 I'm Marsha Joyner, and we are navigating the journey. Navigating the journey is dedicated to exploring the choices in life. Together, we explore the various paths the life's ending. Together, we make all of the difficult conversations easier. One of the difficult conversations is medical cannabis or marijuana. Today, we can explore the pros and cons of medical marijuana. Together, we can move this issue so that our loved ones do not suffer needlessly. Together, we can make sure that our own wishes and those of our loved ones are expressed and respected. So if you're ready to join us, we ask. Navigate the journey. And today is a special day because we are going to venture into medical cannabis. Yes, marijuana. Yes, cannabis, whatever you like. But we have a great guest today. Wendy Gibson is an RN, and she is an educator in medical marijuana. And all of the other titles lead us to what she is doing and what this conversation is about. What I know for sure is that there's so many people in hospice and palliative care that have the medical marijuana card, but there's nowhere to get it. And they die waiting on it. So our question, of course, is not only what is medical marijuana, but what is taking so long? Since 2000, the state approved this. What's taking so long that people are dying waiting? Well, it was only in 2015 that we passed the medical cannabis dispensary bill. And so that has given the state and the dispensary licensees time to create multiple corporations. Each dispensary licensee has to create a grow site. They have to create a manufacturing area as well as a dispensary. And every step of that process is new to Hawaii. And every step of that process, the Department of Health, has been tasked with creating entire sets of regulations and guidelines for them, including a seed to sell tracking systems. So it's not an easy task. But this long? Yeah, actually, this long. I'm not surprised that it's taken this long, personally. OK. Well, let's start at the beginning. What is medical marijuana? What is cannabis? Cannabis. It's a very unique plant that has chemicals in it, many chemicals in it. Some of them are very similar to chemicals that your own body produces. So because your body produces them, they're called endocannabinoids. So in the plant, there are phyto cannabinoids. In your body, there are endocannabinoids. And because your body is wired for that, we have more receptor sites for that in our bodies than any other type of receptor, it works for many, many different conditions. So we don't have a rejection issue like we do with medicine, drugs. No. You can build a tolerance to it, just like that's a normal response to other medications. But in terms, they have not yet found a toxic level of it. So nobody has died from cannabis. And that's largely due to where the receptors are in your body. Because with opioids, they shut down the breathing center in your midbrain. Because that's where there's a lot of receptors. But there's not so many when it comes to the cannabis receptors, and so it can't shut down your breathing or your cardiac function. Now, the Bible refers to this seed, this weed, as it is. And cultures all over the world have had this. It's been used for tens of thousands of years. China, India, I can't remember all the other countries. It was in Ayurvedic medicine, Greece. It's been around a long time. So what happened between the time that it was in full use and today? Well, it went wrong. It was legal in the United States, and it was available in pharmacies from 1850 to 1937. It was one of the top selling medications. It was available in many forms, in tinctures and oils, and even in a smokable form for treating asthma. But most of the changes came about in the 1930s. About 1937, there was a campaign against cannabis, as the medicine as they knew it as cannabis. And they changed the name to marijuana. And it's a racially charged slang term, mostly targeting Mexican immigrants. It was right after the Mexican War. And it was also during the economic depression. And then also the end of alcohol prohibition, when the Narcotics Enforcement Bureau was newly formed and they kind of needed a new target, they needed jobs too. So Congress passed the Marijuana Stamp Tax Act. After a large media campaign pioneered by William Randolph Hearst, it was a huge racially charged media campaign. And then the Reef for Madness movie was all part of that. What I read about Hearst is that all the newspapers, to that point, had been manufactured by Hemp, which is part of the plant. And then he has a newspaper nationwide. He also has a forest with trees. So he decided that it was better to make paper out of his trees than out of this weed called hemp. Yes, this was driven by industrialists as well. Because cannabis sativa is the medicine. And cannabis sativa, the other form, is hemp. So this largely shut down not just the medical portion of it, but it shut down the hemp industry. And hemp was being used to make everything, pretty much everything, all the fibers in your clothing, anything canvas. So ship sails, the ropes on ships, the oils were used. It was a great machine oil and also as a biofuel. OK, so that's when it was all shut down. Now, however, the Americans own the patent that says, gives all the things it cures. And the Americans own the patent. I would never say cure. But no, that's what they call it in the patent. The United States government holds many patents on it. One of them is a patent on CBD, showing it's US patent number 6630507. And it's held by the Department of Health and Human Services and has been since at least 2003. And what this patent says is that CBD is useful in minimizing the harms of, well, brain damage, ischemic stroke and hemorrhagic stroke. Also useful in the treatment of Alzheimer's, Parkinson's, and HIV dementias, which is something that we are seeing coming to fruition in Alzheimer's clinics. Well, the one I'm talking about was 1949, where it lists. I don't have the number with me. But it lists what it can, it says, a cure for. And it lists these things. So that's wartime, right after the war. So back in 1850, the Pharmacist Guidebook, the United States Pharmacopia, that USP that you see on all of your medications, the United States Pharmacopia is the Pharmacist Guidebook. And from 1850 to the 1940s, cannabis was listed as a useful medicine, useful in the treatment of many, many conditions, including seizure disorders for alcohol and opioid dependence and pain, which are all things that we are just now rediscovering. So 1850, they knew this. I'm not familiar with the 1940s. I'll have to go and dig it up for you, yes. But I was amazed that they knew this. And yet there was this big push to do away with it, to criminalize it. It was further criminalized during the Nixon administration. 1970 was really the final nail in the coffin, making it one of the most illegal substances on the planet. Made it, putting it into a schedule one drug category, which it never belonged in. Scientifically, it doesn't belong in any of the categories. However, that was also a racially charged campaign. I remember as a child, there were reefers. I don't know what anybody, you know, I don't know anybody that had any ordinary people, because it was this thing that only entertainers had reefers. The jazz musicians. Yes. But I never heard of ordinary people in the community that had any of this. It was just something that was relegated to the entertainment world. Yeah. And so this was also, I guess it was only, I was a freshman in college in 1956, when I discovered that, well, maybe this isn't just for entertainers. You know, that's. Sure, yeah. Yeah, there was huge cultural revelation in the 60s, of course. Yeah. But still, it. But it was kind of kept underground. It was. It was. It was very secretive. And. Well, probably, because people were being prosecuted once the marijuana stamp tax act went into place. And that required that you buy a stamp from the government in order to buy or sell it and fill out paperwork. And if you didn't have, it weren't strict compliance, you could be prosecuted for that. The government only issued a few stamps, and they cost between $1 and $100 per gram, I believe. And so that, in 1937, that's about a lot of money. Well, let me tell you this little story, and then we'll go to break. OK. I'm a freshman, right, at Howard University. And on the table in the dining room, every table had salt and pepper and Lipton tea bags. Every table. So I decided, well, I can make some money, because everybody in Maryland, which was the tobacco country, everybody had papers where you roll tobacco. That was a given. Oh. Yeah, where you roll cigarettes. OK. Because that's what you do in a tobacco country, right? OK. So I decided I could make money, and I could charge $1. So I would take a Lipton tea bag, open it, put the tea in the paper, and roll it and sell it as a reefer for $1. Oh, my. Oh, my. And then a person that came along that really knew what it was jumped me down. Yeah, that can't happen. That ended like that. Yeah. Now we'll go to break. You're watching Think Tech Hawaii, which dreams live on thinktechhoai.com, uploads to YouTube, and broadcasts on cable OC16 and O'Lello 54. Great content for Hawaii from Think Tech. Some say scuba divers are the poor man's astronaut. At DiveHeart, we believe that to be true. We say, forget the moon. DiveHeart can help children, adults, and veterans of all abilities escape gravity right here on Earth. Search diveheart.org and imagine the possibilities in your life. And we are back with Wendy Gibson. And we are talking about cannabis. Wendy is an expert. She's an RN and an expert in cannabis education. And so she's here with us today to educate us on medical marijuana or cannabis, whichever you want to call it. I prefer the term cannabis. That's the botanical name, the name of the medicine. That is the, that's what it will be. OK. So where are we in the process? What happens next? We have the laws in place. People can apply for a card. And then they take it to special doctors who can then prescribe. I think this is a process. The doctor helps issue the card. Oh, the doctor helps issue the card. Yeah, you have to have your examination first. First. Oh, OK. All right. And then you get your card. And then you get your card. But now that I have my card, now what? Well, you're allowed to grow your, since the medical cannabis program was created in 2000, patients have had a right to grow their own medicine. And we just increased the plant count to 10. So that's the only legal way you can get your medicine right now until the dispensary's open. And we're hopeful that that will be by the end of August. OK, so tell us what is going on with? Well, we're at a point where we're just weeks away from being able to open the first dispensaries. And it's largely reliant upon getting lab and lab testing in place before we can do that. Some of the dispensary licensees have already grown a crop or two and have a product that they can sell as soon as it gets tested and passes the infection. Well, what are they testing for? Multiple things. They're testing for pesticides, heavy metals, any kind of contaminant, mold, bacteria. So that it's a pure plant is what you're, to make sure that it's a pure plant. Yes, because this is medicine that's going to patients. And some of our patients are children. We need to make extra sure that this is quality medicine. They'll also be testing to see which cannabinoids and terpenes are in there. Those are the active ingredients that have therapeutic value and are also responsible for some of the side effects. So we can look at the chemical profiles of them and we can dose it. And we can predict what the effects are going to be. What are the side effects? What do we look for in side effects? Well, it depends upon the person. It depends upon the chemical composition of the plant. And there are over 6,000 varieties. So I can't answer that question easily, quickly. The most common side effects for naive users, an experienced user generally doesn't have side effects. What do you mean a naive? A first-time user, somebody who hasn't. There can be some anxiety. Your heart rate may come up. Those are the two general negative side effects, dry eyes, dry mouth. Well, so now tell me the difference in the marijuana that or the cannabis. Thank you. Marijuana that you smoke, the cannabis that's a medicine. What's the difference? There's, or is there a difference? There's basically no difference. The cannabis that's being grown for medical use, we're trying to bring up the levels of CBD. Because for many years, the recreational users have been using lighting processes and techniques to raise up the levels of THC to make it more fun, more recreational. However, the CBD in it helps balance out the effects of the THC. And both are hugely important medicines. But the medicinal hybrids are generally higher in CBD than the recreational use one. So the CBD, what is the difference in the CBD in the cannabis and the CBD in hemp, hemp oil? Hemp? Well, it's not actually a great source of CBD. You have to use a lot of plant to get it. Whereas if you're using the medicinal one, you don't have to use as much. Not many knows, too, in the hemp and the cannabis, because they're both labeled CBD. Well, hemp is cannabis sativa. It's just like the cousin of the other. And you're asking what the difference in the CBD levels are? They're higher in hemp, generally speaking. But it's still not the best source of CBD, mainly because it's a bioremediator, meaning the plant takes toxins out of the soil while it's growing. It's great for cleaning up soil, toxic soil. But if you're concentrating that and giving it to a patient, I'm not all down with that, unless you have really good independent lab testing to go with it, showing that there's no contaminants in it. I know we're talking about the medical marijuana, cannabis and hemp and all this. Now, since this is a plant that just grows, it's a weed, just grows anywhere, why is it that the state of Hawaii can't, you just said it cleans up the soil, the toxins out of the soil. You make paper, you can build houses, you can do all these things with hemp. Hemp has thousands and tens of thousands of uses. Doesn't it seem, now I know this is your field, but it seems to me that we could build houses less expensive since we have a housing shortage. If we grew hemp, used it as a building project that we could reduce the cost of houses. Yes, I'm very much a hemp advocate. And there were three permits that were issued in the state of Hawaii to grow it for research and industrial purposes. I'm hopeful that we'll see good results with that. I know that Mrs. Thielen, representative Thielen, worked for years. She's been a champ. She's been for years on him. And so there's so many products, I just think that the state has just missed the ball. But not using this. Well, what would really be most helpful is to get cannabis out of the schedule one drug category. It never belonged there. It is not a schedule one drug. Schedule one drugs have no medical value whatsoever. And I am a proponent of unscheduling it. Get it out of that scheduling process, not reschedule it. Because changing it to another schedule doesn't make much of a difference. Mostly because the FDA will never approve a botanical medicine as an FDA approved drug. They just don't have a process to do that. But it's not a drug. It's not a drug. But because it's being categorized in a drug category, the FDA approval process is the only way to make it into a prescription drug. And simply changing it to a schedule two drug, that's for a prescription drug. Which it will never be. The FDA doesn't have a process to make that happen. And no, and they are all employed by Monsanto anyway, so that's not gonna happen. Yes. Anyway, that's a different subject. However, from what I've read about the safety and what you've told me, this sounds a lot safer than any of those prescription drugs, any of them. I worked in healthcare for over 30 years, 10 of those in pharmacy. And I have never seen a drug that has such a great safety profile. And the side effects do not include death. And it has such a wide range of therapeutic uses. Because like I said, it's sort of part of your body already. Some of the chemicals in it are very similar to the ones that your body produces. So, you know, our program, we have been championing medical aid and dying. And it seems to me that if this were available, medical marijuana was available to people at the end of life, that the trauma and the suffering that they go through and that horribleness of giving them morphine until they just go away could be eliminated. This is part of what drives me. I took care of my mother when she was dying of lung cancer. And back then I knew nothing about cannabis, the medicine, and I really wished that I had known back then what I know now. I know my mother's, I helped my mother live her dying and I know it would have been a much easier process if we had had cannabis aboard. Well, I went through the same thing with my mother. She had COPD and, you know, oh, it was just awful. But so many patients I know at the end, like I said, we are championing the bill of medical aid and dying to assist people who are in that tragic state and say, I want out. If this was readily available, where they wouldn't suffer, where they wouldn't, the way they could go peacefully. Well, we do have a medical cannabis program and hopefully the dispensaries will be open soon enough so that some of those patients can make use of the medicine. Do we have a cadre of doctors who are still in yesterday and so that I'm not gonna do that to my patient? I'm not gonna, yes. Yeah, I'm a cannabis nurse educator and I am trying to educate as many nurses and doctors and anybody who will sit still for an hour and a half to learn about the endocannabinoid system and the plant chemistry and how this works. And there are companies who have policies against letting their physicians or APRNs make the recommendations and so that they have to do it on their own and because it's been so stigmatized and because this information just hasn't been out there for them, readily accessible to them and, well, the pharmaceutical companies pretty much fund the medical schools so everything has to be a five milligram pill for them to be comfortable using and they're not gonna be comfortable using something where the patient has to find their own dosage and they're not comfortable with botanical medicines like they used to be back in the day. That was standard of care and now the standard of care is, well, there's many protocols that they have to follow and cannabis simply isn't one of those alternatives although I would like to see it used more in place of opioids because I feel that this could help reduce the number of deaths from opioid overdoses. It could. Hugely. Well, you know, it takes an hour and a half you said to learn. Yes, and I give it for free if you want to put together a group of healthcare professionals or anybody who will sit still for an hour and a half. Well, our time has run out so we don't have an hour and a half but we would love for you to come back again, please. Thanks for having me. Aloha. It's been a real pleasure and there's so much to learn so we will come back and talk again. Have you. Aloha. We look forward to it.