I grew up in a large, non-catholic, chaotic, bohemian family of artists. I spent a lot of time reading in a closet. It was the only place I could eat jello powder undetected. We might have been Catholic, but my Nonna was exiled from the church, or I may have been Jewish after my biological father converted to Judaism and married someone named Gay. Unfortunately for my Dad and Gay, the wedding ended after we told the San Franciscan Rabbi about the other wife in Hawaii. I recently found out my father was onto something when my DNA came back one percent Ashkenazi Jew. Somehow, I’m missing most of my known family lineage in my genealogical profile. Someone else must have shot-put half of me into existence fifty-five years ago. I’m still waiting for the inheritance.

As a family, we lived on the brink of perpetual disaster in a city’s most affluent neighbourhood. When professional hotshots came to rent the suite in our home, they mistook my stepfather, who looked like a Mexican Jesus on a Vegas cruise, for the gardener. He went along with it. Some gossips referred to us as the Royal Tenenbaums, but we were closer to the Osbournes. When the pizza guy showed up, seventeen dogs answered our door, but no one else. They also got the pizza.

At parties, my six siblings hid under a fort made from draping blankets over antique Chippendale chairs. We drank bourbon, smoked weed and rated the ankles of guests who walked by. Occasionally, a guest stooped to draw back the fabric and join our sibling cadre of Oz introverts. At peak social claustrophobia, we unceremoniously bumcast them forth into the trousered fray of hipsters and dancing business suits doing the Twist.

When my stepfather wasn’t taking surveys at parties about people’s voting and eating preferences, he was giving decorating advice to local restaurant owners who never asked for it. Our family, “the Hillbillies of Pleasantville,” was a stark contrast to the neighbourhood families of judges and doctors. While school friends attended a debutant coming-out party, I sat on a dead elk watching my family excavate family heirlooms from the local dump. If we were actually invited to anyone’s wedding, we ruined it from the moment we tried to arrive on time. Pretentious weddings were our specialty: Mom ripped the backside of her dress on a landscape hose, one of my sisters tore the crotch of her pants while sliding down the entrance pole in a mock fashion show, a circus of oddly costumed siblings rearranged and rewrote the guest placeholders, and we all congregated on the back steps smoking and doing Betty Davis impressions when the wedding speeches made us break out in a collective, rare rash.

After high school, I did an ill-prepared, impromptu audition for a New York Acting School, auditioning internationally. Why I did it. I couldn’t tell you, but it was likely instigated by seeing a poster in front of the auditorium on the way to a friend's. I never thought I’d hear back. I was accepted. I’d made it. Until my parents saw the cost. In this moment, I rightly remembered my family's recreational outings to the local dump. Daring to dream this big, if it was a dream, more like an impulse for change, couldn’t possibly happen on my parents’ dime. So I got a job slinging coffees and baked goods and eventually made my way to New York with my Dad, sister and myself. When we got there, my Dad told us not to look anyone in the eyes, to be on the alert, and to be street smart. I imagined gangsters and bagels. Our first night in the hotel, I heard a noise, likely a housekeeper gleefully running the linen cart over her manager, but I heard gunshots, so I commando-closed the curtains and hit the floor prostrate.

After much tagging along with my Mexican Jesus Dad and interviewing schools, we found a perfect sock to our Hillbilly shoe, HB Studio. We worked in the office and the neighbouring HB Foundation Theatre to help pay our tuition. We were two Canucks, no hockey sticks, just two sisters giving away our Northern identity with every “roof”, “aboot” and “eh” we dropped like pucks hitting the ice in awkward conversations.

I studied with Sandy Dennis, Earl Hyman, Herbert Berghoff and a curious, unassuming dialect coach named Ruth, a diminutive woman with large, round wire spectacles and an outstanding, unintentional seventies wardrobe. One day, while I was practicing a scene in front of Sandy’s class, out of the blue, she said deadpan, “I want to give you a Tony.” At this, I felt my nonexistent confidence grow slightly, maybe too hopeful, too grandiose, like the Grinch, mistaking a request to borrow an eraser from his sweetheart-crush as a sign of love. I thought she meant an award, but she wanted to give me a perm. But I suppose, a movie star perming your hair trumps a faux-gold, table statue for most. Herbert lamented my Canadian accent and called me Gena Rowlands, a name I’d not heard of, but I nodded in agreement anyway. You dared not disagree with Herbert if you didn’t want to lose every last hair— head, nose, toes, and low’fro — from his tempestuous, verbal windstorms. After all, I imagined the student-teacher, apoplectic yelling assaults as necessary preparation for “aaaaaaaahchting!” In a quieter, gentler class, during one of my nether-clenching, anxiety-ridden, serially apologetic, class performances, Earl Hyman, in a Black American English accent, said with utmost but emphatic kindness, “Girl! You apologize for living!” I just told him I was Canadian.

Two off-Broadway plays later, one working as an actress, and another as an incompetent stage manager, sound tech and set decorator, the sun was shining. But as with all tenuous weather predictions, and a re-membering of my shadowy, family history of debasing dump dates, sunny expectations were the thief of any hope of handprints and a star in a cement sidewalk. Instead, fate farted and sent me uninsured to a low-income, emergency ward with a bowel obstruction from ingesting New York deli cornbread. While arguing with my father over the nurse’s phone about how much it may cost him, I witnessed a procession of ne’er-do-wells thoroughly trash the unit. Between the yelling and threats in the background, I remained on the phone, avoiding knife punctures. Little did I know that the unflinching perseverance in telephonic dialogue under threat of violence portended the use of this critical skill in my future profession. Meanwhile, the unit clerk suffering from excruciating ennui, cannonballed a gangrenous-legged senior to the street, and I experienced a marginal epiphany. Marginal only because of intense intestinal pain and an unrequited relief from trapped gas. Acting seemed meaningless. A profound calling stirred in my cramping pelvic area, and upon a bulletless discharge, I returned home to become a road nurse, not to revive dead aspiring relatives seeking publication, but to soften a patient's embarrassment into welcome laughter.

I work two jobs in the community. I often encounter the same people. Unwittingly, they participate in human behaviour labs stationed between my senses and viscera. One lab steeped in abstraction and ephemeral detachment, the other hemorrhaging into somatic rivers of pain, apathy, joy or other bodily reactions. Drawing on observations, I sculpt their personality’s tableau into a relatable story of suffering, imperfection and a forgivable fracturing of self-composure. It helps me to stem infantile, knee-jerk reactions to their unsavoury behaviour and instead find compassion. It makes rudeness palatable, like adding sweet, hot pepper jelly to obscure the taste of stale crackers and rancid cheese.

Through the deli window, I watch the regulars siphon through the morning pedestrian rush from half a block away. I know their idiosyncrasies in their stride, their strategies for getting past the crowds and the colours of their wardrobe palettes. In anticipation, I slap their order on the counter before they push their decaffeinated bodies through the door. The regulars barely notice the effort. They are often absorbed in their phones or the newspaper.

One regular, a diminutive, sallow fellow with feathered, shoulder-length, home-streaked hair, a pinched anus mouth, and a large hooked nose twice his size, admonishes staff on the daily. His wife, always laden with custom Native jewelry, feathers, linen and denim, stares blankly forward, her blue eyes the colour of a wolf, a loner in a forest of people. He grimaces and checks his watch. His wife, feeling the change in mood, walks straight for the corner table, head down, and picks up an art magazine. I want to join her.

As if on cue, the Director belts a proclamation across the counter to announce his displeasure.

“I. AM. A. DIRECTOR!”

He spits on himself. The dribble catches on his collar and elongates into a teardrop from the forced air blasting from his flared nostrils. We all stare at the droplet as if watching a person standing backside to a cliff. Do we tell him? I contemplate the trajectory possibilities. I can almost see my reflection in the ball of it. I move my hands upward as if to cradle the crystal ball but catch my finger in my nose-ring and missile sneeze across the counter. The spitball drops to stretch across the sleeve of the customer beside him. I grab a baguette from the day-olds and sweep it like a cobweb unnoticed by anyone. He barks another order at the girl in training. She starts crying. I put on Barry White Christmas music. I want to yell, “Cut! It’s a wrap!” and shove his ass out the door but, my throat closes around the primordial mumble and it fades into black. I reach for a brownie from the glass case and give another to a workmate. Chocolate helps everything.

Everyone hears him, most staff ignore him, but the new staff panic, scurry and sweat regardless of our debriefings ahead of the shift. To shut him up, they make his latte first, despite his position in line.

He pays with his debit card and omits the tip. I give him a free baguette. He launches into his usual diatribes. Sometimes he mutters about the superior coffee in France and Italy or threatens to sue if the floors are wet. His coffee is too bitter, too cold, too diluted or too hot. He is the Goldilocks of directors and us, his pet bears. Yet, day after day, he returns.

Later in the week, while sitting in my car collecting my purse and bags before entering Walmart, I see the Director standing near a garbage can. He’d look better in it. He wears skinny jeans, a newly purchased jacket in the same shade of blue denim and an oversized, brown, oil-cloth, duster overcoat. His head sprouts like a withered seedling from dirt. It’s the only time I’d approve of using weed killer. The rain keeps watering him and I hope for a freak flood to wash him away. I squint my eyes to see him through the wet windshield. He picks through the garbage extracting receipts by the handful. Another fellow exits the store and drops another without notice. The Director scuttles over, hair wings flapping in rhythm with his little black Dayton boots and shoves the receipt into his pocket. The rain stops. I wish for an earthquake of 8.2 but only where he’s standing.

I slip past him. I shop for a while and run into him in the vegetable section. Beside the Folgers instant coffee and no-name brand noodles, he places in exact alignment some potatoes and broccoli in his cart. Unimaginative, I thought for a creative.

I track him to the cashier. A piece of squashed ripe banana sticks to his heel and as he walks, it gathers floor dust like an ancient rum ball from Christmas past. Who likes rum balls anyway? Not even dead people take them to their grave. He grabs a Snicker from the rack, fondles it, takes a bite and drops it into the bag of an elderly customer. At till number 10, instead of unloading his groceries, he selects one of the receipts from his pocket and saunters out the door. A clerk stops him. The Director dramatically produces a crumpled mass, holding it within inches of the clerk’s nose until his eyes cross. “I’m a Director”, he says. The fellow recoils and lets him go. Still, no earthquake.

On the weekend, I work at a strip club as a coat check. The Director showed up with a posse of friends. All in dusters. Some wearing cowboy hats despite living in a cosmopolitan city without horses. They talk over one another while pulling off their coats in unison.

“May I harness your coats in the barn?” I say dryly, reaching for their jackets.

They keep talking. The Director fails to recognize me from the deli.

Later, I leave the coat check for a break. I grab a beer and sit on a red plastic and chrome barstool, sweaty from the last person sitting there. The Director approaches the bar. He changes his cocktail order several times. The music is so loud, the bartender cocks his ear to hear him. On the third attempt to appease the Director, the bartender climbs a ladder to reach the prime tequila. The Director, taking advantage of the diversion, pilfers tips from the jar, leaving some behind. He grabs his drink and staggers to his seat in gynecology row and drops a coin in the dancer’s bullet-bra. She ignores him, turns on her red patent stilettos and exchanges glances with the pole dancer before exiting the stage. For the rest of the show, the girls played stage right and avoided the centre. The Director fell asleep, the posse left and he awoke to a bouncer kicking him out.

He returned to the coat check alone. “Did you find five bucks?”
My coworker checks the lost and found drawer.
“No, but someone turned in a ten.”
He feigns searching his wallet, shows her a five, and says, “Oh ya. It was a ten, not a five,” and snatches the bill from her hands. She pulls a middle finger under the counter like an Olympic swan dive in reverse. I could have stopped the blatant theft, but I’d blow my cover. I never told the girl and gave her my tips.

A couple of days later, at the deli, as per routine, I place the orders on the counter in anticipation of the regular arrivals for ten am. The Director’s wife walks in. She beams. Before the server puts two lattes on the counter, she drops a twenty in the jar and blurts, “He’s dead. He haggled on a brake repair.”

She didn’t elaborate. I didn’t ask. Instead, I howled and she howled back, taking her latte out the door into a forest of people. Back in the lab, I never figured out the Director’s backstory, but I’ll be looking for his obituary. Perhaps, I’ll find something redeeming, some evidence of a cataclysmic catalyst steering the good within him to evil. But some folks live as they die, hell-bent for a brick wall without brakes. He directed the movie, but the mechanic stole the ending. I have his number if you need a repair, just ask him nicely.

We’ve talked before, always about life, family, and other philosophical matters, never small talk and only ever on the trails. Today was my first foray from the couch since I returned from Mexico. It’s been a while since I’ve seen her. I was jogging along and examining the mushrooms sprouting from beneath the fallen leaves and looked up to see her running toward me. She stops me with urgency. I’m glad to rest as I am eager to find an excuse to stop. Her eyes turn into crescents as she rubs her hands together to keep them warm and says, “You look different. When someone says this to you, you are about to win money.”

I smile. “I’d love that!” She tells me these are Ukrainian superstitions.

“I take them seriously” she says lowering her voice as if to tell a secret, “I believe in them”.

I tell her of my reoccurring dreams of overflowing toilets, usually taking place in my old elementary school bathroom. While standing up to my knees in the poop of a hundred classmates, I am always ridden with anxiety, terrified of drowning. I often wondered if it portended an imminent disaster, or if it signified some subconscious, perverse Freudian pathology. She assures me this is a good luck omen. “Next time, you must buy a lottery ticket” she insists. I’m grateful to reframe the visions hoping they end in pot-of-Gold rainbows instead of the sewers of my childhood nightmares.

She continues talking as if sitting by a bonfire, and tells me a story about her index finger. It had grown a sizable, troublesome skin growth on the side of her knuckle and interfered with her ability to write. She had it assessed and the cost to remove it was beyond her means. She holds up her finger, furrows her brows in singular focus, looks at her finger in disgust and reenacts the evening after the assessment: “Before bed, I just looked at the lump and said to it: ‘I do not like you, I want you gone’. The next morning I looked at my finger and the lump was gone! I shook my husband awake to show him and he told me to look at the other finger. So I did. But, I was right, the attached lump had completely disappeared! This thing was firmly attached and in no way could it have fallen off!”

She looks at me intently. “We have powers in our family.” She recounts “My grandmother would boil eggs and go into the forest to talk to the egg. Then, she’d bring the egg back and rub it on the chest of a child who stuttered. After performing her hardboiled egg ritual, the stutter would disappear.”

“You are among a line of Ukrainian shamans!” I say and I’m beginning to believe it.

She wants to start running again, her body is cooling down from sweating but encouraged by my interest, she lowers her chin and looks up at me, “Can I tell you just a little more? Then I must get moving.”

Without waiting for an answer she begins, “I once dreamt of everyone around me covered in poop. Not me, just everyone else. So I told everyone I knew, they should buy a lottery ticket. I never heard of a win among those I told, but I heard someone won in a nearby rural town, away from the city. I didn’t know anyone who lived there, so assumed my dream was wrong. Later, a woman who I had told to buy a ticket, told me she bought a ticket at a gas station in this town. She won millions in the lottery!”

As she tells her story, I realize she may be talking about a relative of a dear, childhood friend. I tell her. She gives more detail saying the woman was married to a gent from the city and gave the location where they moved after winning. “She had never bought a lottery ticket before! They even stored the ticket in a frozen turkey before claiming the prize to ensure its safety.” I’m gobsmacked.

We stand there in awe. We wonder at the co-incidence: two strangers who meet by chance on trails meandering through rural farmlands so regularly we feel like friends, and here we have this strange connection between us.

I encourage her to write down these superstitions, beliefs and memories for fear they be lost with time. “I worry about losing oral and other forms of recorded history to digital formats. The technology is evolving so quickly, we can’t keep up with the cataloging.” She agrees. Her grandfather fought in the Ukrainian wars and she is the remaining keeper of his stories. “The Ukrainians have been through a lot. They’d send the Ukrainian’s to the front lines and shoot them in the back”. She trails off lost in thought and lists a string of offenders, something about the Bolsheviks but I didn’t quite get the whole list.

For a while, we reflect. It’s chilly but neither one of us are ready to part. I tell her about a documentary I saw on privilege and how someone had said, “You are so lucky. Our ancestors came over as slaves. We don’t know where we came from, but you all do.” She could understand the point but felt this was also true for many others with historical trauma. Through wars and genocides, many lost much of their ancestral history as men travelled across the globe to fight or find work. Often they’d have children with other women or die without any explanation or knowledge of their whereabouts or life abroad. Through the traumas, families separated and much of the history was lost leaving behind gaps and progeny without a sense of identity.

“You know, I once found letters covered in rat feces in an abandoned house near a high school” I said thinking about lost stories. “Kids congregated there at lunch time. One day, my kids told me about the house and intrigued, I asked to go see it. There I found the last records of a family who had since died out. The letters, illustrated correspondence from a husband serving in the war to his wife, spoke of ordinary things. He had lovingly illustrated between the paragraphs on onion skin paper. Amongst the letters, I found music books and receipts from hair cuts and other sundries scattered across the floors and in the attic. It bothered me to see the last of their memories destroyed by vermin and chucked around by kids without a concept of their historical importance or value.”

“Did you take them?” she asked. “Yes, I have them in a box. I tried to give them to a museum but they were worried it would contaminate their other artifacts. I even tried to call the minister that knew the family but he never returned my call.” In a way, this was my lottery, to be a keeper of memories, to hold their love in a box.

Finally, we had to move. She was shivering and I needed to return for dinner. She ran off toward the horse stables and I, toward home. Her shamanic premonitions lingered within me and to honour her stories, I bought a pack of lottery tickets. If I win, she will hear from me — my magical, Ukrainian friend from the woods, teller of stories, professor of good things.

― James Baldwin

“It’s not crack but it’s not lettuce (either).” I recently heard this dry-witted phrase from a medical presentation on cannabinoid medicine. On the internet, cannabis is personified as omniscient and omnipotent, or the devil incarnate. As science is discovering, cannabis is not one medication, it’s many. For some, it’s been an answer to poly-pharmacy, a remedy or purported cure for many illnesses.

For the past few months researching this topic has been a full time endeavour. I poured over medical journals, books, interviews and watched medical lectures. I’ve abandoned my family, my friends and consumed more fast food than I care to admit. Questions bubble up during conversations, driving, showering or in my sleep. Once in a while, I step back to broaden perspective and then dive like a kamikaze to search for the answers. It is an exercise in metacognition, critical thinking, exploration, and discipline. I try to hold a dialectical self-discourse and it leads to more labyrinthian mazes.

To delve into the history of this plant has been a jarring jaunt into reefer madness induced racism. It’s a Sherlock Holme’s and Watson’s nemesis and hero, a Jekyll and Hyde medical mystery. It encapsulates a metaphysical yin and yang. Decades of research is revealing that cannabis could treat a multitude of illnesses but it must prove itself via the usual rigours of research and scientific scrutiny. I look forward to the development of a new specialty, endocannabinoid medicine. How far we are from that, is anyone’s guess.

Cannabis, a 12,000 year old weed is re-emerging into medicine once again and is providing many benefits but it also has darker implications. It is a source of food, fibre, medicine and fuel. Some say it enhances creativity and focus. Yogis and other religions use it for meditation and spiritual connection. Yet growing the plant can have large environmental impacts. Prohibition has helped promote this damage via the black market practices. I have no doubt green innovation practices can resolve this as producers strive for excellence in growing technology and quality assurance. Legalization and regulation will help curb possible contamination from moulds, mildews, bacteria, fungi, pesticides and extraction byproducts which pose serious potential for harm.

Studying cannabis expands our allopathic view of medicine. It is not just a singular scientific inquiry but a philosophical adventure. Doctors and nurses like things precise and predictable. Most of all, we like data. Listing euphoria as an adverse effect, sparks hot debate and sometimes moral opposition. We deem it “euphoriphobia”. This weed dares us to think beyond the box.

The endocannabinoid system was uncovered in the late 80’s and early 90’s. The system maintains homeostasis throughout the body. It may hold the key to understanding many underlying pathologies of diseases that have yet to be treated beyond their symptoms. To comprehend the biochemistry of the endocannabinoid system in the body is complex. There are journal publications on cannabis daily; some within the same day with opposing results. Given that the endocannabinoid system is a system of balance, this is not surprising.

Endocannabinoid physiology and pharmacology are missing from many medical and nursing text books. Most troubling, is that politics and societal views have influenced the content of medical and nursing curriculums. I suppose this is nothing new, however, one would think that politics would stay out of our formal science education in this present day. Scientists as we have all seen, are still marching for science free from political influence both in Canada and the USA.

Many nursing and med students will face patients taking cannabinoids and will need to be informed. In fact, we should have been better prepared years ago. Most often, we have associated cannabis with marginalized groups and scoffed at the idea of cannabis having any medicinal properties. It pains me to think how narrow minded we have been. If only we had looked beyond our borders. We are supposed to be inquisitive and science-minded but we have fallen prey to propaganda, fear-mongering, our own inflated egos and not bothered to look any further. We have been lazy scientists.

The subject of cannabis cannot be fully elucidated in a one-hour cannabis 101 lecture. The system is complex. As you sift through research studies, you find they are fraught with confounders such as tobacco, alcohol and contributing social determinants. Yet government sites state the harms with certainty despite lacking quality evidence on either side of the debate. I’ve yet to see a government fact sheet that states harms and lists the problems with the methodologies of the studies in plain view as well as the confounders. These fact sheets should also list in plain view, the level of evidence for each fact.

https://www.canada.ca/en/health-canada/services/substance-abuse/controlled-illegal-drugs/health-risks-of-marijuana-use.html

For example, we are warned of the persistent loss of IQ attributed to youth’s heavy cannabis consumption. If you search further you read critiques of these studies. These “facts” then become half-truths. Critics will call attention to the difficulty in capturing evidence of cognitive deficits. The more cognitive tests, the more variables. What are the social determinants? Were they also using tobacco? Alcohol? What was their IQ before consumption? How much did they reveal in surveys? Were the surveys biased? The list goes on. http://www.sciencemag.org/news/2016/01/twins-study-finds-no-evidence-marijuana-lowers-iq-teens

From my patient interactions, I see people losing confidence in their professional caregivers. This is partly, in my view, our own fault. We fail to address our patient’s inquiries with curiosity and open minds. Instead, we state harms with authority and without quality evidence-based knowledge; sometimes, in a condescending manner — not always, but it seems this experience is too common.

Those who benefit from cannabis, can be relegated to the stoner’s corner. Disheartened with the medical community’s reticence, they navigate their treatment without guidance. Academia and government tend to focus on cannabis harms and understate the potential benefits . Once bitten, twice shy given the scare with opioids- no one wishes to repeat this debacle. Patients want doctors to believe that cannabis is helping them. With an over-focus on harm reduction government loses their audience. That ship has sailed according to some.

NIDA’s alarmist approach played out like the story of Never Cry Wolf. They blocked medical research on cannabis benefits while funding research to find harms. Their paycheque depended on finding such harms and this was a problem (Dr. Carl Hart-see link below). In the process they lost credibility. They have done important research and it appears at least to some degree, they are turning the corner. Peter will need a real wolf if further research demonstrates harms from cannabis. One concerned citizen who listened to my presentation asked me about “fake news”. I told him I’d been reading medical journals and have been taking a medical cannabinoid curriculum course. “How did you know that the medical journals weren’t fake news?” he replied. One need only to scurry to Pubmed, Intech, Ovid or others to see that research is happening and this is good news.

Seniors: The seniors today remember smoking cannabis and growing it in their backyards. The world did not fall apart as a result. Their memories are often associated with good times shared with friends. Today, cannabis chemovars with higher THC profiles are much different than seniors remember. They are searching for the more balanced low THC:CBD cannabis they consumed in the 60’s. Many suffer sleep and pain issues and find that cannabis is helping them where other medications have failed.

Youth Education: Or better yet, encouraging debate and critical thinking.

We underestimate the knowledge and critical thinking capability of youth. If possible medical benefits of cannabis are not acknowledged, we lose their attention. Youth can see that drug companies are searching to synthesize cannabimimetics. In light of this, they will doubt a fear-mongering approach. If you can teach them to get past the hyperbole, and foster critical thinking, this is the battle we want to win. We must encourage scientific exploration including teaching about the endocannabinoid system, rather than impose dogmatic statements of doom. They can explore and debate cultural, historical and social implications as well as environmental impact.

Teach them how to think, not what to think. Let it be done without the agenda that “THIS IS BAD”. If they detect a “right” or “wrong” answer, we risk losing their attention and they will interpret it as a thinly-veiled attempt to impose an agenda.

In my youth, I will never forget the impact of preparing and arguing in debates. I retained the information and more importantly it empowered me and helped build skills for a lifetime. Therefor, support students to debate and present to peers their findings in the classroom.

Lastly, realize that prohibition and too strict a legislation has lead youth to greater exposure of harm through the black market. As a parent this is a big concern. As a harm reduction approach, if they were going to access it without parental knowledge, I would rather they’d access it through a regulated system with a traceable batch number with labels identifying content and percentages of cannabinoids and that it is tested for contamination.

https://www.npr.org/sections/health-shots/2016/11/18/502567273/will-legal-marijuana-lead-to-more-people-smoking-tobacco

Cannabis addiction rates thus far, are a steady 9 percent, although this number is said to be highly conflated. The dependence and addiction profile is said to be similar to caffeine. How this will change is yet unknown. Due to high THC without CBD shatters, waxes and dabs this could potentially cause stronger withdrawal symptoms if used frequently (also to be defined).

What is the definition of addiction? Of dependence? The definitions concerning dependancy and addiction are often debated along with their aetiology and how to treat them. If you take a sleeping pill every night are you addicted and a chronic user? If you take a nightly dose of Indica tincture for sleep, it this substance abuse? Are the Indian Sadhus also addicts? Rastafarians? The Buddhist Nepalese? Where does one draw the line? Dr. Mitch Earleywine discusses some of these thorny conundrums in his book “Understanding Marijuana: A New Look at the Evidence” He also critically reviews some of the studies done to date on cannabis’ cognitive effects. It’s an excellent primer and helps one to look at all studies with a more critical eye.

https://global.oup.com/academic/product/understanding-marijuana-9780195182958?cc=ca&lang=en&

Some doctors are feeling cornered. Doctors cite paucity of quality evidence for safety and efficacy. They don’t want to be forced into signing authorizations. Our professional licenses, integrity, and training demand that decisions are based on quality research and evidenced-based medicine. Patient visits leave little time for education due to the current billing system. And here in Canada we face doctor shortages. Cannabis requires in-depth patient teaching and monitoring as there are so many variables in the patient’s metabolism of the plant. The plant’s cannabinoid/terpenoid profile is different from chemovar to chemovar thus its effects vary widely. One must also consider method of administration, burning temperatures if vaping and duration of action just to name a few of the considerations.

As the turmoil toward legalization continues, there is grandstanding, corporate green-rushing and the threat of monopolies. Wall Street investors run roughshod over cannabis advocates who risked prosecution. Those imprisoned? Many are the minority populations plagued by poverty despite consumption rates being equal throughout the population. I doubt their legal bills will get paid, nor their records expunged.

We need to consider our own ethnocentric paradigm. We cannot discuss the plant without addressing racism in present day. See the graphs below. Highest possession and trafficking charges are in Nunavut and the NW Territories. That being said, I am aware that some in these Northern communities feel they are not ready for legalization due to lack of resources and support for mental health and addictions.

Senate Debate Feb 8, 2017, Cannabis Bill, Bill to Amend, Second Reading, Debate continued, First Nations: https://sencanada.ca/en/content/sen/chamber/421/debates/179db_2018-02-08-e#68

See also: http://www.globalresearch.ca/the-war-on-weed-monsanto-bayer-and-the-push-for-corporate-cannabis/5534771?utm_campaign=magnet&utm_source=article_page&utm_medium=related_articles

To break through a listener’s preconceived ideas you must talk about history, ethnobotany, politics and racism. Only then, can you get past the wall of stigma. For Canadian history, read “The Black Candle” by Judge Emily Murphy. She was a proponent of eugenics and a promoter of the evils of “marijuana”. She is the Harry Anslinger of Canada. Her book was responsible for the prohibition of cannabis in the land of pancakes, seal oil and fur. Her statue stands on Parliament Hill. The Temperance Movement, moral gatekeepers of the time, saw cannabis as a threat to the purity of the white race. They warned of cannabis’ intoxicating effects on white women; it lead to inter-racial mixing. Decades of propaganda later, we are still in this moment, only a little more sophisticated.

We need to have open dialogue. If not, we are putting people at further risk as they seek answers elsewhere. Dr. David Casarett’s Ted talk illuminated what dispensaries offered patients. His revelations were a long time coming. We have holes in our current system. It is a call to action for us all.

In Canada, cannabinoid researchers are making strides. There is intolerance of the chuckles from the side lines. They are finally getting respect. It’s admirable, refreshing and bold.

In closing, I share with you some of the questions that I know many have asked before. It appears that there is a need for quality of research with better control of confounders and testing of specific chemovars, routes of administration etc. before doctors will embrace this as a medicine. But perhaps the most important point of all, is honouring patient preference, self-empowerment and autonomy. We can help educate and support in relation to these choices and make for a healthier society with open attitudes and respect.

A research journal on Cannabinoids “The International Cannabis Research Society”: http://icrs.co/

Questions:

Research: Why aren’t more studies done in cultures where they have been consuming cannabis? In the past, a PhD nurse with a background in anthropology did this in Jamaica. Her research was eventually shut down by NIDA when she found positive outcomes.

• Prenatal Marijuana Exposure and Neonatal Outcomes in Jamaica: An Ethnographic Study
• Five-year follow-up of rural Jamaican children whose mothers used marijuana during pregnancy. - PubMed - NCBI

“Cannabis: A Neurological Remedy or a Drug of Abuse in India” http://www.ingentaconnect.com/contentone/ben/cnsnddt/2017/00000016/00000005/art00009

Why continue to rely on pharmaceutical industries to provide funding for research? We could use taxes from cannabis, tobacco and alcohol as a source of funding.

Is this possible for many of our pharmaceutical drugs?

Is it time to change our thinking about barriers and find alternative solutions? It’s an innovation problem not an unbendable rule of physics.

https://www.utoronto.ca/news/making-medicine-not-money-how-one-u-t-researcher-s-startup-rethinking-big-pharma-s-business

Patients could use apps to record the details of their medical cannabis consumption. We’d have a huge reservoir of stats and usage patterns for research purposes. This would facilitate continuity of care and be shared with health care personnel.

Cultural: Are we being ethnocentric in our view of this plant? Is the dialogue and paradigm through which we view this plant another form of colonialist thinking? What is the view of other cultures? How has western politics, morality, and religious missionary influences with an aim to “civilize” cultures, damaged cultural practices with regards to cannabis use in modern day? Have we robbed other world cultures of their link and connection to their own medicine and spiritual practices? Who is the bigger criminal?

“Entheogenic Spirituality” http://bora.uib.no/handle/1956/12355

http://bora.uib.no/bitstream/handle/1956/12355/144653987.pdf?sequence=1&isAllowed=y

Here is a short article on the history and use in India: https://www.psychologytoday.com/blog/the-teenage-mind/201106/history-cannabis-in-india

The highly controversial Dr. Carl Hart: “Why Marijuana Usage is Biased to a Negative Effect” with Dr. Carl Hart, Neuroscientist. I love how he stretches the boundaries of our entire view of drug use. He challenges us. I feel uncomfortable with his radical view at times and I think this is a good thing. My feelings are based on fear, not science. https://www.youtube.com/watch?v=54P99A18wkU

Marketing, Money and Health:

Obesity, now ranks higher than tobacco for health care costs to the Canadian health care system. How does this compare and contrast to the other major issues for public health and its cost to the health care system? The marketing of food and beverages filled with high fructose corn syrup, and other junk has created a monster in terms of costs to our population health and well-being. The food industry lobbyists have influence on our food guides.

Canada food guide, influence of lobbyists: https://www.theglobeandmail.com/news/national/secret-memos-reveal-efforts-to-influence-canadas-food-guide/article36725482/

Here is a document obtained from the Freedom of Information Act on the comparison of cannabis and other pharmaceutical drugs:

http://www.oregon.gov/pharmacy/imports/marijuana/public/deathsfrommarijuanav17fdadrugs.pdf

What are the losses to the pharmaceutical industry due to the legalization of cannabis? Why?

What are the losses to the alcohol industry for the same reasons and why?

“Helping Settle the Marijuana and Alcohol Debate: Evidence from Scanner Data” https://papers.ssrn.com/sol3/papers.cfm?abstract_id=3063288

What are the losses to the Tobacco industry if any, why or why not?

Why are proposed marketing regulations for cannabis in Canada parallel to tobacco only?

Why is alcohol not regulated in their marketing the same way as Tobacco and Cannabis when it has been shown to account for one of the largest costs to the health care system?

*These stats below lump together synthetic cannabinoids which are pure THC without the modulating terpenes or CBD with the plant form.

Why are the pharmaceutical industry ads and their reps not regulated as strictly in their advertisements and their visits to offices in the same way?

Overall, it is not a level playing field if we are to compare it to a game. A game that includes new players, a green rush, clambering to get to the front of the line amassing money and power on the backs of advocates who have been jailed to bring us to this time in history.

Research studies, government fact sheets, statistics and presentations must state the criticisms of the methodology, state confounders if any, and include levels of evidence, along with possible solutions in how to further explore and extricate the truth if we are to start cutting through the prolific hyperbole that continues to spread like a virus, especially in this field. I look forward to the results whatever they may be and hope that we can finally get the bottom of this mystery for the benefit of us all.

“Harm Reduction Hawaii 2017" Dr Carl Hart: https://youtu.be/flTxnGxdiv0

• Drug discovery from plant sources: An integrated approach
• Screening Plants for New Medicines
• The worldwide trend of using botanical drugs and strategies for developing global drugs
• Herbal Medicine
• Herbal medicines can have dangerous side effects, research reveals
• The Plant vs Pharmaceutical False Dichotomy

• NO conflict of interest. I do not make any money in the cannabis industry. I am interested in patient advocacy and learning the truth while keeping political bias in mind. As an nurse, I am interested in research and currently volunteer time in giving talks on cannabis to the public. I’ve dedicated full time hours to this pursuit.