 Okay, we're back. We're live. I'm J. Faidele. This is Think Tech, and more specifically, this is Community Matters, and we're going to talk about cannabis today, marijuana, because everything in our world is being affected by COVID, and why not marijuana too? So for this discussion, we have a very knowledgeable person. In fact, the medical professional person, this is Wendy Gibson-Diviani. She's a PTA, an RN, and a BSN. Let me break that down. What's a PTA, Wendy? I was a physical therapist assistant for about eight or nine years. Okay, we know RN, we know that one, and BSN, something about nurse. Bachelor of Science in Nursing, yes. Okay, okay. She's a member of the American Cannabis Nurses Association, plus the cannabis, oh, she is a cannabis nurse educator. Do you teach classes? I do. I travel around, and I lecture mostly to healthcare professionals, other nurses, and doctors about how the endocannabinoid system in the medical cannabis works. Then we have, she's a field organizer for the Drug Policy Forum, and for you guys who are going to take the final exam, that's D-P-F-H-I. Okay, what is a field organizer for the Drug Policy Forum, Wendy? Well, the Drug Policy Forum works on changing drug law in Hawaii. So mostly, I try to help educate people about what bills are in motion, how it will affect the medical cannabis patients and program, and then rally support for the bills. So I'm also an activist. Okay, an activist. Great. We like activists. Activists is a way to, you know, a progressive policy, that's what it is. The Medical Cannabis Coalition of Hawaii, and I guess that means you're a field organizer for them, M-C-C-H-I, right? Yeah, Medical Cannabis Coalition of Hawaii is a project of the Drug Policy Forum of Hawaii, and it's specifically set up as a support network for medical cannabis patients in Hawaii. Okay, I think we qualified the witness. Now, let's get to what's really going on here. You know, if you thought that because we had COVID, cannabis was quiet, it's not really quiet, it's a lot of issues. So first of all, let's get a state-of-the-law thing. Where are we? We're in recreational, yeah? We're recreational and lit. We're not in recreational? We're not in recreational. We've had a medical cannabis program in Hawaii for... I'm sorry, I meant to say that. To me, it's a continuum. Okay, so we're in medical cannabis now, and of course, there's a lot of people who want to see it go recreational, and they, you know, had there been a legislature until Monday. Monday, it's very opening, you know that, right? Today? All those bills are going to pick up again. We'll see what happens, and it's not a lot of time. We're already in May, right? By the middle of May, it's almost over anyway. So the question is, what is the status of it now? It's medical. You've had a fair amount of legislation about it. You've had some contention about it. You've been involved a bit on the cutting edge. Where are we now in terms of cannabis in Hawaii? Well, we were picking up some steam. We got a medical cannabis dispensary bill passed in 2015. We opened our first dispensaries and labs in 2017, and they were trucking along, okay. But then when COVID hit, a lot of changes happened to not just the program, but the first thing that happened was the legislative session ended on March 19th, and there were bills in motion that were designed to help patients in the medical cannabis program. What were those bills? Why don't you take a look for us? Sure. We had one that provided employee protection. So medical cannabis patients, an employer couldn't refuse to hire a medical cannabis patient just because they had cannabis in their bloodstream, and they also couldn't fire a patient just for having it in their bloodstream also. There was one bill that would allow insurance companies to pay for the medical cannabis. There was a bill that would have helped with regulation of CBD products and allow the hemp farmers to sell tested products. They also had a bill that would allow dispensaries to offer edibles and delivery services, and one of those bills in particular was Senate Bill 2787. It made it through two Senate committees, one House committee, and then the session ended. So we were hopeful that that one would have passed, would have been very helpful. But it's unlikely that any of these bills are going to be passed this year. You're saying that because, not because there's a sentiment against them so much as there's no time. Yeah, it's not top priority. Priority, right? Okay, at the end of the day, it's probably most budget. So you'll have to start again. Is next year by any other no? I think so. So these bills carry over then, huh? I believe so. Well, yeah, I believe so. I believe it would. Okay, well, they don't have to do something about that because of the way this this has been so discombobulated. Yeah, all right. So there's had an impact on future improvements to the program, but it also had an impact on the patient registry and the dispensary system. So up until March, when the stay at home order was given, the number of patients in the registry had been increasing by about 700 to 900 patients a month. And then each month, there's another 1000 patients that renew their cards. And that money supports the program. At last count, we had the program that it supports. I mean, you have these these dispensaries, they're all separate businesses. So what's the program? The patient registry to administer through the registry. And that's a government program. Yes. But the government doesn't provide any funding for it. You have to get the funding out of these registration fees. Yes, we try to be as self sufficient as can be. Well, it sounds like you have to be. Yeah. Yeah. Last count, we had about 28,000 patients. And according to the CDC, most of these patients are at high risk for severe illness if they are exposed to COVID. Explain that to me. I saw that in your notes. By the way, Wendy wrote notes out. And we're going to have it published in an 800 pound book. Why do you say that? Well, our patients, the average age is 51, but we have a fair number over 6000 patients are over age 66. Most of them have chronic and debilitating diseases and multiple diseases. And including. So it's a it's a it's a logic thing. If a person needs medical marijuana, if that person qualifies for the prescription of medical marijuana, then the likelihood is that that person has comorbidities that make that person vulnerable to COVID. Am I right? That's correct. Yes. So the we have patients who are immune compromised and have multiple comorbidities. Okay. All right. So I think, you know, what I want to get to now is exactly how is the market reacted to COVID? I mean, COVID sort of snuck up on us. And sometimes we acted prudently. And sometimes we didn't act at all. And sometimes we overreacted. So I guess, I guess my question is, are more people seeking and using the registration, you know, the license, so to speak, and using cannabis now than say in January, as COVID increased the usage of cannabis in the state of Hawaii? No, we have some obstacles to that. The first one is that no new patients can be certified using telehealth. The current rules say that telemedicine can only be used for follow up visits, not for certifying new. Why can't I just call my doctor by a primary physician, go down there and say, look, you know, I'm, I feel like I'm vulnerable. You know, I'm vulnerable. I want you to, oh, I suppose that's a follow up. If the doctor already knows me, it's a follow up. So then the patient who wasn't using cannabis before can have telemedicine with the doctor as a follow up, and then get a prescription for cannabis. Well, only once you're established as a medical cannabis patient, that then they allow telemedicine for the follow up visits for those patients. Oh, that does, that doesn't sound rational at all. Because cannabis may be, you know, another medicine for an ailment which existed before COVID came. In other words, if I'm concerned about my vulnerability, if I'm concerned about any one of my core morbidities and I would like to have cannabis now, even though I had it before, I can't get it. Is that what you're saying? Well, it's a lot more difficult now. And Hawaii is the only state in the nation that hasn't enacted any special protections for these patients. They haven't relaxed any of the guidelines. And a decrease in the number of new patients will greatly reduce the revenue needed to run the program, first of all. Okay, this is Wendy Gibson. We're going to take a short break. We'll be right back after this break. We're back. We're live. I'm Jay Fidel. This is Wendy Gibson. And she's a nurse and she's into the marijuana cannabis movement, so to speak. And we're talking about how cannabis and the use of cannabis and the legislation around cannabis has evolved in the time of this session, this year, and this COVID. You know, I mean, COVID is pretty serious business. And, you know, if I'm going to be taken to the hospital, then I really like every medicine I could possibly have. There's been some suggestion, hasn't there, that COVID, that cannabis is an appropriate what do you want to call it, not a therapeutic, but a medicine to put you better at ease if you're having a crisis like COVID. Am I right about that? Well, cannabis may be useful in helping treat COVID or preventing it. And there are some studies going on right now in three countries that look promising, but, you know, studies take a long time to conduct. So we don't have any hard, fast answers right now. But we do know that cannabis does have some good anti-inflammatory properties. Well, it's all about anti-inflammatory, when you get into the lung phase of it, right? The body handles the inflammation, the body makes greater inflammation. And that greater inflammation, that damages the lungs, we're right. Yeah, so in the phases of the COVID infection in the lungs, later on, not early stages, but later on, when it turns into what's called the cytokine storm, that's when cannabis medicine might be the most useful. And one of the trials is using cannabis alongside cortisone to see if they can use less steroids to help treat lung inflammation. Okay, why is steroids good or not good in dealing with COVID? Well, steroids are useful for reducing inflammation, but they carry a long list of harmful side effects, really damaging side effects. And so the healthcare professionals are trying to get away from using so many steroids. Okay, and cannabis can help you do that? It potentially could, yes. Okay, but it's not, it's not happening. Now you said that with trials going on, where and who and how far advanced are they? Israel has three studies, they're focused on- You leave it to Israel, they're always a step ahead, aren't they? Oh yeah, we rely on them. So they're looking at a CBD inhaler that might help heal the lungs. They're looking at, they're doing that study that combining it with steroids to see if they can use less steroids. And then they're also using, that's just CBD for those two. And then the third one is going to be using whole plant extracts to see what effects it might have on lung infection in general. So what are the results so far? I believe they were able to use less steroids, so promising. Okay, so are we doing anything here? Are we just watching other jurisdictions? United States, the best we can do as far as research is looking at it as a potential disinfectant for surfaces. Oh, let's talk about that. Wow. You know, there's so much being published about this. Gee, I mean, everything you've talked about, it was in the paper in the last 24 hours. Not about cannabis, but about the need for disinfectants. In fact, Hong Kong Airport has initiated a huge number of things to make it safe, and to make travelers think it's safe. Disinfecting the whole airport with these new machines, including machines that look like the little telephone booth that you walk through, except this telephone booth disinfects you. I mean, technology is rolling out and these questions are rolling out. And so if cannabis is the answer to at least one or two of them, that's fabulous. Okay, so we have cannabis trying to suppress the immune reaction, and therefore reduce the damage that the immune reaction has to the lungs. Now, what was the other thing you mentioned a minute ago that it does? Well, to help heal the infected lungs, reduce the amount of steroids, and just to see disinfectant. You mentioned this. Why is cannabis a disinfectant? Well, cannabis has some antibacterial and antiviral properties. There were some studies done, I believe Italy again, showing that it could control MRSA, the methicillin-resistant staphylococcus aureus. So the antibiotic resistant strains. This is inside the body. Yeah. Inside the body. Inside the body. How do you take the cannabis? You just ingest it, and it has a disinfectant property to it. I'm not sure I would have to go back and look at that study. It was probably not done on humans. It was probably done in lab. Okay, it's not like Lysol though. No. I'm only kidding. No. Yeah. Okay. This is really interesting. Not for injection, not for injection. Okay. Okay. All right. So, okay. So, you know, but the problem is you have this kind of resistance, or what did you call it before, lack of priority. Even at a time when we ought to be going all guns to try to find ways to ameliorate this disease. And who knows, we might have a secret solution for at least some of the problems in cannabis. Well, research on cannabis has been suppressed for so many years. It's a huge struggle. It goes back to the time the federal government put it on, you know, that schedule. And so, you know, when Eric Holder, even under Obama, Eric Holder was giving you a hot foot on so many things about moving money around and all this. If those federal problems been resolved, you mean knowing a little about our president, I doubt it. Has he been, has he warmed to the subject of allowing cannabis to cross state lines and to allow bank accounts on cannabis proceeds? No. To my knowledge, the people he relies on are not at all in favor of anything like that. Okay. Now, what about the state legislature? You talked about priorities that I'd like to drill down on that a little bit. Do you have any, do you have any champions? Do you have anybody sitting in the state legislature who champions the cause, who champions these bills that you have introduced this year, maybe more next year? Not that I'm aware of. Not right now at the moment. In the past, we had some good champions, but I'm not sure where they are right now. Well, it could be that, again, as you said, priorities. Right now, the priorities are a little scattered, but they're all around COVID. Well, can I talk a little bit more then about the two main problems that we're having? So the first one being that we can't, we're having trouble certifying new patients because telehealth is not allowed. And that's been really hard on our providers because the healthcare professionals, the doctors and nurses who do the certifications are not seeing patients face to face. And patients are, because they're more at risk of catching diseases, they don't want to come into the clinics anyway. And that problem is spilling over into the dispensaries. Patients who are at high risk of getting infected don't want to come into the dispensaries. The dispensaries have done their best to keep everything clean, to protect the patients by using social distancing and having special hours for patients who are most at risk and that kind of thing. But the dispensaries have also asked patients who are not feeling well to stay home. So that's not good for business. Then, and the dispensaries were already struggling financially before this all hit. And they're not going to be able to get any of their monies back through any federal programs because the federal government does not recognize medical cannabis. Years ago, not too many years ago, when was the medicinal bill passed two or three years ago? For the dispensaries? 2015, we passed. Five years ago already. Yeah. But the first ones came online in 2017. It took two years to get the whole program. Like it was a fair amount of bureaucracy. That's the bureaucracy with a capital B that took so long. But now it seems to me that there's all the reason in the world to look at this more carefully. In fact, when those bills were pending in the first place, there were a bunch of doctors who testified about them and who appeared in various seminars, you must have been at those seminars, advancing the notion that cannabis would be the subject of medical research here in the islands. And Hawaii would be ahead of other places because we had an initiative that would allow for medical research on the benefits of cannabis and the effects of cannabis. Has that happened? There is some research going on. The problem is obtaining research materials. So getting the medical cannabis to use. They can get pieces and parts, synthetics, but not the whole plant medicines very readily because the real strict controls on that through the National Institutes on Drug Abuse, and they only have one grower. And I don't know if you're aware of the research of Dr. Sue Cisley. She's the only researcher who was approved to use smoked cannabis on human subjects that was veterans to see if it helped with PTSD. And the research materials were delivered to her from NIDA. And she said, National Institutes on Drug Abuse, the ones who control the research materials. And she said she couldn't even tell if it was cannabis or not. It had been milled and it had been in a freezer for two years. And so it killed all of the medicinal properties of it. So they really sabotaged her research from the outset. It's too bad. So Hawaii hasn't realized its own wish and which was to me a part of that whole initiative that we were going to do research here. And the federal government has stood in the way. I mean, Eric Holder, who we like, and Obama, who we like, they stood in the way. They didn't ease up for a minute. And the result is that the industry here in other states was hampered and suppressed, if you will. And so I had the impression going in that the people who were going to open the dispensaries, the growers and the people who were going to open the dispensaries, were going to make a fair amount of money. Now, they invested a lot of money. We know that. We had all kinds of angel investors coming in. We had investments from local residents and from investors offshore. And they believed that this would be a worthwhile industry and a good investment. Has that happened? From what you said, it sounds like it hasn't happened in the way they might have expected. They were, I believe, breaking even, but a lot of patients think that they're making money hand over fist because of their high prices and such, but they weren't. Yeah. Okay. So these various organizations, and you're an activist in them, are trying to straighten all this out. But it sounds like you have an uphill road. When you go down and testify on these bills, who's in the room? There's many people show up at these hearings. Aside from patients and potential recreational users, is the medical community there? Who are your champions in the community? I asked you about your champions in the legislature, but now I'm asking about the people who show up and testify. I don't know. There have been so many hearings. It's hard to well, the police certainly show up to testify against some of our bills. They think that's a slippery slope argument. Gateway. The medical community, well, yeah, patients do show up. Drug policy forum, the health and harm reduction people. I'm not really sure. I have a good list for you. Well, it sounds like this is just as much in play as it was five years ago, that people are still making the same argument. So the question, my last question to you, after that, I'm going to give you a free run on anything you want to say. How close are we to recreational marijuana? What stands in the way? How many years do you think we'll have to wait? People were hopeful that there would be a three-year rollout and that would be rolling out next year. However, Governor E. Gay expressed that he would veto any bills and so legislators were not at all motivated to try to pass any bills. It sounds like so many other initiatives where he stood in the way of the natural process. Okay, so at time we have three or four minutes left. I think why don't you tell me everything you want to tell me? Okay, great. For now, you know, you got to put the notes down. The too many notes gets in the way. Just tell me from the heart. Okay, so the two main problems that patients are facing right now are that we can't get new patients because telemedicine is not being allowed for new patients and patients who can't make it to the dispensaries or can't send their caregiver to the dispensary can't get their medicine because we don't have a delivery service. All the other states created some changes to the rules and guidelines so the patients could get their medicine but Hawaii did not do that. They were allowed to deliver prescription medicines. People were allowed to deliver alcoholic beverages but not medical cannabis and so that's very hurtful. There were letters sent to Governor E. Gay and to the Department of Health asking if they could make some concessions during this crisis and now we're realizing that it's not just during this crisis that we need that help. It's because when things open back up again, our patients are still going to be the most at-risk patient population. So what we need is telehealth for new patients and we need delivery service for patients who can't make it into the dispensaries and both of those the letters to both Governor E. Gay and the Department of Health were sent back saying no this can't happen but no no real explanation as to why not and so there's a petition that's been started by a group of concerned people and it's called Parity for Patients and Parity is Equality and medical cannabis patients have been one of the most ostracized and patient populations that I've ever worked with and so we're just asking for equality. The state says they recognize this as a medicine. They need to recognize that this is a medicine and you should be able to deliver it. You should be able to get certified to use it using telehealth. So there is a petition and I'm part of a group called Parity for Patients Coalition and we're trying again with a petition asking Governor E. Gay to please reconsider both telehealth and delivery services for patients. Parity being parity with other medicines all of the medicines in other words to treat the concept as implemented that this is a medicine like all other medicines. Yes absolutely. Well it strikes me that the takeaway here is that that is especially the case the parity point is especially true in the time of COVID and not treating it like every other medicine medicine stands in the way of treating COVID patients allowing them to recuperate and doing research on exactly how cannabis can help a COVID patient or not. We need to have medical research on this and that was the idea in the first place and I think it sounds like we're kind of stuck and one of the reasons we're stuck is the legislature was stuck for most of this session and I'm sure there are other areas in which the legislature also should have been able to move and fail to move because of this very long and very disruptive recess. So I hope you mount the campaign next year again. I agree it's not likely you're going to be priority this year in the remaining weeks or it can't be very long in the remaining session starting Monday but maybe next year. You know maybe we can be hopeful that by June 14th which is the 20th anniversary of having a medical cannabis program in Hawaii that we will see something happen. Okay and I think it's appropriate that we take a look at your flyer for that. June 14th is a medical cannabis day in Hawaii. Yes let's see the flyer for that. 20 years of patients having legal access to medicines. For some this is a celebration of the end of a conflict between state and federal over whether or not cannabis actually is a medicine and yeah. Okay well I hope you come around again Wendy because this is obviously a little stuck right now and hopefully it'll ease up and we'll have some progress and a progressive issue in the near term. So let's circle back. And may I give some thanks. Thank yous to everybody on the front lines especially the people in the healthcare. Sure please. Thank you so I'd like to say thank you to everybody who's on the front lines especially those in the healthcare profession and I would like to say thank you to everybody who helped flatten the curve by doing social distancing and wearing masks. I believe you did make a difference in helping flatten the curve and and thank you for that. Thank you Wendy. Wendy Gibson. So nice to have you in the program. We can talk again.