SweetSue's Class Notes

[Alafornia]

It's interesting that your response to my post is much more considered than the original posts to which I replied. I think that's what Alafornia was referring to when he mentioned your advocacy overtaking you.

It just seemed at that moment that euphoria was the only side effect under consideration and also no acknowledgement that for some euphoria and the downsides to that can be problematic for some. I meant no offense. It's more that I believe in your message, Sue, and want to see it make an impact. Credibility enough to admit the downsides for some will go a long way with some people.

I can’t walk around angry at the medical/industrial complex in the world and our country in particular and claim to love without condition, can I?

Yeah..... I’ll get that straight.

Sure you can. It's not really the people you hate (mostly). It's the system.

I came here to do a simple grow journal. That seems a long time ago.

And what beautiful work you've done.

 

[InTheShed]

I meant no offense

Sorry fornia, I didn't mean to make it look like your were saying something that could be considered offensive!

 

[Alafornia]

Sorry fornia, I didn't mean to make it look like your were saying something that could be considered offensive!

Nah. Sue seems to be in a rough patch and I just didn't want to be a reason why.

 

[SweetSue]

Nah. Sue seems to be in a rough patch and I just didn't want to be a reason why.

Sue is an emotional woman. I come up against this resistance every once in a while. You should have seen me writing my first article for the dispensary. Lol! I was a mess for days.

It’s part of human nature that we resist taking that big step because it can result in your becoming somehow distanced from those people you love and were having a good time with just because you chose a path that became a passion. The trick, I’m learning, is to not take yourself too seriously.

And for whatever reason I enjoy the tumble through spiritual chaos as I recalibrate back to my joyful center. I finally got to the point where I admitted that I don’t have to do any of this, and I do it because I love it and really can’t not do it. Remembering I have a healing arsenal others don’t, I pulled out my bottle of infused oil and slathered the neck and shoulders, massaged across the brow and along my jawline to cut back on the building tension that serves no one well. Lol!

Suddenly I recalled I’d just done a couple articles on terpenes, and dabbed drops of lavender oil around my neckline and on the hem of my blouse.

Knowledge is power, eh?

There’s nothing wrong here. I’m not sure what this emotional reaction is really due to. Might be as simple as the new moon cycle. But I know I’ll get through it, and I know I won’t stop writing or studying.

This feels too much like being alive.


Sure will be glad when the tears stop. My daughter laughs and says, “Great joy needs the balance of deep pain Mom.” She’s right.

 

[SweetSue]

I’m a study buddy of weed, and I’m good at it.

I think I’m through the crazy stage now. Coffee and the laughter in the shop helps. Knowing I’m surrounded by the best cannabis warriors on the internet helps just as much.

 

[SweetSue]

Back Pain, Chronic Pain, Nerve Pain & Cannabis - Mara Gordon, for Green Flower Media

Pain changes who you are. The chronic expectation of pain restricts thought, movement and actions.

Mara grew up in a house ruled by the pain of her arthritic mother and she came through that experience expressing many of the same genetic tendencies for pain, further complicated by injuries to her back. She’s lived in her own painful universe for about 30 years. She has first-hand experience in the comparisons between conventional chronic pain management and cannabis therapies.

Mara’s husband, a sober alcoholic, broke his back, and preparing for surgery he rebelled against the “life-sucking opioids” put forth as his only option for pain management. No member of the medical support team offered cannabis as an option, in California, where it was medically legal.

• A friend stepped forward. “Hey, I make brownies for my boyfriend.”
• Starting with brownies awakened the idea that there was more than meets the eye, and they dug further.
• What they found was credible relief and hope that there was a better way to treat debilitating pain.

80% of Americans will experience some sort of back pain in their lives.

Back pain

• SweetSue
• Feb 20, 2020

Materials by Green Flower Media

When you add in the rest of the world the number falls to only 10% of the world population. Sounds like we would be well advised to do some serious lifestyle changes, eh?

• Back pain is the most prevalent reason people seek medical help.
• Between 7-10% will develop chronic back pain.
• Only a small percentage are helped with traditional pharmaceutical or OTC solutions.

The difference between acute pain and chronic pain is that chronic pain is the disease.

• Pain is a signal to the body that something needs tending to.
• A person without a pain response is in serious threat of harm or death.
• With chronic pain there’s so much memory about the pain that the painful loop never really stops.

People are choosing multiple drugs, looking for relief, and few are finding it.

• NSAIDs
• OTC drugs: Tylenol, Ibuprofen, etc
• Opioids: Fentanyl, Oxytocin, Vicodin, Norco, etc
• Muscle relaxers: Soma, Flexarol, etc.

All of these choices come with a list of undesirable side effects like

• Constipation
• Mood swings

When people tell Mara they don’t want euphoria she responds with, “Is it because you feel good that’s the problem? Because all these other choices are to some extent psychoactive, but in a depressing way.“

***Desk work is the leading cause of chronic back pain. ***

I’d bet my life it’s got a lot to do with the hump. I already knew it was a bad idea to train humans to be seated. It’s part of what led to my husband early death. Circulation and energy don’t like to be restricted.

• Kids spend their youth sitting at desks in schools and hunched over game consoles in free times instead of running around outdoors.
• Then they graduate to desk jobs.
• We’ve created the perfect storm for chronic, ongoing nerve pain.
• From an evolutionary standpoint we haven’t been bipedal all that long, and we certainly haven’t evolved quickly enough to adapt to sitting hunched over all day, with our arms in front of us on the desk all day, every day.

Glad I am that I set up a standing work station the other day.

Make the option to stand to work, or to move around with regularity to counteract the hunching.

Women present 8% m chronic back pain than men.

• Interestingly, Men miss 50% more workdays for back pain than women do.
• Women push right through the pain. Anyone who’s given birth understands this power.
• $50 billion per year in direct costs, $100 billion per year for indirect costs.

You get into a loop:

• You get injured or develop pain.
• Pain increases to debilitating.
• You can’t work and sign up for disability.
• Pain, lack of feeling productive, and restricted income create an environment ripe for depression.
• Other complications arise, stemming from further injury, pain, or medical response to control pain.

Most people would rather be out there working. When you think your neighbor is lucky because he doesn’t have to go to work you’re wrong. “Lucky” and “back pain” aren’t compatible.

Chronic Pain serves no protective biological function.

The Nervous System

• SweetSue
• Feb 20, 2020

Materials from Green Flower Media

If anything, back pain is self-perpetuating.

• Pain makes you less active. The myofacial tissue that isnt moved around turns to a felt-like consistency and the ECM crinkles, making it more challenging for cells to send and receive signals.
• Muscles break down and skeletal support begins to fail.
• You’re not supporting the inflamed and damaged nerves the way you would if you were moving freely and stronger physically.
• The last thing you want to do when you’re on opioids - which make you sleepy and loopy - is to get up and go for a walk.

The way our disability system is set up there’s a discouragement to heal.

• When you start to get better they take the income away.
• Theres an encouragement to perpetuate being sick to keep the roof over their head and food on the table.
• What people want os to get back to work in a healed manner, to become another productive member of their community.

My daughter deals with this fear, and her disability claim is for severe anxiety, the worst her diagnosing psychiatrist or the judge that ruled in her favor had ever confronted in an applicant for disability income. She worries all the time that they’ll strip her of her income and she’ll be destitute. She feels a need to continue to prove that she deserves the income, and worries now that it’s been over a year since she’s been able to find a replacement for the therapist that wasn’t doing much more than fall asleep while she talked, but was making those notations every month.

Yeah ..... the system has flaws.

How does chronic pain work? What do THC and CBD do in your body to bring relief from chronic pain? It’s not a masking of the pain. It’s a physiological change in response to the components found in the essential oils of cannabis.

There are five mechanisms of action involving THC and pain reduction. Reality: we use cannabis because your body is under so much stress that the ECS can’t keep up with demand for cannabinoid signaling

1. THC retards the electrochemical charge at the peripheral pain receptor. (eCB1)
2. THC also interrupts the pain signal at the dorsal root ganglia. (eCB1)
3. THC interrupts the pain signal at the neuron. (eCB1)
4. THC activates the CB2 receptors, enhancing immune response.
5. The euphoric effect of THC offers the possibility of a break from the pain cycle, as it breaks the memory loop that keeps pain on the forefront of consciousness.

CBD is 30-50 times more potent as an anti-inflammatory than cortisone without shutting down the adrenal system. When you take steroids it’s difficult to get away from them because your adrenals stop working on their own.

The U.S. federal government has a patent on CBD as a neuroprotector, despite the fact that they keep it at the top of Schedule One as the most dangerously addictive and toxic medicine known to man, with no medicinal value. Go figure.

The ECS vs pain

• SweetSue
• Feb 20, 2020

Materials by Green Flower Media

eCB1 activation doesn’t BLOCK the pain, it blocks the pain signal, so you don’t feel it as pain, so , in a sense, pain isn’t registering as pain.

eCB2 activation blocks inflammation, thusly controlling pain response.

• You’re causing a physiological change by positively reducing the inflammation around the nerve.
• You're also stopping the transmission of the pain signal.

Your brain and pain

• SweetSue
• Feb 20, 2020

Materials by Green Flower Media

All epithelial cells have nerve endings.

• Every cell with a nerve ending can have a pain response.
• Pain signals travel from the point of pain to the basal root ganglia.
• The signal travels up to the brain stem to the pain perception areas.

Your brain and body and the eCBRs

• SweetSue
• Feb 20, 2020

Materials by Green Flower Media

• eCB receptors are expressing themselves anywhe they’re needed on the surface of the cell

Note: The surface of a cell is a fluid thing, constantly changing as receptors express themselves as needed.

• When activated, the CB1 receptors stop the transmission of the pain signal.
• The pain signal is stopped at 1) the point of pain, 2) the basal root ganglia, and 3) the brain’s pain perception areas.
  
  
• Microglia impact the inflammation itself, slowing the inflammatory response and clearing out the clutter inflammation leaves behind.
  

Cannabis offers a complete pain reduction program, not just a masking of pain perception.
1. Reduced pain perception.
2. Reduced inflammation.
3. Euphoria.
4. Short term memory reduction.

With cannabis you reduce or possibly eliminate the pain you're experiencing.


The graphic speaks for itself.

Cannabis use reduces polypharmacy of dangerous pharmaceutical and OTC drugs

• SweetSue
• Feb 20, 2020

Materials from Green Flower Media

In states with legal medical:

• People find relief from chronic pain.
• Sleep is restored.
• Depression incidents decrease. Pain is depressing. It robs you of your identity and your vigor.

Because fewer pharmaceuticals are consumed you also see a significant drop in secondary and tertiary conditions that typically arise as a result of the pharmaceuticals. Pain patients get caught in polypharmacy to deal with the many uncomfortable side effects of their single-molecule medicines.

• If you start with cannabis you don’t have to go through the mess of drugs and side effects.
• Cannabis saves the federal government lots of money in pharmaceutical and medical costs.

Which cannabinoid should I use? To be honest, you can’t go wrong.

Choosing your cannabinoids

• SweetSue
• Feb 20, 2020

Materials by Aunt Zelda’s, by way of Green Flower Media

Acid Cannabinoids:

• CBGa is found in the young cannabis plant, before the transformation of oil components has begun. Analgesic, anti-inflammatory
  • If all you do is walk up to a cannabis plant and pick off a bud to eat it you’ll get medicinal benefit, albeit not too efficiently.
    
    
  • Raw buds are difficult to dose, if you’re trying to maintain tight values, and they don’t taste as good as you might have thought they would.
    
• THCa
  • Anti-inflammatory
  • Anti-cancer
  • Anti-spasmatic
• THCVa
  • Anti-inflammatory
• CBDa
  • Anti-inflammatory
  • Anti-cancer
• CBDVa
  • Anti-inflammatory

Decarboxylated cannabinoids:

• CBG
  • Anti-cancer
  • Analgesic
  • Anti-bacterial
  • Bone stimulant (with degenerative disks or bone disease, think CBG)
  • Anti-depressant
  • Anti-fungal
• THC
  • Anti-cancer
  • Anti-inflammatory
  • Analgesic
  • Anti-bacterial
  • Anti-spasmatic
  • Bronchodilator
  • Neuroprotective
• THCv (diabetes, weight loss, and other conditions. Not really all that valuable for chronic pain) THCv is more about bone stimulation than inflammatory response of analgesia
  • Anti-convulsive
  • Appetite suppressant
  • Bone stimulant

Although THCv stimulates the CB1 receptor, it doesn’t present as much euphoria as THC will.

• CBD
  • Anti-cancer
  • Anti-inflammatory
  • Analgesic
  • Anti-bacterial
  • Anti-spasmatic
  • Anti-anxiety
  • Immunosuppresive
  • Neuroprotective
  • Anti-depressant
  • Anti-convulsive
  • Anti-psychotic

CBD expresses itself in three different ways in the patient population. There’s no way to predict which way you’ll feel it until you try.

1. Patient gets really sleepy.
2. Patient gets really energized.
3. Patient feels no difference at all.

• CBDv
  • Anti-convulsive
  • Bone stimulant

Aged cannabinoids

• CBNa
  • Anti-inflammatory
• Delta-8 THC
  • Anti-anxiety (low level)
• CBN used to be the way the dispensaries noted the age of cannabis. Now we know it’s a potent sleep aid and much more.
  • Anti-inflammatory
  • Analgesic
  • Anti-convulsive
  • Anti-insomnia

CBN activates the CB1 receptors, but with a much lower affinity for euphoria than THC.

If you go to Mara and say, “I’m in chronic pain” she’s gonna put you on

• CBD for inflammation
• THC for all the anti-inflammatory, analgesic, and neuroprotective properties benefits of euphoria.
• CBG for the great benefits, especially as an anti-depressive.

How much do I take?

Every patient is individual, and requires individual titration, but patterns and guidelines do exist.

Weight isn’t a good determinant of cannabinoid need.

Start low. Go slow.
​

Pick healthy products. Don’t use medicine that’ll harm you.

Patient #1: Female

Dosing guidelines

• SweetSue
• Feb 20, 2020

Materials by Aunt Zelda’s, by way of Green Flower Media

This is the magic formula of terpenes for chronic pain management.

• Beta-caryophyllene activates CB2 receptors, stimulating the immune response.
• Limonene is uplifting, restorative.
• Linalool is calming, soothing, relaxing.
• Myrcene increases availability of the components of the essential oils by helping them pass through the BBB more easily, and it’s also relaxing to the point of encouraging sleep.
• Pinene opens the airways and speeds uptake and effect of cannabis components.

Target dose was 30 mg THC/day, in two sublingual 15 mg doses, morning and evening, after a small dose of healthy fats. Cannabinoids are fat-soluable.

She also took 20mg of CBD once a day, in the afternoon, sublingually.
- This dose allowed her to be highly productive through the day without psychoactivity until later in the day.

Last, but in no way least, a topical was used. Topicals won’t touch deep pain, but they do offer benefits to the chronic pain patient.

• Nerve endings close to the surface are soothed.
• Tense muscles relax.
• No psychoactivity.
• No limitations on using topicals. Use as needed. You need to reinforce this fact in the senior community.

 

[SweetSue]

All done guys. Excellent course, isn’t it? Courses like that make my monthly subscription worth it.

 

[Alafornia]

All done guys. Excellent course, isn’t it? Courses like that make my monthly subscription worth it.

To what do you subscribe, if I may ask.

 

[SweetSue]

To what do you subscribe, if I may ask.

Green Flower Media. They do an excellent job of educating the public on cannabis. Their video classes are chock-full of valuable morsels, taught by industry leaders like Mara Gordon, who started Aunt Zelda’s, and taught this class and the one they have on cancer.

They also have extensive conferences and articles. Multi-media devoted to cannabis. One of my many favorite teaching centers. They have this class I’m salivating over on medical cannabis that requires another in advance. One day...... Amy took the first course already, lucky girl.

 

[Alafornia]

Things I wonder:

1. cost

2. I see where terpenes do this or that. Do they explain how chemically it does these things? I need to know the science behind the claims in order to validate them for myself.

3. I love what you’re doing here. We need more of it in the world.

 

[Alafornia]

Got look at the website. Looks nice. Not cheap. Could be worth it.

 

[SweetSue]

Things I wonder:

1. cost

2. I see where terpenes do this or that. Do they explain how chemically it does these things? I need to know the science behind the claims in order to validate them for myself.

3. I love what you’re doing here. We need more of it in the world.

It’s one fiscal outlay I don’t miss. I feel like I’m helping the cause by contributing, and they have contacts that’ll be valuable. In the end it’s as much who you know as what you know.

I’m not sure anyone explains clearly what terpenes do at a cellular level. I’m still working out how to explain this so it doesn’t make eyes glaze over. Lol!

And thanks. It’s all a labor of love.

Got look at the website. Looks nice. Not cheap. Could be worth it.

Definitely worth it.

 

[Amy Gardner]

cool, that example of daily dosing looks very much like what I do - except I take a little more overall now and in more, smaller doses.

All done guys. Excellent course, isn’t it? Courses like that make my monthly subscription worth it.

glad you resubscribed. I haven’t yet and may not - I had a patron help me get signed up to Dr Sulak’s program. I haven’t dived in yet but I am very close to doing so.

Green Flower Media. They do an excellent job of educating the public on cannabis. Their video classes are chock-full of valuable morsels, taught by industry leaders like Mara Gordon, who started Aunt Zelda’s, and taught this class and the one they have on cancer.

They also have extensive conferences and articles. Multi-media devoted to cannabis. One of my many favorite teaching centers. They have this class I’m salivating over on medical cannabis that requires another in advance. One day...... Amy took the first course already, lucky girl.

lucky yes! I had help and also did it while they were a little smaller and before the prices went up. Current exchange rate to USD is so bad for me theres no way I can do any of it now

Things I wonder:

1. cost

2. I see where terpenes do this or that. Do they explain how chemically it does these things? I need to know the science behind the claims in order to validate them for myself.

3. I love what you’re doing here. We need more of it in the world.

Sometimes they covered bits of the science and that was just in the intro course so I expect it will be there. What they do do is provide you with all the references you need to chase it up youself. It’s very well put together and delivered.

I’d say data on terpenes is partly scientific research produced/discovered and partly clinical evidence, which is what many anecdotes become when Drs (folks, anyone really ) take note of them and see correlations and patterns etc. The science of terpenes in cannabis is very young. But if it’s there, I’d wager that GFM will tell you about it!

 

[SweetSue]

Notes from Project CBD

Martin Lee on cannabis therapeutics:

• Personalized medicine
• no single, proper combination (ratio) of THC and CBD for all - find your own
• many enjoy the high, many don’t
• The higher the ratio of CBD to THC the less high

Goal: Consistent, measurable doses of a CBD-rich remedy with as much THC as a person is comfortable with.

Emerging patterns of specific ratios for disease - For a novice patient:

• Start with a small dose of CBD with little THC
  • Anxiety
  • Depression
  • Spasms
  • Psychosis
  • Seizures
• Start with a low dose of a balanced, 1:1 ratio of CBD:THC
  • Cancer
  • Autism
  • Neuropathic pain

Some use different ratios at different times of the day

• higher CBD for daytime
• higher THC for evenings and sleep

Almost any chemovar or product could benefit a wide range of inflammatory and autoimmune diseases.

• THC activation of CB2 receptors regulates immune response.

Optimal Dosing of CBD-rich oils

• Doses range from a few mg to a gram or more.
• Begin with low doses of high CBD and very low THC
• small doses across the day as opposed to one large dose
• Stay with a new dose for at least two days to feel effects before changing dose volumes.
• Don‘t overdo it.
  • Biphasic means low and high doses of the same substance can create opposite effects.
  • Small doses of cannabis tend to stimulate.
  • High doses of cannabis tend to sedate.
  • Too much THC can lead to amplify anxiety and mood disorders.
  • Excessive CBD could be less effective therapeutically than a moderate dose.

With cannabis therapies, less is often more.
​

Single-molecule (isolate) CBD

• has a smaller therapeutic window​
• to be therapeutically effective
  

  • requires precise dosing​
  • requires high doses​
  • lacks entourage effect​
• low dose, whole-plant, CBD-rich treatment regimens are working for many conditions

The Entourage Effect - Many of the compounds in cannabis essential oils are medically valuable on their own. Combined by the plant they work in synergy inside the human body, becoming “more.”

CBD will deactivate cytochrome P450 enzymes, altering the metabolism of

• painkillers
• statins
• blood thinners
• insulin
• other drugs using this pathway to metabolism

This is more likely to become a problem with isolate CBD.

• monitor labs
• adjust drugs as needed (adjust pharmacy drugs)

Dr. Sulak see doses ranging from 1 mg/ total cannabinoids to over 2000 mg (with no adverse effects)

• He believes ultra-low doses can be more therapeutically effective than ultra-high doses.
  

Micro-dosing: consuming sub-psychoactive or slightly psychoactive doses of cannabis.

Cannabis products come as

• oil extracts
• infused
  • sprays
  • tinctures
  • edibles
  • gel caps
  • topicals
  • patches
  • other products

​

 

[SweetSue]

New Patient Dosing Guidelines by Russo and MacCallum

Smoking

• one hit, wait 15 minutes
• if needed, take another hit and wait another 15 to 30 minutes
• Continue, spacing the hits out to 15 - 30 minutes until you find the relief you seek.

Oral (high-THC) **Remember it can take 60 - 90 minutes to feel effects.**

• Start with 1.25 - 2.5 mg of THC
  • shortly before bedtime
  • for 2 days
• If all is well, increase by 1.25 - 2.5 mg
  • for another two days
• Continue until you find the relief you seek.
• If you get too high, back off to the last dose where you did feel comfortable.
  

Titrating THC - For adequate relief some need dosing throughout the day.

• Days 1 & 2: one dose of 2.5 mg of THC.
• Days 3 & 4: increase to 2.5 mg THC 2x/day
• If well-tolerated, increase dose volumes to a total of 15 mg THC/day
  • Doses exceeding 20-30 mg of THC a day may increase adverse effects or induce tolerance without therapeutic efficacy.

“Adverse effects” refer mostly to the euphoric effects of THC, and are dose-dependent and individually determined, patient-by-patient.

According to Dr. Sulak, overconsumption shows many of the same symptoms we use cannabis to treat:

• nausea
• vomiting
• sweating
• diarrhea
• spasms
• tremors
• anxiety
• panic attacks
• paranoia
• disconnection
• disturbed sleep
• hallucinations
• acute psychosis I’m curious as to how many cases of acute psychosis there really have been historically? I’ve never bothered to chase it down. As I read this list I’m seeing visions people using dabs, showing a lot of these symptoms, but the symptoms pass quickly.

Slow titration (introducing cannabinoids to the body slowly and gently increasing doses)

• minimizes adverse effects
• helps you find the minimum effective dose

THC and CBD together

A 2010 report British Journal Of Pharmacology had a report on clinical trials that demonstrated CBD will potential THC

• Adding CBD to an ineffective low dose of THC will make it effective.
• With CBD added you can get medicinal benefits of THC at lower doses.
  

Journal Of Pain study of Sativex:

• 263 cancer patients not getting relief with opioids
• broken into 3 groups
  • A) 21 mg Sativex/day = significant improvement
  • B) 52 mg/day = less significant improvement
  • C) 83 mg/day = no better than placebo with more adverse effects

When high THC is needed, balance it with high CBD to tamp down psychoactive effects.

Full-spectrum CBD-rich extracts

• as general rule, you won’t get high
• FECO are better than isolates
• choose quality
• insist on labs of the product so you know what you’re buying

”Start low, go slow, and don’t be afraid to go all the way. - Dr. Sulak​

 

[SweetSue]

10:05 PM. Been at this most of the day. Are we having fun?


Time to indulge and get my butt to bed.

 

[SweetSue]

Maybe just bed.

 

[SweetSue]

 

[InTheShed]

New Patient Dosing Guidelines by Russo and MacCallum

Do you have the link for that info?

 

[SweetSue]

Do you have the link for that info?

Yes I do Shed. It was from the March 2018 issue of the European Journal of Internal Medicine.

Eur J Intern Med. 2018 Mar;49:12-19. doi: 10.1016/j.ejim.2018.01.004. Epub 2018 Jan 4.

Practical considerations in medical cannabis administration and dosing.
MacCallum CA1,Russo EB2