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Holistic Cannabis Academy

Learn about cannabis as medicine, the endocannabinoid system, and nutrition-related health conditions. Understand cannabis history, formats, and delivery systems for wellness and remedy integration. Discover the legislative landscape and why dietitians should care. Uncover challenges in accessing medical cannabis and the importance of evidence-based training. Explore the endocannabinoid system, cannabis dosage impact, and the differences between Sativa and Indica strains. Dive into cannabis constituents like cannabinoids and terpenes, and various delivery systems including smoking, edibles, and topicals for holistic integration.

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Holistic Cannabis Academy

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  1. Holistic Cannabis Academy RDNs: Get Up to Speed about Cannabis! Denver Dietetic Association November 9, 2017

  2. Donna Shields, MS, RDN Co-Founder, Holistic Cannabis Academy donna@holisticcannabisacademy.com 305.967.1600

  3. Integrating Cannabis Holistically

  4. Today’s Objectives • Review the history of cannabis as medicine • Discuss the endocannabinoid system + cannabinoids • Classify cannabis formats + delivery systems • Examine nutrition-related health conditions for integrating cannabis as a remedy + for wellness

  5. Cannabis as Medicine History • Cannabis as medicine for thousands of years, only illegal in US for about 80 years • US Pharmacopeia listing • Ancestors used mother nature’s medicines – plants – to heal

  6. Legislative Landscape

  7. Why Should Dietitians Care? • Healthcare paradigm shift driven by consumer demand gaining national momentum • Cannabis has synergy with nutrition-related health conditions + general wellness • Other healthcare practitioners becoming competent • Remain competitive, expanding scope of knowledge

  8. Cannabis Is a Plant!

  9. RDNs versus Store Staff importance importance “…some are recommending cannabis that has either not been shown effective for, or could exacerbate, a patient’s condition. Findings underscore the importance of consistent, evidence-based, training of dispensary staff who provide specific recommendations for patient medical conditions.

  10. Challenges for Cannabis • Not covered by insurance in the medical model • Access to medical cannabis products in various formats – flower, oil, topical – varies among states • Not approved in all states • Not always approved for all health conditions • Cannaphobia is real

  11. DEA Schedule 1 Listing • Controlled Substances Act • Listed as a schedule 1 drug with heroin, cocaine, MDMA, LSD • Contradiction between states and federal regulations

  12. Endocannabinoid System (ECS) • All living things with a spine produce endocannabinoids • Collection of binding molecules • Ligands • Enzymes • Receptors • Endocannabinoids – keys that open receptors • Anandamide + 2-AG, or 2-arachidonoylglycerol

  13. Endocannabinoid System • Key component of physiology of healing • System of communication between cells • Balance + homeostasis • Basic components are receptors • System similar to other receptor systems with lock + key mechanism • Key = chemical compound

  14. Endocannabinoid System • Two key receptors discovered to date • CB1 - CNS, adipose, heart, lung, GI, muscle, joints, skin • CB2 - immune, bone, spleen • Regulates physiological processes

  15. Why Modulate the ECS? ‘modulating ECS activity may have therapeutic potential in almost all diseases affecting humans, including obesity/metabolic syndrome, diabetes and diabetic complications, neurodegenerative, inflammatory, cardiovascular, liver, gastrointestinal, skin diseases, pain, psychiatric disorders, cachexia, cancer, chemotherapy-induced nausea and vomiting, among many others’.

  16. Cannabis Dosage Impact on ECS • Chronically high doses can desensitize or down-regulate endocannabinoid receptors • Fewer receptors means maximal effect of cannabis diminishes • Reduce the dose to allow cells to build new receptors • Micro-dose to restore sensitivity

  17. Endocannabinoid: Anandamide • Derived from ananda = Sanskrit for bliss • Chronic anti-depressant/anti-psychotic meds elevate anandamide production • Receptors eventually get desensitized

  18. Sativa versus Indica Dr. Russo: Since the taxonomists cannot agree, I would strongly encourage the scientific community, the press, and the public to abandon the sativa/indica nomenclature and rather insist that accurate biochemical assays on cannabinoid and terpenoid profiles be available for Cannabis in both the medical and recreational markets. Scientific accuracy and the public health demand no less than this.

  19. Cannabis Constituents + Terms • Cannabinoids – compounds in cannabis • THC, tetrahydrocannabinol: psychoactive, analgesic • CBD, cannabidiol: anti-inflammatory • THCA + CBDA – acids, prior to heating • Decarboxylation • Ratio – CBD:THC • Terpenes – volatile molecules present in plants

  20. Cannabis Characteristics • Lipophilic = binds to fat • Hydrophobic = repels waters • Body fat impacts absorption • Start low, go slow • Cannabinoid release from adipose • Vigorous exercise

  21. Cannabis Delivery Systems • Smoking – raw plant flower, immediate effect • Vaporizing – raw plant flower or extracts (more controlled dosage) immediate effect • Edibles – extracts in foods, slow absorption • Tinctures – oil bases, highly concentrated, sublingual, mid-range absorption • Topicals – extracts in oils, non-psychoactive

  22. Format Follows Function • Format depends on individual patient • 90/90 rule for inhaled meds: 90% peak plasma drops in 90 minutes • Tinctures: 15-20 minute onset lasting 2-4 hours • CBD patch: up to 8 hours of relief

  23. Raw Cannabis Juicing • Raw, unheated leaves means no psychoactivity • Ingredients, such as kale & Echinacea, influence cannabinoid receptors • Raw cannabis leaf juice • Chlorophyll is a super anti-oxidant • Wheat grass “on steroids” with cannabinoids • For autoimmune + blood disorders

  24. Gastrointestinal Disorders Inflammation Insomnia Multiple Sclerosis Pain Stress Tourette’s Syndrome Women’s Health ADHD Alzheimer’s Disease Anxiety Autism Cancer Crohn’s Disease Epilepsy Fibromyalgia Integrating into Nutrition Care

  25. Intersection with Nutrition Food + nutrition can optimize cannabis effects

  26. Intersection with Nutrition • Anti-inflammatory foods + cannabis = symptom relief for joint pain, fibromyalgia

  27. Intersection with Nutrition • Caffeine elimination, protein + fat at all meals + herbals teas + cannabis = improved sleep

  28. Mood Disorders + Nutrition • Adaptogenic herbs + morning protein + hydration + cannabis = improved anxiety management

  29. What Are Terpenes? • Unsaturated hydrocarbons found in plant essential oils • Monoterpenes are most abundant • Beta-caryophyllene is major terpene found in hemp seed oil

  30. Aromatherapy asIntroto Cannabis • Phytocannabinoids + terpenes are synergistic • Herbal steams of hemp oil with other essential oils are non-threatening + non-psychoactive • Inhalation influences limbic system for healing benefits

  31. Functions of Terpenes Beta-caryophyllene • In carrot seed • Anti-fungal • Anti-malarial • Protects gastric cells • Skin protection

  32. Functions of Terpenes Limonene • In citrus • Immune stimulant • Reduces anxiety • Treats acne • Fights breast cancer cells

  33. Functionsof Terpenes Linalool • In lavender • Local anesthetic • Reduces spasms • Anticonvulsant • May counteract psychoactivity

  34. Functions of Terpenes Myrcene • In mango + thyme • Analgesic • Muscle relaxant • Promotes digestive mobility

  35. Functions of Terpenes Pinene • In pine • Anti-inflammatory • Helps arthritic pain • Acetylcholinesterase inhibitor to aid memory

  36. Cannabis + Meditation + Yoga Cannabis facilitates • Mindfulness • Slowing down • Decision making • Empowerment • Self-determination

  37. Cannabis + Stress • Can reduces stress • PTSD + anxiety + mood disorders • Lower stress = healthier adrenals = healthier thyroid

  38. Colorado MJ Resources Colorado.gov/cdphe • MMJ Registry • Research Grants • Testing & Safety

  39. Holistic Cannabis Academy Expands your scope of practice plus client base Positions you as a progressive practitioner Provides a unique point-of-difference for clients

  40. Free Resources & Discounts • CELEBRATE 10%

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