Cannabis Nurse Truths

To date, cannabis has been legalized or decriminalized in 23 states, and 32 states have passed medical marijuana laws. This means that 74% of Americans live in a state where marijuana is legal for either recreational or medical use, and 54% live in a state where the recreational use of marijuana is legal. Yet within each state lies a hidden population: a group of gun owners who are now considered criminals by the federal government because they choose to use a plant as their medicine. Gun dealers are also confused about their ability to sell firearms to cannabis users, as they too are considered criminals if they allow guns to be bought by known cannabis consumers.
On the safety side of gun ownership, prohibitionists claim that cannabis use leads to increased suicide ideation and completed suicides, which is another argument to prohibit cannabis users from owning firearms.  While there is limited research on the concerns related to gun ownership and cannabis use, robust evidence suggests that the rates of both suicide ideation and completed suicides decrease after states legalize regulated access to cannabis.  In this episode of Cannabis Nurse Truths, we explore the issues surrounding this untenable choice: Cannabis or Guns, You Can’t Have Both.
EPISODE RESOURCES
Anderson, D. M., Rees, D. I., & Sabia, J. J. (2014). Medical Marijuana Laws and Suicides by Gender and Age. American Journal of Public Health, 104(12), 2369–2376. https://doi.org/10.2105/AJPH.2013.301612
Andreuccetti, G., Ye, Y., Kang, J., Korcha, R., Witbrodt, J. A., Carvalho, H. B., & Cherpitel, C. J. (2017). The Effects of Acute Cannabis Use on Nontraffic Injury Risk: Reviewing the Available Literature and Identifying Ways Forward. Contemporary Drug Problems, 44(2), 147-158. https://doi.org/10.1177/0091450917710763
Bartos, B. J., Kubrin, C. E., Newark, C., & McCleary, R. (2020). Medical Marijuana Laws and Suicide. Archives of Suicide Research, 24(2), 204–217. https://doi.org/10.1080/13811118.2019.1612803
Federal Bureau of Investigation (FBI). (2019, May 2).  Information and Examples of the Application of Title 18, United States Code (U.S.C.),Section 922, Subsection (g)(3):PERSONS WHO ARE UNLAWFUL USERS OF OR ADDICTED TO ANYCONTROLLED SUBSTANCE. Retrieved from  https://www.justice.gov/tribal/media/1135246/dl?inline= 
Grucza, R. A., Hur, M., Agrawal, A., Krauss, M. J., Plunk, A. D., Cavazos-Rehg, P. A., Chaloupka, F. J., & Bierut, L. J. (2015). A reexamination of medical marijuana policies in relation to suicide risk. Drug and Alcohol Dependence, 152, 68–72. https://doi.org/10.1016/j.drugalcdep.2015.04.014
Jaeger, K. (2023, December 8). Medical Marijuana Growers And Caregivers Can Own Guns, But Patients Can't, FBI Says In Little-Noticed Memo. Retrieved from https://www.marijuanamoment.net/medical-marijuana-growers-and-caregivers-can-own-guns-but-patients-cant-fbi-says-in-little-noticed-memo/ 
Marijuana Policy Project. (n.d.). Marijuana Policy Reforms and the Second Amendment. Retrieved from https://www.mpp.org/policy/federal/secondamendment/ 
Rylander, M., Valdez, C., & Nussbaum, A. M. (2014). Does the legalization of medical marijuana increase completed suicide? The American Journal of Drug and Alcohol Abuse, 40(4), 269–273. https://doi.org/10.3109/00952990.2014.910520
Schanie, A. (2024, Dec. 11). Starting Jan. 1, Kentuckians will have to choose between medical marijuana or firearms. Retrieved from https://www.wdrb.com/news/starting-jan-1-kentuckians-will-have-to-choose-between-medical-marijuana-or-firearms/article_730a16b6-b80c-11ef-9721-93daace5ff86.html 
Small, C. (2023, April 17). The Intersection Between Marijuana and the 2nd Amendment: What Gun Owners Need to Know. Retrieved from https://www.clarkhill.com/news-events/news/the-intersection-between-marijuana-and-the-2nd-amendment-what-gun-owners-need-to-know/ 
Times Observer. (2025, February 24). DA to not seek re-election, admits marijuana use and eyes shift to advocacy. Retrieved from https://www.timesobserver.com/news/local-news/2023/12/da-to-not-seek-re-election/ U.S. v. Cooper, 224 F. App'x 537 (7th Cir. 2007). Retrieved from https://ecf.ca8.uscourts.gov/opndir/25/02/241998P.pdf 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

Welcome to an emerging post-prohibition world, where cannabis is legal around the globe and consumers are using cannabis in everyday living. Hemp fibers and seeds are used for construction and food, while the compounds that are extracted from cannabis - the cannabinoids - are used as medicine. The industry is growing at a rapid pace, driven by consumer demand which has ignited an unprecedented body of research, innovation and technology. The post-prohibition society is here, ready to intensify.
Don’t believe it? Well, get ready for the Stoned Age, where past arguments against the use of the plant are no longer effective. Prohibitionists insist that cannabis use is dangerous and deadly, and pharmaceutical corporations spend a lot of money to ensure cannabis never comes to market, as it will quickly put them out of business. Yet almost every one of the 45,000 published studies does not support the arguments that cannabis is dangerous and deadly; in fact, almost all cannabis studies indicate that cannabis works very well as a medicine when it is treated as such. Here’s an idea - how about we practice evidence-based medicine and help our patient population achieve wellness in mind, body and spirit?  That’s what we expect in the Stoned Age, the Era of Wellness.
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

At the base of the Blue Ridge Mountains in the heart of the Shenandoah Valley lies Elkton, Virginia, a town composed of 1.4 square miles and populated with just under 3000 residents.  But there is a secret operation in this sleepy little rural town - a hemp company run by the Johnson family.  Pure Shenandoah is a true seed-to-sale company, with its three brothers serving as foundational members to provide hemp for not only industrial uses, such as construction and fibers, but also in processing wellness products.
Pure Shenandoah grows their own hemp, from which they process into cannabinoid oils, cannabis beverages and smokable hemp flowers. They also offer cultivation classes for people to learn how to grow cannabis. In today's episode of Cannabis Nurse Truths, we are excited to speak with our special guest, Abner Johnson, Chief Operating Officer of Pure Shenandoah. Abner shares insights into what it's like to be a hemp farmer in the last chapter of cannabis prohibition, because even small hemp companies like Pure Shenandoah have faced their own challenges as a cannabis business. 
EPISODE RESOURCESPure Shenandoah: https://pureshenandoah.com 
Pure Shenandoah Facebook: https://www.facebook.com/pureshenandoah  
Pure Shenandoah Instagram: https://www.instagram.com/pureshenandoah/  
Pure Shenandoah YouTube: https://www.youtube.com/channel/UCqhQXkMBMoaPWeoI-yqd8rA  
Welcome to the Town of Elkton: https://www.elktonva.gov/ 
Jojack, B. (2024, June 27). Competition’s fierce for Shenandoah medical marijuana permit. Virginia Business. https://virginiabusiness.com/competitions-fierce-for-shenandoah-medical-marijuana-permit/  
Urenko, C. (2022, April 12). Pure Shenandoah opens its doors in Elkton. WHSV3. https://www.whsv.com/2022/04/13/pure-shenandoah-dispensary-opens-its-doors-elkton/  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

Did you know that every cannabis plant sold legally in the United States is tracked from the time it is planted to the moment it reaches the consumers’ hands?  This is a mandated process called Seed-to-Sale, and while the intention of these regulations is to keep legal cannabis off the illegal market while ensuring transparency in the supply chain, there is a growing concern about how Seed-to-Sale data is used and the burdens related to this process.
In this episode of Cannabis Nurse Truths, we look at the complexity and concerns related to Seed-to-Sale processes, where currently, cannabis is the only industry that must follow these over-reaching regulatory and mysterious processes. And by the way, if you have purchased legal cannabis in a state-run dispensary, your personal identifying data is also part of this tracking system. So if you are thinking about buying a bunch of 'flowers' for your Valentine sweetheart, cannabis buyers beware!  
 
 
EPISODE RESOURCES
CannabisLifeNetwork.com. (2021, April 6). All About Seed-to-Sale Tracking: The Good, The Bad, And The Ugly. https://cannabislifenetwork.com/all-about-seed-to-sale-tracking-the-good-the-bad-and-the-ugly/
Caulkins, J.P., Davenport, S., Doanvo, A., Furlong, K., Siddique, A., Turner, M., & Kilmer, B. (2019). Triangulating web & general population surveys: Do results match legal cannabis market sales? International Journal of Drug Policy, 73, 293–300. https://doi.org/10.1016/j.drugpo.2019.06.010
Costantino, A., Maiese, A., Lazzari, J., Casula, C., Turillazzi, E., Frati, P., & Fineschi, V. (2023). The dark side of energy drinks: A comprehensive review of their impact on the human body. Nutrients, 15(18), 3922. https://doi.org/10.3390/nu15183922
FlowHub. (n.d.). 2025 Marijuana Industry Statistics & Data Insights: How The Industry Is Performing And Where It's Headed. https://flowhub.com/cannabis-industry-statistics
Goldsberry, D. (2018, August 13). Is Seed-to-Sale Tracking Helping Or Hurting The Industry? Cannabis Business Times. https://www.cannabisbusinesstimes.com/interviews-opinion/news/15696437/is-seed-to-sale-tracking-helping-or-hurting-the-industry
IndicaOnline. (2025, January 16). Industry Statistics 2024 And What We Learned. https://indicaonline.com/blog/industry-statistics-2024/
Lintilhac, P. (2019, October 5). The Fatal Flaws of Seed-to-Sale. Medium. https://medium.com/pauls-blockchain-blog/how-did-we-get-here-d80d169359e8
MJ Freeway. (n.d.). Cannabis Seed To Sale Software: What is Cannabis Seed To Sale Software? https://mjplatform.com/what-is-cannabis-seed-to-sale-software/
Pacula, R.L., Pessar, S.C., Zhu, J., Kritikos, A., & Smart, R. (n.d.). Federal Regulation of Cannabis for Public Health in the United States. https://healthpolicy.usc.edu/wp-content/uploads/2022/07/USC-Schaeffer-Center-white-paper_Federal-Regulation-of-Cannabis-for-Public-Health-in-the-United-States.pdf
Perdomo, C. (2024, September). Industrial Hemp Production in the US - Market Research Report (2014-2029). IBIS World. https://www.ibisworld.com/united-states/industry/industrial-hemp-production/3315/
Sobie, R. (2024, November 12). 10 Things to Know about the Drug Supply Chain Security Act. Pharma Manufacturing. https://www.pharmamanufacturing.com/compliance/article/55242138/10-things-you-need-to-know-about-the-drug-supply-chain-security-act
Statista. (n.d.). Total number of medical prescriptions dispensed in the U.S. from 2009 to 2022. https://www.statista.com/statistics/238702/us-total-medical-prescriptions-issued/#:~:text=Total%20drug%20prescriptions%20dispensed%20in%20the%20U.S.%202009%2D2022&text=In%202009%20the%20number%20of,dispensed%20was%20around%206.7%20billion.
Vaders, M.J. (2021, October 20). Seed To Sale: The Buzz On Understanding the FDA Regulatory Landscape For Cannabis. https://www.womblebonddickinson.com/us/insights/articles-and-briefings/seed-sale-buzz-understanding-fda-regulatory-landscape-cannabis
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

Stoner. Pothead. Loser. Couch potato.  These are just a few of the choice names for individuals who choose to use a plant to self-medicate or relax.  The stereotypes related to the cannabis enthusiast have been crafted over decades of lies and deceit, and in the public eye, cannabis is promoted as a harmful gateway drug only used by the lowest elements of our society.
That stereotype is changing fast, as numerous high-profile individuals, like Elon Musk and Robert F. Kennedy Jr., have come out in support of cannabis legalization and appropriate use.  To further the conversation, new evidence is indicating that yes, indeed, there are numerous benefits to using cannabis for health and well-being.  And within our own culture, we see it every day as high-functioning stoners operate multi-million dollar businesses, participate in physical activity, and perform their daily adult responsibilities without incident. In this episode of Cannabis Nurse Truths, we consider the high-functioning stoner, a mythical creature that is gaining in population as the US continues to move toward cannabis legalization. 
 
 
EPISODE RESOURCES
Anderson, D.M., Fe, H.T., Liang, Y., & Sabia, J.J. (2024). Recreational marijuana laws and teen marijuana use, 1993-2021. JAMA Psychiatry, 81(8), 840–842. https://doi.org/10.1001/jamapsychiatry.2024.0698
Bradford, A.C., Lozano-Rojas, F., Shone, H.B., Bradford, W.D., & Abraham, A.J. (2024). Cannabis laws and utilization of medications for the treatment of mental health disorders. JAMA Network Open, 7(9), e2432021. https://doi.org/10.1001/jamanetworkopen.2024.32021
Brenan, M. (2022, August 5). More in U.S. Say Alcohol Adversely Affects Drinkers, Society. Gallup. https://news.gallup.com/poll/395867/say-alcohol-adversely-affects-drinkers-society.aspx
Brown, D. (2025, January 14). Canada's Medical Cannabis Market Remains Steady, Exports Continue to Increase. StratCann. https://stratcann.com/news/canada-medical-cannabis-market-exports-increase/
Caulkins, J.P. (2024). Changes in self-reported cannabis use in the United States from 1979 to 2022. Addiction, 119(9), 1648–1652. https://doi.org/10.1111/add.16519
Cavalli, J.M., Cuttler, C., & Cservenka, A. (2025). A naturalistic examination of the acute effects of high-potency cannabis on emotion regulation among young adults: A Pilot study. Human Psychopharmacology: Clinical and Experimental, 40(1), e2915. https://doi.org/10.1002/hup.2915
Centers for Disease Control and Prevention. (2024, August 6). CDC Data Show Improvements in Youth Mental Health but Need for Safer and More Supportive Schools.https://www.cdc.gov/media/releases/2024/p0806-youth-mental-health.html
Choo, E.K., Trent, S.A., Nishijima, D.K., Eichelberger, A., Kazmierczak, S., Ye, Y., Brasel, K.J., Audett, A., & Cherpitel, C.J. (2024). Risk of motor vehicle collision associated with cannabis and alcohol use among patients presenting for emergency care. Accident Analysis & Prevention, 198, 107459. https://doi.org/10.1016/j.aap.2024.107459
Coley, R.L., Carey, N., Kruzik, C., Hawkins, S.S., & Baum, C.F. (2024). Recreational cannabis legalization, retail sales, and adolescent substance use through 2021. JAMA Pediatrics, 178(6), 622–625. https://doi.org/10.1001/jamapediatrics.2024.0555
Colorado Department of Public Health & Environment. (2022, June 15). CDPHE releases latest Healthy Kids Colorado Survey data. https://cdphe.colorado.gov/press-release/cdphe-releases-latest-healthy-kids-colorado-survey-data-0
De La Torre, I.D., Hébert, E.T., Kezbers, K.M., Walters, D., Pope, Z.C., Mao, B., Benson, L., Shi, D., Stanley, N., & Businelle, M.S. (2025). Associations between cannabis use and same-day health and substance use behaviors. Addictive Behaviors, 163, 108239. https://doi.org/10.1016/j.addbeh.2024.108239
English, F., & Whitehill, J.M. (2023). Risk factors for adolescent cannabis use in a state with legal recreational cannabis: The role of parents, siblings, and friends. Clinical Therapeutics, 45(6), 589–598. https://doi.org/10.1016/j.clinthera.2023.04.002
Grimm, B. (2017, April 20). 50 Most Successful Marijuana Enthusiasts You Should Know. Rolling Stone. https://www.rollingstone.com/culture/culture-lists/50-most-successful-marijuana-enthusiasts-you-should-know-114790/zayn-malik-3-112209/ 
Karmakar, B., Mukherjee, G., & Kar, W. (2024). Using penalized synthetic controls on truncated data: A case study on effect of marijuana legalization on direct payments to physicians by opioid manufacturers. Journal of the American Statistical Association, 1–16. https://doi.org/10.1080/01621459.2024.2406583
Marijuana Policy Project. (2025, January 9). New Data Shows Adult-Use Cannabis Legalization Corresponds with Drops in Teen Use. https://www.mpp.org/news/press/new-data-shows-adult-use-cannabis-legalization-corresponds-with-drops-in-teen-use/
McCarthy, J. (2024, August 10). Fully Half of Americans Have Tried Marijuana. Gallup. https://news.gallup.com/poll/509399/fully-half-americans-tried-marijuana.aspx
Merrill, R.M., Ashton-Hwang, K., & Gallegos, L. (2024). Association between cannabis use and physical activity in the United States based on legalization and health status. Journal of Cannabis Research, 6(1), 39. https://doi.org/10.1186/s42238-024-00248-6
Miech, R.A., Johnston, L.D., Patrick, M.E., & O’Malley, P.M. (2024). Overview and key findings for secondary school students. National Institute on Drug Abuse National Institutes of Health. https://monitoringthefuture.org/wp-content/uploads/2024/12/mtf2025.pdf
Mital, S., Bishop, L., Bugden, S., Grootendorst, P., & Nguyen, H.V. (2024). Association between non-medical cannabis legalization and alcohol sales: Quasi-experimental evidence from Canada. Drug and Alcohol Dependence, 257, 111137. https://doi.org/10.1016/j.drugalcdep.2024.111137
Patrick, M.E. (n.d.). Daily or near-daily cannabis and alcohol use by adults in the United States: A comparison across age groups. Addiction, 1-4. https://doi.org/10.1111/add.16748 
Rosen, E.M., Kerr, W.C., Patterson, D., Greenfield, T.K., Ramos, S., & Karriker-Jaffe, K.J. (2024). Prevalence and correlates of alcohol and drug harms to others: Findings from the 2020 U.S. National Alcohol Survey. Journal of Studies on Alcohol and Drugs, 85(6), 794–803. https://doi.org/10.15288/jsad.23-00387 
Sargent, M. (2025, January 13). What Is a High-Functioning Stoner? Royal Queen Seeds. https://www.royalqueenseeds.com/blog-what-is-a-high-functioning-stoner-n1726
Younis, M. (2023, August 17). More Americans View Moderate Drinking as Unhealthy. Gallup. https://news.gallup.com/poll/509588/americans-view-moderate-drinking-unhealthy.aspx 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

In 1998, a group of researchers proposed a hypothesis known as the Entourage Effect, in which a multitude of the compounds found in cannabis can synergistically work together based on the fact that these effects were also seen in the synergism properties associated with our own endocannabinoids. However, after 26 years, this hypothesis has never been supported clinically, meaning that while we have a lot of proposals and a lot of research suggesting interactions, we've never actually applied it to a patient population in a real-life setting.
In this episode of Cannabis Nurse Truths, we examine this hypothesis known as the Entourage Effect, because while there is a lot of research suggesting this phenomenon is occurring, meaning that something is happening - we just don't know what it is - critics state that there is not enough evidence to support this in science. Their claim is that it is really just a marketing tool to help promote cannabis products. So which is it - an actual phenomenon that explains why cannabis compounds work together to heal the body, or is it just a gimmick to sell more weed? Bottom line; cannabis contains over 500 compounds that all have beneficial physiological effects, so does it really matter which is true?
EPISODE RESOURCES
Al-Khazaleh, A.K., Zhou, X., Bhuyan, D.J., Münch, G.W., Al-Dalabeeh, E.A., Jaye, K., & Chang, D. (2024). The neurotherapeutic arsenal in Cannabis sativa: Insights into anti-neuroinflammatory and neuroprotective activity and potential entourage effects. Molecules, 29(2), Article 2. https://doi.org/10.3390/molecules29020410
Ben-Shabat, S., Fride, E., Sheskin, T., Tamiri, T., Rhee, M.-H., Vogel, Z., Bisogno, T., De Petrocellis, L., Di Marzo, V., & Mechoulam, R. (1998). An entourage effect: Inactive endogenous fatty acid glycerol esters enhance 2-arachidonoyl-glycerol cannabinoid activity. European Journal of Pharmacology, 353(1), 23–31. https://doi.org/10.1016/S0014-2999(98)00392-6
Blasco-Benito, S., Seijo-Vila, M., Caro-Villalobos, M., Tundidor, I., Andradas, C., García-Taboada, E., Wade, J., Smith, S., Guzmán, M., Pérez-Gómez, E., Gordon, M., & Sánchez, C. (2018). Appraising the “entourage effect”: Antitumor action of a pure cannabinoid versus a botanical drug preparation in preclinical models of breast cancer. Biochemical Pharmacology, 157, 285–293. https://doi.org/10.1016/j.bcp.2018.06.025
Boggs, D.L., Nguyen, J.D., Morgenson, D., Taffe, M.A., & Ranganathan, M. (2018). Clinical and preclinical evidence for functional interactions of cannabidiol and Δ9-tetrahydrocannabinol. Neuropsychopharmacology: Official Publication of the American College of Neuropsychopharmacology, 43(1), 142–154. https://doi.org/10.1038/npp.2017.209
Christensen, C., Rose, M., Cornett, C., & Allesø, M. (2023). Decoding the postulated entourage effect of medicinal cannabis: What it is and what it isn’t. Biomedicines, 11(8), 2323. https://doi.org/10.3390/biomedicines11082323
Cogan, P.S. (2020). The “entourage effect” or “hodge-podge hashish”: The questionable rebranding, marketing, and expectations of cannabis polypharmacy. Expert Review of Clinical Pharmacology, 13(8), 835–845. https://doi.org/10.1080/17512433.2020.1721281
Cunha, J.M., Carlini, E.A., Pereira, A.E., Ramos, O.L., Pimentel, C., Gagliardi, R., Sanvito, W.L., Lander, N., & Mechoulam, R. (1980). Chronic administration of cannabidiol to healthy volunteers and epileptic patients. Pharmacology, 21(3), 175–185. https://doi.org/10.1159/000137430
Fowler, C.J. (2003). Plant-derived, synthetic and endogenous cannabinoids as neuroprotective agents non-psychoactive cannabinoids, ‘entourage’ compounds and inhibitors of N-acyl ethanolamine breakdown as therapeutic strategies to avoid psychotropic effects. Brain Research Reviews, 18. https://pubmed.ncbi.nlm.nih.gov/12505646/
Gallily, R., Yekhtin, Z., & Hanuš, L.O. (2015). Overcoming the bell‐shaped   dose‐response of cannabidiol by using cannabis extract enriched   in cannabidiol. Pharmacology & Pharmacy, 6(02), 75–85. https://doi.org/10.4236/pp.2015.62010
Namdar, D., Anis, O., Poulin, P., & Koltai, H. (2020). Chronological review and rational and future prospects of cannabis-based drug development. Molecules, 25(20), Article 20. https://doi.org/10.3390/molecules25204821 
Pamplona, F.A., da Silva, L.R., & Coan, A.C. (2018). Potential clinical benefits of CBD-rich cannabis extracts over purified CBD in treatment-resistant epilepsy: Observational data meta-analysis. Frontiers in Neurology, 9, 759. https://doi.org/10.3389/fneur.2018.00759
Russo, E.B. (2011). Taming THC: Potential cannabis synergy and phytocannabinoid-terpenoid entourage effects: Phytocannabinoid-terpenoid entourage effects. British Journal of Pharmacology, 163(7), 1344–1364. https://doi.org/10.1111/j.1476-5381.2011.01238.x
Russo, E.B. (2016). Beyond cannabis: Plants and the endocannabinoid system. Trends in Pharmacological Sciences, 37(7), 594–605. https://doi.org/10.1016/j.tips.2016.04.005
Russo, E.B. (2019). The case for the entourage effect and conventional breeding of clinical cannabis: No “strain,” no gain. Frontiers in Plant Science, 9, 1969. https://doi.org/10.3389/fpls.2018.01969
Simei, J.L.Q., Souza, J.D.R., Lisboa, J.R., Campos, A.C., Guimarães, F.S., Zuardi, A., & Crippa, J.A.S. (2024). Does the “entourage effect” in cannabinoids exist? A narrative scoping review. Cannabis and Cannabinoid Research, 9(5), 1202–1216. https://doi.org/10.1089/can.2023.0052
Spindle, T.R., Zamarripa, C.A., Russo, E., Pollak, L., Bigelow, G., Ward, A.M., Tompson, B., Sempio, C., Shokati, T., Klawitter, J., Christians, U., & Vandrey, R. (2024). Vaporized D-limonene selectively mitigates the acute anxiogenic effects of Δ9-tetrahydrocannabinol in healthy adults who intermittently use cannabis. Drug and Alcohol Dependence, 257, 111267. https://doi.org/10.1016/j.drugalcdep.2024.111267
Svendsen, K., Sharkey, K.A., & Altier, C. (2024). Non-intoxicating cannabinoids in visceral pain. Cannabis and Cannabinoid Research, 9(1), 3–11. https://doi.org/10.1089/can.2023.0113

Welcome back to our Cannabis Nurse Truths podcast!  Lee and I took some much-needed time off for the holidaze but we are back to share more truths about cannabis as we move into a new year.
2024 was a crazy year for the cannabis industry, and in the United States, we anticipate more changes as federal, state, and even global perceptions of cannabis shift dramatically.  In this episode, we reflect on some of the major events that happened in the cannabis industry that saw both successes and failures for everyone involved in cannabis - both businesses and users.  But from my perspective as a cannabis nurse, I recognize the underlying trend across the US - cannabis is being used by so many individuals that it can no longer be denied - cannabis is medicine. Welcome to Cannabis Nurse Truths in 2025!
 
EPISODE RESOURCES
Bailey, J.A., Tiberio, S.S., Kerr, D.C.R., Epstein, M., Henry, K.L., & Capaldi, D.M. (2023). Effects of cannabis legalization on adolescent cannabis use across 3 studies. American Journal of Preventive Medicine, 64(3), 361–367. https://doi.org/10.1016/j.amepre.2022.09.019
Ballard, J. (2024, July 17). Marijuana Leads Alcohol For Daily Usage. Alcohol Is Well Ahead For Monthly Usage. YouGov. https://today.yougov.com/health/articles/50106-marijuana-leads-alcohol-daily-usage-alcohol-ahead-monthly-usage
Bradford, A.C., Lozano-Rojas, F., Shone, H.B., Bradford, W.D., & Abraham, A.J. (2024). Cannabis laws and utilization of medications for the treatment of mental health disorders. JAMA Network Open, 7(9), e2432021. https://doi.org/10.1001/jamanetworkopen.2024.32021
Business Wire. (2025, January 16). The Two Largest Cannabis Industry Groups Combine Policy Advocacy Efforts To Form Singular, Leading Authority Representing Industry In Washington. https://www.businesswire.com/news/home/20250116788639/en/The-Two-Largest-Cannabis-Industry-Groups-Combine-Policy-Advocacy-Efforts-to-Form-Singular-Leading-Authority-Representing-Industry-in-Washington
Carrión, R.E., Auther, A.M., McLaughlin, D., Adelsheim, S., Burton, C.Z., Carter, C.S., Niendam, T., Ragland, J.D., Sale, T.G., Taylor, S.F., Tso, I.F., McFarlane, W.R., & Cornblatt, B.A. (2023). Recreational cannabis use over time in individuals at clinical high risk for psychosis: Lack of associations with symptom, neurocognitive, functioning, and treatment patterns. Psychiatry Research, 328, 115420. https://doi.org/10.1016/j.psychres.2023.115420
Caulkins, J. P. (2024). Changes in self-reported cannabis use in the United States from 1979 to 2022. Addiction, 119(9), 1648–1652. https://doi.org/10.1111/add.16519
Cavendish, V. (2025, January 9). New Data Shows Adult-Use Cannabis Legalization Corresponds with Drops in Teen Use. Marijuana Policy Project. https://www.mpp.org/news/press/new-data-shows-adult-use-cannabis-legalization-corresponds-with-drops-in-teen-use/
Centers for Disease Control and Prevention. (n.d.). Youth Risk Behavior Survey: Data Summary & Trends Report 2013-2023. U.S. Department of Health and Human Services. https://www.cdc.gov/yrbs/dstr/pdf/YRBS-2023-Data-Summary-Trend-Report.pdf
Colorado Department of Public Health & Environment. (2022, June 15). CDPHE Releases Latest Healthy Kids Colorado Survey Data. https://cdphe.colorado.gov/press-release/cdphe-releases-latest-healthy-kids-colorado-survey-data-0
Darakjian, L., Glassman, H., Lo, C.Y., & Russo, F. (2024). Exploring the interaction between cannabis, hearing, and music. OSF. https://doi.org/10.31234/osf.io/pmuhx
Evoy, R., & Victoroff, T. (2024). Prevalence of cannabis use among US workers in 15 states, 2016–2020. American Journal of Public Health, 114(S8), S645–S653. https://doi.org/10.2105/AJPH.2024.307788
Halman, A., Chenhall, R., & Perkins, D. (2024). Changes in pain and mental health symptoms associated with prescribed medicinal cannabis use: A one-year longitudinal study. Journal of Pain & Palliative Care Pharmacotherapy, 1–13. https://doi.org/10.1080/15360288.2024.2414898
Herrington, A.J. (2025, January 13). DEA Judge Cancels Marijuana Rescheduling Hearing Set For Next Week. Forbes. https://www.forbes.com/sites/ajherrington/2025/01/13/dea-judge-cancels-marijuana-rescheduling-hearing-set-for-next-week/
Jaeger, K. (2025, January 8). New York Marijuana Consumption Lounges Could Sell Food And Drinks While Hosting Live Concerts Under New Bill. Marijuana Moment. https://www.marijuanamoment.net/new-york-marijuana-consumption-lounges-could-sell-food-and-drinks-while-hosting-live-concerts-under-new-bill/
Karmakar, B., Mukherjee, G., & Kar, W. (2024). Using penalized synthetic controls on truncated data: A case study on effect of marijuana legalization on direct payments to physicians by opioid manufacturers. Journal of the American Statistical Association, 0(0), 1–16. https://doi.org/10.1080/01621459.2024.2406583
Leatherdale, S.T., Amores, A., Bélanger, R.E., Battista, K., Patte, K.A., & Jiang, Y. (2023). Youth perception of difficulty accessing cannabis following cannabis legalization and during the early and ongoing stages of the COVID-19 pandemic: Repeat cross-sectional and longitudinal data from the COMPASS study. Archives of Public Health, 81(1), 214. https://doi.org/10.1186/s13690-023-01224-x
Martinelli, A. (2025, January 5). Maryland Lawmakers File Legislation To Allow On-Site Marijuana Consumption Establishments And Events. The Marijuana Herald. https://themarijuanaherald.com/2025/01/maryland-lawmakers-file-legislation-to-allow-on-site-marijuana-consumption-establishments-and-events/
Mirshahi, D. (2024, December 2024). Va. Democrats To Press Cannabis Market Bills in 2025. VPM News. https://www.vpm.org/news/2024-12-16/paul-krizek-aaron-rouse-glenn-youngkin-virginia-cannabis-market-bill
National Rifle Association Institute for Legislative Action. (2025, January 13). U.S. Appellate Court Issues Case On Marijuana Use And Firearm Possession. https://www.nraila.org/articles/20250113/us-appellate-court-issues-case-on-marijuana-use-and-firearm-possession
Roberts, C. (2025, January 13). Marijuana Rescheduling Process Paused Indefinitely After Judge Cancels Hearing. MJ Biz Daily. https://mjbizdaily.com/judge-cancels-marijuana-rescheduling-hearing/
Rosen, E.M., Kerr, W.C., Patterson, D., Greenfield, T.K., Ramos, S., & Karriker-Jaffe, K.J. (2024). Prevalence and correlates of alcohol and drug harms to others: Findings from the 2020 U.S. National Alcohol Survey. Journal of Studies on Alcohol and Drugs, 85(6), 794–803. https://doi.org/10.15288/jsad.23-00387
Skodzinkski, N. (2024, November 22). Trump Is In: Will Pro-Cannabis Reform Be In Or Out? Cannabis Business Times. https://www.cannabisbusinesstimes.com/home/news/15708936/trump-is-in-will-procannabis-reform-be-in-or-out
Substance Abuse and Mental Health Services Administration. (2024). Key substance use and mental health indicators in the United States: Results from the 2023 National Survey on Drug Use and Health (HHS Publication No. PEP24-07-021, NSDUH Series H-59). Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration. https://www.samhsa.gov/data/report/2023-nsduh-annual-national-report
Yang, J., Mejia, M.C., Sacca, L., Hennekens, C.H., & Kitsantas, P. (2024). Trends in marijuana use among adolescents in the United States. Pediatric Reports, 16(4), Article 4. https://doi.org/10.3390/pediatric16040074
Younis, M. (2023, August 17). More Americans View Moderate Drinking As Unhealthy. Gallup. https://news.gallup.com/poll/509588/americans-view-moderate-drinking-unhealthy.aspx
 
 
 
 
 
 

Several years ago, a medical case appeared that took the scientific and medical community by storm. A patient appeared for surgery who reported never feeling anxiety, depression, or pain, despite numerous injuries and surgeries for which she required treatment.  As scientists analyzed her genetic profile, they discovered something amazing - Joanne Cameron lacked the genetic code that was responsible for transmitting pain and creating anxiety and depression.
In this episode of Cannabis Nurse Truths, we examine the curious case of Joanne Cameron that has led to some very surprising research that targets this important physiological phenomenon, and drug companies are furiously developing drugs to capitalize on this incredible potential to decrease pain, anxiety, depression, and treat a number of psychological and physical disorders. One of the most incredible findings linked to this case: cannabinoids, like CBD, also enhance the natural physiological activities of the body linked to the FAAH-OUT gene, where inflammation is halted (reducing pain), while also reducing or eliminating anxiety and depression.  
 
EPISODE RESOURCES
Ahn, K., Johnson, D. S., & Cravatt, B. F. (2009). Fatty acid amide hydrolase as a potential therapeutic target for the treatment of pain and CNS disorders. Expert Opinion on Drug Discovery, 4(7), 763–784. https://pmc.ncbi.nlm.nih.gov/articles/PMC2882713/pdf/nihms-116402.pdf  
Bartel, S. J., Sherry, S. B., & Stewart, S. H. (2020). Self-isolation: A significant contributor to cannabis use during the COVID-19 pandemic. Substance Abuse, 41(4), 409–412. https://pubmed.ncbi.nlm.nih.gov/33044893/ 
Bisogno, T., & Maccarrone, M. (2013). Latest advances in the discovery of fatty acid amide hydrolase inhibitors. Expert Opinion on Drug Discovery. https://www.researchgate.net/publication/236044861_Latest_advances_in_the_discovery_of_fatty_acid_amide_hydrolase_inhibitors 
Boileau, I., Mansouri, E., Williams, B., Le Foll, B., Rusjan, P., Mizrahi, R., Tyndale, R. F., Huestis, M. A., Payer, D. E., Wilson, A. A., Houle, S., Kish, S. J., & Tong, J. (2016). Fatty acid amide hydrolase binding in brain of cannabis users: Imaging with the novel radiotracer [11C]CURB. Biological Psychiatry, 80(9), 691–701. https://pubmed.ncbi.nlm.nih.gov/27345297/  
Bornscheuer, L., Lundin, A., Forsell, Y., Lavebratt, C., & Melas, P. A. (2023). Functional variation in the FAAH gene is directly associated with subjective well-being and indirectly associated with problematic alcohol use. Genes, 14(9), 1826. https://pubmed.ncbi.nlm.nih.gov/37761966/ 
Cravatt, B.F., & Lichtman, A.H. (2003). Fatty acid amide hydrolase: An emerging therapeutic target in the endocannabinoid system. Current Opinion in Chemical Biology, 7(4), 469–475. https://pubmed.ncbi.nlm.nih.gov/12941421/ 
Di Marzo, V., & Petrosino, S. (2007). Endocannabinoids and the regulation of their levels in health and disease. Current Opinion in Lipidology, 18(2), 129–140. https://pubmed.ncbi.nlm.nih.gov/17353660/ 
D’Souza, D. C., Cortes-Briones, J., Creatura, G., Bluez, G., Thurnauer, H., Deaso, E., Bielen, K., Surti, T., Radhakrishnan, R., Gupta, A., Gupta, S., Cahill, J., Sherif, M. A., Makriyannis, A., Morgan, P. T., Ranganathan, M., & Skosnik, P. D. (2019). Efficacy and safety of a fatty acid amide hydrolase inhibitor (PF-04457845) in the treatment of cannabis withdrawal and dependence in men: A double-blind, placebo-controlled, parallel group, phase 2a single-site randomised controlled trial. Lancet Psychiatry, 6(1), 35–45. https://www.thelancet.com/journals/lanpsy/article/PIIS2215-0366(18)30427-9/abstract 
Girella, A., Di Bartolomeo, M., Dainese, E., Buzzelli, V., Trezza, V., & D’Addario, C. (2024). Fatty acid amide hydrolase and cannabinoid receptor type 1 genes regulation is modulated by social isolation in rats. Neurochemical Research, 49(5),1278-1290. http://www.ncbi.nlm.nih.gov/pubmed/38368587 
Giuffrida, A., Leweke, F. M., Gerth, C. W., Schreiber, D., Koethe, D., Faulhaber, J., Klosterkötter, J., & Piomelli, D. (2004). Cerebrospinal anandamide levels are elevated in acute schizophrenia and are inversely correlated with psychotic symptoms. Neuropsychopharmacology, 29(11), 2108–2114. https://www.nature.com/articles/1300558 
Habib, A. M., Okorokov, A. L., Hill, M. N., Bras, J. T., Lee, M.-C., Li, S., Gossage, S. J., van Drimmelen, M., Morena, M.,Houlden, H., Ramirez, J. D., Bennett, D. L. H., Srivastava, D., & Cox, J. J. (2019). Microdeletion in a FAAH pseudogene identified in a patient with high anandamide concentrations and pain insensitivity. British Journal of Anaesthesia, 123(2), e249–e253. https://europepmc.org/backend/ptpmcrender.fcgi?accid=PMC6676009&blobtype=pdf  
Haseltine, W.A., (2023). No pain, FAAH-OUT. Forbes.https://www.forbes.com/sites/williamhaseltine/2023/06/19/no-pain-faah-out/ 
Huggins, J. P., Smart, T. S., Langman, S., Taylor, L., & Young, T. (2012). An efficient randomised, placebo-controlled clinical trial with the irreversible fatty acid amide hydrolase-1 inhibitor PF-04457845, which modulates endocannabinoids but fails to induce effective analgesia in patients with pain due to osteoarthritis of the knee. Pain, 153(9), 1837–1846. https://pubmed.ncbi.nlm.nih.gov/22727500/  
Jacobson, M. R., Watts, J. J., Silva, T. D., Tyndale, R. F., Rusjan, P. M., Houle, S., Wilson, A. A., Ross, R. A., Boileau, I., & Mizrahi, R. (2020). Fatty acid amide hydrolase is lower in young cannabis users. Addiction Biology, 26(1), e12872. https://pmc.ncbi.nlm.nih.gov/articles/PMC7944390/ 
Lever, I. J., Robinson, M., Cibelli, M., Paule, C., Santha, P., Yee, L., Hunt, S. P., Cravatt, B. F., Elphick, M. R., Nagy, I., & Rice, A. S. C. (2009). Localization of the endocannabinoid-degrading enzyme fatty acid amide hydrolase in rat dorsal root ganglion cells and its regulation after peripheral nerve injury. Journal of Neuroscience, 29(12), 3766–3780. https://doi.org/10.1523/JNEUROSCI.4071-08.2009 
Leweke, F. M., Giuffrida, A., Wurster, U., Emrich, H. M., & Piomelli, D. (1999). Elevated endogenous cannabinoids in schizophrenia. Neuroreport, 10(8), 1665–1669. https://pubmed.ncbi.nlm.nih.gov/10501554/ 
Leweke, F. M., Piomelli, D., Pahlisch, F., Muhl, D., Gerth, C. W., Hoyer, C., Klosterkötter, J., Hellmich, M., & Koethe, D. (2012). Cannabidiol enhances anandamide signaling and alleviates psychotic symptoms of schizophrenia. Translational Psychiatry, 2(3), e94–e94.  https://www.nature.com/articles/tp201215 
Machado-Vieira, R, & Haseeb, A. (2024). A trial of the fatty acid amide hydrolase inhibitor palmitoylethanolamide in bipolar depression. Identifier NCT06229977. https://clinicaltrials.gov/study/NCT06229977?cond=DEPRESSION%20&term=FAAH&rank=1&a=1  
Mikaeili, H., Habib, A. M., Yeung, C. W.-L., Santana-Varela, S., Luiz, A. P., Panteleeva, K., Zuberi, S., Athanasiou-Fragkouli, A., Houlden, H., Wood, J. N., Okorokov, A. L., & Cox, J. J. (2023). Molecular basis of FAAH-OUT-associated human pain insensitivity. Brain: A Journal of Neurology, 146(9), 3851–3865. https://pubmed.ncbi.nlm.nih.gov/37222214/ 
Minkkila, A. M., Saario, S., & Nevalainen, T. (2010). Discovery and development of endocannabinoid-hydrolyzing enzyme inhibitors. Current Topics in Medicinal Chemistry, 10(8), 828–858. https://doi.org/10.2174/156802610791164238 
Patel, S., Hill, M. N., Cheer, J. F., Wotjak, C. T., & Holmes, A. (2017). The endocannabinoid system as a target for novel anxiolytic drugs. Neuroscience and Biobehavioral Reviews, 76(Pt A), 56–66. https://pmc.ncbi.nlm.nih.gov/articles/PMC5407316/pdf/nihms843439.pdf 
Pfizer. (2009). A multiple dose trial evaluating the safety, tolerability, pharmacokinetics and pharmacodynamics of PF-04457845 in healthy volunteers. Identifier NCT00836082. https://clinicaltrials.gov/study/NCT00836082?term=pf%2004457845&checkSpell=&rank=1&tab=table 
Pfizer. (2010). A study to establish the effects of PF-04457845 on sleep in healthy volunteers. Identifier NCT01092845. https://clinicaltrials.gov/study/NCT01092845?term=pf%2004457845&checkSpell=&rank=7&a=7  
Pfizer. (2019). A study to investigate whether PF-04457845 is effective in treating pain, is safe and tolerable in patients with osteoarthritis of the knee. Identifier NCT00981357.https://clinicaltrials.gov/study/NCT00981357?cond=osteoarthritis%20&term=FAAH&rank=1  
Sanofi-Aventis. (2013). An eight-week study of SSR411298 as treatment for major depressive disorder in elderly patients (FIDELIO). Identifier NCT00822744. https://clinicaltrials.gov/study/NCT00822744?term=SSR-411298&rank=1&a=9  
Schlosburg, J. E., Kinsey, S. G., & Lichtman, A. H. (2009). Targeting fatty acid amide hydrolase (FAAH) to treat pain and inflammation. AAPS Journal, 11(1), 39. https://pmc.ncbi.nlm.nih.gov/articles/PMC2664876/pdf/12248_2008_Article_9075.pdf  
Tripathi, R. K. P. (2020). A perspective review on fatty acid amide hydrolase (FAAH) inhibitors as potential therapeutic agents. European Journal of Medicinal Chemistry, 188, 111953. https://pubmed.ncbi.nlm.nih.gov/31945644/  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

In the schizophrenic United States of Cannabis, Americans have been denied fundamental Constitutional Rights because of their choice to use a plant. Long after court requirements are satisfied from a marijuana charge, many Americans are denied basic rights like employment, voting, housing, property, child custody, and college loans that keep them from Life, Liberty, and the Pursuit of Happiness. As the laws and regulations regarding cannabis undergo extreme transformations, Americans are still subjected to discrimination, but now, there could be a light on the horizon.
In this episode of Cannabis Nurse Truths, we are excited to host our first poTcast guest, Tamara Lyn Netzel, a nationally-recognized cannabis advocate and author, who has just published her second book, Humans of Cannabis in a Renaissance of Hope, highlighting the struggles and successes of normal everyday Americans who have decided that cannabis is their drug - or medicine - of choice.  Tamara is the founder of the non-profit 501c3 Cruel Consequences: Portraits of Misguided Law after becoming a medical cannabis advocate for treatment of her multiple sclerosis symptoms and in this episode of CNT, we discuss her journey to cannabis as medicine and her passion for cannabis advocacy.
 
EPIDSODE RESOURCES
Cruel Consequences: Portraits of Misguided Law https://cruelconsequences.org/  
Amazon: Humans of Cannabis in a Renaissance of Hopehttps://www.amazon.com/Humans-Cannabis-Tamara-Lyn-Netzel/dp/B0DHJH9HJV?sr=8-1  
Portraits of Misguided Law: The Human Cost of Marijuana Prohibitionhttps://checkout.square.site/buy/RLKFXWPJQ5N4K6HDMBMBEVSL  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

In order to understand how we ended up in the schizophrenic United States of Cannabis, we have to travel back in time to when cannabis was part of the American experience.  For nearly 150 years after the first colony was established in Jamestown, Virginia, cannabis was utilized for spiritual rituals, rope, fibers, textiles, bird seed, oils and medicine, both for humans and pets. Until one day, a bunch of men in business suits decided that they needed a lot of money to start a war on drugs. 
In this episode of Cannabis Nurse Truths, we take a look at the very mixed-up and unfair hijinks used by the Federal government agencies that would later also benefit from its prohibition.  It is all too apparent that our federal government is seriously flawed and even worse, those government entities who created this national psychosis are still benefiting from the effects of prohibition over 80 years later.
 
EPISODE RESOURCES
Adams, E. S. (2024). Just don’t do it: Why cannabis regulations are the reason cannabis businesses are failing. Nevada Law Journal, 24(349). https://scholars.law.unlv.edu/cgi/viewcontent.cgi?article=1935&context=nlj0 
Galliher, J. F., & Walker, A. (1977). The puzzle of the social origins of the Marihuana Tax Act of 1937. Social Problems, 24(3), 367–376. https://doi.org/10.2307/800089  
Griffith, R. C. (2021). A breath of fresh air: A Constitutional amendment legalizing marijuana through an Article V Convention of the States. University of Massachusetts Law Review, 16(200), Article 2.https://scholarship.law.umassd.edu/umlr/vol16/iss2/2  
LaGuardia, F. (1944). The Laguardia Committee Report New York, USA (1944).https://rodneybarnett.net/PDF/Laguardia%20Report%201944.pdf  
Last Prisoner Project. (n.d.). Exactly how many people are locked up for weed? https://www.lastprisonerproject.org/cannabis-prisoner-scale 
National Conference of State Legislatures. (n.d.). State Medical Cannabis Laws.  https://www.ncsl.org/health/state-medical-cannabis-laws?__cf_chl_tk=jj5C1HNOjfrPgfuAOfFuEtsRvbrl0ufw5tdRo54kBBk-1730819983-1.0.1.1-3WmtBp1aGo4X66bWfielCviKdPcDqEI.k1hG1LmOiH4  
National Institute on Alcohol Abuse and Alcoholism. (2024). Alcohol Use in the United States: Age Groups and Demographic Characteristics.  National Institutes of Health. https://www.niaaa.nih.gov/alcohols-effects-health/alcohol-topics/alcohol-facts-and-statistics/alcohol-use-united-states-age-groups-and-demographic-characteristics
Musto, D. F. (1972). The 1937 Marijuana Tax Act. Archives of General Psychiatry, 26, 101-108. https://static1.squarespace.com/static/54b9fbd9e4b0b6737df63e5d/t/627af393d870030771a32aa1/1652224915619/The+1937+Marijuana+Tax+Stamp+Act-Musto-1972.pdf  
Patton, D. V. (n.d.). A history of United States cannabis law. Journal of Law & Health, 34(1). https://engagedscholarship.csuohio.edu/cgi/viewcontent.cgi?article=1567&context=jlh