For decades, marijuana, even for medical uses, was demonized or questioned.  When states like Colorado legalized it for recreational use, more studies began to determine provable efficacy for its use as a medicine. The Federal government still classifies marijuana the same way it classifies heroin: harmful and with no medical benefits. Now we can see that this is wrong. When states legalized marijuana, referred to as cannabis here, they had an interest in getting data to see what good it could do. Proving efficacy could increase medical marijuana sales, benefit people who might at least find some medical use, and overall would bring tax dollars into the state coffers.

Without funding studies, the Federal government has done very little to demonstrate what good cannabis can do. After all, if the presumption is that it helps nothing, there would be no motivation to determine with scientific data that it does anyone any good. But we have convincing data now about its beneficial use for epilepsy and some data showing good results with use of cannabis for veterans with post traumatic stress. Studies as to how it can help older people, particularly with dementia (Alzheimer's disease being the most common kind of dementia), have been lacking. However, better and newer data is now reported and the results look very promising.

At AgingParents.com, we look constantly at families who have an elder with dementia. The most heart-wrenching stories are those the adult children tell us concerning their aging parent whose dementia-related behavior is out of control. They describe how their loved one becomes aggressive, abusive, gets kicked out of care facilities, and turns into a caregiving nightmare. Even paid caregivers are endangered by the behaviors. It's not the parent's fault--it's the disease. And the medical establishment, still constrained by the Federal government's misplaced drug classification of cannabis, can't prescribe it, and can only recommend its use in states where such use is legal. Typically, care facilities do not allow use of cannabis on the premises, as they receive Medicare (Federal dollars) and Medicaid (Federal, State and county dollars) reimbursement which they cannot endanger. Instead, they "dope 'em up" with heavy tranquilizing and psychotropic medications used for people who have mental illness. We can do better.

Recent research on the medical benefits of cannabis has reached positive conclusions:

National Academies of Sciences, Engineering, and Medicine. Washington, DC: The National Academies Press. 2017. In this systematic review of medical studies, researchers confirm the substantial evidence for cannabis as an effective treatment option for many conditions.

“In vivo Evidence for Therapeutic Properties of Cannabidiol for Alzheimer’s Disease,” by Georgia Watt and Tim Karl -Frontiers in Pharmacology

February 2017. The studies provide “proof of principle” that CBD and possibly CBD-THC combinations are valid candidates for novel AD therapies. (AD refers to Alzheimer's disease).

One of the most hopeful studies I have seen is from a small pilot project in Geneva. They studied 10 women with severe dementia-related behavioral problems in a care facility, giving them a measured dose of cannabis. It was oil containing both components of cannabis: CBD, which does not get anyone high and THC which does have a psychoactive effect. The study concluded that an oral cannabis extract with THC/CBD, in higher dosages than in other studies, was well tolerated and greatly improved behavior problems, rigidity, and daily care in severely demented patients. Behavior problems went down by 40%, psychotropic medications were eliminated in half of the women studied and overall, they were far easier for the staff to manage.

No one is claiming that cannabis can cure dementia. However, as the disease progresses, behavior problems can create a horror for families caring for a loved one with dementia. If there is a gentler, "less-doped" alternative than psychotropic meds, let's use it! In the Geneva study, there were no side effects, no harm to any patient and much relief to staff in managing these severely affected women.

As the World Health Organization now urges reclassifying cannabis under international treaties, this move, if adopted, would represent formal recognition that the world's governing bodies have been wrong about the lack of therapeutic benefits and alleged harms.

The Takeaway:

If you are in a state where medical marijuana is legal and you have a parent with dementia-related difficult behavior, look at the research here and more. Get a doctor's recommendation for your loved one and work with that professional to supervise what you do. If you do decide to have your parent try cannabis, find the product that contains the combination of CBD/THC in oral drops in dosages tried in the Geneva study, and consider it as a trial for your loved one. You may have to experiment with the right dosage as nothing is standardized for any diagnosis yet. It could be a relief for all concerned.

The marijuana legalization movement has a lot of friends in high places these days that were not always there for the cause.

It goes without saying that, despite just how popular cannabis has become over the past few years, it was not always the opinion of those who write our laws in the United States that we should embrace the herb similar to alcohol and tobacco and allow it to become a part of legitimate society.

It was the Democrats that initially took the reins on this issue, fighting for it on Capitol Hill without any success. But them something bizarre started to happen.

Republicans, a group staunchly opposed to legal weed since the dawn of time, started to come out of the pot closet. There are now more Republicans in Congress that support the cannabis movement in one way or another than ever before. The following is a list of those fighting to give the cannabis industry more rights to operate without antiquated federal controls.

Representative Steve Stivers: Republican Representative from Ohio, where medical marijuana is now legal. He is a co-sponsor on a bill designed to give banks permission to do business with the cannabis industry. It is known as the SAFE Banking Act.

Senator Cory Gardner: Republican Senator from Colorado, where marijuana is legal for both medical and recreational use. He supports bringing an end to federal marijuana prohibition and is considered one of the primary voices for the movement on the Hill.

Representative Rodney Davis: Republican Representative from Illinois, where marijuana is legal for both medical and recreational use. In addition to his support for the SAFE Banking Act, he has also cast several votes in favor of giving veterans access to medical marijuana.

Representative Duncan Hunter: Republican Representative from California, where marijuana is entirely legal. He is a co-sponsor on the SAFE Banking Act.

Senator Mitch McConnell: Republican Senator from Kentucky. He hates marijuana (at least for now) but played a huge role in the legalization of industrial hemp production last year, giving the agricultural community, as well as the CBD sector a boost.

Representative Dan Newhouse: Republican Representative from Washington, where marijuana is legal for recreational use. He is a co-sponsor on the SAFE Banking Act and has voted in favor of medical marijuana access for veterans.

Representative David P. Joyce: This Republican Representative from Ohio is the co-chair of the Congressional Cannabis Caucus, a group pushing for marijuana reform at the national level. He is a supporter of several marijuana legalization efforts, including the SAFE Banking Act and the Marijuana Data Collection Act.

Representative Don Young: Republican Representative from Alaska, where marijuana is legal for recreational use. He recently joined forces with Democrat Tulsi Gabbard to introduce the Ending Federal Marijuana Prohibition Act of 2019. He is a state’s rights supporter and a co-sponsor on the SAFE Banking Act.

Representative Matt Gaetz: Republican Representative from Florida, where medical marijuana is legal. He recently introduced the Medical Cannabis Research Act of 2019 because, he says, “we cannot reform cannabis law without researching its safety, its efficacy, and its medical uses.” He is also a co-sponsor on the SAFE Banking Act.

Senator Kevin Cramer: Republican Senator from North Dakota, where medical marijuana was made legal by way of ballot initiative. He is part of a group working to give marijuana-related businesses access to comprehensive and affordable insurance coverage.

Representative Denver Riggleman: Republican Representative from Virginia, which has a medical marijuana program. He is a supporter of all things medical marijuana and eliminating prosecutions for petty pot offenses. He is also a co-sponsor of both the STATES Act and the SAFE Banking Act.

Senator Lisa Murkowski: Republican Senator from Alaska. She believes states should be permitted to make their own rules when it comes to marijuana, and that financial services should be made available to the cannabis trade. She is presently a co-sponsor of the Secure And Fair Enforcement Banking Act of 2019.

Representative Mark Amodei: Republican Representative from Nevada, where marijuana is legal for adults 21 and over. He has called out the federal government for accepting tax money from the cannabis industry, all while refusing to legalize. He supports the SAFE Banking Act.

Representative Troy Balderson: Republican Representative from Ohio. He is a supporter of medical marijuana. Balderson was part of the “yes” crew that legalized it for therapeutic purposes in his state in 2016. He is presently a co-sponsor for the SAFE Banking Act.

Representative Tom McClintock: Republican Representative from California. He is all about keeping the federal government out of state marijuana business. And while he admits that he’s not a big fan of the substance, he doesn’t believe prohibition is working. He has supported medical marijuana legislation and is presently a co-sponsor on the SAFE Banking Act.

Representative Chris Collins: Republican Representative from New York, where medical marijuana is legal. Co-sponsor of the SAFE Banking Act.

Senator Rand Paul: Republican Senator from Kentucky. He is a huge supporter of medical marijuana. He has sponsored cannabis legislation from the CARERS Act to the STATES Act. He is also favor of eliminating policies that force pot offenders to be sent to prison.

Representative Gregory Steube: Republican Representative from Florida. He is a supporter of giving veterans access to medical marijuana. In fact, he introduced the Veterans Cannabis Use for Safe Healing Act, earlier this year, aimed at preventing Veterans Affairs from denying patients the use of medicinal cannabis in states where it is legal. He is also a supporter of the SAFE Banking Act.

Representative Thomas Massie: Republican Representative from Kentucky, which has a restrictive low-THC medical marijuana program. He is a big supporter of eliminating policies that prevent medical marijuana cardholders from owning guns. Massie has championed legislation to remove the cannabis question on the ATF forms. He is also a co-sponsor on the SAFE Banking Act.

Senator Dan Sullivan: Republican Senator from Alaska. Not always a supporter of marijuana reform, but advocates for state’s rights and cannabis research. He is also a co-sponsor of the Secure And Fair Enforcement Banking Act of 2019.

Representative Guy Reschenthaler: Republican Representative from Pennsylvania, where medical marijuana is legal. In addition to being a co-sponsor on the SAFE Banking Act, he is also one for the Federal Clean Slate Act, which aims to seal the marijuana convictions of those involved in non-violent crimes.

Representative Fred Upton: Republican Representative from Michigan, where marijuana is completely legal.  He has received a B rating from NORML with respect to his position on cannabis. Upton is a supporter of the Congressional Cannabis Caucus and co-sponsor of both of the Ending Federal Marijuana Prohibition Act and the SAFE Banking Act.

Representative Jim Banks: Republican Representative from Indiana, which still locks people up for cannabis crimes. He is a co-sponsor on the SAFE Banking Act.

Representative Daniel Meuser: A newbie Republican Representative from Pennsylvania. He believes veterans should have medical marijuana access. He is also a supporter of the SAFE Banking Act.

Senator Andy Barr: Republican Senator from Kentucky. He is pushing for industrial hemp and CBD companies to be given access to financial services.

Representative Kelly Armstrong: Republican Representative from North Dakota. He is a supporter of ending federal marijuana prohibition. Armstrong is a co-sponsor of the SAFE Banking Act.

Representative Bob Gibbs: Republican Representative from Ohio. He has supported widespread medical marijuana legislation in the past, including the dusty CARERS Act. He is currently a co-sponsor of the SAFE Banking Act.

Representative James Comer: Republican Representative from Kentucky. He is a massive supporter of legalized hemp. He worked closely with Senate Majority Leader itch McConnell to include the legalization of industrial hemp on the 2018 Farm Bill. He also supports allowing cannabis operations to deposit cash, which is just one of the reasons he is presently a co-sponsor of the SAFE Baking Act.

Representative Tom Graves: Republican Representative from Georgia, where low-THC medical marijuana is legal. He is a co-sponsor of the SAFE Banking Act.

Representative Anthony Gonzalez: Newbie Republican Representative from Ohio. He has signed on in support of the SAFE Banking Act.

Although microdosing may go against the grain of the old time stoner philosophy, doctors say that finding the “minimum effective dose” is the key to medical treatment.

There are those cannabis connoisseurs who enjoy getting super stoned at the end of a long day at the office, while others are now embracing an emerging trend called microdosing, a procedure that allows the user to moderate their mind by taking small doses throughout the day.

The concept of microdosing is simple: instead of consuming enough THC to join the land of catatonia, the user leans on somewhere between 3 to 10 mg to feel some effect without entering into a realm of laughing fits, paranoia and ravenous hunger. It is increasingly popular practice that Rolling Stone calls “Marijuana 2.0,” an idea that less is actually more when it comes to using cannabis for its therapeutic and creativity-inducing benefits.

However, there are some challenges involved. What is considered a low dose for some may not cut it for others. It is similar to how it would be if measuring the effectiveness of Ibuprofen on a large group of people. Some of them would find relief with 200 mg, while it might take others near pharmaceutical levels to cut through the pain. So, the core of this dosing principle is really just about the individual finding the perfect “micro-buzz” that allows them to feel comfortable and productive.

Dr. Duston Sulak, who has been working with medical marijuana patients in Maine for the past eight years, told Rolling Stone that he has developed a system to help people find their optimal microdose.

“Abstain from cannabis for two days. On day three, consume one milligram of THC and one milligram of CBD, preferably in a tincture or oil where they can be measured precisely,” he said. “Before consuming, ask yourself three questions, and answer on a scale of one to 10: How easy is it to breathe, how comfortable and calm does your body feel and how easy is it for you to smile authentically, to feel content and grateful?”

Feel nothing? Increase your dose by one milligram, the doctor says.

“You repeat this process over the next few days, increasing the dose by small increments,” he explained. “When you reach a point where you feel a difference after consuming, you’ve found your minimal effective dose.”

No matter how high of a tolerance a person has, the doctor says 48 hours of abstinence is all that is needed to hit the rest button.

Although microdosing may go against the grain of the old time stoner philosophy, medical experts say that finding the “minimum effective dose” is the key when treating a patient with any medication. After all, it is not advised to take other medications at intoxicating levels, so why should marijuana be treated any differently?

Nevada’s cannabis industry has broken the $100 million dollar mark in taxes and fees for the first time. Dispensaries, cultivators, laboratories and producers have paid more than $109 million in taxes and fees in fiscal year 2019.

$99.18 million was paid in taxes compared to $74.7 million last year. How much of that went to education is not yet available from the state. However, changes to the law this year under the leadership of Governor Sisolak mandate that 100 percent of taxes will go to education in future years. For the next two years, the state is projecting more than $100 million per year in tax collections. Cannabis sales were also up from $529 million in fiscal year 2018 to approximately $639 million in fiscal year 2019, an increase of $110 million.

“These sales and tax figures are a milestone that should be celebrated by the people of Nevada.” said Riana Durrett of the Dispensary Association. “It shows that the public and visitors to Las Vegas from around the nation are becoming more comfortable purchasing cannabis and the industry is improving its ability to serve the public. The winners are the people of Nevada, gaining highly-skilled jobs, industry diversification and education.”

“While these sales figures are strong, we should not take them for granted,” Durrett said. “The number one goal is to ensure public safety and second is the stability of the industry. Millions more in taxes and fees are paid at nearly every level of government including county and local. Significant changes in the market or regulatory framework could impact tax collection, especially given competition from the illegal market. The illegal market continues to deprive the state of funds that could be going to education.”

“Nevada continues to be a model for the industry and regulators nation-wide,” Durrett said. “We must continue to carefully analyze the impacts of regulation and taxes is ensure continued success.”