Barriers to access: Plant medicine as constitutional right, part one
Dr. Shelley Turner CCFP FCFP, founder and chief medical officer of Ekosi Health Centre Corporation, and Spencer Hawkswell, CEO of TheraPsil, describe a patient-first approach to defending the therapeutic use of cannabis and psilocybin in the treatment of Canada’s most vulnerable.
January 17, 2023 By Haley Nagasaki
When it comes to therapeutic plant medicines, a one-size-fits-all model falls short. And the diversity of patients’ needs, their degree of education on the matter, as well as barriers to access must be taken into consideration.
Stringent government regulations surrounding cannabis taxation, in this case for medical purposes, are generally counterproductive. Meanwhile, opioids and other potentially harmful drugs may be freely accessed, posing problems on an individual and collective scale, while inequity and worsening economic conditions fan the flames that further these barriers.
This two-part piece seeks to explore the therapeutic benefits of cannabis as well as psilocybin from a medical perspective — from sleep and mood disorders to end-of-life psychotherapy — while making the case that community-based and patient-first organizations are leading the charge on bringing forth the diverse voices of patients and sharing the lived experiences of both patients and practitioners in an undeniably human way.
Compassionate clinics seek to continue breaking down the stigmas potentially playing into the political maneuvers that keep the people in need from accessing scientifically proven and safe treatment alternatives.
Ekosi (eh-goh-say) Health: Manitoba’s community-based healthcare
What Dr. Shelley Turner encounters on a day-to-day involves the limitations of allopathic medicine where medications prescribed to patients may have ceased effectively treating their symptoms. Many would like to explore other options to health management, particularly around issues of pain, mood and sleep, as well as other chronic disease states such as autoimmune disorders.
Canada’s aging population are among those whose conditions frequently require over 6-10 medications, some of which may have interactions or cause additional harm. Though the prevalence of autoimmune among young people is on the rise — the cause of which is largely unknown.
Physicians at Ekosi Health Centres take an intensive approach to patient consultation. Comprehensive screening processes turn patient constitutions into the hard data and statistics needed for further research and reference in the medical community. The juxtaposition then exists between supporting the heart-felt journeys of individuals with the intent of delivering their stories to the mechanical mind of governance in a reductionist way.
As a trauma-informed practitioner, Dr. Turner works to understand a patient’s history to better guide them on their healing journey and to ensure safety in providing access to a new medication or therapy.
Dr. Turner practices through Manitoba-based and Indigenous-owned Ekosi Health Centres, with locations in Winnipeg and Gimli, blending evidence-based and evidence-informed practices, harm reduction principles, in-house research and data collection, while including the patient every step of the way.
Ensuring the guiding principles of OCAP are upheld (The First Nations principles of ownership, control, access, and possession), Dr. Turner being of settler and Cree heritage, invokes a conscious approach to her work and the responsibility she feels guides her practice.
A patient presenting with chronic insomnia and pain may already be taking multiple medications. It’s for this reason, she believes, “the medical cannabis system is so important and needs to evolve,” because of the potential for drug-drug interactions and the possibility for cannabis to either inhibit or increase the effect of certain medications.
In addition, “support, education, and point of sale access is needed for those in rural communities, and better coverage is required for those where finances impose a barrier to health and healing,” she affirms.
Dr. Turner seeks to build bridges by sharing patient data, participating in research, and by encouraging patients to personally advocate for the medical cannabis system.
“It’s about bridge-building,” she says. “I think that supporting any research as it relates to plant medicine is hugely important, but it has to be done in a respectful way. And so how do we bridge those two together?” she asks. “Transparency and research is one way,” and that includes studies and clinical trials and support from our governing bodies.
(Case) studying the relationship between sleep and cannabinoids
Recently, Ekosi Health and Cerebra, a Canadian tech company specializing in sleep innovation and research, came together to conduct a study on the relationship between sleep and cannabinoids — or the potential role of cannabinoids in sleep hygiene.
Utilizing Cerebra’s specialized equipment, patients were able to use self-applied in-home technologies, such as Odds Ration Product (ORP) and in-home Polysomnography (PSG) to study individuals having sleep disturbances while mapping and scoring sleep architecture.
Subjects used different dosages, ratios, and combinations of cannabinoids throughout the study to determine what works for some, and what does or doesn’t work for others, in the creation of dataset compilations.
This is but one example of numerous studies and trials used to decipher the link (and its meaning) between the human mind and the medicinal potential of psychoactive compounds.
The rebirth of entheogens
Dr. Turner’s work in medicinal cannabis has branched out into the areas of maintaining everyday health and wellness, in addition to her interest in drug-assisted psychotherapy for the treatment of chronic illness.
After working with patients struggling with substance use, mental health and addictions, she perceives the exciting and hopeful research from her psychedelic psychotherapy colleagues as a way of moving the needle forward in research and support for patients’ living.
This has informed Dr. Turner’s continuing medical education by participating in Numinus’ harm reduction training, as well as the advocacy organization, TheraPsil, where she was honoured to participate in Cohort 21 under the guidance of Dr. Ingrid Pacey and Charlotte Jackson.
“We are on cusp of a major breakthrough in plant-based medicine for those that need it most,” she says, “and the numbers speak.”
With over 20 thousand patient interactions, Dr. Turner has woven an intricate patchwork of data to bring forth to skeptics, colleagues, and decision makers.
These stacked skills in the toolkits of medical practitioners ensures they will be well-equipped when other regulated substances become more available to the Canadian medical community, which, in speaking with Spencer Hawkswell, CEO of TheraPsil, may be as soon as early 2024.
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