Holistic Cannabis Academy RDNs Get Up to Speed

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

Donna Shields, MS, RDN Co-Founder, Holistic Cannabis Academy donna@holisticcannabisacademy. com 305. 967. 1600

Integrating Cannabis Holistically

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 4

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 5

Legislative Landscape

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

Cannabis Is a Plant!

RDNs versus Store Staff 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.

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

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

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

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

Endocannabinoid System • Two key receptors discovered to date • CB 1 - CNS, adipose, heart, lung, GI, muscle, joints, skin • CB 2 - immune, bone, spleen • Regulates processes Appetitephysiological. Memory Pain Sleep Mood Immune Function

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’.

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

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

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.

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

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

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

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

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

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

Intersection with Nutrition Pain Anxiet y Insomnia Food + nutrition can optimize cannabis effects

Intersection with Nutrition Reduce Chronic Pain Anti-inflammatory foods + cannabis = symptom relief for joint pain, fibromyalgia

Intersection with Nutrition Mitigate Insomnia Caffeine elimination, protein + fat at all meals + herbals teas + cannabis = improved sleep

Mood Disorders + Nutrition Reduce Anxiety Adaptogenic herbs + morning protein + hydration + cannabis = improved anxiety management

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

Aromatherapy as Intro to 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

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

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

Functions of Terpenes Linalool • In lavender • Local anesthetic • Reduces spasms • Anticonvulsant • May counteract psychoactivity

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

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

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

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

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

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

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