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As a Family Nurse Practitioner and Medical Cannabis Specialist, I regularly consult with parents who are curious if CBD or THC could be beneficial for their child. The most common reasons being afflictions such as cancer, epilepsy, PTSD, and conditions related to autism (self-injury, aggression, sleep disturbances). I have seen cannabis change people’s lives, but it is not for everyone. It is important to not only do your research, but to have realistic expectations going in. What I do know is that through proper consultation, diagnosis, and support nearly all of our patients who use cannabis therapeutically have derived benefits from it; qualitative research has shown that this is the experience of most individuals who use cannabis medicinally. Despite the proven medical efficacy of cannabis for multiple conditions, families still face barriers in trying to access this option for their children. They often experience negative feedback, social stigma in their communities, and pushback from medical providers. The cost of treatment is not covered by insurance and there is great risk and a valid fear of legal trouble for treating their child with a substance that is illegal at the federal level. In the face of all of this, more and more families are moving forward with medicinal cannabis as a treatment option, in the hopes that this plant might help their child where traditional pharmaceuticals and treatments have failed. The question I hear most frequently is, “will this have negative long-term consequences on my child’s brain?” and the truth is we don’t have enough long-term data to be able to answer this unequivocally. What we do know is that cannabis has an excellent safety profile and that it is a neuroprotectant. There have been some studies correlating heavy THC use with negative psychiatric outcomes in susceptible individuals. However, the studies were looking at illicit cannabis use (which could potentially include high THC concentrates) - not supervised medical use – and they did not establish a causal relationship between THC use and any mental disorder. We need more research so we can develop pediatric medical guidelines. In the meantime, what’s important for families considering cannabis as an option, is to have a careful risk-benefit analysis done prior to starting treatment, and close follow-up with an experienced provider versed in treating pediatric patients with medicinal cannabis. As a practitioner, the best advice I can give to parents is to enlist the help of a cannabis clinician, cannabis nurse, or doctor trained in the endocannabinoid system. Most medical providers simply are not qualified to manage this treatment because they lack both education and experience with cannabis as medicine. A cannabis clinician is trained to provide education about the cannabis plant and how it works in the body, to offer dosing and administration guidance to parents and patients, to assess potential drug interactions, and to advocate for the patient as part of their medical team. If mental health issues are part of your child’s clinical history or if they are a teen, I highly recommend including a cannabis-informed mental health provider as an additional support person to assist in the proper monitoring of your child for any unwanted or unforeseen side effects. I believe that cannabis can be a safe and highly effective treatment option for many conditions, and that it should be available for pediatric patients - not just as a last resort. When it comes to minors especially, getting the advice of a licensed professional is important. You don’t want to wing it, rely on just what you come across online, or simply take the advice of family and friends. Finding the lowest effective dose for an individual is both an art and a science that requires patience and good communication from everyone involved, but the benefits for the child can be enormous.
Occasional doses of CBD may provide some relief, or not seem to do anything. For optimal results, and health benefits can be potentially life changing, consider the advice of Dr. Dustin Sulak who has been guiding patients on the use of medical cannabis since 2009. 1. Find your optimal intake amount CBD has varying effects on each person.. It is important to find the amount that works best for your body in order to get the best results. Dr. Sulak recommends that people start low, taking about five milligrams for two days and then go up to ten drops for two days if they aren’t yet feeling benefits, and increase by five drops every other day until they achieve the benefits they’re seeking. For those that experience CBD as energizing and want to try it as a sleep aid, some find that doubling or even quadrupling the amount they take may decrease the energizing effect and support relaxation and sleep. 2. Give it time - up to a month Some people get almost instant results with CBD, while others don’t achieve perceptible effects until using it for about a month since it can be a cumulative effect 3. If using a tincture, hold the drops in your mouth at least one minute, or take it with a fatty food Tinctures are absorbed through the soft tissues in your mouth, best when placed between the inner cheek and gums or under the tongue and held for no less than one and up to two minutes before swallowing. Tooth brushing before can increase blood flow in the mouth making the onset faster. Whether choosing drops, a tincture, capsules or gelatin-based gummies, taking your CBD with healthy fats, can facilitate absorption and result in a stronger effect. 4. Use Consistently (if not noticing immediate results) Some people achieve their desired results with occasional use of CBD or CBDA*, taking it only when needed. The anti-inflammatory effects of CBD and CBDA provide relief for others with daily use. *CBDA is the raw form of CBD. CBDA converts to CBD slowly at room temperature, or rapidly when exposed to high temperatures. 5. If CBD is not working for you, consider trying CBDA Dr. Sulak has found through his clinical work with CBDA that even small amounts can have significant effects; several animal studies yielded similar results. CBDA absorbs 5x-10x more than CBD. He recommends you consider trying CBDA if you are not achieving your desired results with CBD. Read the original article, Top 5 Reasons CBD Isn’t Working for You” on Healer.com
Some of the common myths about marijuana (sometimes referred to as “marihuana”), many of which have been spread and amplified over the years through ad and media campaigns by industries that benefit from the prohibition of marijuana. Following are some the myths, and brief description of the truths: MYTH: Marijuana harms your brain FACT: Contrary to what we were taught by the war on Drugs, many studies have proven that cannabis does just the opposite – cannabis has been shown to promote neuroregeneration. Neurogeneration is the regrowth or repair of nervous tissues, cells or cell products that promote the growth and development of new brain cells. MYTH: Marijuana causes you to feel high or stoned FACT: While marijuana can cause a psychoactive effect that people describe as a pleasant euphoria and enhancement of the senses, it is possible to gain the medical benefits of cannabis without any intoxication or impairment. Furthermore, breeders of medical cannabis are currently creating strains that emphasize the health advantages and lessen or completely eliminate the psychoactivity. MYTH: Cancer is caused by smoking marijuana. FACT: The therapeutic substances in cannabis actually have strong anti-cancer properties. MYTH: Marijuana is a gateway drug to other substances and is addictive. FACT: While uncommon, cannabis dependence does exist. However, most people don’t have any trouble stopping using cannabis when and if they need to, since it is not a physical addiction. MYTH: People who use marijuana get fat and hungry FACT: You’ve probably heard people say that cannabis causes “the munchies”. Cannabis has been used successfully with AIDS and cancer patients to reduce nausea and promote appetite in a helpful way. However, cannabis affects the brain centers related to pleasure and eating as well as metabolism hormones. When used correctly, it can support a return to balance for individuals who are both underweight and overweight. MYTH: People who use marijuana become mentally unstable FACT: Some evidence points to cannabis consumption being linked with the onset of psychosis or schizophrenia. Whether or not cannabis use can actually trigger the onset of mental illness, something scientists continue to debate, if it does, it’s extremely rare. It is much more common for cannabis to actually help mental illnesses such as depression, anxiety, PTSD, bipolar, and even schizophrenia. Read the full story, including medical research citations, at, https://healer.com/blog/marijuana-myths-cannabis-facts/
Many of us following the ever expanding cannabis industry in the United States have seen more and more CBD-infused food and drink products hitting the market and becoming readily available for consumers. There are CBD gummies, cookies, elixirs, seltzers, sodas, coffees, smoothies, and anything else you might imagine. These products are available all over the place, from high end grocery stores to bodegas, and everywhere in between. What people may not know, however, is that CBD-infused products remain illegal at the federal level. CBD, short for cannabidiol, is a compound in cannabis which has recognized medical value, but does not produce the high or euphoria created by the more commonly known cannabis compound THC. The United States legalized CBD derived from hemp in December of 2018. In 2018, the FDA approved Epidiolex, the very first CBD medication cleared for patient use in the United States. Somewhat ironically, this approval once gave the FDA pause in its formal position on CBD in food and drink products. The FDA’s official position has clearly been that CBD-infused food and drinks were illegal because none of those products had gone through the rigorous regulatory testing to which Epidiolex was subjected before approval. In the spring of 2019, the FDA indicated a possible position change, when the then outgoing FDA chief Scott Gottlieb spoke about the potential for legalizing CBD infused food and drinks as long as those products met certain regulatory standards. The FDA’s formal statement included the following: “There are open questions about whether some threshold level of CBD could be allowed in foods without undermining the drug approval process or diminishing commercial incentives for further clinical study of the relevant drug substance.” In late 2018, the FDA released a statement saying that it would crack down on CBD in food and drinks (and there were inspections, penalties, and fines on certain retailers nationwide, notably in New York, Ohio, California, and Maine). At the very least, Chief Gottlieb’s statements in 2019 indicated that the FDA was envisioning a world where certain CBD-infused food and drinks could be legal at the federal level. So what has happened since then? Well, the CBD market has continued to grow at an incredible rate. According to Forbes, one forecast predicts that the market will climb to $19.5 billion by 2025. This projection includes a compound annual growth rate of nearly 37%. There is, however, a catch (and it’s a BIG catch): The estimate hinges on whether the FDA will finally approve CBD as a legal additive to consumer products. Despite the seemingly positive movement in 2018-2019, the FDA is maintaining a very cautious and measured approach with CBD, and CBD infused food and drinks remain illegal and subject to great scrutiny. In an article posted by the FDA in late 2022, the agency explained that “the data on CBD point to real risks that need to be considered. Risks include liver injury, harm to the male reproductive system, and side effects, such as changes in alertness and other symptoms. In addition, drug interactions – taking CBD with other medications -- may increase or decrease the effects of other medications, which may lead to more side effects from, or decreased effectiveness of, the other medications.” In that same article, the FDA acknowledged that there is great public interest in CBD, despite the fact that CBD cannot lawfully be added to foods or dietary supplements. Further, the FDA stated that it is continuing to explore “policy solutions to address the large, violative market of CBD products” and that it would continue to monitor the CBD market and would take action, as needed, against companies that it feels pose a high risk of harm to the public. In November of 2022, the FDA issued warning letters to companies for illegally selling foods with CBD (and Delta-8 THC), including products that the FDA felt appealed to children. In short, there has not been any real CBD policy movement by the FDA in the past couple of years. It is certainly possible that the FDA’s focus on COVID-19 and addressing vaccines may have prevented the agency from addressing other issues, including CBD. US legislators have certainly noticed the delay. Rep. James Comer, the chair of the US House Oversight Committee, commented recently that that the committee desires to question the current FDA Commissioner Robert Califf regarding the agency’s lack of movement on a number of issues, including CBD. It remains to be determined when this committee questioning will occur. Currently, CBD businesses wishing to infuse the compound into food and drinks must take on a certain amount of risk and bet on the eventual legalization of CBD infusions. While the FDA certainly still seems very cautious and hesitant about legalizing these products for the time being, it is also likely that CBD infusions will eventually become legal in some form (but highly-regulated). Manufacturers, marketers, distributors, and retailers of CBD-infused food and drinks, and those wishing to enter this exploding market, should certainly keep an eye on the FDA’s position and comments in 2023. In the past, the FDA has held public hearings on CBD and has taken comments from the public. The FDA continues to gather data on the safety of CBD in food products as well as feedback on how the FDA could regulate certain aspects of the industry (including manufacturing, marketing, and labeling). Additionally, the FDA openly encourages individuals to submit comments, data, and information related to cannabis and cannabis-derived products, including CBD, to the public docket, which the FDA reopened in March of 2020. FDA reopened the docket to provide a public and transparent way for those in the industry to provide new and emerging information to the FDA in real time. In 2023, for those in the industry, it is important to make your voices heard by posting comments and information for the FDA to consider as it continues to grapple with its position and policy on CBD. Update: Things happen fast in this space. Today, January 26th, the FDA released a statement concluding that the current regulatory framework for food and supplements are simply not appropriate for CBD! Looks like this is up to the lawmakers in congress now!
Last week, La Shawn K. Ford, a Democratic member of the Illinois House of Representatives, introduced the Compassionate Use and Research of Entheogens Act, or CURE Act, as the very first bill during the opening session of Illinois 103rd General Assembly. Entheogen is a term used to describe a psychoactive, hallucinogenic substance or preparation (such as psilocybin, the active component in so called “magic mushrooms”) especially when derived from plants or fungi and used in religious, spiritual, or ritualistic contexts. The proposed legislation would set up the Illinois Psilocybin Advisory Board within the Department of Public Health (“DPH”) for the purpose of advising and making recommendations to the Department regarding the provision of psilocybin and psilocybin services. Additionally, the CURE Act sets forth that the DPH shall begin receiving applications for the licensing of persons to manufacture or test psilocybin products, operate service centers, or facilitate psilocybin services. Further, it provides that that the DPH may obtain, relinquish, or dispose of psilocybin products to ensure compliance with and enforce the Act and rules adopted under the Act. The CURE Act also contains various provisions concerning rulemaking; taxes; fees; zoning; labeling; and penalties. The Act also calls for the expungement of certain criminal records relating to the possession of psilocybin and psilocin. Significantly, the Act would amend the Illinois Controlled Substances Act, removing psilocybin and psilocin from the list of Schedule I controlled substances, and effectively decriminalizing psilocybin in Illinois. Four different types of licenses could be obtained under the new law; a Psilocybin Product Manufacturing License; a Service Center Operator License; a Psilocybin Services Facilitator License; and a Psilocybin Products Testing License. This law is a direct response to the ever increasing amount legitimate scientific evidence, including studies, approvals, and press releases from the FDA, demonstrating that psychedelic / entheogenic treatments can be offered in a safe and controlled environment, with an excellent success rate. Studies have shown that such treatments have been successful for patients suffering from a wide array of ailments including addiction, traumatic brain injury, depression, and PTSD. Psilocybin has become increasingly popular in the research setting to treat neurological and mental health conditions. In fact, in the fall of 2022, the FDA approved an investigational new drug application which would allow for clinical trial testing to determine how psilocybin therapy impacts the treatment of anorexia. The CURE Act is not only a response to this growing scientific evidence, but also based on comments from “patients and from their medical providers, that Illinoisans should have access to these exciting new treatment options," according to a press release from Rep. Ford. Illinois is not the first state to address the decriminalization of psilocybin seeking to legalize its use in a clinical setting. In May of 2019, Denver, Colorado decriminalized the naturally occurring compound. Since that time, cities Ann Arbor, Michigan, Somerville, Massachusetts, Washington D.C., Seattle, Washington, and Cambridge, Massachusetts have decriminalized the possession, use, and propagation of psychedelic mushrooms. Oregon, with the passage of 2020’s Ballot Measure 109, was the first state to formally decriminalize psilocybin and legalize its use in a therapeutic setting. Colorado passed similar legislation in 2022. While it remains to be seen if the CURE Act will become law in Illinois in 2023, the bill’s introduction is a step forward in the ever changing landscape of public and legislative acceptance of the benefits of psychedelic / entheogenic based therapies for patients searching for more profound and effective treatments of various conditions. Despite these positive changes, Psilocybin remains completely illegal under federal law and is considered a Schedule I substance under the federal Controlled Substances Act (defined as a substance which has a high potential for abuse and no currently accepted medical use). Given the federal status of the compound, individuals and companies who wish to operate in the psychedelics field (even in the states with legalization measures) must be careful to do so in an manner that does not run afoul of any state or federal law. This is where trusted legal counsel can be a valuable asset. Those interested in applying for licensure to work with or research these controlled substances (under the CURE Act if it passes, or under the current regulatory scheme) should seek the advice of counsel who have experience in working with the DEA and state agencies to get clients properly approved and licensed as researchers or analytical labs. Attorneys at Amundsen Davis have assisted clients in the successful application to become an analytical lab, researcher, and manufacturer of psilocybin. We are proud to be on the forefront of helping clients in this groundbreaking field, and welcome the opportunity to work with anyone closely monitoring this exciting area of research and progress.
Last month, the Illinois Department of Finance and Professional Regulation (IDFPR), announced that it would begin accepting applications for 55 new adult-use cannabis retail licenses after January 30, 2023. The IDFPR, the governmental entity tasked with regulating the recreational cannabis dispensaries in Illinois, has issued guidelines for what is being called the Social Equity Criterial Lottery. In order to be issued a conditional license pursuant to this application and lottery process, an applicant must be able to establish that it is 51% or more owned or controlled by one or more individuals who each meet the combination of at least one of the criteria under two distinct categories (A and B) set forth by the IDFPR. For “Criteria A” the individual must have: a) resided for at least 5 of the preceding 10 years in an area that has a poverty rate of at least 20%, or b) resided for at least 5 of the preceding 10 years in a census tract where at least 20% of the households receive assistance under the Supplemental Nutrition Assistance Program, or c) resided for at least 5 of the preceding 10 years in a census tract area classified as “low income and low access” where at least 100 households are more than one-half mile from the nearest supermarket and have no access to a vehicle or a significant number (at least 500 people) or share (at least 33%) of the population is greater than 1 mile from the nearest supermarket, supercenter, or large grocery store for an urban area or greater than 20 miles for a rural area, as classified by the latest data set that is publicly available at the start of the application window, or d) received Medicaid, Supplemental Security Income, Social Security Disability, and/or subsidized housing for at least 5 of the preceding 10 years, or e) resided for at least 5 of the preceding 10 years in a census tract in the top 15th percentile for the percent of residents in the census tract failing to graduate from High School in that state. For “Criteria B” the individual must have a) been arrested for, convicted of, or adjudicated delinquent for any offense, or substantially similar offense, of Illinois, federal, or other state law for: possession of not more than 500 grams of cannabis; or manufacture, delivery, or possession with intent to deliver, or manufacture of cannabis up to 30 grams; or b) a family member who has been arrested for, convicted of, or adjudicated delinquent for any offense, or substantially similar offense, of Illinois, federal, or other state law for these same crimes, or c) been a victim of a firearm injury. After the applications are processed, the IDFPR will post the list of eligible lottery participants. If the applicant is awarded an opportunity for a conditional license in the lottery, in order to actually be issued the conditional license, the applicant must then actually prove the business entity is 51% or more owned or controlled by one or more individuals who each meet the combination of at least one of the criteria under Criteria A and one of the criteria under Criteria B. The applicant will have 45 days to submit this proof along with other operational requirements. After the prove up period, the applicants’ documents will be reviewed by the IDFPR, and each applicant will be allowed time to cure any deficiencies. After a successful prove up, the IDFPR will issue a conditional license. The conditional license does not allow the holder to actually sell cannabis, but rather allows the holder to begin its zoning, operational, and build-out process. The application process has been greatly streamlined compared to the sprawling and highly intricate applications that were required for dispensary applicants when Illinois first legalized recreational cannabis. Based on a “mock” application released by the IDFPR (the final application form has yet to be released), the applicant will need to fill out a form that is less than five pages, providing only basic information on proposed ownership and the proposed entity and making certain acknowledgements that the applicant fits the aforementioned criteria. The 55 new licenses will be distributed throughout seventeen different pre-determined geographic regions within Illinois (also known as BLS – Bureau of Labor Statistics). In another significant change from the initial round of retail licensing, no applicant group may file more than one application. Additionally, each application is limited to only one BLS Region. Finally, the application fee has been greatly reduced, from $2,500.00 to $250.00. With these changes, it certainly looks like Illinois is attempting to level the playing field, so to speak, and create a process that is more equitable for applicants who cannot afford to flood the system with multiple applications. Further, Illinois is continuing to stress the importance of equity in its cannabis market and community. Governor J.B. Pritzker has often mentioned his desire to make the Illinois’ cannabis market one of the most accessible and equitable in the country, and this new round of licensing appears poised to achieve that goal. Despite the greatly streamlined application process, the window for submission will likely be short (approximately two weeks), and qualifiers for the lottery are expected to be announced as soon as February 21, 2023. Additionally, the post-lottery prove up period will be document intensive and draw detailed scrutiny from the IDFPR as it aims to make sure that the Social Equity Applicants are truly qualified under the set criteria. Applicants can benefit greatly from the guidance and counsel of experienced cannabis lawyers in Illinois, and should seek assistance to guide them through this new process.
Cannabis topicals can be found in the form of balms, creams and lotions, oils, salves, gels, and transdermal patches. Many people report this to provide targeted relief of pain and inflammation, including arthritic pain. They can be applied to localized areas for localized relief from pain, or to reduce inflammation. Cannabis topicals often contain cooling, moisturizing, and soothing ingredients in addition to cannabinoids and terpenes. Essential oils and hyaluronic acid may be found in cannabis topicals, as well as carrier oils that help the compounds to more deeply penetrate the skin. Topicals are best absorbed when applied to clean skin. Anecdotally, applying topicals after a shower or bath may increase efficacy by increasing absorption due to the pores being more open. This is but one of the areas of cannabis science on which more research is needed to confirm anecdotal evidence. For transdermal patches, the skin should be dry to allow for optimal adhesion. Just as different cannabis strains can have different effects when inhaled or consumed orally, topicals may vary on the relief they provide for different symptoms based on the cannabinoids and terpenes in the product, in addition to the other ingredients. Preliminary research has shown that applying cannabis topically, particularly CBD, can relieve topical skin conditions like eczema and acne in addition to helping with inflammation, muscle soreness, and inflammation. Note: It is possible that one may test positive for cannabis on a drug test with the use of topicals, especially if used on a highly venous area of the body since cannabis is absorbed into the bloodstream. Some sites erroneously state this can never happen.
The “entourage effect” in cannabis is a theory that suggests that the cannabinoids, terpenes, flavonoids, and other compounds found in the cannabis plant work together synergistically to enhance their effects. From decreasing inflammation and lowering anxiety, to numerous other wellness issues, the different compounds found together in nature in the cannabis plant may work together to support a person’s well-being. As research progresses and more and more is learned about cannabinoids, terpenes, and flavonoids, the cannabis scientific community learns more about how these compounds react when they enter the body. This is due to the unique nature of each, and how they interact with the human endocannabinoid system.
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