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Telemedicine in Colorado: Take Action Now!

Medical cannabis telemedicine has been banned under Colorado State Law, only allowed temporarily under an executive order issued by Governor Polis during the COVID-19 pandemic.

 

Since 2021, when the executive order ended, Colorado has witnessed an exodus of medical card holding patients leave the system. The requirements of patients for obtaining and maintaining a medical card coupled with the scarcity of clinics who offer services in rural areas of the state, are leading reasons for non-renewals. While many will suggest recreational purchasing as an alternative, for several the high tax and less-concentrated product allowances makes even recreational cannabis inhibitory.

 

Many of Colorado’s medical cannabis patients are homebound, immunocompromised, and/or disabled. Just as 32+ of the states in our nation offer, Colorado patients should have access to telemedicine as an avenue to support their health care.

 

If you agree that telemedicine should be brought back to Colorado, and here to stay, please fill out this form in support. Your information will be shared with the state legislature who are bound to keep your needs and interests at the forefront of their decision-making.

 

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Cannabis for Dogs and Cats: 2023 Results Show Promise in Veterinary Medicine

The Endocannabinoid System (ECS) has been found to be present in vertebrates (mammals, birds, reptiles, and fish) and invertebrates (sea urchins, leeches, mussels, nematodes, and others). It regulates sleep, appetite, behavior, and multiple metabolic processes. The ECS also plays an important role in pathologies that affect other organs and systems, working to restore homeostasis. Scientific evidence of the ability of phytocannabinoids to assist the ECS in regulation is growing, even in the realm of veterinary medicine to understand the potential benefits in alleviating symptoms associated with different animal disorders. 

 

Despite legal restraints from country to country, use of cannabinoids in dogs, cats, and horses have been reported to include:

 

  • Reduction in anxiety
  • Reduction in pain
  • Improvement in mobility issues associated with osteoarthritis
  • Regulation of appetite
  • Control of type 2 diabetes
  • Control of inflammatory conditions
  • Lessened epileptic episodes

 

Published results from a United States survey reported that nearly 60% of pet owners give or were giving cannabidiol (CBD) to their dogs and 12% reported the same for their cats. From these, 64% found it helped with pain reduction, 50% found it helped with sleep, 49% found it reduced anxiety, and 30% found it reduced convulsions. 

 

Argentinian Study Shows Promise

 

Between May and November 2021, Argentinian Cannabis Veterinarians conducted the first national survey to assess and evaluate cannabinoid therapy treatments provided by veterinarians to dogs and cats. Results were published in 2023. The survey evaluated the following comprehensive list:

 

  • Location of the practitioner
  • Species treated
  • Breed
  • Age
  • Weight
  • Pathology
  • Type of feeding
  • Treatments implemented
  • Type and concentration of cannabis (full spectrum THC dominant, full spectrum CBD dominant, or a full spectrum 1:1 ratio)
  • Route
  • Dose

 

Of the treated species, 77% were dogs and 21% were cats. 

 

Dogs


The dog ages ranged between 0.4 and 19 years old. Pain was the most prevalent condition followed by behavioral and seizures. Remaining disorders included distemper, cancer, senile cognitive dysfunction, and dermatopathies. Veterinarians determined the cannabis oil type based on the condition. For example, 97% of dog patients with pain were treated with either a THC dominant or 1:1 ratio formulation, whereas 58% of dog patients with behavioral disorders and 54% of dog patients with seizures received the CBD dominant formula. 

 

Among the dogs treated for pain, 37% showed significant improvement after 15 days of treatment and 80% showed significant improvement after 60 days of treatment using the THC dominant formula. Those treated with the 1:1 ratio formula saw a significant improvement of 75% after 15 days. Dogs with seizures and behavioral disorders using CBD dominant formulas witnessed reduced seizure frequency, duration, and intensity in epileptic conditions. They also had minimized behavioral disorders such as anxiety, restlessness and compulsive behaviors. 

 

Of the 89 dogs who received cannabis oil, 28 were using it as a standalone therapy without any other medication.

 

Reported adverse effects for the dog patient group  included lethargy and one case of a paranoid state with a patient taking other medication and with a pre-existing behavioral disorder. 

 

Cats

 

The age range of cat patients was similar to dogs at 2 years to 18 years old, although a smaller group was observed. The main diseases and conditions observed included behavioral disorders, pain, gingivostomatitis, dermatopathies, autoimmune diseases, and combinations of two or more conditions. 

 

THC dominant, 1:1 ratio, and CBD dominant formulas were used for cats with pathologies such as behavioral disorders, pain, and cancer. Dermic pathologies were mostly treated with just the CBD dominant formula. The THC dominant formula showed a 66% improvement at 15 days while the CBD dominant formula showed a significant improvement of 43% at 15 days and 75% at 30 days. 

 

For cats, the use of the cannabinoid products alone or combined with other medications improved clinical parameters. Ten cats received cannabis as their single therapy. Just as with the dog group, veterinarians and caregivers saw a reduction of clinical signs and symptoms at 15, 30, and 60 days. 

 

Study Takeaways

 

This exploratory study presented the opportunity to determine the status of cannabinoid therapy in veterinary medicine. In all cases, veterinarians and caregivers both reported a positive perception of treatments, indicating moderate to significant improvements in the quality of life at 15, 30, and 60 days. The promising results support the case to develop a plan that builds solid scientific evidence. Researchers also advocate for the education of the ECS for veterinarians, understanding the quality and safety of products before recommending to animal patients, initiating treatments at the lowest possible dose, and closely documenting health outcomes. 

 

Finding Support

 

Looking for guidance on locating quality products and dosing? The care team at Realm of Caring is here to assist by offering up-to-date research resources and one-on-one support. Call 719-347-5400, email info@realmofcaring.org, or schedule an appointment to get in touch. 

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CBD & CBG for Bone Healing and Pain Management

Among the most common injuries to the musculoskeletal system are bone fractures. They most often happen when more force is applied to the bone than the bone can take. This can happen as a result of falling, trauma, or a direct blow to the body. Overuse or repetitive motions may also lead to a stress fracture by tiring muscles, which then put more pressure on the bone, an occurrence more commonly found in athletes. Diseases that weaken the bone may also lead to a fracture, such as osteoporosis or a cancer-induced bone disease. Symptoms of a fractured bone may include:

 

  • Sudden pain
  • Trouble using or moving the injured area or nearby joints
  • Swelling
  • Obvious deformity
  • Warmth, bruising, or redness

 

Fracture healing takes time as new bone is formed between the broken parts. The process of healing starts immediately after injury, at a cellular level, and continues thereafter. Components in the healing process are broken up into three main phases: inflammation, repair, and remodeling. 

 

Current pain management used for bone fractures are nonsteroidal anti-inflammatory drugs (NSAIDs) and opioids. However research indicates that NSAIDs may inhibit bone repair by preventing the critical inflammatory phase. Opioids have not proved to offer a better alternative as they may interfere with the functional status of patients, where effective healing of a load-bearing bone requires proper micro-movement and weight-baring. Therefore, delaying movement may delay healing and/or lead to further bone loss and additional broken bones. There is a clinical need to address pain management while not negatively impacting the healing process. 

 

It has been previously researched the potential role cannabinoids may have in aiding bone health. This is due to the endocannabinoid system (ECS) being connected to the regulation of bone cell activity and bone remodeling. Studies have shown that endogenous cannabinoid ligands, cannabinoid receptors, and enzymes all play key roles in bone mass and in the regulation of bone disease. The main endocannabinoids, anandamide and 2-arachidonoyl glycerol (2-AG), are present in bone tissue at levels similar to those found in the brain. CB2 receptors are expressed in bone cells and have been discovered to have a bone anabolic action. Considering the involvement of the ECS in bone remodeling, modulation of the ECS could offer a possible treatment where bone loss is observed. 

 

A limited number of studies have looked to cannabidiol (CBD) for its impact on fracture healing and bone homeostasis. In 2015, Kogan et al. suggested that CBD-induced stimulation of fracture healing takes place in the later phases of healing, increasing the toughness of the bone 8 weeks after fracture. Researchers concluded that “CBD alone is sufficiently effective in enhancing fracture healing”. In 2017, Li et al. used rodent models to investigate the therapeutic effect of CBD on severe bone loss due to spinal cord injury. Treatment with CBD provided the first direct indication of evidence that CBD prevents sublesional bone loss and deterioration of trabecular bone subsequent to spinal cord injury. 

 

Recognizing that the investigation of cannabinoids for their therapeutic potential in managing fracture pain is in its infancy,  Kumar Khajuria et al. used a mouse model of endochondral fracture healing to assess the impact of CBD and cannabigerol (CBG) on the different phases on healing and pain managing effects. CBG is far less studied, however derivatives have shown to modulate inflammation and immune response, much like that of CBD. Using the mouse model, they assessed the efficacy of CBD and CBG in post-fracture pain and their influence on the structure and quality of the newly formed bone. Results were published in 2023.

 

In the set of pain behavior tests, both CBD and CBG ameliorated post-fracture pain as effectively as NSAIDs, proposing their use as efficacious alternatives in managing pain in fracture patients. Additional results after day 14 post-fracture, indicated that consistent treatment with CBD and CBG promoted bone formation. Specifically, CBD and CBG increased the number of osteoblasts (cells that form bone tissue) per bone surface area and induced the proliferation of bone lining cells. Later in the healing stage, at day 28 post-fracture, no significant difference in the stiffness was observed however CBD and CBG substantially increased the biomechanical strength of the healed bone. This collective data indicates striking similarities that both CBD and CBG promote bone formation and fracture repair throughout the healing process. 

 

Bone fractures are considered a global public health issue. Osteoporosis alone causes more than 8.9 million fractures annually. Alternative therapies and preventative measures are needed, especially those that may ameliorate pain while improving the healing process. While research for cannabinoid use in this matter is limited to date, results thus far are promising and pave the way for more research to take place. 

 

Finding Support

 

There is a lot to consider when starting cannabinoid therapy but, as always, a Realm of Caring care specialist is here to help with free one-on-one support to answer your questions. Contact us today by calling (719) 347-5400 or by emailing info@realmofcaring.org.

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Cannabis and Weight Loss: Exploring Nature’s Ozempic and More

In recent years, the cannabis plant has emerged as a surprising ally in the battle against weight gain, with certain strains showing promise for weight management. Among these, Tetrahydrocannabivarin (THCV) has been gaining attention as “nature’s ozempic,” due to its potential in aiding weight loss and managing appetite.

 

THCV: Nature’s Answer to Weight Loss?

 

THCV, a compound found in cannabis, differs from THC in its effects on appetite and metabolism. Unlike THC, which is known to stimulate appetite, THCV has been observed to decrease appetite and increase energy metabolism in rodent models. This unique property of THCV makes it an intriguing option for weight management and the treatment of obesity and diabetes​​.

 

The Endocannabinoid System (ECS) is a complex network of receptors found throughout the body, including the brain, organs, connective tissues, glands, and immune cells. The primary function of the ECS is to maintain bodily homeostasis—biological harmony in response to environmental changes. The ECS comprises mainly two types of receptors: CB1 and CB2.

 

THCV is known to act as a CB1 antagonist and a CB2 partial agonist. As an antagonist, THCV blocks the action of cannabinoids at the CB1 receptor, especially in the central nervous system. This action is crucial because CB1 receptors are widely implicated in appetite regulation and feeding behavior. By blocking CB1 receptors, THCV can potentially reduce hunger and prevent overeating.

 

Moreover, in lower doses, THCV appears to act as a CB1 antagonist, but in higher doses, it may start to activate CB1 receptors, albeit less intensely than THC. This dual action makes THCV an interesting subject for research in appetite control and weight management.

 

Research suggests that THCV may also influence metabolism. By interacting with the ECS, particularly through the CB2 receptors, THCV might help in regulating blood sugar levels and reducing insulin resistance. This is particularly significant for individuals with obesity or type 2 diabetes, where insulin resistance is a common issue.

 

Four Cannabis Strains for Weight Loss

 

Beyond THCV, several other cannabis strains are notable for their potential in aiding weight loss. Here are four strains that might help:

 

  • Remedy: This strain is known for its high CBD content and low THC levels. It’s reported to relieve stress and anxiety without causing the munchies​​.
  • ACDC: Another high-CBD, low-THC strain, ACDC is chosen for pain management and relaxation, also avoiding the munchies​​.
  • Lifter: With its high CBD percentage and almost no THC, Lifter is a popular choice for daytime use, enhancing mood without intoxicating effects​​.
  • Cherry Wine: This strain is appreciated for its relaxation benefits after a long day and its high CBD content, making it unlikely to trigger hunger pangs​​.

 

CBD Oil and Weight Loss: The Science of Fat Browning

 

An intriguing aspect of weight loss research is the role of CBD oil in promoting the browning of fat cells. This process is essential for generating heat by burning calories, aiding in weight loss. CBD, a major cannabinoid found in cannabis, may contribute to the transformation of white fat into brown fat, which is more metabolically active and burns more calories. This transformation is a promising area of research for those looking to manage their weight more effectively​​.

 

The Endocannabinoid System and Appetite

 

The Endocannabinoid System (ECS) in our bodies plays a crucial role in appetite control. It influences everything from appetite suppression to the treatment of conditions that involve reduced appetite and weight loss. CBD, as a cannabinoid receptor antagonist, may help manage obesity, while THC, a receptor agonist, might be a therapy option for conditions like anorexia​​.

 

In conclusion, THCV presents a fascinating aspect of cannabis research, especially in the context of weight management and metabolic health. Its unique interaction with the ECS, particularly its antagonistic action on CB1 receptors and potential metabolic benefits, make it a cannabinoid of interest for further study in the realm of obesity, diabetes, and general wellness.

 

As the understanding of cannabis and its components deepens, it’s clear that certain strains and compounds have significant potential in weight management. With strains like Remedy, ACDC, Lifter, and Cherry Wine offering benefits without the munchies, and CBD oil promoting the browning of fat cells, cannabis is showing itself to be a valuable tool in the journey towards a healthier weight.

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Mental Health Wellness for the New Year

A new year allows us the opportunity to reflect on the past year to understand what we want to let go of and what we want to prioritize in the year ahead. One priority that many have at the top of their list is improving individual mental health wellness with natural remedies. To aid in that journey to become the best versions of ourselves, we have gathered up key guidance and resources on how cannabinoids such as cannabidiol (CBD) may benefit us from the inside out. 

 

Being consistent in the short-term for long-term goals

 

Among the questions we receive, one of the more frequently asked is how and when to take CBD products. When it comes to your therapy, consistency is key to successful results. For CBD in particular, this is for a couple of reasons. 

 

First, CBD has a low bioavailability and a short half-life. Consistent dosing 2-3 times daily may allow CBD, among other minor cannabinoids, to remain present in your body to offer the beneficial effects you are looking for. While the amount you take and how often you dose is highly dependent on your specific needs and situation, a Realm of Caring care specialist is here to help with free one-on-one support to help find what is right for you.

 

Secondly, given that CBD has low bioavailability and a fairly short half-life. It may take time for the cannabinoids to fully present themselves and for the benefits to be revealed to the consumer. Therefore it is advised to be patient before increasing the amount you are taking. Increasing too much too soon may lead to undesired effects while taking too little may provide no benefit. The key is to find your individual, therapeutic dose.

 

Implementing self-care rituals 

 

Engaging in a self care routine has been clinically proven to reduce or eliminate anxiety and depression, reduce stress, improve concentration, minimize frustration and anger, increase happiness, and improve energy.

 

There is a continuous need to seek more efficient, safer, and widely available methods to treat medical conditions, skin pathology included. Topical use of cannabis as a form of therapy covers a wide scope of skin disorders due to anti-inflammatory, anti-itching, wound healing, anti-microbial, and anti-proliferative effects. 

 

Elements of the ECS have been discovered in the skin, to include our skin’s immune system. Through interaction of the receptors in our skin layers, cannabinoids have shown through research to alter pain, stimulate wound healing, and alleviate itch. These studies may add a different dimension on how we see the treatment of several skin diseases. 

 

Of the cannabinoids researched to date for skin health, CBD is a widespread ingredient in skin care products formulated as body oils, moisturizers, salves, lotions, and balms. Delta-9-Tetrahydrocannabinol (THC), and potentially cannabinol (CBN), may also be responsible for skin benefits such as reducing cytokine production and oxidative stress. Additionally, cannabigerol (CBG) has powerful anti-inflammatory and antibacterial properties that may add benefit to our skin health. 

 

Keeping your gut in check 

 

Our gut health is a complex ecosystem, composed of over 1,000 microorganisms. These microorganisms have significant roles in our daily energy uptake by breaking down complex carbohydrates into simple sugars. They also impact our immune system and imbalances of the gut may contribute to weight fluctuations, obesity, food sensitivity and more. 

 

In addition, you may be familiar with the brain-gut connection (sometimes referred to as gut-brain), which helps us to understand how functional bowel problems and bowel disorders such as Irritable Bowel Syndrome (IBS) may be responsible for sending signals to the central nervous system that trigger mood changes, leading to anxiety and depression. 

 

The ECS performs protective activities in our gastrointestinal (GI) tract and shows promise as a therapeutic target against bowel disorders such as IBS, Crohn’s disease, irritable bowel disease (IBD), and motility-related conditions. The main role of the ECS in the GI tract is controlling intestinal hyper-contractility, modulating visceral sensations, intestinal inflammation, and brain-gut communication. 

 

A significant population of individuals suffering with IBD use cannabis to relieve symptoms of pain, nausea, and appetite, as well as to improve their overall mood. THC has been shown through anecdotal evidence to improve abdominal spasms, cramps, and visceral pain; whereas CBD may contribute to the relief of intestinal inflammation, modulating cortisol and metabolism, improve the immune response of the gut, and alleviate the anxiety and stress associated with gastrointestinal discomfort. In a 2021 review of 682 studies of cannabinoid use for IBD patients, clinical symptoms (abdominal pain, general well-being, nausea, diarrhea, and poor appetite) were all improved with cannabinoid therapy. 

 

Fostering clarity and focus

 

Proper cognition and energy levels throughout the day can be attributed to healthy sleep. CBD is among those cannabinoids that may help eliminate brain fog during the day, while also improving our sleep quality during the night. 

 

CBD has therapeutic properties that have the potential to mitigate symptoms that interfere with sleep. It also has the potential to improve sleep-wake cycles leading to an increase in the percentage of total quality sleep overtime.

 

Prolonged CBD therapy has shown positive improvements in psychological symptoms and cognition. Currently, using cannabinoids to benefit neurological issues and serve as a neuroprotectant is being studied. The antioxidant properties of cannabinoids, such as CBD, may have the ability to provide neuroprotection. As well, research is showing that elevation of cannabinoid receptor activity could potentially slow down the progression of brain aging and alleviate symptoms associated with neurodegenerative disorders, therefore cannabinoids with the ability to activate receptors may provide these additional benefits. 

 

Additional ingredients in your cannabinoid product may also enhance cognitive function in your day to day. For example, lemon balm is known to improve mood, cognition, and aid as a natural anti-inflammatory, anti-oxidant, and decongestant. Combining CBD and lemon balm may calm the nervous system to ease stress, refocus energy, and relax. The functional mushroom, lion’s mane, is another ingredient known to have a host of benefits for neurodegenerative diseases such as ischemic stroke, Parkinson’s, Alzheimer’s, and depression. It may also promote recovery and enhance nerve regeneration, therefore improving cognitive performance and reducing brain fog. 

 

Finding support

 

When looking to cannabis for medical conditions, we always recommend speaking with a healthcare professional. However, if you are in need of support while on your journey we are here to help. From product selection to dosing guidance to answering questions your family has about your decision to choose cannabis – we are here every step of the way. Send as an email to info@realmofcaring.org, call us at 719-347-5400 or chat with us at realmcaring.org.

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Most Frequently Asked Cannabis and CBD Questions of 2023

Just before 2023 came to a close, we featured a webinar where we answered the most frequently asked cannabis and CBD questions of the year. In this blog, we break those questions down for you to use as a helpful resource when starting out. 

 

What is the difference between milligram (mg) and milliliter (mL)?

 

A milligram (mg) is a measure of weight for an ingredient while a milliliter (mL) is a measure for the volume of a liquid. When reading the label on a CBD tincture bottle, the mg content tells us the amount of cannabinoids that are concentrated in a given amount of mL of liquid. A label may tell us how many mg’s there are of CBD in an entire bottle or how many there are per every one mL of liquid. In most cases, a full dropper is equal to one mL. 

 

For example, if you have a 30mL bottle of CBD and it states an amount of mg on the front label, such as 1500mg, that means there is 1500mg of CBD in the entire bottle. Given that it is a 30mL bottle, you would divide the mg by the mL to find that there is 50mg of CBD per every mL of liquid.

 

What is half-life and why is it suggested to take CBD two to three times daily? 

 

Half-life describes the amount of time it takes for an active substance in your body to reduce by half. This can vary greatly depending on the individual. CBD’s half life has been researched to last anywhere from 1-11 hours after the first dose. Consistent users of CBD may have half lives up to 2-5 days. 

 

The half-life and bioavailability may be enhanced by how you administer your CBD. Orally taken CBD bioavailability is fairly low due to the extensive first pass metabolism, so finding ways to enhance the bioavailability of your product may benefit your overall therapy. 

 

For example, a study published in 2005 showed that one hour after oral capsule administration containing 5.4mg of CBD in males and females, blood samples showed CBD levels averaging 0.93 nanograms (ng) per mL. A subset of participants who consumed a standard breakfast meal one hour after the capsules showed a slightly increased average of 1.13ng/mL. The CBD remained detectable for approximately 3-4 hours after administration. Co-administering CBD with a food high in fat, has shown in research to increase oral bioavailability by almost three-fold. As CBD is a highly lipophilic molecule, CBD may dissolve in the fat content of food, increasing its solubility and absorption, therefore bioavailability. 

 

Therefore, in order for CBD to provide consistent relief, it is advisable to administer 2-3 times per day, being mindful to space the administration from pharmaceuticals or over the counter medications. To increase bioavailability of the CBD, it is also recommended to take CBD with healthy fat foods. 

 

How soon can I increase my CBD dose?

 

Again, CBD has low bioavailability and a fairly short half-life. It may take time for the cannabinoids to fully present themselves and for the benefits to be revealed to the consumer. 

 

Additionally, if you are using a full spectrum CBD product, the product will contain small amounts of THC. The Cannabis sativa plant has over 500 compounds, with over 100 cannabinoids present. When extracted, a full spectrum product considers all of those parts of the plant, THC included, in a way that is non-intoxicating in a dose that is right for you. However, as you increase the amount of CBD you are taking, that amount of THC will also increase. You want to allow your body the time to adjust to the increased levels of cannabinoids so there are no intoxicating effects. 

 

It is also important to keep in mind that administration may be made complicated by the non-linear response of cannabinoids. It is non-linear in that our response to cannabinoid administration forms a bell curve. This means that higher amounts do not always equate to more relief. In fact, we should be cautioned to assume that higher amounts of cannabinoids will lead to enhanced therapeutic effects. What you may find is that higher amounts could exacerbate related symptoms. Therefore, it is recommended that if improvements begin to diminish over time, especially after an increase, that you consider reducing the amount as a potential strategy. 

 

Most will ask when starting out CBD, “will I feel anything?”. Cannabis advocate and researcher, Mara Gordon has explained, “you don’t have to feel medicated to be properly dosed, and if you feel medicated it is likely that you are taking too much”. It is essential to give your body time to adjust and for specific needs, the Realm of Caring Care Team is here to assist with free one-on-one guidance. 

 

How can I check for potential drug-drug or drug-herb interactions?

 

When taking other medications, it is very wise to respect the metabolism of everything you are putting into your body and acknowledge that CBD may interact with several medications as it is metabolized by the cytochrome P450 (CYP450) system, which is also responsible for metabolizing several other medications. In addition, CBD inhibits CYP2C19, CYP2C9, CYP2D6 and CYP3A.

 

One study determined that strong interactions likely occur with high-dose oral CBD (700 mg) and CYP3A substrates. Increasing CBD levels were also associated with changes in serum levels of common anti-epileptic drugs, although levels remained within acceptable serum ranges. Like-findings were also seen with CBD and common anti-anxiety medications with slightly increased serum levels of the medications. 

 

There are online sources for checking interactions between CBD and medications, however it is best to check with your doctor, a pharmacist, and our care team is always here for guidance as well.

 

When it comes to THC, what is the difference between sativa, indica, and hybrid?

 

Here is another classification you may find when in a dispensary or referring to a high-THC cannabis product. There is a lot of conflicting information out there about cannabis strains. Some say strains don’t matter, others say strains may help you achieve a specific feeling or benefit. When used to describe a cannabis plant or product, the word strain is used interchangeably in different contexts.

 

Some conclude that the genus cannabis comprises a single species, Cannabis Sativa (C. sativa). It is proposed by others that the cannabis genus consists of three species, C. sativa, C. indica, and C. ruderalis. Others will even include a fourth species that can be identified as any hybrid between the aforementioned three. Sativa-types are characterized by their tall and narrow leaves, widely believed to produce a stimulating, cerebral psychoactive effect. Indica-types are short with wide leaves, reported to produce sedative and relaxing effects. Ruderalis is thought to be a descendant of indica, although adjusted to the climate where it originates, resulting in a shorter and stalkier plant. 

 

A 2015 study found a “moderate correlation between the genetic structure of marijuana strains and their reported C. sativa and C. indica ancestry and show that marijuana strain names often do not reflect a meaningful genetic identity”. The different species may have more to do with the structure of the plant alone, rather than an effect that may be produced. 

 

When considering the biochemical components, strains do matter. Understanding the quantifiable amounts of cannabinoids of your product is an important step in knowing the quality of your product. Differences in observed effects can be attributed to terpene content versus the strain name of sativa, indica, hybrid. For example, it might not be the fact that a strain is labeled indica as to why one feels sedated. That feeling may actually be attributed to myrcene, a terpene with researched, sedative effects. 

 

It is equally important to recognize that a strain’s effects on one person could trigger a different outcome for someone else. Factors such as ailments, genetic predispositions, tolerance level, setting, consumption method, and others are all worth consideration in determining the result a product may have.

 

What is a Certificate of Analysis (COA) and why is it important? 

 

With a lack of oversight by the U.S. Food and Drug Administration (FDA), it is up to the consumer to check on the accuracy of labels. This involves an extra step, but is worth it to ensure that you are using a safe and quality product. 

 

For example, CBD labels should include how much CBD the product contains, as well as the carrier oil, other cannabinoids, supplements, terpenes, and/or flavoring. One way to verify the concentration of listed ingredients is to check it with a COA. Each quality company should be able to provide you a COA for the product you purchase, that is verified by a third party lab.

 

While additional cannabinoids can be listed directly on the label of the product you are purchasing, the cannabis plant has hundreds of minor cannabinoids that may be in your product. Each cannabinoid has potential benefits and works synergistically with the major cannabinoids. To figure out the list of other cannabinoids that are detected, look back to that COA. If you were finding success with one product and then switched to another and were not achieving the same results, you might find that one had a higher/lower concentration of a specific cannabinoid other than CBD. For example your product could yield a higher percentage of THCA, CBG or CBN. 

 

Many CBD products will have 2-3 ingredients such as: hemp oil, a carrier oil, and (occasionally) a natural flavoring. However, you may recall advertisements for CBD products that promote “best for sleep” or “best for pain”. Typically, these claims can be made if: 

  1. Research supports the claim for the specific product, or 
  2. The product includes an ingredient, other than CBD, a carrier oil and a natural flavoring, that has been researched to affect the normal functioning of the body in that way. 

 

For example, if a CBD product is labeled for sleep, then it may include Melatonin, L-theanine, or Valerian Root. CBD has researched sleep benefits of its own, but may work synergistically with these added ingredients for an additional boost. Before purchasing, understand what ingredients have been added and if those are right for you. 

 

What is the difference between recreational and medical cannabis dispensaries? 

 

Going to a dispensary can be overwhelming, there is a lot to choose from so it is always a good idea to know before you go. Most dispensaries will have their full menu available to look at online. This way you can research product companies, ingredients, and what administration method is right for you. 

 

For purchasing in a medical dispensary, you will have to have a medical card in the state that you live in and are purchasing in. Each medical state has their own set of rules for obtaining a card, and it is typically something you can search for in your state’s .gov website. 

 

If you do not have a medical card or you live or are visiting a recreational state, you may purchase if you are at least 21 years old and have valid identification. Whether the dispensary be medical or recreational you can still research your products ahead of time and you should be getting the same, quality customer service by the retailer at the store. If you need help before you go, our care team is here to assist in your decision-making process. 

 

What happens if I take too much THC?

 

If you feel you have taken too much, first of all – do not panic. Just as with consuming too much caffeine, it may be unpleasant and uncomfortable, but with time it will pass. You may experience symptoms such as lethargy, anxiety, paranoia, and/or low blood pressure that may lead to nausea. 

 

To help, you may want to try an isolate CBD, as CBD may reduce the head high effects of THC. Drinking water with lemon or eating black peppercorns may also help to offset those effects. Deep breaths, getting fresh air, and focusing on something you enjoy or talking to a close friend may also help to deter any feelings of anxiety. 

 

It is good to know that cannabis itself will not cause you harm. There is no realistic lethal dose of cannabis following consumption and the low density of CB1 receptors in the brainstem region means that no damaging effect will be had on cardiovascular or respiratory functions.

 

In addition to being worried about “taking too much” in the moment, there are what are referred to as Cannabis hangovers, also referred to as “weed hangovers,” which refer to the range of effects that may take place the day after consuming cannabis products. These unpleasant sensations, which range from feeling drowsy and fatigued to headaches and nausea, might ruin the experience or discourage someone from using cannabis.

 

Research is limited in understanding the consumer complaint of cannabis hangovers. While one report shows that undesirable, residual effects of cannabis consumption can be felt the day after smoking, another reports that any effects are minimal at most. Regardless of the available data, consumers tend to blame the product formulation or overconsumption.

 

A rich terpene entourage may reduce the likelihood of cannabis hangovers. A traditional Moroccan remedy for cannabis hangover includes a glass of cold, fresh lemonade with black pepper sprinkled on top. This works because of its terpene entourage of limonene from the lemons and beta-caryophyllene from the pepper. Both limonene and beta-caryophyllene possess potent anti-inflammatory activities. Limonene has also been studied for its anti-nausea, anti-vomiting, and uplifting properties, reported to boost mood and metabolism while decreasing stress and anxiety. 

 

Michael Backes, author of Cannabis Pharmacy: The Practical Guide to Medical Marijuana explains to avoid residual feelings of grogginess the next day, it may be best to pay attention to the terpene content, quality of the product, and how much you are consuming. His methodology is “sip don’t rip”. Most consumers inhale too rapidly. Reducing the intensity of inhalation also reduces the combustion temperature, which results in a smoother, less harsh experience. I advise taking a gentle inhalation (sipping) rather than hitting hard (ripping).

 

Starting low and increasing slowly enables one to find their therapeutic dose at the lowest amount possible. Finding your individual threshold can also help to prevent effects that carry over into the following day. 

 

Want to view the rest of the most FAQ of 2023? Watch the webinar recording here.

 

Questions about your therapy or where to begin? Our Care Team is here to offer you free one-on-one support. Email info@realmofcaring.org, call (719)347-5400, or schedule an appointment

 

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Understanding Cannabis Smoking vs. Vaping

Cannabis consumption has evolved significantly over the years, offering users various methods to experience the plant’s benefits depending on preference and desired results. Two of the most commonly seen today are vaping and smoking. It’s important as a consumer to know the differences between puffing a vape pen or smoking a joint or glass pipe. Read on to learn more about the unique characteristics, potential impacts, and safety concerns.

 

Smoking 101

 

Cannabis smoking, a time-honored and traditional method of consumption, involves inhaling the smoke produced by combusting dried cannabis flower. This approach allows individuals to experience the effects of cannabinoids, such as THC and CBD, in a relatively swift manner. 

 

The process is straightforward: the cannabis flower is ground, rolled into a joint or packed into a pipe, and then lit with a lighter or similar. As the plant material combusts, it releases a flavorful array of compounds and terpenes that contribute to the unique and varied profiles of different cannabis strains. Inhaling the smoke from the combusted flower into your lungs allows the cannabinoids to quickly enter your bloodstream. 

 

Smoking, appreciated by many for its ritualistic and social aspects, offers users a direct and immediate connection with the plant. It’s important to consider individual preferences and health factors when choosing this method, as it provides a distinct sensory experience that contributes to the rich tapestry of cannabis culture. A downside to consuming this way, is it actually wastes a portion of the terpenes and cannabinoids. However, 77% of cannabis patients still reported this as their favorite method of consumption in 2019.

 

Vaping 101

 

Cannabis vaping has emerged as a modern and increasingly popular method of consumption, offering users a more controlled and nuanced experience. Unlike smoking, vaping doesn’t involve combustion; instead, it utilizes specialized devices to heat cannabis concentrates or flower to a temperature that releases the desired cannabinoids and terpenes without creating smoke. It instead turns into a cannabinoid and terpene rich vapor that can be inhaled.

 

This method provides a cleaner inhalation process, reducing exposure to harmful byproducts associated with combustion. Vaping allows users to savor the flavors and effects of different strains with precision, often featuring adjustable temperature settings for a personalized experience. This more controlled method of consumption helps contribute to a cleaner feeling high.

 

The discreet and portable nature of vape pens also adds to their appeal, making cannabis vaping a convenient and socially considerate choice for those seeking a modern approach to enjoying the therapeutic and recreational benefits of cannabis. Early studies suggest that the higher potency of cannabinoids produces stronger effects than smoking cannabis for infrequent users.

 

Safety 101

 

Whether one opts for smoking or vaping, we always recommend understanding the impact on one’s health. Smoking cannabis involves inhaling combusted plant material, which can introduce harmful byproducts into the respiratory system. Though the long-term health effects of smoking cannabis are still a subject of ongoing research, it’s advisable to be mindful of potential risks, particularly for individuals with pre-existing respiratory conditions. 

 

While cannabis and tobacco smoke are not equally carcinogenic, studies indicate cannabis smoke contains many of the same harmful carcinogens and chemicals as tobacco smoke. What you smoke cannabis flower with also impacts the effects, as a water pipe or bong may negate some of the issues that burning papers in joints presents.

 

On the other hand, vaping, when done responsibly with high-quality products (no harmful additives) and a properly designed device, is generally considered a safer alternative as it eliminates combustion-related byproducts. However, some vapes may contain additives and diluents (like PG/VG commonly used in nicotine products), and because cannabinoids vaporize at higher temperatures, this could produce vapor with harmful byproducts. Always avoid shopping illicit products, as they may contain dangerous acetates and can be fatal (vaping associated pulmonary injury).

 

Lower vape temperatures generally lean towards fewer things being inhaled beyond what is in the starting material. Vapor is also traditionally less hot and dense than smoke, meaning it is likely to be less irritating and physically damaging to your lungs (again, assuming you are consuming quality non additive products). Regardless of the chosen method, moderation, mindfulness, and adherence to safety guidelines contribute to a positive and health-conscious cannabis experience.

 

Don’t Ignore Expiration Dates

 

Being mindful of expiration dates is another great way to practice safe cannabis consumption. Just like any consumable product, cannabis and vape products have expiration dates for a reason. Using products beyond their expiration dates may not only compromise their potency and flavor but could also introduce potential health risks. It’s essential to check and adhere to these dates, especially with vape cartridges, to avoid inhaling degraded or potentially harmful substances. 

 

As cannabis ages, its chemical composition can change. Exposure to air, light, and improper storage conditions can lead to the degradation of cannabinoids and terpenes, impacting the flower’s overall efficacy. Additionally, the potential growth of mold or mildew becomes a concern with improperly stored cannabis, posing health risks when consumed. To ensure safety, consumers should store cannabis in a cool, dark, and airtight environment, regularly inspecting their supply for signs of aging or contamination.

 

By respecting expiration dates and choosing high-quality, regulated products, consumers contribute to a safer and more enjoyable cannabis experience, minimizing any potential risks associated with expired or compromised products. Education and awareness play a pivotal role in fostering a culture of responsible and health-conscious cannabis consumption.

 

As always, consulting with a medical professional is recommended. There is a lot to consider when starting cannabinoid therapy and a Realm of Caring care specialist is here to help with your questions. Contact us today by calling (719) 347-5400 or by emailing info@realmofcaring.org.

 

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Cannabinoids found in non-cannabis plants

One thing that has become well-known in the last several years of cannabis research, is that Cannabis Sativa is a very complex plant. Through the on-going discovery of compounds, we are becoming more aware of the capabilities of the plant as well as where compounds may appear otherwise in nature. 

 

The Complexity of the Cannabis Plan

 

More than 550 chemical compounds have been discovered in cannabis, with more than 100 phytocannabinoids identified to include delta-9-tetrahydrocannabinol (THC) and cannabidiol (CBD). In addition to phytocannabinoids, over 100 terpenes have also been identified. The many constituents of the plant have been indicated as therapeutic agents across numerous medical conditions. Phytocannabinoids were earlier thought to be exclusive to Cannabis sativa but have now also been discovered in Rhododendron species, some legumes, the liverwort genus Radula, and fungi

 

Beta-caryophyllene (B-caryophyllene)

 

B-caryophyllene is a terpene present in many herbs and spices such as black pepper, cloves, basil, and oregano. It is also one of the first cannabis-derived compounds other than THC, CBD, and cannabinol (CBN) shown to bind directly to CB2 receptors in the endocannabinoid system (ECS). As one of the most abundant secondary metabolites in cannabis essential oil, it has the distinction of being known as the first “dietary cannabinoid”. Orally administered B-caryophyllene has shown to produce strong anti-inflammatory and analgesic effects as well as effective at reducing neuropathic pain. 

 

Cannabigerolic acid (CBGA)

 

A 2023 study published in Nature Plants showed the presence of more than a dozen cannabinoids in the glandular trichomes of Helichrysum umbraculigerum, an Asteraceae species found in South Africa and more commonly known as “woolly umbrella”. While major cannabinoids THC and CBD were not found, significant amounts of CBGA (the acidic precursor to CBG) were found. 

 

CBD

 

Even more recently than the previous study, scientists have discovered CBD in a common Brazilian plant known as Trema micrantha blume. Currently the lead researcher at the Federal University of Rio de Janeiro (UFRJ) is gathering a team of biologists, chemists, botanists, and geneticists who will research the most efficient way to extract CBD from the shrub. Once they do, they will analyze the newly found CBD to understand if the CBD found there contains the same properties as CBD extracted from the Cannabis sativa plant. 

 

The Role of Phytocannabinoids in Mammals and Plants

 

Phytocannabinoids play significant roles in therapeutic effects in mammals with an ECS. This includes, but is not limited to, antiseizure, anti-inflammatory, anti-tumoral, anti-depressant, analgesic, antiemetic, anti-anxiety, sleep improving, and bone growth activity. In plants, phytocannabinoids defend against pathogenic attack, herbivory, heat and cold stress, oxidative stress, and radiation stress. Antibacterial and antifungal properties have also been discovered. 

 

Given the versatile use of phytocannabinoids in both humans and plants and benefits realized when appropriately used, further investigations are needed across different plant species to deepen our understanding of their mechanisms of action as well as availability in nature.   

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Grief Awareness and Resources

National Grief Awareness Week takes place each year to provide a dedicated period for individuals, communities, and organizations to come together and acknowledge the varying aspects and complexities of grief. Grief is a natural response to loss, or anticipatory loss, that should be met with understanding and support. This week brings awareness to that and serves as a reminder to address each other with compassion.

 

In October, Realm of Caring founder Heather Jackson sat with Dr. Cristi Bundukamara (Dr. B) author of Pain & Purpose: My Journey to Mental Strength to discuss the complexities of grief and how one may find purpose through the unimaginable pain. Dr. B is a psychiatric nurse practitioner having earned her doctorate in healthcare education. She is the owner of Mentally Strong Psychiatric Clinic and the creator of the Mentally Strong Method. Dr. B discusses how she finds purpose having endured the devastating loss of her two children, Reggie and Miah, diagnosed with the same incurable, terminal disease that her husband Bundy is living with, Dentatorubral pallidoluysian atrophy (DRPLA). 

 

Heather Jackson: For me there were two major themes, first is that each person should choose to find purpose in our pain. And the second emergent theme is that we all have this deep within, amazing ability to overcome life’s worst moments. And if that’s not encouraging, I don’t know what is. 

 

Dr. B: I don’t know if it’s finding purpose in the actual pain, but it’s not giving up on your life, your purpose. Sometimes pain cannot be rationalized, explained, given purpose. Sometimes someone loses a child to cancer and then they spend their life raising money for cancer research and, honestly, I want nothing to do with DRPLA. It feels hopeless. So, the purpose doesn’t necessarily need to come in the pain. But, the point is not giving up on your life, your purpose. Because I do know that we all have a purpose and sometimes pain derails us from that and makes us want to give up on that. 

 

HJ: For sure, it can be consuming and blinding and doesn’t really allow you to move forward, which is why you’re one of my real life heroes. Because you’ve dug really deep and I want to get to some of how you did that, but I think that the book is extremely vulnerable. You don’t often read when people call out themselves, their spouses, their kids – and not call out but just be like, look this is the raw, honest, transparent book of our life. And it’s beautiful, and it’s brutal, and I’m really curious as to why you wanted to share it. What inspired you to write the book? What’s the purpose? Aside from it being a part of your healing journey, that I know you’ve been a part of lately, and I have been able to come alongside occasionally for that, but why? Why did you write it? 

 

Dr.B:  I’ve been in, and I think a lot of parents that are in the Realm of Caring, are in a constant fight or flight. And the initial reaction was still in that fight, I have to do something, I have to help somebody else because I wasn’t able to help my own child. So I think it’s just now that I’m trying to get out of that fight or flight. But it’s hard, it’s an addiction. I’ve always been like that – whatever is happening, it’s got to help someone else. And I’m not a writer. The first version of the book was evident of that. It took seven years and a writing coach to get to the first fifteen chapters. But I’ll tell you that the last chapter was written in three hours, and it was 100% all me and it just came out. It’s part of the healing process, not just healing, but how am I going to tell my story? There was a version in between that abruptly ended at Miah’s death and I was like, every good story has a happy ending and when you look at my life from the outside – there’s no happy ending there. And so I sat down to write that last chapter and thought, but I do have a happy ending, there is an eternal relationship. It’s part of my character, whatever is going on in my life I just have to figure out how to reframe it. 

 

HJ: So I know it’s a part of your personality, but what really struck me over and over again in the book was not just your tenacity but no white flags – there was no giving up. It was another, third theme. Where does that come from? What is your greatest source of inspiration and support? Because, as you mentioned, we serve so many families, my family included, who are just continuously one blow, one challenge after the other and I don’t even know how to do it some days. I don’t know how to get up and put one foot in front of the other. And I haven’t been through what you’ve been through. 

 

Dr.B: I wish I could say God. That’s the right answer. And I have struggled so much with my relationship with God. I remember a book I read, and I don’t remember if it was before Johnny’s death or shortly after Johnny’s death but it was before I was doing my own Mentally Strong Method, and it’s Viktor Frankl’s Man’s Search for Meaning –

 

HJ: Yes, your book is very reminiscent of that very famous book

 

Dr.B: And when I picked up that book, if I had known it was about the Holocaust I wouldn’t have read it because I don’t seek out painful things. And one of the things that I will never forget about that book is that there was a time when they thought that they were going to be released. They were in the concentration camps and the spirit was up and people had energy, but that day came and went. And several months after that, many, tons of people died. And he was talking about how the science of losing hope can actually lead to your death. And that hope is a choice. And it’s hard when life keeps hitting you, but I just had known from that point that it’s a choice, everything is a choice. How you respond is a choice – not what’s happening around you. And it’s just what I’ve always done and this is what I tell anyone because I do know that I have a very distinct gift to be publicly vulnerable with my story. That is not everybody else’s purpose. It is my gift. But how you respond to your pain, you have to figure out how you can respond to your pain. Yes, I do believe you’ll be inspired by my ability to do that, but I always tell people that I struggled with depression before I even had a reason to be depressed. Now I have a reason, but it’s not like I was this really mentally strong person before, it’s a choice, it’s constant, it’s hard. There are days when you feel like giving up, and I will never give up but that doesn’t mean there’s not days where I feel like giving up. 

 

HJ: Well can’t we just for the morning? It’s a serious question, can’t we just give ourselves – talking to the families who are in fight or flight 24/7 – can I give myself a morning off from the fight? 

 

Dr.B: Well it depends if your kid lets you. Sometimes, and this is very serious though, you always had that. And now the mornings are literally the hardest times for me. One, my daughter died in her sleep in the middle of the night and the trauma of that morning but also getting up for what? So we might have both types of people here – some that have lost and some whose children are there and they’re struggling – I remember times being irritated that I had to get up because Miah needed me and I just wanted to just lay in bed. So it really depends on if your child will allow you to take a morning off. But that’s why it’s important to schedule them. 

 

HJ: And we can totally do that, we can prioritize ourselves also, which I think is really important and often overlooked and can lead to depression, anxiety, the decline of our physical health, which I’ve experienced and still experience. I think it’s important to figure out somehow, within your community, and even if it’s trading with another parent with a special needs kiddo and trading off and on.

 

Dr.B: Another thing that I don’t think mother’s do is figuring out what actually fills your cup. Because, you know, we get four hours off but then we’re thinking and we’re depressed and we’re worried about this and we didn’t actually do anything that fills our cup. And it’s different for everybody, people used to say “go get your nails done”. To me that’s another responsibility. I don’t like getting my nails done, I do it because I want my nails to look okay but that doesn’t fill my cup. I was almost turning 50 before I was trying to figure out what I actually like to do. People would say “go exercise” and this and that but there’s really only two types of exercise I like to do. So why was I wasting my time with all of those other ones? I don’t like the exercise but everyone is saying that’s what is good for depression so that’s what I’m doing. And movement, and it doesn’t have to be intense exercise, but movement, which we talk about in ceremony, we talk about this when we go to sweat lodge, movement is more than just exercise, it’s sitting and sweating. It’s going through ceremony and trying to move things out of the body. Processing the reality of the life of having a disabled child or adult, there’s this constant fear of something happening to them. We have to process that and minimize it. You don’t just act like it’s not a reality, because it is a reality for many people that their child could die. I remember several kids in the community I could not attend their funerals, and this is when my children were alive, it’s just because this was my biggest fear and I was so sorry I could not be there for them. And you are always right there for people in that moment and I know it’s a fear for you too. So that takes strength to be able to be there for other people. It’s just figuring it out for yourself, what actually fills your cup and making sure you take that time. 

 

HJ: That’s such a great, practical tip. I want to dig in a little bit more – I remember in the beginning your mission was to cure DRPLA, you were going to find a cure. And I noticed that at some point there was this transition into maybe not even acceptance but your goals shifted a little bit. Maybe the goal was mental strength and teaching others how to do that. Am I correct in your shift and that the shift happened? And why do you feel like you made the shift? And then how do you define being mentally strong? 

 

Dr.B: Managing or regulating yourself and being able to find balance. Joy and pain can coexist and figuring out how to do that practically. We all have pain. I took a personality test that pretty much says I’m a rebel, so even in the beginning where, you know this is a terminal condition, there is absolutely no cure, there’s 20-50 years of research that would have to happen to cure this, I didn’t believe it. And this also goes to my relationship with God. I was like nope God is going to provide something and I’m going to do the actions and I’m going to fly to Canada and fly to Mexico and I’m going to see all of these specialists. I’m going to pick up my family and move to Colorado. And when Reggie died, Reggie’s life was so traumatic. He was in and out of the hospitals, ICU’s, multiple people told me he was dying and I was like no, no, no. And when he did die, it was like, okay, I can do this. But I’m not going to miss opportunities to just be present with Miah. And I’m not going to make her do all of these stupid diets and not eat chocolate cake and I did everything all the ketogenic stuff with Reggie and I think that’s why Miah’s death has just been so much harder, spiritually harder. She was not sick. I don’t think she’s ever spent the night in the hospital, she’s done EMU’s overnight but she was not sick. This was not supposed to happen. I thought I had a lot of time left. This year and a half since her death has been an intense spiritual journey. Because you just want to say “F you, God”.

 

HJ: I’m glad you’re really honest about that and the spiritual struggle that you’ve had and being able to be honest about raising a fist and saying this doesn’t make sense. I think that is a very common experience. It is one of my greatest honors, to watch you continue to put one foot in front of the other over all of these years and be focused on continuing to help the community and help people, not with some pie in the sky mentally strong like “I’m always okay and my energy is always high” that’s not what you’re teaching and that’s not reality. The practicality that you teach and what you do is so important. What’s alive for me and a lot of our community is this anticipatory grief and I wanted to talk with you a little bit about that. I think about your husband, Bundy, and he’s living with DRPLA, and for those who don’t know DRPLA is a neurodegenerative disease and so he will pass away, and so your son Reggie, your daughter Miah and now your husband, Bundy. There is still this anticipatory grief and for those of us who still have kids with life limiting conditions and our friends kids are passing away and it could happen to us at any point and so I’m wondering what advice you would give to those of us who have this pain present now, daily, who it’s still the first thing we do in the morning is check on our kids in the morning to make sure they are okay, how do we metabolize that or how do we work through the anticipatory grief?

 

Dr.B: As a professional we have taken your spiritual self out of the equation of mental health and it’s such a huge part, especially in the process of death. And I challenge everyone, regardless of where you are on your spiritual journey, whether you have a strong belief system or don’t believe in God, there is something outside of us. There are other dimensions, there are eternal relationships, and this is one of the things I say all the time – make relationships a priority because they are the only thing that is eternal. How you believe that plays out, it’s not as important as believing that it plays out and that death is not the end and figure that out. Have a pursuit of an authentic spiritual relationship, because that is what will bind you to your child eternally. And that is what I talk about in the last chapter, I accepted Christ many years ago and I was a born again Christian and I still believe in the Christian faith but when Reggie died he spoke to me, and he said “Momma, I’m okay, daddy’s okay, Miah’s okay”. He even said to me “you think you’re so smart” and I rationalized that in my Christian doctrine of God spoke to me in Reggie’s voice, I rationalized it. When Miah died I was like, I’m not taking this and the first time Miah came to me I was ready to be open to that and to experience that. And so, an authentic spiritual relationship. 

 

HJ: I really love that because it also gives us something to do now. It’s not as if we’re waiting for this inevitable thing to happen, we can do something now. We can work on this authentic spiritual relationship. It’s actually in the epilogue, but I wanted to end with the beginning in mind. It’s a question you ask the reader and I wanted to ask the same question, what kind of joy, peace, or happiness are you longing for? And at this point in your journey, with everything you’ve been through and everything that will come, what kind of joy, peace, or happiness are you longing for? 

 

Dr.B: I think I find joy and happiness and it’s a choice and sometimes you have to pursue it, peace I’m still working on. Really understanding that the present moment is what we have and I heard someone else say depression is thinking about the past and anxiety is worrying about the future and I spend a lot of time in those two places when I should be enjoying the moment. I do not regret, I made a lot of happy moments with my kids and we did a lot of things. I was just looking at the Hawaii trip and with Miah for her 21st birthday we spoiled her rotten at Disney World and we did, we pursued those moments of joy and happiness. In the midst of it, of raising terminally ill children, you do have to pursue those moments of happiness and joy. But also choosing to find peace and peace is only in the moment.

 

HJ: I could not agree more, a really big download for me these last couple of years as someone who is really driven and is always focused on the future and what I could have done better. It’s the only place to be. It’s interesting how everything is vying for our attention to go back or go forward. The myth of normal. 

 

Dr.B: We think that peace is a destination and the only place that you have peace is in the moment.

 

View the entire interview on Realm of Caring’s Facebook Page

 

For additional resources, please visit MentallyStrong.com

 

 

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Crohn’s, Colitis, and Cannabis

Inflammatory bowel disease (IBD) is an umbrella term used to describe disorders that cause chronic inflammation of your gastrointestinal (GI) tract. How IBD differs from irritable bowel syndrome (IBS), is that IBD can cause destructive inflammation and permanent harm to the intestines, can be seen during diagnostic imaging, and may increase the risk for colon cancer. The two most common forms of IBD are Crohn’s disease and ulcerative colitis.

 

Cannabis has been often used as a form of self-medication by individuals with IBD for symptomatic relief and its cannabinoid derivatives have grown increasingly popular as a potential therapy for IBD. A 2007 study by Garcia-Planella and colleagues in Spain surveyed 214 patients with IBD. They found that nearly 10% of patients were active users of cannabis or its derivatives. In 2011, 291 patients with IBD were surveyed at a tertiary care center in Ontario, Canada by Lal and colleagues. Results showed that 33% of ulcerative colitis patients and 50% of Crohn’s patients who were lifetime users of medicinal cannabis were specifically using for IBD symptomatic relief. 

 

It is estimated that today, about 15-40% of individuals living with IBD rely on cannabinoids to reduce the needs for other medications, as well as increase appetite and reduce pain. Studies have shown that not only may symptomatic relief be realized, but that by modulating the endocannabinoid system (ECS), which regulates various functions to include the pathogenesis of IBD, there may be a therapeutic effect on the GI tract. 

 

The Role of the ECS in IBD

 

The ability of the ECS to modulate inflammatory responses demonstrates its role in preserving gastrointestinal function. A 2011 study by Di Sabatino and colleagues used biopsy specimens from participants with Crohn’s disease and ulcerative colitis to analyze endocannabinoid levels, expression of cannabinoid receptors, and activity of enzymes. Levels of the endocannabinoid, anandamide, were significantly decreased in inflamed IBD mucosa. The different levels of elements of the ECS in IBD models showed that cannabinoids appear to have a clear role in gut pathology, offering a potential target for drug intervention in the treatment of IBD. 

 

Pharmacological Effects of Cannabidiol (CBD)

 

CBD is one of the main pharmacologically active cannabinoids of the Cannabis sativa L. plant. It is non-psychoactive and exerts a number of beneficial effects to include anti-inflammatory and antioxidant properties. Several studies have contributed to the understanding of the therapeutic potential of CBD for many diseases, including those associated with oxidative stress. Oxidative stress is a significant pathophysiological factor that plays a role in the initiation and progression of IBD. The use of antioxidants for individuals with GI disorders has been proposed as an alternative therapy to the use of anti-inflammatory or immunomodulatory drugs to both mitigate the adverse effects of traditional treatments and enhance the individual’s quality of life. 

 

Markers of Improved Quality of Life

 

Irving and colleagues evaluated ulcerative colitis patients receiving a CBD-rich botanical dose for 8 weeks in 2018. While there was no statistical relevance regarding clinical improvement, the treated group reported an improvement in quality of life compared to placebo. Another study by Mbachi and colleagues in 2019 showed that the use of CBD for ulcerative colitis patients was associated with reduced prevalence of severe constipation and hospital length-of-stay when compared with nonusers. 

 

Symptomatic Control with CBD and Delta-9-Tetrahydrocannabinol (THC)

 

A significant population of individuals suffering with IBD use cannabis to relieve symptoms of pain, nausea, and appetite, as well as to improve their overall mood. THC has been shown through anecdotal evidence to improve abdominal spasms, cramps, and visceral pain; whereas CBD may contribute to the relief of intestinal inflammation, modulating cortisol and metabolism, improve the immune response of the gut, and alleviate the anxiety and stress associated with gastrointestinal discomfort. In a 2021 review of 682 studies of cannabinoid use for IBD patients, clinical symptoms (abdominal pain, general well-being, nausea, diarrhea, and poor appetite) were all improved with cannabinoid therapy. 

 

Choosing a product: Benefits of the full cannabis plant 

 

When looking for a product, it is first advised to understand that the quality of your product matters. We have developed a guide to help you ensure the product you purchase is of quality and have vetted specific products to help you on your journey. Our care team is also on standby with free one-on-one support to help you get started with product choice and dosing guidance. 

 

When looking for a product for IBD symptoms, it may be worthwhile to consider a full-spectrum product that includes cannabinoids, terpenes, and flavonoids to further enhance benefits.

 

As more research becomes available for additional cannabinoids, we further our understanding of the benefits this plant may provide. For example, CBG may reduce effects of IBD and the development and growth of colon cancer. CBDA shows promise by inhibiting vomiting induced by toxins and possibly reducing involuntary vomiting. 

 

Terpenes are compounds produced by plant species, Cannabis sativa included, that are responsible for determining their distinct scents. They also play a protective role in plants and are known through comprehensive research to have multiple health-promoting properties in humans. Several terpenes have been evaluated in models of IBD and have shown to benefit intestinal anti-inflammatory activity by preventing oxidative stress, combating dysbiosis, restoring intestinal permeability, and improving the inflammation process in different signaling pathways. 

 

Finding Support

 

Reported data for cannabinoids and terpenes is promising and suggests therapeutic potential. However, there is still a lot of research to be done especially when considering how much to take. Before beginning any alternative therapies, consulting with a medical professional is always recommended. 

 

There is a lot to consider when starting cannabinoid therapy and a Realm of Caring care specialist is here to help with your questions. Contact us today by calling (719) 347-5400 or by emailing info@realmofcaring.org.