Author: Michelle Sexton

Aromatherapy was defined and coined in 1936 as the use of essential oils, applied topically, orally, or by inhalation to promote health, hygiene and psychological wellbeing.  All kinds of aromatic plants such as lavender, frankincense and rosemary have been used since antiquity for these purposes!

Terpenes and terpenoids are the primary components in essential oils, with about 300 of these traded on the world markets, estimated in 2013 to be worth over $1 billion. They are used in the flavor industry, in cosmetics, the pharmaceutical industry (a German company synthesizes THC from limonene), cleaning products, hair and skin care and for aromatherapy.   They have their own pharmacological activity, penetrate the skin, and also can be toxic to the skin, neurons, and reproduction.

Terpenes are what the compounds that we smell in Cannabis, and the upcoming event: Terpestival™ Terpene Tournament and Festival on July 23rd in Hopland, CA will provide a platform for the industry to further discover and define what :terps” mean for the bottom line, and for specific medical conditions.

The Terpestival™ Terpene Tournament and Festival will host three expert panels discussing these topics in detail:

1) Terpenes in extraction/product making. How does this translate to the market?

2) Terpenes in Growing: How does this translate to the market?

3) Terpenes in Health and Ritual

There is a growing trend in the Cannabis industry to make efforts toward preserving the terpenes during extraction, as well as during curing of the cannabis flower. These compounds are also concentrated with supercritical CO₂ extraction. Whenever the plant is heated in extraction, the terpene ratio dramatically shifts away from the lightest weight compounds, the monoterpenes to the heavier and more complex terpenoids or sesquiterpenes.

Plants of the same genus that are almost identical in appearance can produce profoundly different chemotypes, as evidenced by Cannabis species.  This unique “fingerprint” of each species or varietal is why a particular one may be your favorite.

For example, a top-selling variety on the West Coast (where it was bred) and in Colorado is Blue Dream.   This strain came from a cross of a Blueberry, reported to be heavily “indica” with Super Silver Haze, a “sativa”. One of the reasons that this may be a popular strain is due to the unique balance of the terpenes: pinene and myrcene.  Here is the terpene profile from 11 Blue Dreams grown in Washington State:

When the afghanica strains (came with the “purples”) were introduced and bred into the genetics, beginning around the mid 1990’s, the terpenoids were resurrected and also began to dominate the industry. When the purples were introduced, there was an explosion of smell (floral and fruity), and these were the first truly branded varietals. This was because the quality has always been defined to the growers by the terps! Does the smell attract you? Then go for that variety!

Terpenes are affected by growing conditions, plant genetics, nutrient availability and plant “stress” such as heat, drought and water. Plant stress is actually what may increase the production of these chemicals. In addition, when harvest occurs and how the plant is handled and cured after harvest are important factors for preserving the individual terpene profile of each plant.

When the terpenes from essential oils are inhaled, we have specific receptors in our nose (olfactory bulb) for recognizing scent. When these receptors are bound by a terpene, electrical signals are sent to the brain. Linda Buck with Richard Axel won a Nobel Prize in Physiology or Medicine in 2004 for this discovery. These “chemoreceptors” are also found in the lining of the gut on what are called enteroendocrine cells, that may signal hormonal or neuronal pathways.

The take-away message is:   “don’t let your cannabis selection be defined just by the cannabinoid profile”.   The terps need to be used along with the cannabinoid profile for the end-user to be satisfied. One way to tell whether your bud is fresh and pleasing, is to smell it!  This is also one indicator for medical use and how a patient may know if a product is going to work for them! This scent is what is going to drive the market!   Start requesting the terpenoid profile from your dispensary or supplier and compare the varietals.  Pinene and terpinolene are two that are more rare, and you should be on the look-out for. Why?  Come to the Terpestival and find out!!

The growing demographic of sophisticated Cannabis connoisseur cares about much more than the THC or CBD content. 

To enter the Terpene Tournament™

To buy tickets to the Terpestival™

The title quote from Grace Lee Boggs, a 98-year old philosopher, feminist and political activist who has been labeled “An American Revolutionary”, is passed on from the mother of a child who suffers from seizure and other diagnoses.  What, might you wonder is the cause of her pronoia? (defined as the opposite state of mind as paranoia)  Because of access to medical Cannabis in Washington State, she has some hope for her child.   She has begun to administer a non-psychoactive Cannabis extract to her daughter under an act passed by voter initiative in 1998. Her attitude, like that of many other families in this same circumstance, is one of expectation that there may be the chance to have improved in the quality of life for her family.

In a contemporary manifestation of the Underground Railroad, parents are turning out to be the heroes/heroines in a struggle against the abolitionist policy regarding Cannabis as medicine. Their children, who suffer from debilitating disorders, are the figurative fugitives in this story, and the parents are accessing local “safe houses” that provide the relief from Cannabis that they have sought for years from pharmaceutical drugs.

Current Washington State law states: “Humanitarian compassion necessitates that the decision to use cannabis by patients with terminal or debilitating medical conditions is a personal, individual decision, based upon their health care professional’s professional medical judgment and discretion”.

With the support of a compassionate doctor in Washington State, this mother is able to access Cannabis for her child under the voter initiative, and has now become an expert in many aspects of Cannabis as medicine.  She has learned how to dilute a cannabidiol-rich (CBD) concentrate so she can give a precise milligram dose of CBD, she is aware of potential drug interactions, how to monitor the weaning from the harmful anti-epileptic drugs her daughter has been on, and what to monitor her daughter for regarding any potential side-effects.  So far, the side effects have been mostly beneficial, such as improved sleep and improved behavior. The seizure reduction will likely follow as she slowly titrates the dose upward, as many other families like hers are teaching her to do.  She is learning that whole plant medicine works where single-agent compounds have largely failed her child.

For now this mother has a level of legal protection under the Washington State law: “Persons who act as designated providers to such patients shall also not be arrested, prosecuted, or subject to other criminal sanctions or civil consequences under state law, notwithstanding any other provision of law, based solely on their assisting with the medical use of cannabis”. Like the original Underground Railroad, these families don’t know what their next move will be, or whether it might be to another State where they can continue to provide medicine for their children, to either grow themselves, or access from a qualified facility.  Not unlike the original cargo, their journey has been fraught with confusion, a perceived danger of reprisal from their doctors, child protective services or family members, as they have “come out” on this new “Upperground Railroad” as Frederick Douglass coined a term.  Now not even Canada is  a safe haven, as it was for slaves, for parents such as these who might want to grow their own medicine. (Patients can no longer grow Cannabis in Canada)

However, as in the gospel lore “the wheels keep on turning”, and this gospel train of liberation from human suffering keeps chugging along, parent-to-parent, family-to-family!   How long will it take before Federal Governments won’t be the only legitimate drug dealers for several plants that have the capacity to alleviate human suffering?  How much longer until this plant and others are set free to interact with the human biome as they were likely designed to do, and not be captured and altered by pharmaceutics?

Until that time, it is likely that these parents, empowered by taking healthcare into their own hands with botanical medicine, will continue to “Follow the Drinking Gourd” to their own true north:  the healing of their children, their families and the trickle-down effects to their communities and the planet at large!

Here is a quote from another of these brave parents: “Parents have the right to save their children’s lives when conventional medicine isn’t effective and causing more harm than good.   With an open mind, researchers and doctors can discover what is true about this medicine that has been used for hundreds of years.  Anecdotal evidence is everywhere!”

The American Herbal Pharmacopoeia has finalized the first installment of a Cannabis monograph.  Dr. Michelle Sexton has been an editor and technical advisor on this project.  Pre-order yours now for Christmas!

An herbal monograph is a document produced on the topic of a single plant that describes nomenclature, parts used, constituents, range of application, contraindications, side effects, incompatibilities with other medications, dosage, use, and action of the herb.  The first installment of the monograph, set to go to press this week, is “Standards of Identity, Analysis and Quality Control”.  This document has been adopted by rule to guide, specifically, the quality assurance testing of Cannabis and related products under I502.  The second installment will focus on therapeutic applications and is expected sometime next spring.  This monograph represents the most up-to-date review of topics from nomenclature, Identification, Constituents, Analytical Standards and International Status.  AHP monographs fill the mission to  “promote the responsible use of herbal medicines and ensure they are used with the highest possible degree of efficacy and safety. Our primary way to accomplish this is through the development of standards of identity, purity, and analysis for botanicals, as well as to critically review traditional and scientific data regarding their efficacy and safety”.

This publication is significant because for the first time since Cannabis was removed from the Us pharmacopoeia in 1942, this “red-headed step child” of a plant now has a home!  Additionally, the American Herbal Products Association  has developed documents to guide regulators and the industry in providing quality assurance and quality control.   Together, the monograph and AHPA standards have guided Americans for Safe Access in development of a Patients First Certification Program.   Despite the fact that I502 regulations will not at this time require medical Cannabis to have the same level of quality control as that marketed in retail stores for adult use, it is hoped that in time the quality of medical products will exceed that of adult use products.

Good Agricultural Practices are addressed in both AHP and AHPA documents and cultivation and processing guidelines are included.  If you want more information about either of these organizations, contact them and we encourage you to join the AHPA if you are involved in any area of production or distribution of Cannabis and related products.  The Chair of the Cannabis Committee at AHPA is Tim Smale.

By Michelle Sexton ND

Recently I had the serendipitous occasion to have a long conversation with Dr. Jonathon Page, who published “The Draft Genome and Transcriptome of Cannabis sativa”.  We were on a bus traveling to the Bedrocan growing facility in The Netherlands.  (Bedrocan is the only licensed company by the Ministry of Health to grow medical grade Cannabis).  It turns out that plants have amazing “genomic resources” (not unlike humans) and Jonathan’s way of summing this up was in the statement “It’s ggod to be weedy, if your’re a crop!”  (Dr. Page published the discovery of olivetolic acid synthase (OAS), an major enzyme in the metabolic pathway of cannabinoids). 

In essence, what this means is that adaptability is important for change.  Plants must be able to survive year after year, in quite variable growing extremes (drought vs. flood; heat vs. freeze etc. . . )  I guess this could be likened somewhat to individuality in humans.  Individuality is an important factor in adapting, especially as we age or deal with disease, for refining our values and “wants”.   When faced with chronic pain or a debilitating disease, simple things may become more valued, just as in times of drought a plant will selectively conserve resources, and only produce the metabolites that are necessary for staying alive.

One factor important for humans’ quality of life, especially during illness is having a source of joy.  It turns out that such a common source reported by those who are ill is nature, specifically, gardening.  Avoidance of a sedentary lifestyle, even if this is by engaging in leisure activity has the potential to increase lifespan.  This has been termed “biopsychosocial benefits, meaning there are benefits to several aspects of well-being.  A reduction in mortality by all causes, enhancement of pain management in nursing home residents, improved happiness, less loneliness, greater life satisfaction, and enhanced psychologic well-being has been reported.  Gardening experiences by women in a homeless shelter, “interupted negative ruminations” and provided stress relief.  This type of “spiritual care” seems to be discounted and often entirely ignored in the current healthcare debate at large.  Healing gardens are used in France to enhance quality of life in Alzheimer patients.  

Obviously, the interactions between humans and the natural environment are complex and always one affects the other.  Tending our environment is a form of therapy, both for ourselves and plants!   The point of writing all of this is to address the recent Draft Recommendations of the Medical Marijuana Work Group from the Washington State Liquor Control Board.  From a perspective of a gardener (with a formal horticulture degree), herbalist and doctor, it is alarming me that the right to grow a medicinal plant may be forbidden.

At the recent International Association of Cannabinoid Medicines meeting in Cologne, Germany, growing one’s own Cannabis was a common theme,  was summed up by Raphael Mechoulam who stated something to the effect of “people smoking Cannabis that we don’t know what is in it, is not medicine”.  It is this sort of thinking that has long frustrated me, since I first became interested in natural medicine at the age of 17.  It has always made sense to me to “live naturally”, peacefully co-existing with the environment,  growing my own food, leaving no trace, etc. . . Our environment has undergone massive change, and we as humans have had to adapt, as has the environment.  

The political environment surrounding Cannabis is now changing, and those of us intertwined with the plant must change, just as we have changed this plant.  It’s time for us “weedy” individuals to become more “weedy”!  This may be a time for opportunistic expansion and the development “refined niches” for the cultivation of medical Cannabis plant material.   It will take the collective creativity of us all to not follow a narrow path such as the one in The Netherlands (single-grower system) nor to merge paths with the “adult use” system (I502).  I see the patients who grow and use their own medicine as empowered individuals, and there is no simple scale by which to measure the benefits of empowerment on quality and quantity of life.  We simply can’t let the current climate  lead to the extinction of such a basic human right as the right to garden.

Tantamount to Freedom

© Michelle Sexton ND 2013

Thus far in my lifetime, I have become involved in two different movements that I realized have several common threads.  The first movement for me was the becoming a midwife and participating in homebirth. This “becoming” was partially as a result of my own hospital surgical birth and the desire to be more self-empowered, and partially to help other women realize the same.  (Later it had nothing to do with this for me, but was solely about nonviolence for the new arrivals!)The second movement was natural health and herbal medicine (which has gone hand-in-hand with homebirth) and subsequently led me to become a naturopathic doctor and researcher of Cannabis as medicine.  One thing common to both of these interests is that they used to be considered “hippy”, counterculture phenomenon and today they have both become more mainstream.  And in the end, both of these choices are tantamount to freedom!  

Here are what I see to be a few elemental similarities between homebirth and Cannabis as medicine:

1) Affordability- there is a relative lowcost for both homebirth and Cannabis as medicine compared to hopsital/pharmaceuticals and this applies whether or not one has access to healthcare insurance. 

2) Risk/benefit ratio- there is a relative measure of safety at a homebirth that is due to the lace of hospital intervention.  Likewise, there can be a risk reduction when discountinuing a number of pharmaceutical drugs in favor of using Cannabis.  The effects of a treatment that produce a negative outcome are called “iatrogenic”, so in alignment with the idea of “not messing with Mother Nature” both homebirth and Cannabis and medicine are more aligned with this value;  

3) Effectiveness- if measured by empowerment, quality of life and outcome, both homebirth and Cannabis as medicine have these in common.

To describe a couple of other abstruse analogies between these two movements, consider both of these practices from a more anthropological perspective.  The first method common to both homebirth and medical Cannabis is the attempt to dismantle hegemonic authority. What does this mean??  This means that people are questioning what the perceived “authorities” attempt at domination over others by forcing certain prescribed rituals or medicine.

The medicalization of childbirth and the medicalization of health have parallels in the emergence of “Western” medicine.  Both homebirth and alternative health and healing could be considered as ethical challenges to the status quo.  However, contemporary homebirthers and medical Cannabis users (or adult users) are no longer necessarily “radicals” or “extremists” rather just educated and empowered people living their lives as they see fit.  

Second, both groups could be considered to be engaged in a more ritualistic form of living, of bringing meaning to and carefully considering how to engage: the body, the spirit, the soul.

Third, the acts of ‘giving’ birth and choosing/preparing/titrating/ one’s own medicine bring meaning and empowerment to the individual.  In this  sense, they could both be considered to be “manipulated rituals of technocratic subversion”.

The real common thread between these two involvements of mine is the people!  Both movements are filled with folks that may have at one time been considered ‘counterculture’.  But wait, just because wanting to participate fully in the birth of your child, you’re not counterculture anymore!   And wait, if you think you are going to be all culturally deviant by using Cannabis for pain relief, or to treat irritable bowel syndrome, or depression or just to alter your consciousness, you’re not!  The dominant values and behavior of society are changing!  If you think you could have either homebirth or medical Cannabis (or other natural medicine) in a system of collaboration and mutual respect, you can!

You are now just a member of the emerging culture, deliberately peeling away at the fiction of the medicalization of LIFE.   Our health and our life, how we live and how we die, do not need legitimacy in political and medical theaters.  To territorialize how we are born, how we die, and how we live the ‘dash’ in between our date of birth and date of death inscribed on a tombstone (or urn!) is tantamount to freedom!