Join Host John Malanca as he visits with PharmD, Dr. Leah Johnson as they discuss Ryan's Law and how CA Pharmacists are pushing for Legal Cannabis Access for End of Life Patients Nationwide. Please follow Dr. Johnson here as she and her group lead in this fight for patients rights. https://cannabiswellnessgroup.com/professionals/dr-leah-johnson/ On September 28, 2021, Governor Newsom approved Senate Bill 311, better known as “Ryan’s Law.” The legislation requires hospitals and certain health facilities to allow terminally ill patients to use medical cannabis, subject to certain restrictions. Governor Newsom had previously vetoed a prior iteration of the bill (SB 305) in 2019, owing to fears that participating hospitals or hospices might jeopardize Medicare and Medicaid (CMS) reimbursements if they permitted medical cannabis onsite, as marijuana remains illegal under federal law. Sponsoring Senator Ben Hueso (D-San Diego) spoke to the repeated setbacks facing the legislation: “It is inconceivable to me that, in a state where medical cannabis was legalized more than 25 years ago, those in deepest suffering receiving treatment in our state’s healthcare facilities cannot access this proven, effective, and prescribed treatment.”
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Join Host John Malanca as he visits with PharmD, Dr. Leah Johnson as they discuss Ryan's Law and how CA Pharmacists are pushing for Legal Cannabis Access for End of Life Patients Nationwide. Please follow Dr. Johnson here as she and her group lead in this fight for patients rights. https://cannabiswellnessgroup.com/professionals/dr-leah-johnson/ On September 28, 2021, Governor Newsom approved Senate Bill 311, better known as “Ryan’s Law.” The legislation requires hospitals and certain health facilities to allow terminally ill patients to use medical cannabis, subject to certain restrictions. Governor Newsom had previously vetoed a prior iteration of the bill (SB 305) in 2019, owing to fears that participating hospitals or hospices might jeopardize Medicare and Medicaid (CMS) reimbursements if they permitted medical cannabis onsite, as marijuana remains illegal under federal law. Sponsoring Senator Ben Hueso (D-San Diego) spoke to the repeated setbacks facing the legislation: “It is inconceivable to me that, in a state where medical cannabis was legalized more than 25 years ago, those in deepest suffering receiving treatment in our state’s healthcare facilities cannot access this proven, effective, and prescribed treatment.”
Visit us at: https://www.unitedpatientsgroup.com
Follow our Podcast: https://www.buzzsprout.com/1129859
Follow us on Twitter: https://www.twitter.com/upatientsgroup
Facebook: https://www.facebook.com/UnitedPatientsGroup/
John Malanca 0:02
Well, hey everybody, John Malanca here with United Patient Group Be informed. Be Well. and we have another return guest happy to see the Dr. Leah Johnson. PharmD and welcome. How are you doing?
Leah Johnson, PharmD 0:13
I am doing great. Thank you so much for having me back.
John Malanca 0:16
Always good to see you. And I'm excited to share this. This is I had, we're going to talk about Ryan's law, but I'll go and so last organization is a nonprofit organization. It's a pharmacist, cannabis Coalition of California, also known as P CCC. And the reason why this really stands out of what Dr. Johnson is doing as well as what this Ryan's law is about, because it hits home gym, which is Jimmy James, you go by James, Jimmy
Unknown Speaker 0:47
James, says Jim to us. Yeah,
John Malanca 0:49
I think Jim Yeah. And I've had Jim on the show, and Jim is Ryan's father and why this is near and dear to me, because Ryan also lost his battle to pancreatic cancer, like my wife, Corinne. And the story how the story goes, correct me if I'm wrong, but he was denied access to his medicine, meaning cannabis medicine, and they kept on pumping him with opioids, drugs, painkillers, and he was kind of in a in a coma. And Jim said, Please, can we try some cannabis, you know, this is what he's been taking. And they finally found another hospital to move him to, which allowed him to try cannabis legally in this in the hospital. With that, it allowed him to wake out of wake up from his opioid dragon do stupor. And be with his family. He with his son, he with his father, and he unfortunately passed, Jim felt that he lost two weeks plus of his son because he was in a in a coma. And he doesn't want any other families for that to happen to and so he's been hard at work, working with organizations like Dr. Leah Johnson PCCC. They've we've spread the word here, United Patients group and so les asked if she'd come on and share what they're doing here in California. So other patients do have access not only patients on hospice, but all patients and we're in that situation. That topic came up quite a bit when Chris father was ill we said he's been using cannabis. May we try this? And we live in California. And we ran into both sides of that. Yes, no, let me see what legalities are in. So have that and welcome back. And thanks for reaching out and say, Hey, John, can I get this message out? And, as always love, love to spread the word. So you're on?
Leah Johnson, PharmD 2:35
Definitely I this is such an important topic for us because for the pharmacists cannabis Coalition of California, because what happened was the law went through. We were thrilled about that. So we are actually an organization of cannabis pharmacists. So all of us, some of us are professors teaching some in UCSD some, one of us is one is teaching in University of Southern California. And we've got hospital pharmacists, long term care, managed care, everything. But our biggest focus is that when the law came out, there was no guidelines or anything for the health care facility. So many of the facilities were like, well, we're not going to do this. It's not federally legal. And so we stepped in and said, Wait, these patients need this medication. I mean, I used to be a long term care pharmacist. So I have seen those comfort packs. I've seen the patient's just sedated for just laying in bed just not even alive. I mean, they're just sedated. It's like what's the point of even being in that state. So and even myself when I was in long term care, I actually convinced a lot of doctors to get these patients off of all these, the the morphine and the and the anti anxieties and the pain and the and the sometimes they would be on antipsychotics for like, and if they had any aggressive behavior or anything, and actually switched them over to cannabis. It was Marinol because it's the only prescription one and sadly, it's not the best cannabinoid medication. But it was useful. And I was actually good able to get people off hospice. So it just shows that cannabis can be really effective. So again, when we saw that this law came out, we were really excited. We were thrilled to see that patients can get the medication they need. But when we listen to our colleagues that didn't have cannabis background or cannabis knowledge, we learned that they were we don't know what to do. We're not very comfortable. We want to get hands off Public Law, and the law really doesn't. And the law specifically in California, which you'll find is if you look up Ryan's law in the country, there are other states with other versions of Ryan's law, but in California specifically, they only they pretty much don't have the cover of protection for the health care professionals. So due to this, pharmacists don't want to touch it. Doctors don't want to touch it. nurses don't want to touch it because they're afraid of losing their license because they're in federal facilities. So just because Ryan's law was approved in California. Why you know, this is a federally paid for building, you know, we can't use it. So what we actually, we actually got the confirmation information from CMS, the Center for Medicare and Medicaid Services, and actually learned that if something is allowed in a state, Medicare and Medicaid Services will not come in and will not cause any issue to facilities. So that was one big thing that you know, made a lot of health care professionals much more secure about using this allowing the patient to use the product and the other thing, so there's no inhalation. That's really the the biggest difference. The biggest thing on Ryan's law is cannabis is completely fine except for inhalation. So they can do oral they can do topical, rectal, vaginal, any of those but they cannot do tinctures which is more oral, but not
John Malanca 5:48
to tinctures. So I was thinking when you're saying we're a morning ingesting via smoking, vaporization or even smoking. So now they're even saying oral tinctures are not available, but no
Leah Johnson, PharmD 5:58
oral tinctures are okay, I would just say I don't consider a tincture different from oral I consider the same because most of them when when you put in your mouth still get swallowed. Yeah, yeah. But in general, though, it's just so we saw that. And so the other issue was that a lot of these facilities were saying, Well, how do we protect our license, this does not protect us. And it does say the patient needs to self administer. So what we actually worked up for the patient was there's a lot of kind of blanks in in our organization, we actually one of our members, his name was Bob or Robert Stein, and he was amazing. He was just the most amazing person and he actually had glioblastoma and passed away. So he as well used cannabis for his end of life. But he was part of PCCC. And he was our cannabis, pharmacist and lawyer, he was a triple threat. And he actually worked to set up policies and procedures with the rest of our organization to provide to our facilities for free. You know, just saying Here Here are policies and procedures and documentation you can have for your facility, just so that you can feel comfortable, you can feel compliant, and you don't feel like you have the risk of losing your license. And PCCC has actually been going around to multiple states, multiple pharmacist based organizations and other health care based organizations to really promote the law and really just educate what people really need to know. And to not be afraid, because so many health care professionals are afraid. And so many patients don't know to ask for it. Because, you know, they hear they're going on hospice, they say, Here's your comfort pack done. And it's like, okay, this is my life. Now it's like, no, you have a choice. So patients need to know you have a choice. If you are in the state of California, and you would like to use medical cannabis, instead of a comfort pack for your hospice, you just need a medical, you actually just need a basic recommendation from any medical provider in the state of California saying that you have been approved to use medical cannabis with that rec any facility in the state of California, whether it's a hospital inpatient, or just long term care, or assisted living, and so on, so forth. Usually, if you're a hospice, you're going to be a long term care. You can use cannabis and they have the right they don't you have the right to have it by your bedside, usually in a locked container that they will give you, you are the the patient or the caregiver because a lot of patients don't have the ability to self administer has the ability has the only access to the key to open that drawer so nobody else can touch it. And then the and then they administer it themselves, but the whole idea is that they should be allowed to use what works for them and not to end up going on these meds that are just going to it's almost like saying, Okay, you got six months to live. Usually the criteria for hospice a mind you Ryan's law is actually palliative care. So it's actually a full year. But it's kind of like, okay, you've got a year, here's a comfort pack. And so they kind of almost take away some of your life, because they put you on this thing that just sedates you fully. So with cannabis, the patient actually helps with anxiety it helps with helps with it actually helps with the depression of dying, and helps with pain and it helps with any sort of agitation and it actually gets the patient to eat more. Because like the one thing that people don't really know and I actually I work a lot with palliative care nurses, when a patient is like the patient's pretty good until they stop eating. The second day, that's the food goes, you got days. That's it.
John Malanca 9:42
That was a whole reason what how we started United Patients group in 2010 because Chris father wasn't eating, we came across a study that showed 40% of cancer patients die and pass a malnutrition before cancer takes over. And I knew nothing about the medical side of this planet. And I asked, I was embarrassed because I was the boyfriend then a grin. I was stupid boyfriend. I said, I don't mean to offend you. May we try cannabis for appetite because they're popping up everywhere. And it's doc shut down, nothing about it, go for it. So we didn't have medical benefits that we knew it would help with appetite, munchies. And that's exactly what it is. And he hadn't been eaten for about three weeks. And so within 24 hours, we started eating, we said, oh, my gosh, it worked. And he'll pass peacefully. And it went a day, five days a week, six months. And he just passed about a year and a half ago from old age, not a cancer. So but that's the portion of the benefits of this planet. It's not, you know, to me is not going to get out of the Grand Slam, like we did with their father of saving a life and definition of helping for me is saving a life which I want to do with Corinne. And I'm certain Jim want to do with the sunrise and others are extend life, as you mentioned, appetite, anxiety, depression, mood, pain, sleep. And so hearing you share about this, and what's by the bedside, has brought back a lot of memories. My memory bank was going through this with Corinne, and hearing a lot of other patients going through I mean, in 1985, I found out after, I didn't find out till 2010 When I was sharing with my family what we were doing launching the site. And my mom said, Did you know your grandfather in 1985, in San Francisco, his doctor said to my kid, and he had colon cancer. And he said, I'd like in Merritt, San Francisco, I'd like you to try marijuana, marijuana. And my grandfather said, Are you out of your mind? I've been against drugs my whole life. And you're wanting me to do it on my deathbed. How dare you give me the give me the morphine. I said, Mom, who was that doctor? She I don't know, it was so long ago, but showed that that doctor in San Francisco was so ahead of his time. And so hearing you talk about the lock and key about administrating caregiver or the patient, yet, there's no blocking key on the morphine or the other pills that are sitting by their bed. And that's, that's, that's the part that that I totally chuckle about.
Leah Johnson, PharmD 12:16
Well, it's just and it's the funny thing, it's like, okay, so a nurse can administer morphine to these patients, but they can administer cannabis. Like, are you serious, like cannabis is so much less harmful, cause a lot so much. I mean, the other thing that people don't realize about morphine, I really want to mention this to your audience, especially for the patients out there is morphine stops the pain by stopping by blocking certain receptors in your brain. However, what people don't realize is those receptors are actually in your stomach as well. So you blocked those receptors, so it makes your brain stop feeling pain, but it also makes your stomach stop moving. And it stops with its stops the digestion. So causes the pain it causes the buildup causes the not eating, the cannabis doesn't do that it has no effect on that. So the patient can eat, they can actually, everything functions like normal, really, cannabis just brings them to a homeostasis. So I would like to I really hope there is actually a bill right now called SB 2302, which is to extend Ryan's law to all patients in California over the age of 65. In Long Term Care for inpatient facilities, with obviously, ailments, you know, they still need a recommendation in our card just to document that they do have an ailment that cannabis is helpful for. And this extension will be really great for a lot of patients to get what they need without being on drugs and on especially harmful drugs. But what we're hoping changes in that new law is that healthcare professionals in the state of California, specifically, nurses who are administering meds can give the patient the med. So that because, you know, family is not always there, you can't be there. 24/7. So if, you know if you've got mom in the hospital, and she's just are not in the hospital in long term care, and she's in pain, you know, you can't keep running back in the middle of the night to give her her cannabis where there is a very competent, very intelligent nurse right there that can give her exactly what she needs. And the only thing that nurse needs is just the protection of her license. And that doesn't seem like too much to ask for
John Malanca 14:22
it. But it is fearful because I work with a lot of Doc nurses and doctors not only here in California, but throughout the states that they have been given written warning more so nurses, you know, have been getting written written warnings and even when we apply for CME courses, and some of these nurse nurses have been told no, you cannot teach these courses or we will take your license away. And so thank you for that. Ryan's law used to be SB 311. And now it the California State Senate Bill 988 and then you're changing it to 302 Did I hear you um, bouncing around.
Leah Johnson, PharmD 15:01
Yeah, so 311 was where it started. And then the number you mentioned was like the current one. And but it was really just to kind of clarify 311, where this is actually an expansion of, of the of the bill, which we're really excited about, because it really takes it to another step. But a lot of organizations, the, I can't even tell you how many organizations came out to talk about this new SB 302. Again, the expansion of Ryan's law, it was the Society of cannabis clinicians came in to talk about to support it, our organization, the California Society of health system, pharmacists, just every all these giant organizations really came in to say, we support this, but we want a couple amendments to protect health care professionals, because that's our biggest thing is, we don't want health care professionals to ever be afraid of helping a patient. And that's kind of where the law is now is they're not supported to help these patients because they're not supposed to be involved. But we want to get them involved, we want to be that allowed, allow them to give the patient the meds they
John Malanca 16:07
need. So again, the compassion access to medical cannabis act of what this is about. It's requiring specific health care facilities to allow terminally ill patients to use medical cannabis within the healthcare facility, as well as at home under guidance with hospice as well. So they may feel competent, that they're able to administer this type of medicine to their patients. And for you, family members, as well as patients. Asking a question is not illegal. And so I don't want you to be afraid to ask and I get that quite a bit. John, I didn't want to ask my doctor, I didn't want to ask my nurse, one because of stigma and embarrassment. But two, I didn't want to get in trouble. Or be considered a drug addict. I hate to hate that word. But but you have a lot of fear. And so please, no, doesn't matter if you're in a legal state or illegal state here in California or not, you can still ask the question. And if your doctor is not familiar, contact myself contact, layup. But also, if your doctor is not familiar with cannabis, ask them if they can recommend another doctor nowadays 2023. I guarantee they know 10 1250 People in their Rolodex that are up maybe on laws in their state, but also know about the endocannabinoid system and the benefits that this plant has to offer. And so I know you're in the middle of work. And I want to honor Your Honor, Your Honor, Your time could you have to go back to work. But is there anything that I'm missing out that I that I want to? I don't want to walk away and go?
Leah Johnson, PharmD 17:48
Of course, yeah. For all information, actually. So it's really great to if you have more questions about Ryan's law, or specifically the pharmacist, cannabis Coalition of California, you can go to www dot P, CCC, rx.org. And we'll have all that information. We actually have webinars we put up we have CES, we put up we have a lot of data, a lot of info, and our biggest focus is really, we're a nonprofit organization for a reason. Our goal is just to get that education out. And actually exactly what John said, if you have a provider that's not and I'm gonna take it a step farther, not just doesn't know about Canada, this but it's anti cannabis, find a new provider, I say this to all patients looking for it, the worst thing you can do is lie to your physician about what you're taking, because that causes issues with other potential things they might prescribe. You want to doctor even if they don't know too much about it, but they're willing to talk to you about it. That's what you want to do.
John Malanca 18:49
Yeah, it's just something that I share with everybody to cannabis because it works for you or your loved one or your aunt or your uncle or your friend. And there are the same age as you or your loved one or your friend. Cannabis is not a one size fits all type of medicine, age, weight, current health conditions, sensitivities. But as Leah was talking about drug to drug interactions are very important. That's why it's very important to have this discussion with your doctor saying this is what I'm considering using Are there any drug to drug interaction because there are drug to drug interactions with any drugs? Not only with cannabis, but with alcohol and combining? Is this something on your website www.pcccrx.org that you share about drugs or drug interactions? Yes,
Leah Johnson, PharmD 19:37
I believe we're actually we're just finalizing the document actually to put up. But we do have that because, you know, there's, you have to be very careful when looking at general like if you go to drugs.com or rx.com and it literally says cannabis interacts with everything and that is not true at all. I mean, any medication that goes on the CIP receptors, which is all most medications, we will interact. So the biggest thing you want to look for is the specific medications that interact. And we will and that will be on the website, as well as just a lot of more information about usage about we have a lot of FAQs that a lot of people like facts and questions that people have. So really, we're I mean, we're happy if there's anything you don't see, our email is right there, reach out to us ask us questions. You literally will have six pharmacists and all of our members at your disposal to answer your questions at the best of our ability and to provide you we can provide you research, we can buy new studies, so providers out there that don't know about cannabis but want to learn about cannabis, come to our website, ask us we can if you say please provide me studies on pancreatic cancer, I can do that. Our organization can do that. And we are happy to do that. We want the education out because want we want people off of these meds that are unnecessary when a much safer and more reputable medication can be effective for these patients, especially in their time of need at the end of their life.
John Malanca 21:04
And well said You know, we don't want anybody to suffer. We don't want to lose our loved ones either. But we don't want them suffering at this time in their life as well. Not only for the patient, but also the the family members watching their loved ones going through what they're going through. And so but Lea Dr. Leah Johnson with the pharmacist, cannabis Coalition of California PCCC I thank you always great to see you. And I appreciate you reaching out say Hey, John, can we get get this information and we're happy to do anything with you. So
Leah Johnson, PharmD 21:35
thank you so much for sharing. i We it means a lot to my organization. It really does. They were thrilled to hear that we that you that you thumbs up us coming to talk about it.
John Malanca 21:44
And so, everyone, you know, I had to get a hold of me Johnny United patient group. You can find Dr. Leah Johnson, as we mentioned on her website, and wishing you all a wonderful blessed day and we will see you soon. Thank you. Bye bye