAIN ABUNDANT RECEPTORS FOR CANNABINOIDS

DIS-LIST

Many people suffering from back pain treat their symptoms with over-the-counter (OTC) pain relievers, such as nonsteroidal anti-inflammatory drugs (NSAIDs), like ibuprofen or naproxen sodium, such as Aleve. These OTC pain relievers come with a side effect list, which includes death. More commonly, “NSAIDs are responsible for 3% to 10% of idiosyncratic drug-induced liver injury (DILI) cases in the Western world.”2 Muscle relaxants are another option to relieve symptoms, but include side effects such as sleepiness and dizziness.

Other options for patients include temporary narcotic drugs, such as oxycodone or hydrocodone, antidepressants, and injections. Many of these options aim to relieve pain by reducing inflammation and provide relaxation to reduce discomfort, which is why many are finding relief with cannabis. Cannabis works within the body’s ECS to aid in inflammation and relieve pain naturally, without harmful and deadly side effects.

markable analgesic capabilities for these individuals.3 “Associations between medical cannabis and prescription opioid use in chronic pain patients: A preliminary cohort study” found “the clinically and statistically significant evidence of an association between medical cannabis program enrollment and opioid prescription cessation and reductions and improved quality of life warrants further investigations on cannabis as a potential alternative to prescription opioids for treating chronic pain.”4 People all around the world are sharing their stories about using cannabis to reduce or eliminate their opioid intake. Doctors in some states are allowed to write cannabis recommendations for a chronic medical condition that is normally treated with a prescription medication that could lead to physical or psychological dependence. A physician can write a recommendation after determining medical use of cannabis could be effective in treating the condition and would serve as a safer alternative to prescription medication. Many have seen the difference, and science shows how the cannabinoids are working within each person’s ECS to provide pain relief. “Cannabinoids have shown significant promise in basic experiments on pain. Peripheral nerves that detect pain sensations contain abundant receptors for cannabinoids, and cannabinoids appear to block peripheral nerve pain in experimental animals.”5

Education on the importance of staying active, reducing stress and worry, and learning how to avoid injury are the top ways to prevent back pain, but the treatment options range from physical therapy and exercise to surgery, depending on the severity. There is not a commonly accepted program to teach people with back pain how to manage their symptoms effectively, so it’s not surprising patients and doctors are interested in learning more about how cannabis can help. Many people are choosing cannabis over a prescription with a list of side effects because knowledge about the plant's ability to help people suffering from chronic pain and regain some quality of life, is quickly spreading. Cannabis continues showing promising results on a variety of conditions, including pain, which is why we need to share education and stories for the laws to change. This plant has the potential to help so many people and should be widely accessible to study and available in hosOne study evaluated pain and its symptoms in papitals and for emergency responders. tients with failed back surgery syndrome refractory to other therapies, in associated with spinal cord stimulation. The study results indicate that cannabinoids, such as THC and CBD, can have re37

BREAKTHROUGH PAIN

BY MATT JACKSON, PHD

According to the National Cancer Institute (NCI), breakthrough pain is “a sudden increase in pain that may occur in patients who already have chronic pain from cancer, arthritis, fibromyalgia, or other conditions.”1 Sometimes you can predict that you’ll trigger the pain and take medications beforehand; say, you know you’re going to be playing with your grandchildren soon, and you’ll be more active than usual. But other times, breakthrough pain comes out of nowhere, builds slowly, and stays longer.2 Recently, the definition for breakthrough pain was rewritten. Just a few years ago, it was defined as pain breaking through “a stable opioid regimen.”2 You could feel the political whiplash as the NCI removed opioids from the definition—rightly so considering that 47,600 people in the U.S. died from opioid overdoses in 2017 alone.3

DIS-LIST

PATIENTS ARE REPORTING MEDICAL CANNABIS IS EFFECTIVE FOR MANAGING CHRONIC AND BREAKTHROUGH PAIN

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Many patients are turning to medical cannabis as an alternative for opioids,4 but some medical experts have expressed concern and speak of “an uncomfortable parallel” between medical cannabis and opioids.5 They argue both cannabis and opioids provide chronic pain relief, but mass pre-

scribing either is concerning without evidence of safety (detailing the risk–benefit ratio). Well, at least we agree that cannabis can relieve chronic pain, but before medical cannabis gets tainted by the opioid epidemic, let’s revisit history.

Over a century ago, heroin and morphine use was rampant until the U.S. Harrison Narcotic Control Act of 1914. Few of us remember the ensuing “opiophobia,” but it was strong. Doctors in the 1950s weaned terminally ill cancer patients off morphine, who suffered until they died.6 Then, the Food and Drug Administration (FDA) greenlit Purdue Pharma to distribute controlled-release morphine in 1987, a stunning fit of amnesia that was repeated with even stronger OxyContin in 1995.3,6 Encouraged by medical experts, opioids then spread beyond cancer patients and into the general public. And in 2000, an influential nonprofit that accredits healthcare organizations, The Joint Commission, mandated doctors with a duty to control pain. At that point, a doctor refusing to prescribe opioids could be legally sued for undertreating pain.6 I think we can agree there is a fundamental difference between the frustratingly slow decriminalization of medical cannabis and pressuring doctors to prescribe opioids more potent than morphine.

But what about safety? It seems common sense: cannabis is safer than morphine, but the absence of safety studies draws criticism for cannabis.

Clinical trials are on the way, so the European Pain Federation is waiting until 2021 before making a formal recommendation.7 There is scientific evidence that cannabis might be a saving grace for patients using opioids for chronic pain. The earliest published reports focused on individual patients with HIV, multiple sclerosis, or traumatic injuries who reduced opioid consumption by 60–100% after starting medical cannabis.8 These reports have proved surprisingly accurate as thousands of patients began reporting their experiences. In one survey, almost 1,000 patients in the U.S. said medical cannabis decreased pain, increased overall health, and helped them decrease or eliminate opioid use, and those results

DIS-LIST

have been replicated in several other countries4 their claims. Science has shown cannabis is not (see the Research Corner on pages 6-7). a one-size-fits-all medicine. Cultivars vary widely in cannabinoid composition, and thus in symptom Many patients have reported medical cannabis relief and side effects. was so effective, they could wean themselves off opioids completely,4 but this may not be the case Unfortunately, federal laws prevent research using for everyone. Some patients might need to supple- cultivars that have enough potency and diversity ment pain relievers with medical cannabis, THC, to match the products at dispensaries.9 Considand/or CBD. Indeed, there are consistent reports ering the opioid epidemic, it is easy to become that THC and opioids can complement one an- frustrated with federal limits against cannabis reother, meaning that patients could augment very search. People are dying, but some patients are small doses of opioids with cannabis and achieve replacing lethal opioids with medical cannabis. the same pain relief as a full opioid dose. A full They say they have been successful, but the meddose of opioids has a high risk of overdose and ical community has been tepid. It’s time to start respiratory depression, so any reduction in opi- listening to patients and take their experiences seoids increases patient safety. Alternatively, some riously. As with every choice in medicine, it comes studies have suggested that CBD can help stave down to the patient and healthcare professional off opioid cravings and addiction.4 weighing the risks and benefits and making the best decision they can.

Overall, patients are reporting medical cannabis is effective for managing chronic and breakthrough pain, and current scientific evidence supports 39

CHRONIC PAIN

BY MICHELLE MARTIN

Pain is like a warning signal to take care of an injury or illness. Chronic pain, however, is pain that continues when there is no good reason for it anymore. It’s as though the signal won’t shut off for months or years after the person is aware of a problem or even after it has healed. At best, this pain is a nuisance and at worst, it is debilitating.

A person with chronic pain is likened to a car with four flat tires in a video put out by the American Chronic Pain Association. Medical treatment may work to fill one tire, but the other tires are still flat, and the car cannot go. The video’s message: it often takes a combination of various interventions to fill all the tires or adequately address someone’s chronic pain and allow them to continue their life’s journey. The Association advocates a “multimodal strategy,” in which a patient incorporates an individualized blend of techniques. These might include self-care activities, such as exercise or meditation; both mind and body-focused therapies provided by professionals; and modalities and medicines prescribed by health-care providers.

DIS-LIST

Acute pain is pain that is the direct result of illness or injury and has a distinct beginning and end. In contrast, persistent or chronic pain is defined as pain that continues three to six months beyond the usual recovery period, or that goes on for months or years due to a chronic condition. “The pain is usually not constant but can interfere with daily life at all levels,” according to the American Chronic Pain Association. The association reported in The Association’s 2019 edition2 of pain manage2002 that more than 50 million Americans suffer ment techniques lists about three dozen therapies. from chronic pain each year.1

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It also introduces a number of pain medications, including acetaminophen, NSAIDs (non-steroidal anti-inflammatory drugs), opioids, antidepressants, antiepileptics, and muscle relaxants. Patients often take medications in which the benefits outweigh the risks or side-effects. Common side-effects of pharmaceutical treatments include insomnia, skin rash, headache, swelling, stomach pain, diarrhea or constipation, confusion, breathing difficulties, abnormal heartbeat, and increased blood pressure.

Cannabis is still a somewhat controversial treatment that might help to fill that first tire in the car analogy. 64% of board-certified pain specialists in Israel recently responded to a survey about cannabis.3 Nearly all of the respondents prescribe cannabis, and 63% find it moderately to highly effective, while 56% encountered mild or no side effects, and 5% perceive it as significantly harmful.

A 2019 study4 by the Veterans Health Administration found that many people substitute cannabis for opioids. Of the 486 people who had reported using both marijuana and opioids in the previous year, 41 percent reported decreasing or stopping opioid use altogether due to marijuana use.

DIS-LIST

It is important to note that most current evidence suggests a difference in pain relief based on the type of pain, the type of cannabis products, and the way they are delivered.

In a 2019 study that was open-label (so no control group), but had more than 30,000 participants, researchers looked at whether patients with severe chronic pain would benefit from an equal parts THC-CBD mouth spray in addition to their regular pain management routines.8 The spray appeared to significantly reduce pain for those suffering from neuropathic pain, had some effect for those with a mix of pain types, but had no effect for those with only nociceptive chronic pain.

One 2017 systematic review of randomized controlled trials found that inhalation provided the most promise for consistent pain relief. Nanotechnology is another technique researchers are exploring as a possible delivery method in the realm of pain.9 In a 2018 review of the research, authors agreed that there is moderate evidence that cannabis can relieve chronic neuropathic pain.10 They go on to cite research findings that explain how cannabinoids’ analgesic effects might come about. Among other things, cannabinoids can inhibit presynaptic nerve endings from releasing neurotransmitters, including neuropeptides; modulate the postsynaptic excitability; activate the brain’s top-down inhibition of pain; and reduce nerve inflammation.

Two major categories of physical pain are neuropathic pain (pain that affects the nerves or nervous system) and nociceptive pain (pain that results from a painful stimulus or injury). It turns out that cannabis is more likely to help with neuropathic pain. In 2014,5 The American Academy of Neurology concluded oral cannabis extracts may work for some kinds of spasticity and pain in patients with MS, though more research on safety would be helpful. Three years later, in 2017, National Academies of Sciences, Engineering and Medicine agreed that patients treated with cannabis or related products were likely to have a significant reduction in pain symptoms.6 That same year, a review of 27 studies that was part of a larger Veterans Health Administration study found there is limited evidence cannabis can help alleviate neuropathic pain.7 The authors site low confidence, because there were inconsistent results of short studies using different formulations and delivery mechanisms that seemed to have little applicability to what was actually available in dispensaries at the time.

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NEUROPATHIC PAIN

BY BEN OWENS

DIS-LIST

Pain is a familiar sensation to most of us that involves some sort of outside stimuli and a sharp, burning, or throbbing sensation. For those living with neuropathic pain, this experience can happen at any time, regardless of stimuli, or may not happen at all, even when stimulated. Neuropathic pain is the result of damage to the body’s nerves that inhibits or aggravates our pain experiences. Typical neuropathy treatments involve a variety of drug classes which cannabis may have the ability to minimize and replace. Science is beginning to validate patient anecdotes about efficacy and add substance to the idea that cannabis and cannabinoids can be an alternative to conventional medical treatments for neuropathic pain.

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Neuropathic pain is pain specific to the nervous system that may be triggered by a variety or lack of stimuli. Most commonly, neuropathic pain is the sensation of pain without a physical trigger, such as feeling a burning sensation but not being subjected to an external heat source. Usually chronic in nature, neuropathic pain does not have a rapid onset or predictable cadence, waxing and waning throughout the day. This form of nerve-based pain is often the result of nerve damage or a malfunctioning nervous system that impairs the body’s ability to transmit sensory information, resulting in numbness when there should be sensation and sensation when there isn’t anything to sense.1,2 As mentioned, neuropathic pain is caused by damaged or malfunctioning nerves. This damage can create the sensation of pain at the site of

the damage or can result in sensations felt elsewhere on the body whose nerve signals may be impeded or blocked. This is often described as a shooting, burning pain or tingling numbness. Our nervous system is made up of our spine, brain, and a variety of nerve receptors found throughout the body. Damage to this system caused by accidents, strokes, or physical trauma can result in neuropathic pain. Additionally, diabetes, alcoholism, cancer, infections and nerve-related diseases may lead to neuropathic pain.1,2 For those suffering from chronic episodes of neuropathic pain, one of the most common treatments is the use of an anticonvulsant or an antidepressant. Additionally, pain killers such as non-steroidal anti-inflammatory drugs (NSAIDs) may also be suggested.1 If the pain is a result of a disease such

as alcoholism, cancer, or diabetes, attempts may be made to better manage the underlying cause of the pain before treating for additional symptoms.

In extreme cases, surgery involving implants and electric stimulation may be used.1,2 Due to the variety of causes of neuropathic pain, it can be hard to treat all of the symptoms and sensations with one cure-all treatment. While conventional treatments may work for others, some require extreme measures to relieve their pain.

Cannabis has been shown to have anticonvulsant, antidepressant, and anti-inflammatory properties, which suggests that it could be an effective supplemental or replacement treatment option for those living with chronic neuropathic pain. Studies are beginning to show cannabinoids such as THC present unique opportunities for alternative treatment minimizing the need for pharmaceuticals and surgery.

Thanks to the FDA’s approval of a specific CBD option for epilepsy, we have seen an upswing in studies focused on conclusive evidence that CBD, and potentially other cannabinoids, possess anticonvulsant properties.3 Studies have gone so far as to examine CBD’s role in neurotherapeutics for epilepsy and other conditions, finding CBD to be an effective anticonvulsant.4 In addition to being an anticonvulsant, cannabis has also been shown to possess antidepressant properties, and literature suggests that if observations are true and replicable, that cannabis is already being used widely "to “self treat” depressive symptoms.”5 Cannabinoids such as ∆9-THC, ∆8-THC, CBG and CBD have been confirmed to "exhibit antidepressant-like actions [on the brain].”6 To top it off, cannabinoids and terpenes found in cannabis have anti-inflammatory properties that make the effective at treating inflammatory disorders and symptoms.7,8

DIS-LIST

RESULTS FROM RANDOMIZED CONTROLLED TRIALS (RCTS) EVALUATING MEDICAL CANNABIS FOR THE TREATMENT OF NEUROPATHIC PAIN INDICATE THAT IS “AS TOLERABLE AND EFFECTIVE AS CURRENT NEUROPATHIC AGENTS Based on these studies alone, cannabis presents itself as a natural alternative to all three categories of prescribed pharmaceuticals upon which conventional treatment lies.

Studies are backing up this deduction. Results from randomized controlled trials (RCTs) evaluating medical cannabis for the treatment of neuropathic pain indicate that is “as tolerable and effective as current neuropathic agents.”9 The majority of studies on cannabis as an effective treatment option demonstrate "improved pain from inhaled cannabis”, particularly with peripheral neuropathy resulting from damage to the body’s ability to send and receive nerve signals.10 Multiple meta-analyses of currently available research have concluded that cannabis can be an effective treatment option for neuropathic pain in a variety of cases. Almost all studies urge caution regarding proper dosage and the lack of knowledge surrounding long-term use of cannabis.9,10,11,12,14 Additionally, due to concerns over the safety of inhaling combusted, smoked cannabis, studies have also

looked into the efficacy of vaporized cannabis and found vaporized cannabis in low doses minimized psychoactive effects while offering “an effective option for patients with treatment-resistant neuropathic pain.”13 While cannabis has shown promising results as an option for the treatment of neuropathic pain, it is important to speak with someone that is knowledgeable about your specific case. If you’re considering cannabis as an alternative or supplement to your existing treatment routine, talk to your doctor about this decision and ask for recommendations. Your doctor may feel CBD or THC specifically may be best and offer recommendations of products that can be trusted. If you live in a state with medical or adult-use cannabis, consider visiting one of your local shops and talking with staff who can advise you on what other patients with similar needs found helpful. As many studies mentioned, serving sizes are incredibly important; start low and go slow; you can always consume more as needed.

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NIGHTTIME PAIN

DIS-LIST

BY MATT JACKSON, PHD

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With chronic pain, getting a good night’s sleep can be a constant battle. Pain assaults sleep on two fronts, the first being easier to guess: nighttime pain. Just moving in the night can jar you awake with pain disrupting your sleep cycle, causing health problems that worsen over time.1,2 Adults over the age of 65 who experience nighttime pain at least 3 times a week are 6 times more likely to feel excessively sleepy the next day,3 and persistent insomnia can cause depression, anxiety, and an increased risk for accidents and being absent at work or school.1

Before you jump in and say pain medications might help, the second thing disrupting sleep is more subtle: side effects. Nonsteroidal anti-inflammatory drugs (NSAIDs) like aspirin can cause gastroesophageal reflux disease.1 People often use proton pump inhibitors to manage side effects, but at night, stomach pH can get out of control and disrupt sleep with heartburn and acid indigestion.1,4 Opioids are more potent for pain relief, but they are even worse for sleep.

Researchers monitored patients taking opioids for advanced cancer, and they found opioids lim-

ited deep sleep, the time when your muscles relax and your brainwaves finally slow down. If you miss out on deep sleep in the first few hours of a night, you might just wake up and go right back to bed.5 These sleep disruptions can worsen pain levels over time, subverting the whole point of opioids, and contribute to mental health problems such as depression.1 As the national opioid epidemic has generated more honest discussion about the addictiveness and side effects of opioids, many patients have turned to medical cannabis for chronic pain relief and help sleeping. This is not the first time in history either. Cannabis was used as an herbal sleep remedy in ancient Indian Ayurveda tradition, and when cannabis was brought to Western medicine in the 1850s, doctors widely prescribed cannabis for sleep when conditions such as pain interfered.1 Now we have a wide range of cannabis cultivars, so it's no longer as simple as saying cannabis is good for sleep. We must consider how different cannabinoids affect our ECS and work to relieve conditions such as pain and disrupted sleep.

THC is the primary psychoactive cannabinoid and can ease the pain pathway of the central nervous system.1 THC can be effective in relieving chronic pain, and in the short-term, THC can help you fall asleep faster and make you feel like you're sleeping better. For example, patients with fibromyalgia found THC to be more effective than the prescription sleep drug amitriptyline.

DIS-LIST

The other most abundant cannabinoid, CBD, can relieve pain, reduce inflammation, and scavenge oxidants without any psychoactive effects.1 At low doses, CBD can be stimulating and increase wakefulness, but as dosage increases, CBD can be sedating. For example, a high dose of 160 mg CBD per day can increase sleep time and decrease sleep disruptions.2 When treating nighttime pain specifically, most research has combined the sedating effects of CBD with pain-relief from THC. The leader in nighttime pain research has been GW Pharmaceuticals, the company that achieved FDA approval for using CBD to treat drug-resistant epilepsy. GW has another product for treating chronic pain in multiple sclerosis, Sativex, which is a whole plant extract with an equal ratio of THC and CBD.1 In clinical trials, GW amassed reports from more than 2,000 people with a total of 1,000 patient years of Sativex exposure, and they demonstrated extracts with 1:1 THC to CBD consistently improved sleep for patients with chronic

pain.1,2 Over 80% of patients reported their sleep was satisfactory, good, or very good through 124 weeks of use, without any evidence of tolerance build-up or dysregulated sleep–wake cycles.1 While Sativex is not yet approved by the FDA, we can borrow the cumulative evidence to suggest which cannabis cultivars and/or products to try for nighttime pain. THC can help manage pain symptoms and initiate sleep, but CBD is an important component to maintain long-term sleep rhythms. So, you could first try extracts with a 1:1 THC to CBD ratio. You might also find some benefit using cannabis high in CBD and low in THC with terpenoids that are sedative, such as terpineol.1 When it comes to how much you should take, when you should take it, and if you should take a low dose of CBD in the morning, that’s up to you.

IN THE 1850S, DOCTORS WIDELY PRESCRIBED CANNABIS FOR SLEEP WHEN CONDITIONS SUCH AS PAIN INTERFERED...

Insomnia from chronic nighttime pain can drain daytime energy, so it's easy to finally get a few nights of pain relief with cannabis but not notice imbalanced sleep rhythms when sleep has been disrupted for so long. I would strongly suggest anyone using cannabis for nighttime pain should take careful notes on what they tried, for how long, and how they felt. Note how long it took to get to sleep, if you woke up in the middle of the night, how long you slept, if you felt rested in the morning, and how your energy levels were the next day.

Were you alert and ready to go, or did you feel drowsy in the middle of the day? If so, that could be a sign you’re taking too much THC, or the balance of CBD to THC is too low. Sativex clearly showed us patients with chronic pain can manage nighttime pain and sleep with cannabis products, but it might take a little experimentation to figure out how cannabis can work best for you.

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FITNESS + CANNABIS RUNNING AWAY FROM NSAIDS

BY ANTONIO DEROSE This entire issue has focused on several pain conditions cannabis can help with and has referenced many scientific studies suggesting the roles cannabis and other plant medicines can play in pain management. With the widespread legalization of medical and adult use cannabis, as well as other substances worldwide, an evolving global culture of self awareness, and accountability for self-care over healthcare, more people are turning to plants over pills. One of those people is accomplished ultrarunner, author, and speaker, Brock Cannon, who is also the Founder and CEO of Prevail Botanicals, where their mission is “Ridding The World Of Ibuprofen One Human At A Time”

THE USUAL

Ibuprofen is one of several drugs, along with others like naproxen and aspirin, that are classified as being NSAIDs (Non-steroidal Anti-Inflammatory Drugs). NSAIDs are used to reduce pain and inflammation, but they’re also known to cause ulcers and bleeding in the intestines. As an ultra runner, in 2016, Brock was taking 2400mg of ibuprofen a day, to treat his pain and inflammation from trail running long distances, up and down the California mountainside. Even though his daily dosage was so high, including 6 pills in the morning, and 6 six at night, he was still in pain, and didn’t feel like the pharmaceuticals were reducing his inflammation. He was also aware of the dangerous side effects associated with their

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overuse, so he started exploring safer, natural, plant-based alternatives like arnica, turmeric, and eventually CBD. “I love any plants with medicinal properties,” says Brock. “If you think about how our ancestors operated even just 100 years ago, we didn’t rely on pharmaceuticals that were created in labs. We relied on plants, botanicals, herbs, and medicines that we had pulled and tested directly from nature. One could argue that pharmaceuticals ultimately come from nature, but I feel like the efficacy changes in a big way once it gets in the lab.” This is the reason he created Prevail Botanicals, to offer people a safer alternative to NSAIDs, by providing a natural plant based treatment for pain and inflammation, especially for runners.

In 2019, Brock won 1st Place overall at the Almost Lost 25k and Whoos Trail 50k, as well as taking 5th overall at the Born to Run 30 Miler and 14th overall at the Leona Divide 100k. In 2020, he will be taking on his very first 100 mile race, the SISU 100 Miler, and he’ll be using his own Prevail Botanicals to help him through it.

From all of us at GRAM, we wish you the best of luck and thank you for advocating for natural plant medicines.

OUTDOORS

MINDFULNESS IN THE GREAT OUTDOORS: HARNESS THE POWER OF MEDITATION WITH NATURE & CANNABIS

THE USUAL

BY BEN OWENS One of the fastest-growing trends since 2012, mindfulness has more than tripled in popularity in recent years as populations move towards a heightened sense of personal awareness.1 This mindful state primarily relies on the practice of meditation, a regular examination of one’s self, as a way of working through the ups and downs of our daily lives.2 Regular meditation has been shown to offer a variety of benefits, such as helping to ease pain and anxiety.1,3 Cannabis and nature have also been known to offer a variety of similar benefits. This article will explore how the benefits of meditation can be influenced and enhanced with the incorporation of cannabis and nature.

Since 1970, meditation has been shown to induce what is known as the “relaxation response.”4 This involuntary response causes a reduction in the sympathetic nervous system. Additionally, meditation has been shown to offer a variety of shortterm benefits including helping to lower blood pressure and improve circulation, lower heart rate, reduce anxiety, improve feelings of well-being, and even help reduce pain.1,3,4,5,6,7 Conventional pain-modulation treatments involve the prescription of powerful painkillers, particularly opioids, that are used to engage opioid receptors in the brain. These medications often carry serious risks, especially for chronic users, who are at an increased risk of abuse, addiction, and overdoses. Studies show that alternative pain relief therapies can offer similar benefits without the risks.3,5,6,7 Meditation is one such alternative therapy. The National Center for Complementary and Integrative Health released a study that found that patients who meditated during placebo administration had “significantly lower pain intensity and unpleasantness ratings compared to those who did not meditate.”3 The findings further suggest that meditation induces pain mitigation independent of opioid neurotransmitters, suggesting that meditation can also be used synergistically with conventional opioid treatments.

The natural world forces us to acknowledge the elements of the world. At its core, the goal of meditation is to be more aware of both our own being as well as its interaction with the world around us. As we reach a greater state of personal awareness, our awareness projects outwards, tuning to the sounds, smells, sights, and sensations inside and around us. Many find it easier to achieve this heightened state when in nature as it is both free of materialistic controls and distractions as well as being an innate reminder of the present moment and all that characterizes it.8,9 How can cannabis help with meditation? Cannabis has been used in meditation and mindfulness practices dating back to early Buddhism.11 Cannabis was used to help facilitate meditation in the Himalayas, and early archeological evidence suggests that Central Asian invaders brought with them traditions of using cannabis vapors for ritualistic and euphoric purposes.11 According to Ed Rosenthal, some consumers are seeking out strains that are high in CBN, often as a result of extended curing periods, as they tend to offer a more introspective effect, great for meditating and inner vision.12 If you’ve never tried meditation, it may be helpful to keep it simple. Set a timer for 10-15 minutes and spend that time focused on one particular aspect, such as breathing. Try spending that time outdoors and in nature if possible. Titrating your particular meditation routine may take some time, trial and error, but doing so can provide a multitude of benefits to help improve pain relief and enhance your quality of life.

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CANNABIS GERMINATION

BY RACHAEL CARLEVALE

WHAT DIDN’T YOU DO TO BURY ME BUT YOU FORGOT THAT I WAS A SEED. The famous words written by Greek poet, Dinos Christianopoulos, refers to the strength needed to grow and rise up out of adversities, and highlights the tremendous potential held within the mighty seed of nature. The process of germination, where a seed sprouts, and grows into a new plant, requires stable genetics, a growing medium, water, and time.

When it really comes down to it, you can throw a seed into some good organic living soil, and from it, a healthy seed starts. After all, this is how nature does it. Such as life, one can choose to make things as simple or as complicated as they’d like. I prefer to keep it simple; keep in mind, all genetics, environments, and growers are different, so results may vary.

The most important thing you want to focus on is making sure you have legitimate genetics.

The best seeds you can purchase are seeds grown and bred in organic living soils. The second most important thing you can have is a healthy environment your plants can sprout in.

Lastly, the third most important thing you can have is a healthy, clean biological medium into which you can germinate the seeds.

Germinate seeds under light with 20 hours on and 4 hours off. Adjust your light source to accommodate height wise for the reality that the plants will grow after they germinate. T5s or LEDs are highly recommended for this stage of growth. Try to keep the room between 70-75 degrees Fahrenheit during the day and 65-75 degrees Fahrenheit when the lights are off.

HOW TO GERMINATE SEEDS - A STEP BY STEP PROCESS: 1. Direct seeding into final soil. Plant the seed directly into moist organic soil because it will allow for the plant to grow into the most natural environment. If your seeds don’t make it within two weeks, then they were not biologically resilient enough to merit staying in your garden.

OR 1. Drop seeds in a cup of clean distilled RO (Reverse Osmosis) water, and wait for the first tap root, or tendril to pop. Keep the cup of water in a dark place. It should take between 24-32 hours to see the white root appear.

THE USUAL

2. Prepare your growing medium, and poke holes the size of your pinky into soil about ½ inch down.

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3. Hold seedling very gently or use tweezers and place the seed, tendril side down into the soil. Lightly backfill with soil to cover the seed.

Be careful not to touch the root, and always use clean hands when working in the garden.

4. Gently water over the soil.

5. Put under light source.

6. Begin watering cycle to keep plant growing.

As you monitor the growth of the plant, make sure you have healthy green vertical growth, and make sure the plant receives the feeding regimen it needs.

7. Soon you will notice the plant emerging from the soil. This first growth is called the cotyledon, and then the next growth you will notice are the first true leaves of your new plant!

Not all genetics are the same, so be patient.

Some will germinate at faster rates than others, and some seeds will not germinate at all. This is all part of the cycle of life, so keep a grow journal to learn the signs and patterns of each genetic you are working with from seed to harvest.

M XINE TAYLOR’S

CELESTIAL EVENTS Maxine Taylor became America’s First Licensed Astrologer after mounting a legal challenge to legitimize astrology in the 1960’s Bible Belt state of Georgia. She became CNN’s Original On-Air Astrologer when the network launched.

THE USUAL

FEBRUARY 2020 ARIES (MARCH 21 - APRIL 19) Your social life picks up during the first week of February, so accept all party invitations – maybe even throw one yourself! For the rest of the month chill, pull back, and enjoy your own company. This is a time of preparation and retreat. Let the world fight its battles while you dream a little dream…

TAURUS (APRIL 20 - MAY 20) February begins with an emphasis on your home and family, so take care of all domestic issues, including interaction between family members.

The rest of the month, you can spend time with your friends. This would be a good time to reconnect with old friends you have not seen in awhile.

GEMINI (MAY 21 - JUNE 20) You’ve got terrific ideas, share them with others the first week of February. After that, focus on your career. Speak to people in authority who can help you put your ambitions into action. If you have to put a project on hold, you’ll be able to pick up in March where you left off this month.

CANCER (JUNE 21 - JULY 22) Your focus is on money as the month begins.

Remember that what you focus on grows. For the rest of February, your vision increases and you see opportunities you didn’t realize were available to you. Travel will expand your vision even more.

If travel is not possible, higher education courses can accomplish the same thing.

LEO (JULY 23 - AUG 22) Put yourself first and do what you want, when you want, how you want. This is a time to rethink your image and self-concept. It’s even a good time to revamp your wardrobe and your appearance in general. As the month progresses, you become more introspective. Give yourself time alone to process your revelations about yourself.

VIRGO (AUG 23 - SEPT 22) When February begins, you want more time alone.

If you crave a spa day or a “staycation”, give it to yourself as a gift. Spend the rest of the month enjoying the company of others – particularly that one special person. And if there is no one special person in your life, now is the time to get out there and invite them to find you.

LIBRA (SEPT 23 - OCT 22) Your friends and social activities are your focus when February begins. Once you get the social urge out of your system, you’ll be able to put your attention on your work. If a project is put on hold, it will pick back up in March. This is a great time to take care of your health by eating correctly, exercising, etc.

SCORPIO (OCT 23 - NOV 21) You are focused on your career and your role as a leader when February begins. You’ll be ready for fun the rest of the month. If you encounter a glitch in your relationship with someone, just know that it is temporary and that you’ll be able to get back together again in March. Till then, keep having fun!

SAGITTARIUS (NOV 22 - DEC 21) Wanderlust takes over at the beginning of the month, so dust off your passport, grab your carryon, and take off running. The rest of the month you’ll want to enjoy all the comforts of home sweet home, so make plans to sit in front of the TV with the remote in your hand and chill.

CAPRICORN (DEC 22 - JANUARY 19) You are secretive as February begins, and you dig beneath the surface to get to the cause of what is going on. Mutually beneficial financial projects can easily be involved. Once you get your answers you can share them with the rest of the world.

Seriously. Do your research quietly and discreetly, then share it.

AQUARIUS (JANUARY 20 - FEBRUARY 18) You let others take the lead and call the shots in early February. Listen to what they are saying and gather information. Then take what they have shared and apply it to your own value system, particularly if the information deals with your finances. This can have a direct effect on your income.

PISCES (FEBRUARY 19 - MARCH 20) As February begins, you are all about getting the job done, so throw yourself into your work. This is also a great time to improve your health and increase your energy. Spend the rest of the month focused on self-improvement. Put yourself and your physical well-being first and take care of you.

It will feel great!

IF YOU WOULD LIKE A FREE BIRTH CHART GO TO MAXINETAYLOR.COM CLICK ON THE READING FORM, AND SELECT FREE BIRTH CHART. THEN JUST FILL IT OUT AND HIT SUBMIT. youtube.com/c/MaxineTaylorAstrologer

twitter.com/wizardstargazer

facebook.com/starmaxinetaylor

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COOKING WITH PLANT MEDICINE FEATURING CHOCOLATIER, LAUREN GOCKLEY

A true chocolatier and artist of the highest caliber, Lauren (along with her Coda signature team) has been recognized as one of the top edibles creators in the state of Colorado and nationally. Lauren completed her studies as a classically trained chocolatier at l’Ecole du Grand Chocolat in Tain l’Hermitage, home of the Valrhona Chocolate Company.

THE USUAL

After graduating at 24, she worked in a series of Parisian pastry shops before returning to the states where she quickly found a place with Jean-Georges Vongerichten’s Bank in Houston, and then on to Thomas Keller’s Per Se in New York. Lauren worked as a raw, vegan chocolatier for four years, gaining great knowledge and appreciation for the complexity and versatility of cacao in its natural form. After 10 years of chocolate mastery, she was named one of Dessert Professional’s Top 10 Chocolatiers in North America.

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Lauren is now the Director of Edibles at Coda Signature. In music, a coda represents the culmination of the musical language that comprises a piece, delivered with a distinct expression all its own. Coda Signature is that moment in the evolution of cannabis. With music as our muse and cannabis as our medium, Coda Signature creates cannabis infused products full of inspiration and imagination.

Meant to warm our hearts, Lauren presents us with this Decadent Coffee, featuring Coda Signature’s award winning Coffee & Doughnuts chocolate bar. (If Coda Signature is not available in your state, it can be substituted with another infused chocolate.)

DECADENT COFFEE WITH CHOCOLATIER, LAUREN GOCKLEY

INGREDIENTS • Coffee & Doughnuts chocolate bar, 100mg THC • Coffee • Whipped Cream • Caramel Sauce (optional)

DIRECTIONS • Brew your favorite coffee roast • Place 1 10mg THC square of Coffee & Doughnuts chocolate to the bottom of a mug • Pour the hot coffee over the chocolate and stir until mixed • Top with whipped cream and caramel sauce for additional sweetness

THE USUAL

SERVING SIZE 1 COFFEE - 10MG THC PER SERVING

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JOIN US AS WE

GROW

APRIL 4 - 6 THE INSTITUTE OF CANNABIS RESEARCH CONFERENCE COLORADO STATE UNIVERSITY | PUEBLO, CO An international, multi-disciplinary cannabis research conference. Hear GRAM’s managing editor, Antonio DeRose speak on the media panel.

APRIL 6 -8 CANNABIS SCIENCE CONFERENCE | BALTIMORE, MD The world’s largest cannabis science event!

MAY 7-9 USA CBD EXPO | ATLANTA, GA The nation’s largest CBD event.

Use Gram50 for 50% off tickets MAY 28-30 CANNABIS WORLD CONGRESS NEW YORK CITY, NY

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@getgramnow

REFERENCES Medical Minute with Nurse Jordan 1. Health Affairs. February 2019.

2. Center for Disease Control. 2016.

3. Journal of Pain. November 2019.

4. University of California. February 2018.

5. https://www.cdc.gov/chronicdisease/resources publicationsfactsheets/arthritis.htm 6. https://www.arthritis.org/living-with-arthritis/ painmanagement/chronic-pain/arthritis-foundationcbdguidance-for-adults.php 7. Division of Drug Risk Evaluation, Food and Drug Administration. 2007 CBD + PAIN | Ben Owens 1. Postgrad Med. 2019 Nov 12:1-6. https://www.ncbi.nlm.nih. gov/pubmed/31711352 2. https://www.jpain.org/article/S1526-5900(19)30848-X/ fulltext 3. https://www.brainandspine.org.uk/information-and-support/ living-with-a-neurological-problem/neuropathic-pain/ Research Corner | Dr. Matt Jackson, PhD 1. https://doi.org/10.1016/j.jpain.2016.03.002 Plant Medicine | Powerful Plants for Pain | Heather DeRose 1. https://usonaclinicaltrials.org/ 2. https://nccih.nih.gov/health/ayurveda/introduction.htm#hed1 3. https://nccih.nih.gov/health/turmeric/ataglance.htm 4. https://www.mdpi.com/1422-0067/20/5/1033/htm 5. https://www.ncbi.nlm.nih.gov/pubmed/31239749 6. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4230973/ 7. https://www.ncbi.nlm.nih.gov/pubmed/31730539 Golnesa Gharachedaghi | Jordan Person 1. https://www.arthritis.org/about-arthritis/types/rheumatoid arthritis/what-is-rheumat oid-arthritis.php 2. https://www.cdc.gov/arthritis/basics/rheumatoid-arthritis. html 3. https://www.mayoclinic.org/diseases-conditions/trigger finger/symptoms-causes/s yc-20365100 4. https://www.linkedin.com/in/allanfrankel/ 5. https://wusah.com/ Jagger’s Journey, The Cotte Family Story | Curt Robbins 1. https://www.umdf.org/what-is-mitochondrial-disease/ 2. https://my.clevelandclinic.org/health/diseases/15612 mitochondrial-diseases Ashley Manta: “The CannaSexual” Professional | Heather DeRose 1. https://publications.sciences.ucf.edu/cannabis/index.php/ Cannabis/article/view/35/16 disLIST | Chronic Pain | Michelle Martin 1. http://www.theacpa.org/pain-management-tools/videos/ support/ 2. https://www.theacpa.org/wp-content/uploads/2019/02/ ACPA_Resource_Guide_2019.pdf 3. doi: 10.2147/JPR.S159852.

4. doi: 10.1371/journal.pone.0222577.

5. doi: 10.1212/WNL.0000000000000250.

6. http://www8.nationalacademies.org/onpinews/newsitem. aspx?RecordID=24625 7. doi: 10.7326/M17-0155.

8. doi: 10.2147/JPR.S192174.

9. doi: 10.3390/molecules23102478.

10. doi: 10.3389/fphar.2018.01259.

disLIST | Breakthrough Pain | Matt Jackson, PhD 1. https://www.cancer.gov/publications/dictionaries/cancer terms/def/breakthrough-pain 2. https://doi.org/10.1097/j.pain.0000000000000721 3. https://www.nimh.nih.gov/about/director/messages/2019/ suicide-deaths-are-a-major-component-of-the-opioid crisis-that-must-be-addressed.shtml 4. https://doi.org/10.1016/j.jpain.2019.01.010 5. https://doi.org/10.1097/j.pain.0000000000001295 6. https://doi.org/10.1007/s40122-018-0097-6 7. https://doi.org/10.1002/ejp.1297 8. https://doi.org/10.1016/s0885-3924(03)00142-8 9. https://doi.org/10.1038/s41598-019-39462-1 disLIST | Nighttime Pain | Matt Jackson, PhD 1. https://doi.org/10.1002/cbdv.200790150 2. https://doi.org/10.1007/s11920-017-0775-9 3. https://doi.org/10.1002/ana.20863 4. https://doi.org/10.1111/j.1365-2036.2006.02944.x 5. https://doi.org/10.1200/JCO.2007.12.2135 disLIST | Neuropathic Pain | Ben Owens 1. https://www.webmd.com/pain-management/guide/ neuropathic-pain 2. https://www.medicinenet.com/neuropathic_pain_nerve_ pain/article.htm 3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5767492/ 4. http://jpet.aspetjournals.org/content/jpet/357/1/45.full.pdf 5. https://www.ncbi.nlm.nih.gov/pubmed/9160645 6. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2866040/ 7. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2828614/ 8. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6308289/ 9. https://www.ncbi.nlm.nih.gov/pubmed/29388063 10. https://www.mdedge.com/ccjm/article/189782/drug therapy/cannabis-peripheral-neuropathy-good-bad-and unknown 11. https://www.tandfonline.com/doi/ abs/10.1185/030079906X158066 12. https://www.sciencedirect.com/science/article/abs/pii/ S1526590015008123 13. https://www.sciencedirect.com/science/article/abs/pii/ S1526590012008644 14. https://www.sciencedirect.com/science/article/abs/pii/ S152659001500601X disLIST | Back Pain + Cannabis | Heather DeRose 1. https://www.mayoclinic.org/diseases-conditions/back-pain/ symptoms-causes/syc-20369906 2. https://www.ncbi.nlm.nih.gov/pubmed/28782674 3. https://www.dovepress.com/cannabinoids-and-spinal-cord stimulation-for-the-treatment-of-failed-b-peer-reviewed article-JPR 4. https://www.ncbi.nlm.nih.gov/pubmed/29145417 5. https://www.ncbi.nlm.nih.gov/books/NBK224384/ Outdoors | Mindfulness in the Great Outdoors: Harness the power of Meditation with Nature + Cannabis | Ben Owens 1. https://www.mindful.org/meditation-is-the-fastest-growing health-trend-in-america/ 2. https://www.merriam-webster.com/dictionary/mindfulness 3. https://nccih.nih.gov/research/results/spotlight/mindfulness meditation-pain Zeidan F, 4. https://www.gaiam.com/blogs/discover/meditation-101 techniques-benefits-and-a-beginner-s-how-to 5. https://www.health.harvard.edu/blog/mindfulness meditation-may-ease-anxiety-mental-stress-201401086967 6. https://nccih.nih.gov/research/blog/mindfulness-meditation pain 7. https://www.theatlantic.com/health/archive/2014/04/ treating-chronic-pain-with-meditation/28418/ 8. https://www.yogajournal.com/meditation/natural-wonder 9. https://www.ehe.health/blog/outdoor-meditation 10. https://www.westword.com/marijuana/marijuana-and meditation-how-to-use-pot-during-deep-reflection-11304337 11. http://www.scielo.br/scielo.php?pid=S1516 44462006000200015&script=sci_arttext&tlng=pt 12. https://www.edrosenthal.com/the-guru-of-ganja-blog/ drying-and-curing-cannabis-the-art-of-enhancing-effect and-flavor

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