Cannabis Basics: History & Law, Science, Purpose, & Advocacy

In February, LBCA hosted Pam Chotiswatdi, MPH, for an event titled, "Cannabis Basics for the Cannabis Curious".  We had such positive feedback after this event that we asked Pam to share the information she presented for those who missed it. The following is what Pam had to say about the event. 

It was a pleasure to facilitate the first "Cannabis Basics" workshop at Long Beach Community Acupuncture. I’ve always been a cannabis supporter, but never an active advocate until I was studying for my Masters of Public Health degree. During this time I had access to a range of studies, reports, and data, and started to look deeper at the cannabis movement, related policy history, and scientific studies.

I observed in my readings a fair amount of misinformation as well as data that was skewed by bias (arising from stigma surrounding cannabis).  I also felt there was a lack of a community perspective and that reports from the "cannabis sector" did not tell the whole story. 

For this reason, I make a point to share the whole story surrounding cannabis when I speak to communities. The following is a summary of our discussion into Cannabis History & Law, Science, Purpose, and Advocacy.

- Pam C.

Read More:

Click here to read more about Cannabis History & Law 

Click here to read more about Cannabis Science & Research

Click here for a Discussion of Medical vs. Recreational Cannabis Use & Public Health Concerns

*DISCLAIMER: It is important that clients rely on advice from their healthcare practitioner to employ sound clinical judgment for their specific conditions. This information is not intended to be a substitute for the advice of a healthcare practitioner nor a recommendation of any particular treatment plan. Please consult with your physician or healthcare practitioner for professional advice pertaining to your particular disease state.

More About Pam: I am a big believer in credibility – academic and street. So, a little about me: Born in Downey, California, I moved around a bit to surrounding cities and counties with my family and then on my own. I moved to Long Beach while earning an undergrad at CSULB – Go Beach! I have spent the last 16 years in Long Beach. I married a Long Beach local and I call the city by the sea my home. I earned a masters degree in public health, specifically in health education in January 2017 and transitioned careers--from being a 10-year editor at a local publication to helping a Long Beach nonprofit. Most recently, I took a key position to help the cannabis industry with health education. Find my blog CannabisCloset.org and on Instagram @cannabiscloset and Twitter @canabiscloset

Community Acupuncture, Distal Treatment, & Trauma-Informed Care (TIC)

“Trauma Informed Care (TIC) recognizes that traumatic experiences terrify, overwhelm, and violate the individual. Trauma Informed Care is a commitment not to repeat these experiences and, in whatever way possible, to restore a sense of safety, power, and self-worth.”                Trauma-Informed Oregon

As I followed the trial and sentencing of Larry Nassar, the doctor who molested young female athletes for decades, I was reminded of how often private medical settings can be places for traumatic events. Whether allopathic or holistic, small private offices can be triggering for people who have experienced sexual assault during what was supposed to be a routine visit. Even if the trauma wasn’t physical, it may have been verbal or emotional, as when a practitioner berates a patient for being overweight or not being able to stop smoking.

What does this have to do with community acupuncture, you might ask? Well, POCA clinics have been discussing ways to address trauma in our communities and all of us are working to provide trauma-informed care. In this blog, I’d like to focus on two aspects of community clinics that help us learn to support people with trauma histories: the group setting and distal needling.

The main defining factor, other than cost, of community acupuncture from current private models is the group treatment room. Not only does it enable us to keep our fees as low as possible but it can allow patients to feel safe because they are not alone with a practitioner in a small private room. Depending on the traumatic experience, a group setting might not work, but often in a community space, patients experience a sense of safety; they can easily see others, and if a patient is new and nervous about how needling might feel, watching people get treated, seeing them relax--even sleep--can be calming.

Best of all, patients do not have to disrobe. This is good for practitioners and patients alike. Even in holistic offices, disrobing and lying on a table while the practitioner remains dressed, standing over the patient, can be re-traumatizing. Most often at LBCA, we ask that patients expose forearms and lower legs, so that we can treat their issues “distally”--meaning away from the site of pain or organ system. This approach initiates one of the main questions we get. When we treat back pain, for example, someone always asks: How you can treat my back, if you aren’t going to put needles right where it hurts?

As a practice, acupuncture acknowledges that body parts and organ systems are interconnected and that the pathways of the acupuncture channels (or meridians) are inter-related. Some of our best points for back pain are on the hands and feet! As a POCA volunteer writes, “While there is an emerging body of research on the efficacy of acupuncture in general, there is no research or data that compares the efficacy of different styles or systems of acupuncture. Anecdotal reports suggest that all systems and styles seem to work equally well.”

Distal needling offers us many advantages. In general, it is safer than “local” needling, especially around the chest and shoulders; there is little possibility of puncturing organs, like the lungs. And in terms of trauma as a “wound”--whether it’s physical or emotional--I prefer not to stick a needle right into a wound. After providing over 15,000 treatments myself, I know that distal treatment works more often than not and I learn more and more every day. Sometimes I treat locally, depending on the problem and how it has responded, but my favorite treatment styles are those of Master Tung and of Richard Tan--distal treatments that can address almost any issue from musculoskeletal problems to organ dysfunction.

Distal treatment allows us to be transparent with what we are doing: patients can watch, if they want, when we insert and remove needles. As a mutual experience, we encourage them to let us know if there is discomfort or pain and honor requests to remove or adjust needles if they are uncomfortable

Any practice is a learning process and as we work to implement TIC into all of our systems, from the front desk to the treatment room, LBCA consciously adheres to the principles of TIC: safety, trustworthiness and transparency, peer support, collaboration and mutuality, empowerment.

Whenever anyone seeks help from a doctor, acupuncturist, chiropractor, massage therapist, reiki master, or psychic, they are admitting that they need help, which is not always easy for people to do. It is a vulnerable position to inhabit and people, generally, do not feel empowered. Our goal is to empower patients and establish trust. Treating in a quiet, common space, and using effective distal treatment are two of the ways we try.

This is the first in a series of installments on TIC and community acupuncture. Stay tuned!

Embracing Uncertainty and Finishing Well

…the three noble principles: good in the beginning, good in the middle, good in the end. They can be used in all the activities of our lives. We can begin anything we do--start our day, eat a meal, or walk into a meeting--with the intention to be open, flexible, and kind.
   Pema Chödrön, The Places That Scare You: A Guide to Fearlessness in Difficult Times

I don’t know about you, but 2017 has proven to be one of the most challenging years for me. My father passed away in February and that event alone pushed me up against discomfort, sadness, and fear in ways that nothing else has.

Like everyone else, I’ve watched daily as our nation struggles to comprehend and adjust to our new political administration. I’ve read the bios of people who have been murdered in mass killings, seen devastating photos of fires, floods, and earthquakes, and often just can’t believe that something else horrific is happening---again--this year.

I’ve treated people who are experiencing nothing short of shock and trauma from these and other personal experiences--some remembering harassment and assault, some mourning their own lost loved ones.

Throughout the year though, LBCA has held me steady and I know that it has been a source of stability for others. My colleague, Nirva, wrote eloquently of the radical acts that take place in our clinic every single day. Indeed, the wonderful moments we experience with patients are a salve, a balm countering the troubles and fears that exist beyond our concrete walls.

2017 has been a year of uncertainty. No one knew what to expect after the January inauguration and we don’t know what 2018 will bring. These are difficult times to be sure. Chödrön is clear: “we can never avoid uncertainty. This not knowing is part of the adventure, and it's also what makes us afraid” (6). I would like to be less afraid, learn to work with discomfort, and enjoy the adventure of not knowing.

As the year winds down, I am thinking about how to finish it well. In any part of a process, it’s important to be mindful at each stage though we tend to gravitate toward beginnings, ignore middles, and rush through or avoid the endings. How will you finish this year well? Being “open, flexible, and kind,” seems like a good starting place.

The Radical Act of Community Healing

As I reflect on this year working with you, I’m not sure I expected to see a space for healing as an integral part of community.  But that’s what Long Beach Community Acupuncture has become for me.  This space on its own is a combination of chairs and concrete.  But everyday, we come to this building and we talk about our pain, joy, sadness, fears, and the desire for balance or release.  These rich conversations breathe life into this old building.  And for these reasons we all have a stake in this community. 

This was most apparent to me in the first month I spent with many of you.  You welcomed me so warmly over and over again.  And you all said the same thing “welcome to our community.”  And it floored me.  Looking at this moment through the lens of my previous career as an urban planner, I know that creating community is not an easy thing to do.  So it has been profoundly important to me to honor and respect that sense of community and commitment you all feel in connection to your health and this space. 

Community acupuncture is so wonderful and it has provided me the environment to extend the values I cultivated in my previous career into this work.  As acu-punks we are committed to providing affordable and accessible care that cuts across race, gender, ethnicity, language, and sexuality.  In this way, we come together to uphold the values of unity, equity, and justice—a radical act. This is what brought me to your community and to this type of practice.

On any given day, I am treating people of all walks of life, from women of color, to immigrants, to men, and limited English speakers, as well as people of differing ability, income, and class.  It is beautiful to see you all lying there in your chairs side by side unified in your healing.  And that is such a significant way for communities to heal.  

Personally it has been such a joy and honor sharing space with all of you over this past year.  I am so happy to be your community acu-punk.  Cheers to the clinic and cheers to another year working together!

Shining a Light

When my husband and I set out for our vacation, we weren't trying to see the eclipse. We were just seeking some solitude in the peaceful National Forests of Nevada before we made our way to Salt Lake City for POCAfest, a gathering of community acupuncture clinic owners and workers.

Being out in a remote area, we thought we might see something even though we were way out of the path of totality and far from crowds. The morning of the eclipse, no one else was in our campground that was shaded by well-nourished cottonwood trees. We made an old-fashioned view-finder to check and see if we could determine any progress of the moon shading the sun.

We walked in the dappled light of trees, noticing how the cottonwood leaves reflected and refracted sunlight. Glowing crescents patterned the dirt, George took pictures, and we carried our view-finder, checking periodically but it showed nothing.

We continued our road trip, checking the sun throughout the day, then decided we had simply missed the eclipse. But once we got to POCAfest, four days later, we were talking to an acupunk who works at WCA in Portland. He happened to be in clinic that day and stepped outside to see it; he explained how the eclipse had also created an interesting pattern through tree leaves: shining semi-circles rimmed leaves and created beautiful shadow and light patterns on the ground. Turns out we HAD seen the eclipse, we just didn't recognize it!

It was a happy revelation and as I think of it now, a great metaphor for how POCA has been for me: shining a light on the obvious and not so obvious, and helping me recognize certain truths.

When I first discovered the community acupuncture model, my heart opened wide; it was a visceral feeling in my chest and I knew I had to practice that way in Long Beach. I didn't need to travel to another country to help underserved people, as there were plenty of people that needed help and access to affordable healthcare right where I live.

POCA helped me see and know that acupuncture doesn't need to be expensive to be effective. It helped me understand better how acupuncture works and how necessary frequent treatments can be to solve and manage difficult health problems. POCA taught me how to develop and grow LBCA and it continues to be a beacon for me, reminding me of my own privilege to practice this medicine.

Members of POCA, like Dr. Tyler Phan and Lisa Rohleder, remind me of the hidden histories of this medicine--the elders and activists who have been elided by the formal history of the profession: Miriam Lee, Mutulu Shakur, Ing "Doc" Hay, and Master Tung Ting Chang.

POCA is a constant source of education and enlightenment, advocating and practicing trauma-informed care and creating the idea of Liberation Acupuncture that draws from the practice of Liberation Theology. All of these ideas can be explored on POCA's website from the thoughtful radicals who have developed them.

It's a good tune-up for me to attend POCAfest when I can. This group of fearless practitioners is actively working to improve acupuncture education and the profession at large and it all begins within one's community. The co-operative ethos of POCA acknowledges mutualism: we need our patients as much as they need us. Together we can begin to address the real issues of pain and suffering that occur in our communities every day.