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Developing the Cannabis Nursing Sector: Industry Insight with Elisabeth Mack, RN, MBA


Medical Cannabis is an exit drug.

An exit drug to sleep medications, antidepressants, and opioids.

It is now known that the long-term use of opioids for chronic pain is associated with abuse and overdose, and we are currently experiencing an opioid epidemic in the United States. As taken from the U.S. Department of Health and Human Services, drug overdose deaths are the leading cause of injury death in the United States and opioid abuse is a serious public health issue. Although prescription opioids are beneficial in managing some types of pain, their function is to mask pain as opposed to fixing the underlying issue, causing even more harm to the body later down the line.

The overuse of opiates for treatment highlights the shortcomings of Western medicine in that it views the body as individual parts, as opposed to an interconnected whole – providing solutions for SYMPTOMS as opposed to the actual PROBLEM within the body. Holistic (“wholistic”) wellness, on the other hand, follows the whole-person concept and treats the mind, body, and spirit as one. Treatments in this realm focus on all aspects of the underlying issue and is much safer for your health; however, a common perception of this type of healing hasn’t developed yet.

Cannabis medicine is going to be the sector that imbeds holistic aspects into future businesses; therefore, the necessary switch in our collective outlook going towards natural, holistic healing is going to be led by the cannabis industry.

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Photo Credit: Corina Jenkins

Cannabis is the only natural alternative to harmful pill-popping that will manipulate our internal operating systems to fix the underlying problems; but if we are going to call it medicine, we have to prove it. We’re still competing against big pharma, medical complexes and government regulations, and in order to rise above, the cannabis medicine sector needs a shape-up.

Here to lead the defining of medical management in the cannabis nursing sector is Elisabeth Mack whose work may be the key to having insurance cover holistic practices in light of our failing medical system.

As an industry leader, an involved cannabis community member, and as an experienced healer in both Western and holistic medicine, Elisabeth Mack shares her insight regarding her work in evolving the cannabis nursing sector, the importance of creating an acceptable business culture in the cannabis industry, the necessity of holistic aspects in cannabis culture, and takeaways for medical students.


Brief Introduction


Elisabeth Mack is an Alternative Medicine practitioner with 30 years of experience as an RN. She earned an MBA in Healthcare Administration and holds a Bachelor of Science in Nursing, and a Bachelor of Arts in Psychology. Her background also includes Operations, Service, Account Management, and Sales Management of several health insurance carriers.

Elisabeth believes that cannabinoid medicine offers our best chance at true healing in a more holistic, economical, and empowering way. In 2016, Elisabeth brought this experience and expertise into the foundation of Holistic Caring of which she is Founder and CEO. Managing cannabis for medical patients is a brand new world in medicine, and Elisabeth feels called from a logical and spiritual place to help guide and develop this option – bridging the gap between traditional and cannabis medicine.

Her high involvement in the cannabis community as a member of the Society of Cannabis Clinicians and as a board member of Women Grow and the American Cannabis Nurses Association makes her perspective of the cannabis industry a highly regarded one. Her position as a cannabis nursing sector leader is admirable, and we were fortunate enough to interview her and gain even further insight on the development of the industry in general, and on the evolution of the nursing sector within cannabis medicine.


What’s your opinion on the cannabis industry’s public perception?


Although the perception of the industry has improved over the years, it still has a long way to go.

What makes a “Cannabis Professional” is inherently unclear. The definition lays somewhere between a trained professional who has entered the cannabis industry, and an individual who considers themselves a professional at participating in their cannabis adult-use rights. Elisabeth Mack insists we need more of the former to ignite mainstream influence on changing the public’s perspective that currently demonetizes the industry, presenting a call-to-action for the industry.

“It’s difficult. Things within the industry need to change  before the public’s perception changes, but it’s moving slowly.”

– Elisabeth Mack, RN, MBA

The Cannabis industry is still set up on the recreational model. It really, really is.

For the stoners, by the stoners. And that’s not ok!

Right now we need to build the bridges to get the professionals to come into this industry and actually take it seriously, to believe some of the things we say as far as what cannabis and hemp medicine can do in the body. They’re not going to believe it as long as the industry looks the way it does and it is represented by the people that are representing the cannabis industry because largely it’s still stoners. The public perception needs to change and people like me that are coming in need to be able to spearhead that.


How about the public’s perception of your segment of the industry?


“There is no public perception to what I’m doing.”

– Elisabeth Mack, RN, MBA

My particular segment is cannabis nursing and giving the industry a supported, educated, connected and empowered patient. That’s my role, is to create that on the patient side.

But I’m building a company in an industry that does not exist.

The cannabis industry exists for people who want to get high, but the cannabis industry does not exist for medical management. That’s what I’m saying is completely non-existent.

You got a couple people in different pockets of the country that are doing telephonic guidance with patients and it’s just call and skype visits.

But I have a different vision. I believe patients need more handling, more support in the field, more help getting connected to product. And how do they know where to find products, who to trust, how to get consistency and reliability in the products that you buy and exactly how to use it and how to take it for the first time. Actual hand-holding support.

As I’m literally starting this from scratch – there is no public perception of what I’m doing. I’m going and marketing to the physicians, to the holistic health practitioners, to the service organizations, to the patients themselves and support groups, trying to get on the agenda saying cannabis medicine is an option. You need to know about it. Here is how it works. Here’s what we do.

My due diligence on the industry itself is like a whole other realm, because people don’t want to be accountable for consistency and reliability in product standards and manufacturing things that are pharmaceutical grade. I’m trying to demand from the industry, but they might not want to be held accountable to yet , but I can’t bring patients until they are.

The industry in itself is absolutely in its infancy so there’s a lot of work ahead of us.


In regards to what you do in defining patient’s exact needs, do you believe your work is a missing piece to “standardizing” patient care?


Taking a diagnosis inclusionary of the western approaches and then integrating cannabis into a treatment plan for complex diseases takes time, knowledge, and research that few practitioners have. She states, it’s part science, and part art.

Everybody’s body is different, everyone has a different ECS [endocannabinoid system], everyone has a different reactivity to this medicine just as people have different reactivities to coffee and caffeine.

There are treatment protocols that we have as a starting point, but then everything else is all adjustments that you make.

The starting points and treatment protocols that we can establish as clinicians – that’s the science!

The art of medicine is where you make all of these adjustments, it’s the – How do we treat it? How do we balance it? How do we adjust this medicine? How do we know when to add in some THC, when to add in THCA? How do we know when to add in whatever is next? How do you know any of that stuff.

When I get an average 70 year old person, they take their pills because it’s time. They don’t listen to their body, and so that becomes Step 1. They can’t move through the cannabinoid medicine system if they don’t listen to their bodies.

I move very intuitively with my patients because there is no cookbook medicine. I’m writing clinical pathways as we speak.


Where do you see your segment of the industry in 10 years, by 2027, if everything progresses as you hope?


“In 10 years I see nurses as peers to everybody else on the holistic side; whether that’s the holistic health practitioners, the integrative physicians, the integrative medical providers, people that are approaching things from a much more holistic standpoint.”

– Elisabeth Mack, RN, MBA

I believe that we need to teach people more of a holistic approach to medicine, period. And that the nurses that are following in what I’m building needs to understand how the body works, how the mind works, how they’re interrelated. How these specific diseases, the inflammatory processes that go on into our body and how that affects everything else in our state of disease and poor health.

It’s trying to get people to realize that holistic medicine makes sense and doing a cost-benefit analysis.

Painting an economic picture of here’s how we do sick care in America, here’s how we spend insane amounts of money to finance how to get well – and it’s not working.

So in 10 years I see nurses as peers to everybody else on the holistic side; whether that’s the holistic health practitioners, the integrative physicians, the integrative medical providers, people that are approaching things from a much more holistic standpoint. Trying to get them all on the same page and to realize that we need reimbursement in medicine for this kind of path.

It’s still a long way off, right now it’s private pay, but that goes back to educating the consumer that look, you guys have $5,000 deductibles now, you have $100 co-pays to see doctors anyway, why not spend $100/hour with one of us that is actually going to say, “Let’s look at what is going to affect you in a much more multi-disciplinary system of your body, rather than just taking a pill for a specific reason – because that doesn’t work, and it hurts you more than it helps you.”

Everything is so related, and the crazy thing is that I can’t say where this is going to be in 10 years, but I hope I’m going to have nurses throughout Southern California by the end of this year that are trained in Cannabis Medicine and are seeing patients. Teaching them all different kinds of ways to approach wellness, and how to integrate what makes sense for them specifically.


Can you provide your insight on the holistic aspects to cannabis and cannabis businesses?


The body, mind, spirit, has to be universal – not only in cannabis medicine, but in life.

– Elisabeth Mack, RN, MBA

People need to realize how interconnected their mind and their body is and all over the world, not just the United States, or their city or state. People need to know that they are connected to each other and to source energy.  It doesn’t matter what spirituality or religion. They just need to connect to something that’s bigger than them, they need to take care of their body, and their mind, and the people around them and if they started a practice that way our world would change. Big time.

The cannabis industry NEEDS to focus on the body, mind, spirit – because it’s sacred.

This plant is causing reactions in your body that are not just at that cellular level but in the spirit, in the mind. Cannabis is a recreational drug because it alters your perceptions, your consciousness, your mood, your connection with others.

If you have a group where people are a little bit tight – you pass around a joint, and all of a sudden they’re into the whole, they’re laughing, they’re communicating, they’re open, they’re smiling, and things are different.

Well what changed? Something is very sacred about this plant.

People need to respect it and realize that it has so many different properties that are not just on a physical, cellular level, not just a spiritual level. It’s so multifaceted and people need to realize how precious an opportunity we have. To affect change on a global level with this plant.

It’s not just wanting to make money in the weed industry or wanting to make a difference because you’re a hippie or idealist. You need to merge everything.

What I set out to do is to merge business and the medicine of cannabis while trying to lay that groundwork in getting people to take a holistic view regardless of what segment of the industry you’re in.


What do you believe the industry currently needs?


“What the industry is lacking is real medical professionals and they’re just too scared to come in because they don’t believe it.”

– Elisabeth Mack, RN, MBA

People think, on the cannabis industry side, that they can dose and guide patients regardless!

One of the things that drives me craziest is the fact that you go to a dispensary and you’ve got a 22 year-old budtender telling someone with Parkinson’s how to manage themselves – how to manage cancer, how to manage the signs and symptoms of rheumatoid arthritis, fibromyalgia and everything going on. How to smoke their vape pens or take the edibles, and there’s no real guidance on anything from the cannabis industry.

The problem that I have with that is that they think they know what they’re doing.

They say, “It’s just a plant, you can’t die, nobody’s ever died from cannabis”

But they’re missing the point in so many different ways on how to practice this safely and how to actually guide a patient to know how to integrate cannabidiol and CBD with THC and when to time it.

Whether you’re a patient that has rheumatoid arthritis and have severe crippling pain or you’ve got cancer – when do you take it? How do you take it? Should you have syringes of concentrated extracts? Should you buy the RSO oil? How many milligrams do you need? Can you take the CBD with the THC? How much CBD do you need to THC, what ratio? Do edibles count when you’re trying to get a milligram per day? How do you do a patch? How do you do gels? What about topicals, does it cross into the bloodstream? Do cannabinoids even get through the blood vein barrier?

None of these people know any of this stuff.

They are actually out in the field practicing medicine because they think that they can and that the plant is so harmless…

But do they know it drops blood sugar? Do they know it drops blood pressure? Do they know how it interacts with alcohol? Do they know how it interacts with the other pills the patient is taking? What kind of blood levels should you get on those pills? How do you talk to your provider?

There’s a million reasons why people out there need a saner approach to this and they need a Holistic Caring nurse to go in there and say here’s what is really happening and here’s how to talk to your provider and here’s what you need to tell them. And bullet-point it out.

The patient goes to their provider and the provider doesn’t know how cannabinoids work. And the people at the dispensary don’t know how traditional medicine works.

As long as we have this disconnect, we are going to drive people crazy, and it’s why companies like mine have to exist now.

What the industry is lacking is real medical professionals and they’re just too scared to come in because they don’t believe it.

The spectrum of the patients that are out there that are able to be healed is broad, but nobody knows what they’re doing. From the medical professionals that are guessing at cannabis that are saying, “It might help, give it a shot,” or budtenders who are saying, “This is what you do, and this is how you do it.”


What is something currently growing the industry in ways you’re proud of?


Elisabeth made it a point to address the fact that the industry still has a long way to go in regards to the creation of standard operating processes, policies, and procedures; but we cannot neglect all the progress the industry has made in other areas.

I think the standardization in processes of products that are going to be delivering to the market is something that we can count on.

When I instruct patients how to use their edibles I want to know that the square on the left and the square on the right are the same.

The industry is moving in very good ways to give me that as a practitioner for my patients. That reliability.

I applaud them for moving towards standardization of procedures so that I can guarantee the patients that they are going to be able to take this medicine predictably and reliably.

That’s moving forward for sure. Let’s accentuate the positives of what we are working on so that people pay attention and believe what we say.

If we say it’s medicine, prove it.


Do you think government support will come after the standard operating processes, policies, and procedures are created?


Cannabis is still federally illegal and that poses as a big issue to progress. The BMCR (Bureau of Medical Cannabis Regulations) is currently writing regulations predominantly on the product side as far as consumer safety; but the growing pains within this market, between the industry and the regulators, are going to be felt together, Elisabeth continues.

It’s going to develop, I think, in tando with the regulations and the industry.

Most people, honestly, just need to be told what to do. “Well fine, I’ll follow the rules, but what are they?”

So somebody has to say, “Ok I’ll lead”

People like me are the ones who will step up – yes I’m walking in the dark too, but I will lead and will develop the standards and then give them to the regulators and say “here we go, what do you think?”

It needs to be a dialogue between all sides. So hopefully the policies and procedures that were instigating will be – the regulators will adapt and be able to press forward with those that follow.


 As a part of Hemp Educate America’s mission we aim to increase Millennial involvement in the industry and for that purpose I’ve extended the article to include additional questions regarding formal education and the holistic medicine pathway for students.

If you are a current college student looking for further insight into the cannabis medicine path, please continue reading below:


What are the disconnects between the world of academia, or formal education, and the cannabis industry?


“Formal education and cannabis are mutually exclusive.”

– Elisabeth Mack, RN, MBA

Formal education and cannabis are mutually exclusive. There is no formal education with respect to cannabis.

You have organizations like Oaksterdam University and things like that, but people don’t believe any of it yet.

The scientific community, if you’re talking biologists, microbiologists, biochemistry, neurochemistry, they believe it.

They believe that there’s an endocannabinoid system.

They believe you can influence changes physiologically in the body by manipulating the system, but this is not getting into mainstream medicine, and mainstream medicine doesn’t believe a whole lot either.

I think until it’s federally legal in a bigger way, I don’t think anybody is going to move on this.

You’ve got somebody like me who’s putting together a company that is based on what we know today and having a lot of faith and hope, but I am divinely guided and feel completely led and called by God to do this, to build this bridge.

And I’ve got to bring other people there, and then when the feds move and it’s no longer illegal, it’s not Schedule I, then we can start to study it and the research will come and the scientists will come in greater numbers and that will get the medical community on a formal education basis to say, “ Ok, let’s put this endocannabinoid system in the curriculum.”

Let’s say, “Ok it probably is one of the chief regulating operating systems of our body and it really does have all of these impacts and these little levers throughout the body really affect great change so we can heal.”

But we’re a long way from that. We’re probably 5 years away from that.

Right now there is no such thing as formal education and cannabis, they really are mutually exclusive.


In your time as a student, professional, and cannabis nursing industry leader – what are some key takeaways or advice you would offer a medical student that has an interest in cannabis as a field of study?


First thing they need to do is know the endocannabinoid system and to be able to understand from a molecular, cellular level what’s happening with communication between the cells, at the synapses – how the endocannabinoids get in there and do what they’re supposed to do; how they get deficient with our autoimmune disorders, chronic stress, with cancer, with everything that goes on in the body.

The nursing students need to learn how this regulatory system called the ECS balances everything, how it goes wrong, and what supplementation does, and how to not be afraid of adding the plant into our body and how that works to supplement the endocannabinoids in their work between the cells.

So with nursing students, medical students and anyone studying this stuff needs to understand is that we can rebuild these roads if done right, but it’s a multi-faceted approach.

We need to learn how holistic medicine works together with the cannabis plant and how to take a patient through that so that they can regain their health, their hope, and optimum functioning.

And why that’s so important is that modern medicine uses pills to just treat a symptom, but is not fixing the cause. Cannabinoids will get in there and actually fix it and they will reestablish that pathway to healing.

Nursing students need to learn basically to explain, in simple terms, how the endocannabinoids work, well enough so that a regular person understands.

We need almost like a video for kids to explain it in those kind of terms so that people understand that they don’t need to be afraid of cannabis and, if done properly, they don’t ever need to be high.

I need to tell nursing students that that’s step one – don’t be afraid that you’re going to walk around being stoned all the time because you don’t have to.

I have a tag line for Holistic Caring “Heal without the high” that’s Cannabis medicine simplified.

If we can fine tune and balance out the reactions between the cells throughout the body, we can heal. We can rebuild that road to health.

But it takes someone brave enough to try.

Learn the endocannabinoid system, learn the basics of it , and be able to say, “Here’s what makes sense, here’s how it works, and let’s just give it a try.”

I would tell every student that you need to start studying it. Learn the diagrams and how the processes in the body work. Remember biology. Go back to the Krebs cycle. It’s all about energy use, mitochondrion, all this stuff that you didn’t want to pay attention to in school – but the basics of it because it really does matter.

Everything that happens wrong in the body, goes wrong at a cellular level.

If you can figure out how to right the ship within that cell and get the mitochondrias to work correctly again, guess what, we now have cures for autism, fibromyalgia, for MS, for all of the things that go wrong in the body.


In closing, it’s clear the cannabis industry needs to build an acceptable business culture so that we can further destroy the stigmas that linger on particularly in the community of professionals.

We need to continue the dialogue and continue educating ourselves and others so that we can then, from collective effort, remove legal hindrances and advance the research of this entire plant family.

Share this article. You never know who needs to see that cannabis medicine is an option.

We’d like to thank Elisabeth Mack not only for her time in providing us with valuable content for our readers, but for all that she is doing within the cannabis community for the health of the people. If you know of someone who would benefit from holistic treatment, please send them to Holistic Caring (www.holisticcaring.com).


About the author: Alanna Hinds is a millennial entrepreneur in the legal cannabis/hemp space known most notably for her brainchild, Hemp Educate America Foundation. She has published numerous articles on the benefits of the cannabis plant family and offers her content as a means to increase student involvement in the building of the green economy in the United States.


 

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