Looking at cannabis from a pharmacist’s point of view

Recently a San Francisco area television news station had a very unflattering news report on Plumas County. The subject of the report was the fact that Plumas County had the highest number of overdose deaths related to opioid use, per capita, than any other county in California. This is not just a local problem, but a national one.

I have had first hand observation, of this issue, because as a pharmacist I was the last in-house pharmacist at Plumas District Hospital in Quincy, at a time of California Board inspection and a part-time pharmacist at Quincy Drug, which reflects on this problem.

A little background on the subject of opioids. This class of drugs originally was derived from a plant called the poppy, specifically the opium poppy, which from the juice of the unripe seed capsule gave us alkaloid chemicals morphine and codeine. These drugs were given for pain and morphine, being the stronger, was used extensively during WW2 for injured troops on the battlefield.

Heroin is derived from morphine, but has no analgesic (pain killing) value, but a great psychoactive effect, and is highly addictive and is banned in the United States and other countries. Since the ‘80s and ‘90s other, stronger analgesic drugs have been synthesized and have come to market, i.e. hydrocodone and oxycodone.

These are the primary drugs that have come under scrutiny by medical and legislative bodies for their huge potential for abuse and overdose, including death. The cause of death is a result of respiratory failure — you stop breathing. These are the opioids.

But these drugs have now been mixed, by illegal offshore laboratories, with a synthetic analgesic, fentanyl, which is 90 times the strength of morphine, and a single tablet of hydrocodone and fentanyl has caused the death of six individuals in California a short while ago. But these illegal labs are not finished. They’re working on other psychoactive, more potent, and with no medicinal value drugs. Every day large amounts of these drugs are interdicted at the borders of the U. S. And unless individuals realize the dangers associated with these unknown substances the deaths will continue. In my experience working in a psychiatric hospital, with addicted patients, I have come to realize that the use of narcotics is a form of escape. The feeling of overwhelming warmth and detachment from the problems of depression, in living every day life is itself a reality.

Now I come to the true purpose and subject of this article. The introduction of legal growing of marijuana in Plumas County.

But first a little scientific background on the subject.

Most people have heard of the chemical called THC, which is the ingredient in marijuana that gets users high. But recently, attention has shifted to another compound in marijuana called cannabidiol or CBD.

CBD is one of over 60 compounds found in cannabis that belong to a class of molecules called cannabinoids.

CBD and THC levels tend to vary among different plants. Marijuana grown for recreational purposes often contains more THC, the psychoactive component, than CBD.

Unlike THC, CBD does not cause a high. While this makes CBD a poor choice for recreational users, it gives the chemical a significant advantage as a medicinal, since health professionals prefer treatments with minimal side effects.

CBD is non-psychoactive because it does not act on the same pathways as THC. These pathways, called CB1 receptors, are highly concentrated in the brain and are responsible for the mind-altering effects of THC. Now the basic marijuana plant has a concentration of THC at between 5-8 percent. These are the plants from the beginning of time until modern times when the hybridization has increased the concentration to 26-30 percent. This is an increase of five times the psychoactive effect, and herein lies the problem. The side effects of decreased motor functions and memory impairment to name just two.

CBD has a wide range of medical benefits. Antiemetic- reduces nausea and vomiting, anticonvulsant-suppresses seizure activity, anti-tumor, anti –inflammatory, just to name a few. Unfortunately, most of this evidence comes from animals, since very few studies on CBD have been carried out in human patients.

But a pharmaceutical version of CBD was recently developed by a drug company in the UK. The company, GW Pharmaceuticals, is now funding clinical trials on CBD as a treatment for certain types   of epilepsy and schizophrenia. Likewise, a team of researchers at the California Pacific Medical Center, led by Dr. Sean McAllister, has stated the hope to begin trials on CBD for as a breast cancer therapy. Now the point of all this is to separate the benefit of drugs and risk involved in using them. Minimize the risk and side effects and concentrate on the medicinal value.

For this reason, introducing legal pot farms in Plumas County, with all the potential crime, intrusion of drug cartels, not to mention the impairment of citizens driving around is not desirable. I lived for a time in Humboldt County, (70s-80s) and saw how the marijuana grows went from the countryside to the cities, where neighbors had to arm themselves, because of indoor grows had taken over the house next door, and others were breaking in mistakenly.

Lassen and Tehama counties as well as other counties around us have turned this down, let’s do the same. Let us not become a notorious county, like we did with opioid overdose use.

My background is that I have been a pharmacist in California for almost 50 years; I have worked in all areas, of pharmacy from acute care, to retail, to psychiatric care, nursing home, prison and as a lecturer. I have degrees in chemistry, as well as pharmacy.

9 thoughts on “Looking at cannabis from a pharmacist’s point of view

  • September 29, 2017 at 9:47 am
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    I’m wondering if there was professional medical input before putting Prop. 64 on last fall’s ballot. If not, there should have been. I think the issue passed because of a liberal view of personal freedoms, but the side effects of the businesses that grow and distribute, and the criminal element attempting to steal harvested buds or transacted cash sales might not have been on the minds of those supporting voters.

    At times, the stories from other jurisdictions are highly worrisome and I fear for Plumas County. Our economic base is built on tourism and travel, with help from lumber milling and “traditional” farming and ranching. I can see no similar benefit from commercial cannabis.

    No matter the path that Plumas County government takes on this activity, the federal government still views all of it as a criminal enterprise. That is unlikely to change, causing continued concentrations of cash that are subject to thievery or violence, or shipping it to offshore banks where growers’ proceeds will escape taxation. That continues the potential burden on all levels of government without any revenue to offset the impact of those burdens.

  • September 29, 2017 at 1:17 pm
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    It’s really a shame that in the U.S. hemp got grouped together with marijuana decades ago when the big crack down on marijuana came about. Fortunately things have been slowly turning around and hemp, and the CBD that derives from it, have been legalized in many (but not all) states. Hemp has almost no THC, so it isn’t something people even used to get high from anyway. See http://greenuva.com for more details.

    • September 29, 2017 at 10:16 pm
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      I wouldn’t try to grow hemp where everyone grows cannabis unless you have female hemp. Good way to cross pollinate hard working peoples cannabis farms.

  • September 29, 2017 at 10:12 pm
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    It’s really a shame that this piece of sh-t, news paper only chooses to print anti cannabis editorials from so called doctors and right wing religious folk.
    It’s a fact that areas that have access to medical cannabis have lower rates of opioid addiction and over dose. Or we just put everyone on methadone……cannabis is legal in california. Sorry, get used to it!

    • September 30, 2017 at 8:58 am
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      Man, I wish you didn’t represent my view point, this is embarrassing. You make good points and then you undermine, the movement. It feels good to get little insulting quips in but it is completely ineffective at changing minds. The only thing it accomplishes is closing doors of opportunity for everyone who has put so much work into pro cannabis education. Lets inform the public, not insult them.

  • October 6, 2017 at 7:54 am
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    Lassen, Tehama, and Humboldt had experiences prior to legalization. Cartels and their associated violence and crime only exist when substances are illegal. The situation is vastly different today.

    Cannabis farmers in Plumas today are legal, they are investing lots of money, their facilities are all in known locations on private land, and they have to abide by laws like the rest of us. This is a completely different scene from illegal grows by cartels in the middle of nowhere usually on public lands, leaving behind trash and toxics, and planting booby traps to guard territory. The ONLY way we’re going to get rid of the cartels, crime, and toxic contamination that comes with anything it to legalize it. Alcohol prohibition caused much the same situation as cannabis is in today. It was completely unsuccessful and only caused illegal production, blindness for some, and constant gang violence. I see no reason to repeat this folly.

    The comparison of cannabis production with opioid use is specious. Drug abuse is nothing new and it doesn’t matter if you’re killing yourself with fentanyl or sniffing glue, abuse is a very different matter from production of legitimate crops for beneficlal purposes. If you conflate these two matters then you should conclude that any substance with the potential for abuse, both currently legal and not, should be banned from production.

    As a county we should move toward rational, logical thinking on these matters. It is absurd to say no to everything that comes our way. Cannabis farming has far lower environmental impact than alfalfa or cattle. It has much higher economic value. It’s becoming increasingly accepted as a mainstream product.

    Let’s deal with opioid and drug abuse as the real problem it is and not conflate it with production of legitimate and beneficial cannabis. Confusing the issues solves neither. Separating the issues of drug abuse from crop production allows both to be addressed as they should.

    • October 9, 2017 at 8:45 am
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      ^^^ I agree 100%

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