Dr. Newton’s unique background, featuring specialized AI certifications in both healthcare and business, allows him to bridge the gap between complex technology and real-world professional application...
Embedded Files
Technology for Neuropathy
Teaching Opioid Alternatives
Breast Cancer & Med Cannabis (Basic)
Breast Cancer & Med Cannabis (Advanced)
CLINICAL CASES ....
CLINICAL CASES ....
Advanced Cannabinoid Medicine: Complex Patient Case Outlines
Advanced Cannabinoid Medicine: Complex Patient Case Outlines
ADVANCED CANNABINOID MEDICINE
Complex Patient Cases — Outline Format
Core Competencies Medical Necessity
---
I. FRAMEWORK OVERVIEW
A. 5-Pillar Documentation Model (The "5 Ds + Goal Monitoring")
1. DIAGNOSIS — Qualifying condition with specific ICD-10 code
2. DYSFUNCTION — Functional impairment quantified with validated tools
3. DRUGS/TX THAT DIDN'T WORK — ≥2 conventional treatments documented with dose, duration, reason for failure
4. DISCUSS + DOCUMENT — Risk-benefit-options analysis; patient-specific assessment
5. GOAL MONITORING — Follow-up schedule, outcome measures, UDS/PDMP, reassessment intervals
B. Complexity Tier Definitions
- Tier 1 (Low): Single qualifying condition, no high-risk meds, ASA I–II → 99213–99214
- Tier 2 (Moderate): 2–3 comorbidities, mild psych history, 1–2 CYP450 risks → 99214–99215
- Tier 3 (High): Polypharmacy ≥7 meds, active psych comorbidity, opioid/benzo co-use, CV risk → 99215
- Tier 4 (Very High): Active cancer, perioperative, psychosis/CUD history, organ failure, age extremes → 99215 + 99417
C. Key Complexity Drivers in Cannabis Medicine
- Polypharmacy CYP450 risk (≥7 meds → 2.61× drug-related intoxication risk)
- Psychiatric comorbidity (psychosis risk, CUD, withdrawal)
- Cardiovascular risk (THC-related tachycardia, orthostasis)
- Age-related vulnerability (≥65: falls, cognition; ≤25: neurodevelopment)
- Perioperative status (airway reactivity, anesthetic requirements, postop pain)
---
II. CASE 1 — PERIOPERATIVE SPINE SURGERY | TIER 4 COMPLEXITY
A. Patient Demographics
- 68-year-old male
- Scheduled for lumbar fusion surgery
B. Pillar 1: DIAGNOSIS (ICD-10 Codes)
- Chronic pain — G89.4
- PTSD — F43.10
- Hypertension — I10
- Obstructive sleep apnea — G47.33
- Insomnia — G47.00
- Cannabis use, uncomplicated — F12.90
- Long-term drug therapy — Z79.899
C. Pillar 2: DYSFUNCTION (Validated Tools)
- Pain: VAS, PEG scale, Oswestry Disability Index
- PTSD: PCL-5
- Sleep: Insomnia Severity Index (ISI)
- Cognition: MoCA (baseline, given age ≥65)
- Perioperative: ASA Physical Status classification
D. Pillar 3: DRUGS/TX THAT DIDN'T WORK
- Document ≥2 failed conventional therapies with dose, duration, and reason for failure
- Examples: gabapentin, duloxetine, physical therapy, NSAIDs, prior opioid trials
- Document current opioid regimen with MME calculation
E. Complexity Multipliers
1. Concurrent opioid therapy → additive CNS/respiratory depression
2. Age ≥65 → start ≤2.5 mg THC; screen falls, cognition, polypharmacy
3. Cardiovascular disease (HTN) → THC-related tachycardia/orthostasis risk
4. Polypharmacy (7 medications) → CYP450 interaction screening required
5. Perioperative status → anesthesia coordination per ASRA 2023 guidelines
F. Clinical Concerns
- Respiratory depression (opioid + THC + OSA synergy)
- Falls risk (age + sedation + postoperative mobility)
- Excessive sedation (CNS depressant stacking)
- Postoperative pain control (cannabis users may require increased analgesic doses)
- Withdrawal risk (abrupt perioperative cessation → irritability, insomnia, anorexia; onset 1–2 days, peak days 2–6)
G. Pillar 4: DISCUSS + DOCUMENT (Risk-Benefit Analysis)
- Risks: CUD, cognitive effects, cardiovascular risk, respiratory depression with OSA, drug interactions, withdrawal
- Benefits: Condition-specific evidence (ACP 2025: balanced THC-CBD → ~0.5–1.0 point pain improvement)
- Alternatives: First-line therapies not yet tried
- Perioperative plan per ASRA 2023:
- Detailed cannabis use history (route, frequency, dose, duration)
- Gradual taper — NO abrupt cessation
- Anticipate increased analgesic requirements postoperatively
- Enhanced PONV prophylaxis
- Monitor for withdrawal postop
- SPAQI recommendation: ideal 2-week abstinence for smokers/vapers
- Informed consent documented: driving/sedation, withdrawal timeline, realistic outcome expectations
H. Formulation Route Selection
1. Oral balanced THC/CBD tincture — nightly
- Rationale: Sleep + pain; oral/sublingual preferred per harm reduction hierarchy
- Start: 2.5 mg THC / 5–10 mg CBD; titrate every 5–7 days
2. Topical CBD/THC cream — TID PRN
- Rationale: Focal lumbar pain; low systemic absorption
3. Vaporized CBD-dominant flower — PRN breakthrough pain/anxiety
- Rationale: Rapid onset for acute episodes; CBD-dominant to minimize psychoactivity
- Caution: Discuss perioperative cessation timeline (≥2 weeks pre-surgery for inhaled)
I. Pillar 5: GOAL MONITORING
- BP monitoring (THC + HTN interaction)
- Cognitive screening (MoCA at baseline and follow-up)
- PDMP check every visit
- UDS at baseline and periodic intervals
- Perioperative coordination: written communication with anesthesia/pain management team
- Validated outcome tools at each visit: VAS/PEG, PCL-5, ISI
- Reassessment interval: Every 2–4 weeks perioperatively; every 4–8 weeks maintenance
J. Billing/Coding
- E/M: 99205/99215 + 99417 (prolonged services, time-based)
- Add-ons: 96127 ×4 (PCL-5, ISI, PEG, MoCA); 80305–80307 (drug testing)
- Document MDM: High problems (chronic pain + PTSD + perioperative crisis), high data (PMP + UDS + specialist coordination + imaging), high risk (cannabis + opioid + perioperative + age ≥65)
---
III. CASE 2 — PANCREATIC CANCER SURGERY | TIER 4 COMPLEXITY
A. Patient Demographics
- 72-year-old female
- Scheduled for Whipple procedure (pancreaticoduodenectomy)
B. Pillar 1: DIAGNOSIS (ICD-10 Codes)
- Metastatic pancreatic cancer — C80.1 (secondary malignant neoplasm); primary site C25.x
- Cancer pain — G89.3
- Cachexia — R64
- Hepatic impairment — K76.9
- Insomnia — G47.00
- Cannabis use, uncomplicated — F12.90
- Long-term drug therapy — Z79.899
C. Pillar 2: DYSFUNCTION (Validated Tools)
- Cancer functional status: ECOG Performance Status or Karnofsky Performance Scale
- Pain: VAS, PEG scale
- Sleep: ISI
- Nutrition: Weight tracking, BMI, albumin/prealbumin
- Cognition: MoCA (age ≥65)
D. Pillar 3: DRUGS/TX THAT DIDN'T WORK
- Document ≥2 failed conventional therapies
- Examples: opioid analgesics (with dose/duration/adverse effects), antiemetics, appetite stimulants, sleep aids
- Document current medication list (12 medications) with CYP450 interaction analysis
E. Complexity Multipliers
1. Age ≥65 → start ≤2.5 mg THC; falls/cognition screening
2. Hepatic impairment → altered THC metabolism (CYP2C9, CYP3A4); reduced first-pass clearance → increased bioavailability and prolonged effects
3. Immunosuppression → infection risk monitoring
4. Polypharmacy (12 medications) → extensive CYP450 interaction screening
5. Perioperative status → anesthesia coordination, PONV prophylaxis
F. Clinical Concerns
- Sedation (hepatic impairment → prolonged THC half-life)
- Altered drug metabolism (monitor for toxicity with narrow therapeutic index drugs)
- Nutrition decline (cachexia → THC may improve appetite; CanPan trial: 56% vs 30% appetite improvement)
- Postoperative analgesia (anticipate increased requirements)
- Hepatotoxicity risk (CBD + valproate → monitor LFTs; avoid high-dose CBD with hepatic impairment)
G. Pillar 4: DISCUSS + DOCUMENT (Risk-Benefit Analysis)
- Evidence base: CanPan Trial 2026 — first RCT in advanced pancreatic cancer
- Early cannabis improved pain (44% vs 20%), appetite (56% vs 30%), insomnia (67% vs 30%)
- Median THC dose: 7.3 mg/day
- ASCO 2024: Dronabinol/nabilone for refractory CINV
- Cochrane 2023: Nabiximols added to opioids did not significantly reduce cancer pain (SMD −0.19)
- Risks specific to this patient: hepatotoxicity, excessive sedation, drug interactions with chemotherapy agents, INR changes if on anticoagulation
- Perioperative plan per ASRA 2023 (same framework as Case 1)
- Informed consent: realistic expectations, hepatic monitoring requirements
H. Formulation Route Selection
1. Balanced THC/CBD tincture — BID
- Rationale: Pain + appetite + sleep; sublingual partially bypasses hepatic first-pass
- Start: 2.5 mg THC / 2.5 mg CBD; titrate slowly given hepatic impairment
- Dose adjustment: Extend titration intervals to every 7–10 days
2. Oral THC edible — nightly
- Rationale: Sleep + appetite stimulation
- Caution: Oral route undergoes full first-pass → 11-OH-THC (more potent); reduce dose with hepatic impairment
3. Topical cannabinoid cream — for focal pain
- Rationale: Low systemic absorption; safe with hepatic impairment
I. Pillar 5: GOAL MONITORING
- LFTs: Baseline and every 2–4 weeks (hepatic impairment + cannabinoid metabolism)
- INR: If on anticoagulation (THC + warfarin → monitor within 3 days of initiation)
- Nutrition tracking: Weight, albumin, caloric intake
- Oncology coordination: Written communication with oncology and anesthesia teams
- Sedation assessment: Standardized scale at each visit
- ECOG/Karnofsky at each visit
- Reassessment interval: Every 2 weeks perioperatively; every 4 weeks maintenance
J. Billing/Coding
- E/M: 99205/99215 + 99417 (prolonged services)
- Add-ons: 96127 (screening tools); 80305–80307 (drug testing)
- MDM: High across all 3 elements (metastatic cancer + perioperative + hepatic impairment + 12-medication polypharmacy)
---
IV. CASE 3 — YOUNG ADULT PSYCHIATRIC COMPLEXITY | TIER 3–4
A. Patient Demographics
- 23-year-old female
B. Pillar 1: DIAGNOSIS (ICD-10 Codes)
- Fibromyalgia — M79.7
- Generalized anxiety disorder — F41.1
- Major depressive disorder — F32.A
- Migraines — G43.909
- Alcohol use disorder, in early remission — F10.21
- Cannabis use, uncomplicated — F12.90
- Long-term drug therapy — Z79.899
C. Pillar 2: DYSFUNCTION (Validated Tools)
- Fibromyalgia: FIQ-R (Fibromyalgia Impact Questionnaire-Revised)
- Anxiety: GAD-7
- Depression: PHQ-9
- Pain: VAS, PEG scale
- Sleep: ISI
- Substance use screening: CUDIT-R (score ≥8 = problematic use), CAGE-AID (≥2 = further evaluation)
- Cognition: MoCA (if cognitive concerns)
D. Pillar 3: DRUGS/TX THAT DIDN'T WORK
- Document ≥2 failed conventional therapies per qualifying condition
- Examples: SSRIs/SNRIs (dose, duration, reason for failure), gabapentin/pregabalin, triptans, CBT, physical therapy
- Document current benzodiazepine use (dose, frequency, prescriber)
E. Complexity Multipliers
1. Age ≤25 → neurodevelopmental risk; general recommendation against cannabis use during neurodevelopment
2. Benzodiazepine co-use → additive CNS depression; THC + benzodiazepines = enhanced sedation
3. Recent alcohol use disorder (F10.21) → cross-substance relapse risk; 29% of medical cannabis users meet CUD criteria
4. Serious mental illness (depression + anxiety) → APA/ASAM recommend against THC in serious mental illness; mixed evidence base
F. Clinical Concerns
- Relapse risk (AUD in early remission → cannabis as potential gateway or substitute)
- Dissociation (THC at high doses can worsen dissociative symptoms)
- Cognitive impairment (age ≤25 + benzodiazepines + THC = compounded risk)
- Paradoxical anxiety (THC is anxiogenic at high doses; biphasic dose-response)
- CUD development (structured screening with CUDIT-R and DSM-5 criteria at every visit)
G. Pillar 4: DISCUSS + DOCUMENT (Risk-Benefit Analysis)
- Evidence for fibromyalgia: UK Cannabis Registry observational data; limited RCT evidence
- Evidence for anxiety/PTSD: CBD-dominant formulations (4:1+) preferred; avoid high-THC
- Evidence for migraines: Limited; no high-quality RCTs
- Risks: CUD (29% prevalence in medical users), cognitive effects on developing brain, relapse to alcohol, paradoxical anxiety, benzodiazepine interaction
- Benefits: Potential symptomatic improvement with realistic magnitude (~0.5–1.0 point pain reduction)
- Alternatives: Ensure all first-line therapies exhausted; psychiatric co-management essential
- Informed consent: Neurodevelopmental risks, driving impairment (3–5 hr post-inhalation), CUD screening, withdrawal symptoms
H. Formulation Route Selection
1. Oral CBD capsules — BID
- Rationale: CBD-dominant for psychiatric comorbidity; anxiolytic without psychoactivity
- Dose: 10–25 mg CBD BID; titrate every 5–7 days
- Note: CBD inhibits CYP2C19 (strong) → check interactions with current medications
2. Low-dose THC edible — nightly
- Rationale: Sleep + pain; low dose to minimize psychoactive/anxiogenic effects
- Dose: 2.5 mg THC; titrate cautiously
- Caution: Avoid >10 mg THC/day in high-risk patients
3. Topical analgesic balm — BID
- Rationale: Focal fibromyalgia tender points; low systemic absorption
I. Pillar 5: GOAL MONITORING
- Mood stability: PHQ-9 and GAD-7 at every visit
- Cognition: MoCA if concerns arise
- Psychiatric follow-up: Co-management with psychiatrist; written coordination
- Misuse screening: CUDIT-R and CAGE-AID at every visit; DSM-5 CUD criteria review
- PDMP check every visit (benzodiazepine monitoring)
- UDS at baseline and periodic intervals
- FIQ-R for fibromyalgia tracking
- Reassessment interval: Every 4 weeks initially; every 8 weeks if stable
J. Billing/Coding
- E/M: 99215 (if Tier 3) or 99215 + 99417 (if Tier 4)
- Add-ons: 96127 ×4 (PHQ-9, GAD-7, CUDIT-R, ISI); 80305–80307 (drug testing)
- MDM: High problems (fibromyalgia + anxiety + depression + AUD + migraines), high data (PMP + UDS + psychiatric records), high risk (age ≤25 + benzodiazepine + AUD history)
---
V. CASE 4 — GI/NEUROPATHY WITH CHS HISTORY | TIER 3 COMPLEXITY
A. Patient Demographics
- 41-year-old male
B. Pillar 1: DIAGNOSIS (ICD-10 Codes)
- Crohn's disease — K50.90
- Neuropathy — G62.9
- Insomnia — G47.00
- Generalized anxiety disorder — F41.1
- History of cannabinoid hyperemesis syndrome — F12.188
- Cannabis use, uncomplicated — F12.90
- Long-term drug therapy — Z79.899
- Therapeutic drug monitoring — Z51.81
C. Pillar 2: DYSFUNCTION (Validated Tools)
- GI: Harvey-Bradshaw Index or CDAI (Crohn's Disease Activity Index)
- Pain: VAS, PEG scale
- Neuropathy: DN4 or NPS (Neuropathic Pain Scale)
- Sleep: ISI
- Anxiety: GAD-7
- Substance use: CUDIT-R, CAGE-AID
- CHS screening: Cyclic vomiting + hot shower relief + chronic heavy use history
D. Pillar 3: DRUGS/TX THAT DIDN'T WORK
- Document ≥2 failed conventional therapies per qualifying condition
- Crohn's: biologics, immunomodulators, corticosteroids (dose, duration, reason for failure)
- Neuropathy: gabapentin, pregabalin, duloxetine, TCAs
- Document current opioid exposure (dose, duration, prescriber)
- Document kratom use history (dose, frequency, duration, reason for use)
E. Complexity Multipliers
1. CHS history → recurrence risk with THC re-exposure; cessation is only proven treatment; amitriptyline 75–100 mg for prophylaxis
2. Chronic opioid exposure → additive CNS depression with THC; monitor for respiratory depression
3. Kratom/polysubstance use → unregulated substance with opioid-receptor activity; CNS depression stacking; no standardized dosing or safety data
4. GI instability → Crohn's flares may be exacerbated or masked; Kang 2025 IBD meta-analysis: symptomatic improvement but NO endoscopic benefit
F. Clinical Concerns
- Dehydration (CHS recurrence → cyclic vomiting → acute kidney injury risk)
- CHS recurrence (any THC re-exposure carries risk; dose-dependent)
- CNS depression stacking (opioids + kratom + THC = compounded sedation/respiratory risk)
- GI instability (Crohn's flare vs. CHS presentation — diagnostic overlap)
- Polysubstance monitoring (kratom not detected on standard UDS)
G. Pillar 4: DISCUSS + DOCUMENT (Risk-Benefit Analysis)
- Evidence for Crohn's: Mixed — some studies show clinical remission; Kang 2025 meta-analysis: symptomatic improvement but no endoscopic benefit
- Evidence for neuropathic pain: Cochrane 2026: THC/CBD may increase PGIC "much/very much improved" (low certainty); balanced 1:1 THC:CBD sublingual has strongest evidence base
- CHS risk: Explicitly document history, recurrence risk, and mitigation strategy
- Risks: CHS recurrence (potentially life-threatening dehydration), CNS depression stacking, GI masking, CUD
- Benefits: Potential neuropathic pain and anxiety improvement with CBD-dominant approach
- Alternatives: Ensure GI-directed therapies optimized; neuropathy-specific agents maximized
- Informed consent: CHS warning signs (prodromal nausea, hot shower compulsion), emergency plan, kratom cessation counseling
H. Formulation Route Selection
1. Oral CBD tincture — daily
- Rationale: Anti-inflammatory + anxiolytic; minimal CHS risk with CBD alone
- Dose: 10–25 mg CBD daily; titrate every 5–7 days
- Note: CBD does not typically trigger CHS (THC-mediated)
2. Topical CBD cream — BID–TID
- Rationale: Focal neuropathic pain; no systemic THC exposure; no CHS risk
3. Vaporized CBD flower — PRN anxiety/pain
- Rationale: Rapid onset for acute episodes; CBD-dominant to minimize CHS risk
- Caution: Even CBD-dominant flower may contain trace THC; monitor for CHS prodrome
- Caution: Inhaled route not preferred per ACP 2025; use only if rapid onset essential
Critical Note on THC Avoidance:
- Given CHS history, THC-containing products carry significant recurrence risk
- If any THC is included, use lowest possible dose with explicit CHS monitoring protocol
- Document shared decision-making regarding THC risk acceptance
I. Pillar 5: GOAL MONITORING
- GI symptoms: Stool frequency, abdominal pain, nausea diary; Harvey-Bradshaw Index
- Hydration status: BMP/electrolytes if GI symptoms worsen
- Substance-use behaviors: CUDIT-R, CAGE-AID; kratom use tracking; UDS (note: kratom requires specialized testing)
- CHS recurrence signs: Prodromal nausea, morning vomiting, compulsive hot bathing → immediate THC cessation protocol
- PDMP check every visit (opioid monitoring)
- GAD-7 and ISI at each visit
- Reassessment interval: Every 4 weeks initially; every 6–8 weeks if stable
J. Billing/Coding
- E/M: 99215 (Tier 3 complexity)
- Add-ons: 96127 ×3–4 (GAD-7, ISI, CUDIT-R, PEG); 80305–80307 (drug testing — consider expanded panel for kratom)
- MDM: High problems (Crohn's + neuropathy + CHS history + polysubstance), high data (PMP + UDS + GI records + labs), high risk (CHS recurrence + opioid + kratom + CNS stacking)
---
VI. CROSS-CASE TEACHING POINTS
A. Universal Documentation Requirements
- Every pillar documented at every encounter
- Higher complexity = more detailed documentation per pillar
- Qualifying condition coded as primary; cannabis complications coded as secondary
B. Harm Reduction Hierarchy (All Cases)
- Oral/sublingual preferred over inhaled
- Avoid >10 mg THC/day in high-risk patients
- Driving impairment: 3–5 hr post-inhalation, longer with oral
- Avoid concurrent benzodiazepines and opioids when possible
- Age ≤25: Recommend against use during neurodevelopment
- Age ≥65: Start ≤2.5 mg THC; screen falls, cognition, polypharmacy
- Absolute contraindication: Pregnancy/breastfeeding
C. CYP450 Interaction Awareness
- THC: Metabolized by CYP2C9 (~70%), CYP3A4, CYP2C19
- CBD: Inhibits CYP2C19 (strong), CYP3A4 (moderate), CYP2D6 (weak-moderate)
- Smoked cannabis: Induces CYP1A2 → decreased clozapine, olanzapine, theophylline, duloxetine
- High-dose CBD (≥640 mg) + THC → increased THC AUC by 161%
- THC + warfarin → monitor INR within 3 days
- THC + tacrolimus → monitor trough levels
- CBD + valproate → hepatotoxicity risk; monitor LFTs
D. Appropriate Coding Summary
Therapeutic use codes:
- F12.90 — Cannabis use, uncomplicated
- Z79.899 — Long-term/current drug therapy
- Z51.81 — Therapeutic drug monitoring
Avoid mislabeling therapeutic use:
- F12.10 (abuse), F12.20 (dependence), F12.929 (intoxication) — only if clinically documented
Complication codes (when present):
- F12.188 — CHS
- F12.288 — Cannabis withdrawal
E. Evidence Benchmarks to Set Patient Expectations
- Pain: ~0.5–1.0 point improvement on 10-point scale (ACP 2025)
- Pain NNT: 11 for 30% pain reduction (BMJ 2021)
- Pain NNH: 6 for any adverse event (BMJ 2021)
- Opioid-sparing: Observational support only; RCTs show no opioid-sparing effect
- Cancer (pancreatic): Pain improved 44% vs 20%, appetite 56% vs 30%, insomnia 67% vs 30% (CanPan 2026)
- Crohn's: Symptomatic improvement but no endoscopic benefit (Kang 2025)
- Mental health: Mixed results; APA/ASAM recommend against THC in serious mental illness
Level 1
Level 1
PART 1 — INTRODUCTION & CORE COMPETENCIES
PART 1 — INTRODUCTION & CORE COMPETENCIES
Slide 1, Advanced Cannabinoid Medicine: Core Competencies & Medical Necessity
Slide 2, Disclaimer and Disclosures
Slide 3, Goals: Competency in Advanced Care
Slide 4, Recent News: The Rescheduling
Slide 5, Recent News: Landmark Publications 2025–2026
Slide 6, JAMA Network Open 2025: 6 Core Competencies
PART 2 — ECS, PHARMACOLOGY & DRUG INTERACTIONS
PART 2 — ECS, PHARMACOLOGY & DRUG INTERACTIONS
Slide 7, Cannabis Plant Components/Images
Slide 8, Endocannabinoid System Diagram
Slide 9, The Endocannabinoid System | Clinical Relevance
Slide 10, Formulations: 1900s → Today
Slide 11, THC Pharmacology & CYP450 Interactions
Slide 12, THC Pharmacology & CYP450 Interactions II
Slide 13, Drug Interactions
Slide 14, Searching for the Evidence
Slide 15, AI/Open Evidence/Cannabase/ChatGPT/Claude
Slide 16, What’s Available vs What’s Most Studied
Slide 17, Types of Medical Cannabis Evidence
Slide 18, Measuring Outcomes & Reducing Risk
PART 3 — SPECIALTIES, EDUCATION & EVIDENCE
PART 3 — SPECIALTIES, EDUCATION & EVIDENCE
Slide 19, Goals: Competency in Advanced Care
Slide 20, Authorizing Specialties & Education Gap
Slide 21, The Big Three Certifying Specialties
Slide 22, Specialist Perspectives
Slide 23, Specialized Populations & Settings
Slide 24, What the Evidence Actually Shows for Pain
Slide 25, Evidence-Informed Treatment Selection
Slide 26, Goals: Competency in Advanced Care
PART 4 — MEDICAL NECESSITY & DOCUMENTATION
PART 4 — MEDICAL NECESSITY & DOCUMENTATION
Slide 27, Definition of Medical Necessity
Slide 28, Why Documentation Matters
Slide 29, Weak vs Strong Documentation
Slide 30, What Every Patient Must Hear Before Certification
Slide 31, The Foundation of Every Cannabis Encounter
Slide 32, 5 Ds + Goal Monitoring
Slide 33, Appropriate Cannabis Coding
Slide 34, Coding It Right | Qualifying Conditions & Complications
Slide 35, Getting Paid for the Work You Do
Slide 36, MDM — Foundation of Complexity Grading
PART 5 — MEDICAL COMPLEXITY
PART 5 — MEDICAL COMPLEXITY
Slide 37, Goals: Competency in Advanced Care
Slide 38, Definition of Medical Complexity
Slide 39, Complexity ≠ Multimorbidity
Slide 40, Medical Complexity in Cannabis Patients — Tiered Framework
Slide 41, Tier 4 Very High Complexity + Key Drivers
Slide 42, Why Complexity Grading Matters in Cannabis Practice
PART 6 — PERSONALIZED CARE PLANS & CASES
PART 6 — PERSONALIZED CARE PLANS & CASES
Slide 43, Goals: Competency in Advanced Care
Slide 44, 5-Step Process for Every Complex Case
Slide 45, Matching Products to Patient Needs
Slide 46, Framework Recap: 5 Ds + Goal Monitoring
Slide 47, Case 1 — Perioperative Spine Surgery
Slide 48, Case 1 — Plan + Monitoring
Slide 49, Case 2 — Pancreatic Cancer / Whipple
Slide 50, Case 2 — Plan + Monitoring
Slide 51, Case 3 — Young Adult Psychiatric Complexity
Slide 52, Case 4 — GI / Neuropathy + CHS History
Slide 53, Cross-Case Summary: Key Takeaways
PART 7 — CASE EVIDENCE & REFERENCES
PART 7 — CASE EVIDENCE & REFERENCES
Slide 54, Case-Based Medical Necessity Evidence Summary
Slide 55, Case References: Systematic Reviews & Guidelines
Slide 56, References 1/3
Slide 57, References 2/3
Slide 58, References 3/3
Level 1
Level 1
PART 1 — INTRODUCTION & CORE COMPETENCIES
PART 1 — INTRODUCTION & CORE COMPETENCIES
Slide 1 — Advanced Cannabinoid Medicine: Core Competencies & Medical Necessity
Advanced cannabis pharmacology and clinical applications
Medical necessity and complexity-based treatment planning
FMCCE advanced clinical education overview
Slide 2 — Disclaimer and Disclosures
Educational content only; not legal advice
State vs federal regulatory differences
Non-FDA-approved cannabis products discussed
Slide 3 — Goals: Competency in Advanced Care
Identify JAMA Network cannabis competencies
Apply medical necessity and complexity frameworks
Develop evidence-informed personalized care plans
Slide 4 — Recent News: The Rescheduling
HHS recommendation for Schedule III review
Ongoing debate regarding evidence quality and safety risks
Clinical documentation standards remain unchanged regardless of scheduling
Slide 5 — Landmark Publications 2025–2026
ACP 2025 chronic pain recommendations
Cochrane 2026 neuropathic pain findings
CanPan Trial 2026 pancreatic cancer outcomes
Slide 6 — JAMA Network Open 2025: 6 Core Competencies
Endocannabinoid system and plant pharmacology
Evidence base and risk assessment
Legal, regulatory, and clinical management principles
PART 2 — ECS, PHARMACOLOGY & DRUG INTERACTIONS
PART 2 — ECS, PHARMACOLOGY & DRUG INTERACTIONS
Slide 7 — Cannabis Plant Components
THC psychoactive effects and analgesia
CBD non-intoxicating modulation and anti-inflammatory effects
Terpenes and entourage effect concepts
Slide 8 — Endocannabinoid System Diagram
CB1 receptor CNS distribution
CB2 receptor immune and inflammatory modulation
Anandamide and 2-AG signaling pathways
Slide 9 — ECS Clinical Relevance
Pain modulation and neuroinflammation
Appetite, sleep, mood, and memory regulation
THC biphasic dose-response considerations
Slide 10 — Formulations: 1900s → Today
Historical tinctures and extracts
Modern dispensary formulations and ratios
FDA-approved cannabinoid medications
Slide 11 — THC Pharmacology & CYP450
CYP2C9 primary THC metabolism
Oral first-pass metabolism → 11-OH-THC
THC dose-dependent drug interactions
Slide 12 — THC Pharmacology II
Smoked cannabis CYP1A2 induction
THC + opioids/benzodiazepines CNS depression
THC-warfarin INR monitoring considerations
Slide 13 — Drug Interactions
CBD inhibition of CYP2C19/CYP3A4
CBD + valproate hepatotoxicity risk
Sedative synergy with opioids/benzodiazepines
Slide 14 — Searching for the Evidence
PubMed, Cochrane, AI-assisted evidence review
Registry data vs randomized trials
Challenges in cannabis standardization research
Slide 15 — AI/Open Evidence Platforms
OpenEvidence and Cannabase resources
ChatGPT/Claude for evidence summarization
Importance of source verification and clinical judgment
Slide 16 — What’s Available vs Most Studied
Epidiolex, dronabinol, nabilone, nabiximols
State-dispensed vs FDA-approved products
Evidence vs availability gap in US cannabis care
Slide 17 — Types of Medical Cannabis Evidence
RCTs and meta-analyses
Registry and observational studies
Patient-reported outcomes and survey data
Slide 18 — Measuring Outcomes & Reducing Risk
PEG, PCL-5, PHQ-9, GAD-7, ECOG, MoCA
Harm reduction hierarchy and dosing principles
Driving impairment and age-related risk counseling
PART 3 — SPECIALTIES, EDUCATION & EVIDENCE
PART 3 — SPECIALTIES, EDUCATION & EVIDENCE
Slide 20 — Authorizing Specialties & Education Gap
Internal/family medicine most common certifiers
Lack of cannabis education in medical curricula
JAMA competencies addressing training gaps
Slide 21 — The Big Three Certifying Specialties
Primary care and chronic pain management
Pain medicine/anesthesiology perioperative roles
PM&R and neurologic rehabilitation applications
Slide 22 — Specialist Perspectives
Neurology: epilepsy, Parkinson’s disease, MS
Oncology/palliative care: CINV, appetite, pain
Psychiatry/addiction medicine: PTSD, CUD risk, psychosis concerns
Slide 23 — Specialized Populations & Settings
Geriatrics and polypharmacy risks
Gastroenterology and CHS considerations
Perioperative cannabis management guidelines
Slide 24 — What the Evidence Actually Shows for Pain
ACP 2025: modest pain improvement (~0.5–1.0)
BMJ 2021: NNT = 11 for 30% pain reduction
Limited evidence for opioid-sparing effects
Slide 25 — Evidence-Informed Treatment Selection
CBD-dominant for psychiatric/cardiovascular risk
Balanced THC/CBD for neuropathic pain/spasticity
Oral/sublingual preferred over inhaled routes
PART 4 — MEDICAL NECESSITY & DOCUMENTATION
PART 4 — MEDICAL NECESSITY & DOCUMENTATION
Slide 27 — Definition of Medical Necessity
Evidence-based clinical justification for treatment
Appropriate, reasonable, and individualized care
Functional improvement and symptom stabilization goals
Slide 28 — Why Documentation Matters
Legal and regulatory protection
Continuity of care and outcome tracking
Audit defensibility and coding support
Slide 29 — Weak vs Strong Documentation
Specific diagnoses and ICD-10 coding
Functional impairment documentation
Failed therapies and risk-benefit analysis
Slide 30 — What Every Patient Must Hear
Risks: CUD, cognition, cardiovascular effects, CHS
Realistic expectations and treatment goals
Driving, sedation, and withdrawal counseling
Slide 31 — Foundation of Every Cannabis Encounter
Diagnosis + validated assessment tools
Failed therapies and treatment rationale
Monitoring plan and follow-up strategy
Slide 32 — 5 Ds + Goal Monitoring
Diagnosis, dysfunction, failed drugs/treatments
Discuss + document risk-benefit-options
Goal monitoring with PDMP/UDS and outcomes
Slide 33 — Appropriate Cannabis Coding
F12.90 uncomplicated cannabis use
Z79.899 long-term drug therapy
Z51.81 therapeutic drug monitoring
Slide 34 — Coding It Right
Qualifying conditions and ICD-10 specificity
CHS and withdrawal complication coding
Avoid inappropriate abuse/dependence labeling
Slide 35 — Getting Paid for the Work You Do
E/M coding by complexity tier
Prolonged service and behavioral assessment codes
Drug testing and chronic pain management codes
Slide 36 — MDM & Complexity Grading
Problems, data, and risk categories
Moderate vs high-risk cannabis encounters
Documentation supporting higher-level coding
PART 5 — MEDICAL COMPLEXITY
PART 5 — MEDICAL COMPLEXITY
Slide 37 — Goals: Competency in Advanced Care
Define medical complexity in cannabis medicine
Apply tiered complexity frameworks to clinical care
Integrate risk stratification into treatment planning
Slide 38 — Definition of Medical Complexity
Interaction of medical, psychiatric, and social factors
Unpredictable, resource-intensive clinical management
Complexity extends beyond diagnosis count alone
Slide 39 — Complexity ≠ Multimorbidity
Multiple diagnoses do not always equal complexity
Social barriers and psychiatric instability increase risk
Workload vs patient capacity framework
Slide 40 — Tiered Cannabis Complexity Framework
Tier 1: stable single-condition patients
Tier 2: moderate psychiatric/comorbidity burden
Tier 3–4: polypharmacy, opioids, organ disease, perioperative risk
Slide 41 — Tier 4 Complexity + Key Drivers
Active cancer, frailty, psychosis, CHS history
Organ failure, perioperative planning, age extremes
Polypharmacy and CYP450 interaction risk escalation
Slide 42 — Why Complexity Grading Matters
Supports E/M coding and medical necessity
Determines monitoring frequency and referrals
Improves safety and adverse-event prevention
PART 6 — PERSONALIZED CARE PLANS & CASES
PART 6 — PERSONALIZED CARE PLANS & CASES
Slide 43 — Goals: Competency in Advanced Care
Develop personalized cannabis treatment plans
Match formulations/routes to clinical goals
Apply monitoring and documentation frameworks
Slide 44 — 5-Step Process for Every Complex Case
Identify diagnoses + severity + ICD-10 coding
Screen cardiovascular, psychiatric, and drug-interaction risks
Establish monitoring tools, goals, and escalation criteria
Slide 45 — Matching Products to Patient Needs
Sleep → THC/CBN bedtime formulations
Anxiety/PTSD → CBD-dominant products
Neuropathic pain/spasticity → balanced THC/CBD formulations
Slide 46 — Framework Recap: 5 Ds + Goal Monitoring
Diagnosis and dysfunction documentation
Failed therapies and informed consent
Goal tracking, PDMP, UDS, validated outcome tools
Slide 47 — Case 1: Perioperative Spine Surgery | Tier 4
Chronic pain + PTSD + opioids + OSA + HTN
Respiratory depression and perioperative risk concerns
Polypharmacy and anesthesia coordination needs
Slide 48 — Case 1: Plan + Monitoring
Oral balanced THC/CBD tincture nightly
Vaporized CBD flower stopped ≥2 weeks pre-op
PEG, PCL-5, ISI, PDMP, UDS monitoring
Slide 49 — Case 2: Pancreatic Cancer / Whipple | Tier 4
Metastatic pancreatic cancer with cachexia
Hepatic impairment and altered THC metabolism
CanPan Trial evidence supporting symptom benefit
Slide 50 — Case 2: Plan + Monitoring
Balanced THC/CBD tincture with slow titration
Nutrition, LFT, INR, ECOG monitoring
Oncology/anesthesia/palliative coordination
Slide 51 — Case 3: Young Adult Psychiatric Complexity
Fibromyalgia, anxiety, depression, AUD remission
Neurodevelopmental and psychiatric risk considerations
CBD-dominant strategy with low-dose THC limitation
Slide 52 — Case 4: GI / Neuropathy + CHS History
Crohn’s disease, neuropathy, CHS history
THC minimization and CHS recurrence monitoring
Expanded UDS and GI symptom tracking
Slide 53 — Cross-Case Summary: Key Takeaways
Oral/sublingual preferred over inhaled routes
Start low/go slow THC dosing principles
CYP450 interactions and coding reminders
PART 7 — CASE EVIDENCE & REFERENCES
PART 7 — CASE EVIDENCE & REFERENCES
Slide 54 — Case-Based Medical Necessity Evidence Summary
BMJ 2021 pain meta-analysis support
ACP 2025 balanced THC/CBD recommendations
CanPan Trial pancreatic cancer outcomes
Slide 55 — Case References: Systematic Reviews & Guidelines
BMJ 2021 systematic review/meta-analysis
Cochrane 2026 neuropathic pain review
ACP 2025 and ASCO 2024 guidelines
Slide 56 — References 1/3
Cannabis pharmacology and RCT references
BMJ and Cochrane evidence sources
AMA/CMS coding references
Slide 57 — References 2/3
Perioperative and geriatric cannabis studies
JAMA Network Open competencies
Oncology and psychiatry references
Slide 58 — References 3/3
CHS and IBD systematic reviews
Opioid-sparing observational studies
Cannabis rescheduling and policy literature
✅ UPDATED — ALL GROUPS COMBINED (FMCCE + CLAB + Cannabase)
✅ UPDATED — ALL GROUPS COMBINED (FMCCE + CLAB + Cannabase)
@Aaron @Brad @Dan @Peggy @Jennifer @Gene @William @Ron @Bonni @Derrick @Catalina @Juan @Mahmudul @Karina @Michelle @Sabrina @Joseph @Lihi @Deondra @Michelle @Anthony @Mandip @Todd @Cassie @Scheril @Kelly @Nick @Emily @Alex @Stew
@Amanda @Beej @Chris @Christa @Christian @Cody @Corey @Crafton @Dana @Daniel @Adam @Roz @Eric @Eric @Eric @Gregg @Javier @Jen @Jillian @Joel @John @Jon @Karen @Krysta @Matthew @Michelle @Tom @Randy @Renee @Rhonda @PJ @Rob @Sam @Sammy @Scott @Stephen @Stewart @Todd @Toros @Vijay @Zach @Connor @Masha
@Hope @Terel @Kyle @Shoshanna @Hemant @Elmore @Nicole @Felecia @Uma @Joshua @Chris @Chad @Angela @Clifford @Yolanda @Raina @Jasmin @Michael @Justin
FMCCE (31)
@Aaron @Brad @Dan @Peggy @Jennifer @Gene @William @Ron @Bonni @Derrick @Catalina @Juan @Mahmudul @Karina @Michelle @Sabrina @Joseph @Lihi @Deondra @Michelle @Anthony @Mandip @Todd @Cassie @Scheril @Kelly @Nick @Emily @Alex @Stew
CLAB (44)
@Amanda @Beej @Chris @Christa @Christian @Cody @Corey @Crafton @Dana @Daniel @Adam @Roz @Eric @Eric @Eric @Gregg @Javier @Jen @Jillian @Joel @John @Jon @Karen @Krysta @Matthew @Michelle @Tom @Randy @Renee @Rhonda @PJ @Rob @Sam @Sammy @Scott @Stephen @Stewart @Todd @Toros @Vijay @Zach @Connor @Masha
🔹 CLAB Leadership Board (Tag-Ready)
🔹 CLAB Leadership Board (Tag-Ready)
@Amanda — Partner, Cannabis Law — Legal Leadership
@Beej — Owner — Retail Operations
@Chris — Audit & Assurance Partner — Financial Oversight
@Christa — Retail Marketing — Brand Strategy
@Christian — Training Director — Retail Education
@Cody — Founder — Cannabis Retail Development
@Corey — Event Partnerships — Industry Engagement
@Crafton — Marketing Director — Cannabis Branding
@Dana — Chief Business Development — Strategic Growth
@Daniel — Founder — Consulting Strategy
@Adam — CEO — Wellness Practice Leadership
@Roz — Founder — Minority Cannabis Advocacy
@Eric — President — Insurance Leadership
@Eric — Project Manager — Construction Operations
@Eric — Operations Director — Retail Execution
@Gregg — Vice President — Supply Chain Leadership
@Javier — Founder — Retail Innovation
@Jen — Business Consultant — Cannabis Finance
@Jillian — Co-Founder — Community Growth
@Joel — Franchise Owner — Financial Operations
@John — CEO — Creative Leadership
@Jon — Partner — Cannabis Legal Strategy
@Karen — Executive Director — NORML Advocacy
@Krysta — CEO — Networking Platform Growth
@Matthew — Partner — Retail Strategy
@Michelle — Regional Manager — Outreach Programs
@Tom — CEO — Retail Expansion
@Randy — CEO — Cultivation Leadership
@Renee — Strategic Partnerships — Business Development
@Rhonda — SVP Banking — Financial Services
@PJ — Executive Director — Association Leadership
@Rob — Founder — Indigenous Cannabis Advocacy
@Sam — President — Architecture Consulting
@Sammy — Shareholder — Investment Strategy
@Scott — Sales Director — Retail Distribution
@Stephen — Chief Strategy Officer — Product Innovation
@Stewart — Consultant — Workforce Solutions
@Todd — Regional Manager — Retail Operations
@Toros — Business Development — Credit Union Strategy
@Vijay — Partner — Legal Advisory
@Zach — Partner — Legal Services
@Connor — Business Development — Retail Technology
@Masha — Growth & Education — Laboratory Expansion
Live Class: Learn w/ AI
Live Class: Learn w/ AI
Live Class
Live Class
FUTURES ... 2nd Sunday | ORL Cars & Coffee
FUTURES ... 2nd Sunday | ORL Cars & Coffee
if (t < 93000) return DayRegime.PreMarket;
if (t < 95000) return DayRegime.OpeningDrive;
if (t < 110000) return DayRegime.MidMorningTrend;
if (t < 120000) return DayRegime.LateMorning;
if (t < 133000) return DayRegime.Lunch;
if (t < 143000) return DayRegime.EarlyAfternoon;
if (t < 154500) return DayRegime.PowerHour;
Below is a professional breakdown of the U.S. index futures trading day (e.g., YM / ES) segmented by time, behavior, and dominant pattern tendencies.This assumes regular U.S. equity session (RTH): 9:30 AM – 4:00 PM ET.
I. Pre-Market Structure (6:00 – 9:29 AM ET)1️⃣ Early Pre-Market (6:00 – 8:20)Character:Thin liquidityOvernight inventory positioningGlobex range developmentCommon Patterns:Range buildingOvernight high/low testsVWAP reversionFalse breakouts due to thin liquidityEdge Type:Mean reversionOvernight structure plays
2️⃣ News Window (8:30 – 9:15)(Economic releases: CPI, NFP, GDP, etc.)Character:Sudden volatility expansionLiquidity vacuum movesRapid repricingCommon Patterns:News spike & retraceNews spike & continuationLiquidity grab through overnight high/lowEdge Type:Fade the spike (if rejection)Acceptance breakout if volume confirms
II. Opening Drive Phase (9:30 – ~9:50)This is the most structurally important part of the day.1️⃣ Opening Drive (OD)Time: 9:30–9:40 (sometimes extends to 9:50)Character:Institutional imbalanceLarge program ordersHigh volatilityWide range candlesPatterns Seen:Straight-line impulse moveGap-and-goOpening trend continuationOpening range breakout (ORB)Stop-run through overnight high/lowSubtypes:Drive & HoldDrive & PullbackDrive & ReverseEdge Type:Momentum breakoutPullback continuationLiquidity sweep + reclaim
2️⃣ Opening ReversalTime: 9:35–10:00Character:Early traders trappedCounter-move against opening spikePatterns:Gap fillSweep of opening extremeDouble top/bottom off first pushEdge Type:Reversal entry at exhaustionVWAP reversion
III. Expansion & Structure Phase (9:50 – 11:00)After opening volatility stabilizes.1️⃣ Trend Continuation WindowTime: 9:50–10:30Character:Structured pullbacksHigher lows / lower highs formingTrend clarity improvesPatterns:Ascending support compressionFlag formationsEMA/SMA pullback entriesVWAP trend holdsEdge Type:Pullback addsStructured scalingBreakout from compressionThis is often where A+ trend days form.
2️⃣ Mid-Morning Liquidity ExpansionTime: 10:00–10:30Common for:Second impulse legHigh-of-day or low-of-day formationAlgo-driven stop sweep near 00 / 25 / 50 levelsEdge Type:Acceptance breakoutLiquidity sweep continuation
IV. Late Morning Transition (11:00 – 12:00)Character:Volume dropsRange compressionRotational behavior increasesPatterns:VWAP ping-pongNarrow range coilFalse breakoutsChop around round numbersEdge Type:Mean reversionSmall scalpsAvoid large scaling
V. Midday / Lunch Session (12:00 – 1:30)Character:Lowest liquidity of the dayAlgorithmic micro-rotationsNo strong initiative order flowPatterns:Tight rangesStop hunts around small intraday levelsSlow grind channelsEdge Type:PatienceLight size onlyAvoid scaling aggressivelyMost large traders reduce size here.
VI. Early Afternoon Repricing (1:30 – 2:30)Liquidity starts returning.1️⃣ Early Afternoon PushTime: 1:30–2:00Character:Repricing toward morning extremesTest of VWAP or daily high/lowPatterns:Trend resumptionRange breakoutFailed breakdown/breakout
2️⃣ Power Hour Initiation (2:00 – 2:30)Often begins directional bias.Patterns:Break of morning rangeGamma-driven movesStrong acceptance beyond key levelsEdge Type:Momentum re-entryStructured adds
VII. Power Hour (2:30 – 3:45)High-probability expansion window.Character:Institutional positioningHedging flowsTrend acceleration or reversalPatterns:Late-day trend continuationSqueeze movesVWAP reclaim + expansionClose imbalance setupEdge Type:Aggressive scalingHold runnersBreakout continuation
VIII. Closing Auction (3:45 – 4:00)Character:Imbalance-driven volatilityFast directional burstsLarge closing printsPatterns:Final squeezeReversal flushClose-only imbalance moveEdge Type:Fast scalpsNot ideal for large new swing entries
Summary View of the Trading DayPhaseTimeBehaviorBest Strategy TypePre-Market6:00–9:29Range / prepMean reversionOpening Drive9:30–9:50ImbalanceMomentumExpansion9:50–11:00Structured trendPullback scalingLate Morning11:00–12:00RotationLight scalpsLunch12:00–1:30CompressionAvoid sizeEarly Afternoon1:30–2:30RepricingBreakoutsPower Hour2:30–3:45ExpansionAggressive scalingClose3:45–4:00ImbalanceFast trades
If you’d like next, I can:Map each time segment to A+/A/B trade grading.Explain which periods statistically support 80–100 contract scaling.Or show how to program ODMAR2 to adjust behavior based on time-of-day regime.
To the author, Javier ...
Thank you for “The Power 100.” I'm honored to be mentioned along other great authors, advocates, and pioneers that paved the way and continue to contribute to an amazing and unique industry. Congratulations to everyone mentioned and those who continue to make progress for communities and patients This piece reflects integrity, context, and respect for the architects of this movement.
- Dr. Newton
MEDICAL CANNABIS STUDIES & AWARENESS MONTHS
MEDICAL CANNABIS STUDIES & AWARENESS MONTHS
Here are some 2025-2026 medical cannabis studies you may find interesting
Here are some 2025-2026 medical cannabis studies you may find interesting
1. April 2025: Global Consensus on Oncological Pain
1. April 2025: Global Consensus on Oncological Pain
Study: Meta-analysis of medical cannabis outcomes and associations with cancer
Numbers: Meta-analysis of hundreds of studies (sentiment analysis of over 2,500 data points).
Ratio & Route: Multi-modal analysis; prioritized oral and sublingual routes for maintenance and vaporization for acute breakthrough pain.
Results: Found clinical support for medical cannabis in cancer care is 31.38x stronger than opposition.
2. May 2025: Breakthrough in Seizure Freedom
2. May 2025: Breakthrough in Seizure Freedom
Study: 19 patients report seizure freedom with medical cannabis oil treatment
Numbers: 19 patients (15 pediatric, 4 adult) with drug-resistant epilepsy.
Ratio & Route: Full-spectrum CBD-rich oils (typically 20:1 to 25:1 CBD:THC) administered sublingually/orally.
Results: Median of 245 days of total seizure freedom; 3 patients successfully weaned off all other anti-seizure medications.
URL: https://www.frontiersin.org/journals/neuroscience/articles/10.3389/fnins.2025.1570531/full
3. June 2025: Florida State Registry (CCORC) Annual Findings
3. June 2025: Florida State Registry (CCORC) Annual Findings
Study: Proceedings of the 2025 Cannabis Clinical Outcomes Research Conference
Numbers: Registry-level data from 930,000+ active Florida patients.
Ratio & Route: Diverse Florida-specific routes including flower (inhalation) and low-THC oils (oral).
Results: Significant statewide reduction in opioid prescriptions; established high safety profile for Florida's geriatric demographic.
4. July 2025: Hospitalization Rates and Quality of Life
4. July 2025: Hospitalization Rates and Quality of Life
Study: Medical Cannabis Use and Healthcare Utilization Among Patients with Chronic Pain
Numbers: Causal inference study using data from a multi-state certifying body (Leafwell).
Ratio & Route: Various dispensary-grade products used over a 12-month period.
Results: 3.2% reduction in ER visits and 2.0% reduction in urgent care visits; fewer "unhealthy days" per month reported.
5. August 2025: Same-Day PTSD Relief for Veterans
5. August 2025: Same-Day PTSD Relief for Veterans
Study: Daily Associations Between Cannabis Use and PTSD Symptoms in Military Veterans
Numbers: 74 military veterans with service-connected PTSD.
Ratio & Route: Ad-libitum (self-managed) use; typically high-THC flower or 1:1 ratios.
Results: Same-day cannabis use significantly lowered symptom severity and "negative affect" spikes.
URL: https://www.sciencedirect.com/science/article/abs/pii/S0165178125002744, and https://www.marijuanamoment.net/using-marijuana-helps-military-veterans-experience-lower-ptsd-symptoms-on-days-they-use-it-federally-funded-study-shows/
6. September 2025: Opioid-Sparing Synergy
6. September 2025: Opioid-Sparing Synergy
Study: CMCR Investigators' Meeting: Opioid-sparing Effects of Cannabinoids
Numbers: Preclinical and preliminary clinical patient data.
Ratio & Route: CBD vapor and THC:CBD combinations.
Results: Vaporized CBD decreased opioid intake without the reinforcing "reward" behavior found in high-THC products.
URL: https://www.cmcr.ucsd.edu/index.php/news-2/homeblog/464-cmcr-investigators-meeting-september-2025
7. October 2025: Alzheimer's Disease Microdosing
7. October 2025: Alzheimer's Disease Microdosing
Study: A randomized clinical trial of low-dose cannabis extract in Alzheimer's disease
Numbers: Phase 2 trial of elderly patients (ages 60–80).
Ratio & Route: 1.4:1 THC:CBD oral extract; micro-dose of 0.35mg THC / 0.24mg CBD daily.
Results: Significantly higher MMSE (cognitive) scores at 26 weeks compared to placebo group.
8. December 2025: Sustained Opioid Reduction (JAMA)
8. December 2025: Sustained Opioid Reduction (JAMA)
Study: Medical cannabis and opioid receipt among adults with chronic pain
Numbers: 204 participants tracked prospectively for 18 months.
Ratio & Route: Clinician-certified medical cannabis via oral, sublingual, and inhaled routes.
Results: 22% reduction in daily opioid MME; a 30-day cannabis supply was linked to 3.53 fewer MME per day.
9. January 2026: Early Integration for Pancreatic Cancer
9. January 2026: Early Integration for Pancreatic Cancer
Study: Pilot Randomized Trial of Medical Cannabis (CanPan)
Numbers: 34 patients with advanced pancreatic cancer.
Ratio & Route: Standard-of-care cannabis (patient's choice); median dose of 7.3 mg THC daily.
Results: 70% improvement in sleep and 44% improvement in pain; early access yielded better outcomes than delayed access.
10. January 2026: Endometriosis and Quality of Life
10. January 2026: Endometriosis and Quality of Life
Study: Cannabis Formulations Associated With Reduced Pain in Endometriosis Patients
Numbers: 28 patients (New Zealand cohort) and 63 patients (UK Medical Cannabis Registry).
Ratio & Route: CBD-dominant oils or balanced THC:CBD flower/oil.
Results: Significant drop in "worst pain" (from 7.62 to 5.38) and massive improvement in EHP-30 health scores.
Here are some of the Medical Awareness Months related to Florida MMJ Qualified Conditions
Here are some of the Medical Awareness Months related to Florida MMJ Qualified Conditions
January
January
Glaucoma
Organizations: Glaucoma Research Foundation; American Academy of Ophthalmology
February
February
General wellness, mobility, chronic pain (adaptive sports education)
' Roll-up' initiative to sport adaptive sports athletes
March
March
Multiple sclerosis; colorectal cancer; traumatic brain injury; spasticity; neuropathic pain
Organizations: National Multiple Sclerosis Society; Colorectal Cancer Alliance
April
April
Parkinson’s disease; autism spectrum disorder (symptom-based)
Organizations: Parkinson’s Foundation; Michael J. Fox Foundation; Neuro Challenge Foundation
May
May
Arthritis; fibromyalgia; chronic musculoskeletal pain; senior health
Organizations: Arthritis Foundation; Administration for Community Living
June
June
PTSD; anxiety disorders; migraine
Organizations: National Center for PTSD; American Migraine Foundation
July
July
General seizure education; chronic pain (7/10 oil-education anchor only)
Organizations: Americans for Safe Access
August
August
Crohn’s disease; inflammatory bowel disease; GI disorders; nausea; appetite loss
Organizations: Crohn’s & Colitis Foundation; International Foundation for Gastrointestinal Disorders
September
September
Prostate cancer; chronic pain; neuropathy
Organizations: Prostate Cancer Foundation; U.S. Pain Foundation
October
October
Breast cancer; cancer supportive care; chemotherapy-induced nausea; neuropathy
Organizations: Susan G. Komen; American Cancer Society
November
November
Epilepsy / seizure disorders; lung cancer; hospice & palliative care; terminal illness
Organizations: Epilepsy Foundation; National Hospice and Palliative Care Organization
December
December
HIV/AIDS; cachexia; chronic pain; sleep disturbance
Organizations: Centers for Disease Control and Prevention; HIV.gov
Key date: December 1 – World AIDS Day
Let me know if you have any questions about any of these studies, other research or the awareness months.
Dr Newton
EVENTS CALENDAR
MARCH
Sat 21 ATL (NAACP) Health Panel
Fri 27-30 S. Florida
APRIL
Fri 3 Tampa (WTOs)
ATL Cannabase
Sun ORL CarsnCoffee - 2nd Sunday.
MAY
End FMCCE
JUNE
JULY
11th SAT NEWTONVILLE, NJ.
===
Here’s the class schedule:
Monday & Wednesday | 8–9 PM ET – Post Market Analysis
Tuesday & Thursday | 9:30–10 AM ET – Live Market Performance (Recording available)
Jax - 3/6, [3/13=Mbeo], 3/20 , 3/27 (Telehealth 10am), 4/3, 4/24
HEALTH AWARENESS MONTHS
HEALTH AWARENESS MONTHS
HEALTH AWARENESS MONTHS
HEALTH AWARENESS MONTHS
JAN — Cervical Cancer / Thyroid / Glaucoma / Migraine
JAN — Cervical Cancer / Thyroid / Glaucoma / Migraine
Cervical CA: 600 K global │ 13 K US yearly. CBD + curcumin reduce inflammation; folate, zinc, and AHCC boost immunity and HPV clearance.
Thyroid: 200 M global │ 20 M US. CBD stabilizes hormones; iodine + selenium support metabolism and stress resilience.
Glaucoma: 80 M global │ 3 M US. THC lowers eye pressure; omega-3 + laser protect vision.
Migraine: MOVED TO JUNE
FEB — Heart Disease / Cancer / PTSD / Fibromyalgia
FEB — Heart Disease / Cancer / PTSD / Fibromyalgia
Heart: 550 M global │ 697 K US deaths yearly. CBD + omega-3 lower BP; CoQ10 + turmeric improve vascular tone.
Cancer: 20 M global │ 1.9 M US. THC/CBD ease chemo pain; IV vit C + hyperthermia improve recovery.
PTSD: 350 M global │ 13 M US. CBN + ketamine calm fear circuitry; EMDR builds resilience.
Fibromyalgia: 100 M global. CBD, 5-HTP, and magnesium improve sleep and reduce central sensitization.
MAR — Brain Injury / Colorectal CA / MS / Anxiety
MAR — Brain Injury / Colorectal CA / MS / Anxiety
TBI: 69 M global │ 1.5 M US. CBD + omega-3 repair neurons; ketamine + rehab enhance neuroplasticity.
CRC: 1.9 M global │ 150 K US. Curcumin + fiber reduce tumor growth; cannabis eases abdominal pain.
MS: 2.8 M global. CBD/THC mix reduces spasticity; vitamin D + B12 enhance myelin repair.
Anxiety: 301 M global │ 42 M US. CBD + mindfulness reduce cortisol; adaptogens like ashwagandha stabilize mood.
APR — Autism / Alcohol Abuse / Epilepsy / Financial Stress
APR — Autism / Alcohol Abuse / Epilepsy / Financial Stress
Autism: 75 M global │ 1 in 36 US kids. CBD eases anxiety; B6 + magnesium aid cognition.
Alcohol use: 283 M global │ 140 K US deaths. IV B-complex detox + cannabis reduce cravings.
Epilepsy: MOVED TO NOVEMBER
Financial anxiety: 200 M global. Budget therapy + journaling reduce pain flare frequency and insomnia.
MAY — Mental Health / Arthritis / Back Pain / Burnout
MAY — Mental Health / Arthritis / Back Pain / Burnout
Depression: 300 M global │ 21 M US. Ketamine + omega-3 elevate mood; magnesium + CBD aid serotonin.
Arthritis: 350 M global │ 53 M US. PRP + CBG relieve joints; curcumin + collagen rebuild cartilage.
Back Pain: 619 M global │ 65 M US. CBD + epidural steroids relieve inflammation; posture therapy prevents relapse.
Burnout: 400 M global. Adaptogens + mindfulness + B12 restore energy.
JUN — Men's Health / MIGRAINE / ED / Sleep
JUN — Men's Health / MIGRAINE / ED / Sleep
Prostate: 1.4 M global │ 288 K US. Saw palmetto + zinc improve flow; CBD + low-dose THC reduce pain.
Migraine: 1 B global │ 39 M US. Botox + CBD block pain; magnesium + riboflavin reduce triggers.
ED: 320 M global. PRP + shockwave restore circulation; L-arginine boosts nitric oxide.
Insomnia: 1 B global │ 70 M US. CBN + melatonin restore REM; magnesium glycinate calms nerves.
JUL — Minority Mental Health / Skin Cancer / PTSD / Burnout
JUL — Minority Mental Health / Skin Cancer / PTSD / Burnout
PTSD: 350 M global │ 13 M US. Ketamine infusions reset trauma pathways; CBN + CBD aid rest.
Skin Cancer: 1 M global │ 5.5 M US. Topical CBD + vitamin D reduce UV-induced DNA damage.
Burnout: 400 M global. Omega-3, mindfulness, and social support prevent physician fatigue.
AUG — Immunization / Psoriasis / Autoimmune / Chronic Fatigue
AUG — Immunization / Psoriasis / Autoimmune / Chronic Fatigue
Psoriasis: 125 M global │ 7.5 M US. CBD + turmeric calm inflammation; UVB phototherapy enhances skin renewal.
Lupus: 5 M global │ 200 K US. Omega-3 + CBD lower flares; vitamin D + CoQ10 aid immunity.
Chronic Fatigue: 150 M global. NAD+ IVs + adaptogens restore mitochondrial energy.
SEP — Chronic Pain / Prostate CA / Neuropathy / Addiction
SEP — Chronic Pain / Prostate CA / Neuropathy / Addiction
Chronic Pain: 1.5 B global │ 50 M US. THC/CBD ↓ opioid need > 60%; nerve blocks + acupuncture improve function.
Prostate CA: 1.4 M global │ 288 K US. CBD reduces bone pain; lycopene + vit D support prevention.
Neuropathy: 240 M global. Alpha-lipoic acid + CBG + IV B12 repair nerves.
Addiction: 200 M global. Cannabis + ketamine-assisted therapy improve long-term recovery.
OCT — Breast CA / Depression / Osteoporosis / Financial Toxicity
OCT — Breast CA / Depression / Osteoporosis / Financial Toxicity
Breast CA: 2.3 M global │ 300 K US. CBD + CBG relieve chemo pain; omega-3 aid tissue repair.
Depression: 300 M global │ 21 M US. Ketamine + 5-HTP lift mood; mindfulness builds resilience.
Osteoporosis: 500 M global │ 10 M US. PRP + vitamin K2 + weight training increase bone density.
Financial toxicity: 80% cancer patients affected — budgeting + advocacy reduce distress.
NOV — Lung CA / Diabetes / COPD / EPILEPSY / Pain Crisis
NOV — Lung CA / Diabetes / COPD / EPILEPSY / Pain Crisis
Lung CA: 2.2 M global │ 234 K US. CBD + vit C IV reduce fatigue; THC aids appetite and mood.
Diabetes: 540 M global │ 38 M US. CBG + berberine enhance glucose control; magnesium supports insulin.
COPD: 390 M global │ 16 M US. Nebulized CBD + breathing rehab improve oxygenation.
Epilepsy: 65 M global │ 3 M US. CBD (Epidiolex) FDA-approved; ketogenic diet aids seizure control.
Pain crisis: 1.5 B global. Multimodal pain + cannabis reduce ER visits.
DEC — HIV/AIDS / Road Injury / Insomnia / Holiday Stress
DEC — HIV/AIDS / Road Injury / Insomnia / Holiday Stress
HIV: 39 M global │ 1.2 M US. CBD ↑ appetite; B-complex + omega-3 boost immunity.
Traffic injury: 1.3 M global deaths │ 46 K US. Post-injury PRP + CBD ↓ opioid reliance.
Insomnia: 1 B global │ 70 M US. CBN + magnesium improve rest.
Holiday stress: Mindfulness + CBD tea ↓ cortisol; gratitude resets the brain.
AWARENESS MONTHS (Empathy & Perspective)
Aug – Immunization, Psoriasis, National Wellness, Pain-Free Posture Awareness, Musculoskeletal Health
Sep – Healthy Aging, Pain Awareness, Suicide Prevention, Cholesterol, Yoga, Fall Prevention
Oct – Emotional Wellness, Breast Cancer, Liver Awareness, Health Literacy, Ergonomics Awareness (Workplace Pain Prevention), Bone & Joint Health, First week = Mental Illness Awareness Week (NAMI), 10th - Depression Screening Day,
Nov – Alzheimer’s, Diabetes, Lung Cancer, Family Caregivers, Sleep Comfort, TMJ Awareness, Sciatica Awareness, National Family Health History Awareness
Dec – Handwashing Awareness Month, Safe Toys & Gifts
Jan – Healthy Weight, Mental Wellness, Glaucoma, Thyroid, Cervical Health, Rheumatoid Arthritis
Feb – American Heart, Cancer Prevention, Black Hx Month
Mar – Nutrition, Kidney Cancer, Colorectal Cancer, Sleep Awareness, Autoimmune Disease Awareness, TBI, MULTIPLE SCLEROSIS - NMSS
Apr – Stress Awareness, Autism Awareness, Minority Health, Parkinson’s, IBS, Injury Prevention, Joint Health
May – Mental Health, Arthritis, Stroke, Osteoporosis, Women's Health, Physical Fitness & Sports Injury Prevention, Fibromyalgia Awareness
Jun – Brain Awareness, Men's Health, PTSD, Migraine, Alzheimer’s & Dementia, National Safety Month (Injury Prevention), Spine Health Work Safety Month
Jul – Healthy Vision, UV Safety, Minority Mental Health, Chronic Disease Management, Scoliosis Awareness
========
HIPAA/Privacy:
Data Privacy Day (January 28): Highlights protecting patient information and HIPAA Privacy Rule compliance.
Health Information Professionals (HIP) Week (March/April): Honors HIM professionals and underscores HIPAA best practices.
Cybersecurity Awareness Month (October): Stresses HIPAA Security Rule adherence through cybersecurity initiatives.
Workplace Safety:
National Safety Month (June): Promotes overall workplace safety, including OSHA standards and injury prevention.
Patient Safety Awareness Week (March): Focuses on reducing errors and improving patient outcomes.
Infection Prevention Week (October): Emphasizes policies to prevent healthcare-associated infections.
Respiratory Protection Week (September): Reinforces the proper use of respirators and OSHA compliance.
Safe + Sound Week (August): Encourages implementing effective safety and health programs.
Fire Prevention Week (Week of October 9): Highlights fire safety measures and emergency evacuation plans.
Favorite Places in
Favorite Places in
Tampa - Aquarium, Attorney Strickland's new office, Trulieve, USF, Ybor,
Tampa - Aquarium, Attorney Strickland's new office, Trulieve, USF, Ybor,
Orlando - BOT, TulipsBlooms.org, Trulieve, Disney Parks, Rosen Centre, Mall at Millenia, Dr Massi's, Dr Mbeo's, MCO, IMG, Oh Que Bueno,
Orlando - BOT, TulipsBlooms.org, Trulieve, Disney Parks, Rosen Centre, Mall at Millenia, Dr Massi's, Dr Mbeo's, MCO, IMG, Oh Que Bueno,
Miami - Brightline, Trulieve, Gables Pain, MARC,
Miami - Brightline, Trulieve, Gables Pain, MARC,
Jax - My office, NWM, Town Center, Libraries, Avenues Mall
Jax - My office, NWM, Town Center, Libraries, Avenues Mall
' Do Every Day, All You Can Do That Day '
' Do Every Day, All You Can Do That Day '
- Dr Newton
- Dr Newton
↑ signal + ↓ noise → success
excel | enjoy growth systems | transfer focus | find genius zone audit | transfer | fill
produce energy | dream bigger | 1 project away |
Dr. Terel S. Newton, M.D.
Board-Certified Pain Specialist | Interventional Pain Consultant | Medical Cannabis Expert
Medical Director, Trulieve MMTC | Total Pain Relief LLC | Stepping Stones CRI
🌐 TerelNewton.com | 🔬 Research Interests
📧 DrTerelNewton@gmail.com | Terel.Newton@Trulieve.com
Languages: English | Spanish (Proficient)
"Advancing Pain Relief Through Innovation, Education, and Compassion."
GUEST SPEAKER: Multiple Conferences and events ...
ELEVATE ATL | BOOK STORE GALLERY
ATTENDED and/or PRESENTED...
FL - CANNABIS LAB, FSIPP, SPACE CON, SMOKEN YOGA
GA - WOMEN IN BIZ EXPO (ATL)
NEVADA - MJ BIZ CON, Blue-Ribbon Study Committee (Ga)
Dispensary Tours (Retail) = Medical Doctors/Clinic Staff, BCFCF, Tulips Blooms, Media Day, Grand Opening.
Dispensary Tours (Cultivation) = Universities, Educators/Research/Community Outreach, et al
SUPPORT ...
BOT CANNABIZIAC M4MM MMERI FMCCE FMA GMA
Disclaimer:
Information provided is for reference only and does not imply affiliation or endorsement with the mentioned individuals, companies, products, services, treatments, and websites. For informational purposes only - contact your medical provider for health and medical advice. Content accuracy, completeness, and timeliness are not guaranteed. Inclusion of information and websites does not constitute endorsement. Users should exercise caution when accessing external content. See your medical, legal, finance, tax, spiritual and other professionals for discussion, guidance, planning, recommendations and greater understanding of the risks, benefits, options and ability to apply any information to your situation.
GREAT PEOPLE TO WORK WITH ...FSU
GREAT PEOPLE TO WORK WITH ...FSU
Faculty Profiles
Faculty Profiles
Dr. Nicole Ennis, Ph.D. – Associate Professor and Vice Chair, Dept. of Behavioral Sciences & Social Medicine (BSSM). Dr. Ennis is a leading behavioral scientist with a focus on public health, substance use, and medical cannabis outcomes researchmed.fsu.edu. She has extensive experience developing and implementing interventions for people with chronic illnesses (e.g. HIV) and those affected by substance misusemed.fsu.edu. Notably, Dr. Ennis and collaborators have been at the forefront of studying medical marijuana’s effects – for example, examining how long-term medical cannabis use (alone or with opioids) impacts driving performance in older adultsmed.fsu.edu. Her work in this area has earned continuous funding from the National Institute on Drug Abuse (NIDA) and other agencies for over a decademed.fsu.edu. In recognition of her expertise, FSU’s president recently nominated Dr. Ennis to the Board of the Florida Consortium for Medical Marijuana Clinical Outcomes Research, a statewide research initiativemed.fsu.edu. This speaks to her openness and leadership in medical cannabis research, as well as alignment with Florida’s health priorities. Contact: nennis@fsu.edu (Department of BSSM, FSU College of Medicine)med.fsu.edu.
Dr. Heather A. Flynn, Ph.D. – Professor and Chair, Dept. of Behavioral Sciences & Social Medicine. Dr. Flynn is a senior faculty member and clinical psychologist specializing in mental health, behavioral health integration, and health services researchmed.fsu.edumed.fsu.edu. Under her leadership, the BSSM department has secured over $21 million in external grants (2015–2019) in mission-focused areas including chronic illness, mental health, substance use/addiction, and health policymed.fsu.edu. She has a proven NIH funding track record (e.g. perinatal depression research) and is a strong advocate for patient‐centered outcomes research and community-engaged studiesmed.fsu.edu. Importantly, Dr. Flynn has demonstrated openness to medical cannabis research – she co-authored a recent study on Florida medical cannabis patients’ health outcomes and opioid use reductionmed.fsu.edu. As department chair, she can lend significant institutional support and ensure any cannabis study aligns with FSU’s values of scientific rigor and public health impact. Contact: heather.flynn@med.fsu.edu (Chair, BSSM, FSU College of Medicine)med.fsu.edu.
Dr. Laura Reid Marks, Ph.D. – Associate Professor, Dept. of Behavioral Sciences & Social Medicine. Dr. Marks is a behavioral health researcher focusing on substance use, mental health, and health disparities in emerging adultsmed.fsu.eductbs.fsu.edu. She directs the G.R.O.W.T.H. research lab at FSU’s Center for Translational Behavioral Science, investigating how factors like discrimination and stress influence health behaviors. Her work includes studying young adults’ alcohol and cannabis use patterns – for instance, she recently published on perceived increases in alcohol and cannabis use among diverse college-aged adults during the pandemicmed.fsu.edu. This background shows her comfort with cannabis-related research questions (especially regarding vulnerable or underserved populations). Dr. Marks’s expertise in culturally tailored interventions and digital health (mHealth) toolsmed.fsu.edu could be valuable for innovative study designs (e.g. mobile health data collection from medical marijuana patients). She would likely champion projects examining cannabis in the context of mental health and health equity, aligning with NIH’s focus on disparity populations. Contact: laura.reidmarks@fsu.edu (Dept. of BSSM, FSU College of Medicine)ctbs.fsu.edu.
Collaboration Options
Collaboration Options
Joint Observational Study (MMJ Registry + FSU Networks): A collaborative observational study leveraging MMJOutcomes.org’s patient registry data and FSU’s clinical networks. This could involve prospectively tracking health outcomes (pain levels, opioid use, functional status, etc.) in patients using medical cannabis. FSU’s statewide clinical footprint (primary care and specialty clinics, plus the geriatric patient base) provides access to diverse patient populations, including older adults and rural patients – groups of high interest as Florida’s medical cannabis usage growsmed.fsu.edu. By pooling MMJOutcomes registry data with FSU clinical data, the study can yield real-world evidence on medical cannabis efficacy and safety (e.g. improvements in pain and quality of life, reduction in opioid dosagessciencedaily.comsciencedaily.com). This aligns with Florida’s public health priorities (addressing the opioid crisis through alternative pain therapies) and would likely earn institutional approval, as it builds on existing FSU strengths in community-based research and patient-centered outcomesmed.fsu.edu.
Co-authored Grant Proposal (Cannabis in Medicaid/Vulnerable Populations): A partnership to co-write a grant proposal focusing on evaluating medical cannabis outcomes in Florida’s Medicaid or other vulnerable populations. This could be a multidisciplinary project studying how cannabis therapy affects healthcare utilization, costs, or health metrics in low-income or minority patients (for example, examining if medical cannabis use correlates with reduced emergency visits or improved chronic pain management in Medicaid recipients). Such a proposal could target NIH (e.g. NIDA or NIMHD) or state funding. It would merge Dr. Ennis’s and Dr. Marks’s expertise in substance use and health disparities with Dr. Flynn’s experience in large-scale health services research. Strategically, this aligns with NIH funding trends encouraging research on cannabis as it relates to pain and opioid reductionmed.fsu.edu, and with Florida’s interest in evidence-based cannabis policy for its most vulnerable citizens. A well-crafted grant on this topic not only addresses pressing state health questions but also leverages FSU’s emphasis on health equity and policy-relevant research.
Cross-Institution Academic Publication (Cannabis Outcomes Review): A scholarly collaboration to produce a comprehensive review or policy paper on medical cannabis outcomes, co-authored by Dr. Newton and FSU faculty for a high-impact academic journal. Possible topics include a systematic review of clinical outcomes of medical cannabis in specific conditions (e.g. chronic pain, PTSD, or in older adults), or a review of policy and public health impacts of Florida’s medical marijuana program. Co-authoring such a paper would capitalize on FSU faculty’s subject-matter knowledge – Dr. Ennis’s work on driving and safety outcomesmed.fsu.edu, Dr. Marks’s insight into young adult usage patternsmed.fsu.edu, and Dr. Flynn’s perspective on mental health outcomes – combined with MMJOutcomes data and Dr. Newton’s registry findings. This publication could serve as a cornerstone for Florida’s thought leadership in cannabis research, and is in line with FSU’s academic mission to translate research into practice and policy. It also sets the stage for future joint projects, demonstrating a united front on cannabis outcomes research that would be well-received by both the university and state consortium.
GREAT PEOPLE TO WORK WITH ...FAMU
GREAT PEOPLE TO WORK WITH ...FAMU
FAMU Profiles
FAMU Profiles
Dr. G. P. Mendie (MMERI Executive Director)
https://www.famu.edu/administration/research/contact-us.php
Dr. Donald E. Palm III
https://www.famu.edu/_training-and-testing/backup-archived-pages/presidential-search/pdf/cv-DonaldPalm.pdf
(Also: https://news.famu.edu/2025/famu-coo-donald-palm-selected-for-news-service-of-florida-50-over-50-list.php)
Dr. Charles A. Weatherford
https://www.famu.edu/info/faculty-staff/profiles/cst/charles-weatherford.php
Dr. Mandip S. Sachdeva
https://pharmacy.famu.edu/research/research_laboratories/sachdeva-laboratory/index.php
Dr. Otis W. Kirksey
https://www.floridahealth.gov/provider-and-partner-resources/research/florida-health-grand-rounds/Bio-DrKirksey020821.pdf
(Also: https://events.diabetes.org/b/sp/otis-kirksey-1080
Dr. G.P. Mendie
Dr. G.P. Mendie
Official Profile: Executive Director of FAMU’s Medical Marijuana Education and Research Initiative (MMERI), listed on FAMU’s Division of Research contact pagefamu.edu. (This page provides his name, title, and email as the MMERI Executive Director.)
Official Image: A professional headshot is available via FAMU’s Service Excellence “Gallery of Distinction” (he was recognized as an Employee of the Quarter)famu.edu. Direct image URL: 640x480_G.P.-Mendie.jpg on FAMU’s site (the photo is embedded on the gallery page, but users can view/download it by accessing the image link).
Dr. Donald E. Palm
Dr. Donald E. Palm
Official Profile: Executive Vice President and Chief Operating Officer (COO) of FAMU. (No dedicated faculty profile page is published; however, FAMU’s news release announcing his recognition as a “50 Over 50” honoree serves as an official bionews.famu.edu.) This news article outlines Dr. Palm’s role and background at FAMU.
Official Image: A formal headshot of Dr. Palm is embedded in the FAMU News articlenews.famu.edu. Direct image URL: 1024x768_donald-palm.jpg on the FAMU News site (the image appears in the news story and can be saved from the page).
Dr. Charles Weatherford
Dr. Charles Weatherford
Official Profile: Vice President for Research at FAMU, and Professor of Physics. His official faculty profile page on FAMU’s website provides his biography and credentialsfamu.edufamu.edu. (This profile notes his roles, education, and accomplishments in research and academia at FAMU.)
Official Image: The profile includes an official headshot of Dr. Weatherfordfamu.edu. Direct image URL: 450x450_Dr.-Weatherford.jpg on the FAMU site (this is the image displayed on his faculty profile, which can be viewed or downloaded directly).
Dr. Mandip S. Sachdeva
Dr. Mandip S. Sachdeva
Official Profile: Professor of Pharmaceutical Sciences in the FAMU College of Pharmacy and Pharmaceutical Sciences (CoPPS). An official page on the CoPPS research site (Sachdeva Lab page) features his Biosketch and qualificationspharmacy.famu.edu. (This lab profile highlights his education, positions, and research focus at FAMU.)
Official Image: Dr. Sachdeva’s headshot is included in the CoPPS faculty/staff directorypharmacy.famu.edu. Direct image URL: Mandip-Sachdeva.jpg on the pharmacy.famu.edu server (the photo is shown in the directory listing and can be downloaded by accessing the image link).
Dr. Otis W. Kirksey
Dr. Otis W. Kirksey
Official Profile: N/A on FAMU site. Dr. Kirksey is a retired FAMU pharmacy faculty member (honored in 2020 as Professor Emeritus of Pharmacy Practice)floridahealth.gov. There is no current faculty profile on FAMU’s websites due to his retirement. (His contributions are noted in external publications, but no active FAMU page exists for him.)
Official Image: Not available. No official image or headshot is posted on FAMU’s current sites for Dr. Kirksey (as a retired faculty, he is not featured on current directories). Any photos of Dr. Kirksey appear on external sites (e.g. American Diabetes Association profiles), not on FAMU-hosted pages.
Vocab List - 1st 50
Monday & Wednesday | 8–9 PM ET – Post Market Analysis
Tuesday & Thursday | 9:30–10 AM ET – Live Market Performance
Absorption Passive limit orders neutralize aggressive orders, stopping continuation and signaling reversal.
ATR (Average True Range) Measures volatility and sets dynamic stop distances.
Bearish Engulfing Large red candle overtakes a smaller green one, signaling reversal.
Bid Stack Visible buy liquidity showing potential support depth.
Breakout Strong move above resistance with volume confirming trend ignition.
Breakdown Strong move below support triggering stops and continuation.
Compression Tight price clustering before explosive expansion.
Consolidation Sideways balance where buyers and sellers neutralize each other.
Continuation Trend resumes after pullback, confirming strong directional pressure.
Cumulative Delta Net aggressive buying vs selling revealing hidden positioning.
Demand Zone Area of prior institutional buying producing future bounces.
Delta Imbalance Heavy skew between buy and sell volume predicting directional moves.
Doji Indecision candle with equal open and close signaling potential shift.
Downtrend Sequence of lower highs and lower lows showing bearish control.
EMA (Exponential Moving Average) Fast-moving average defining short-term trend direction.
Engulfing Pattern Candle overtakes previous candle’s range signaling momentum takeover.
Expansion Volatility widening after compression, enabling strong trend legs.
Fair Value Gap (FVG) Inefficiency zone often retraced for balance.
Fib Retracement Key pullback levels (38.2, 50, 61.8) used for trend entries.
Fib Target Zone Common profit zones (100%, 127%, 161.8%).
First Pullback Entry High-probability early-trend entry after initial push.
Footprint Chart Displays bid–ask volume inside candles to expose imbalance.
Hammer Bullish reversal candle showing strong rejection of lows.
Hanging Man Bearish reversal candle after an uptrend with long lower wick.
Higher High New swing high confirming bullish structure.
Higher Low Rising trough confirming buyers stepping in earlier.
Imbalance Aggressive displacement leaving inefficient price areas later filled.
Impulse Leg Strong directional move used for Fib anchoring.
Inside Bar Candle fully inside previous bar signaling contraction.
Liquidity Grab Stop-triggering sweep beyond a key level before reversal.
Limit Order Passive order resting at a specific price.
MACD Momentum indicator showing trend acceleration or reversal.
Market Order Immediate execution consuming liquidity, indicating urgency.
Micro Pullback Very shallow retracement during strong trends showing dominance.
NQ/ES Futures Basics Highly liquid index futures used for intraday trend trading.
Order Block Institutional footprint of accumulation or distribution.
POC (Point of Control) Highest volume price acting as magnet and pivot.
Price Discovery Auction process establishing fair value.
Range Expansion Break from tight structure into larger price moves.
Range Contraction Tightening volatility showing indecision before move.
Rejection Wick Long wick showing strong denial of price continuation.
Reversal Trend turning after exhaustion and structural break.
RSI Momentum oscillator identifying overbought/oversold or divergence.
Scalping Framework Fast execution system targeting small high-frequency gains.
Slippage Worse-than-expected fill due to volatility or thin liquidity.
Stop Run Targeting of stop clusters to create volatility and fill liquidity.
Structure Break Major swing break confirming trend shift.
Supply Zone Region of previous institutional selling causing future resistance.
Support Price area where demand stops decline.
VWAP Volume-weighted fair value used for mean reversion and trend strength.
Advanced
Advanced
I. Master Alphabetical Glossary (High-Capital Scalping)
I. Master Alphabetical Glossary (High-Capital Scalping)
AAR – Aggressive Add Reclaim
Reclaim of key liquidity level after sweep with immediate displacement and confirming order flow, allowing confident size increase.
Example: Sweep PDL, reclaim with impulse + delta surge → add 30c.
ABR – Algo Break & Run
Algorithm-driven breakout with rapid expansion, minimal pullback, sustained velocity beyond structure.
Example: ORB break, stacked prints, 60-point run in two minutes.
AON – All-or-None Execution
Full-size order must fill entirely or not at all, preventing fragmented execution in thin liquidity.
Example: 75c AON above range high during expansion setup.
ATRX – ATR Expansion Event
Current range exceeds recent ATR average, signaling volatility expansion and institutional participation.
Example: 1m candle doubles 14ATR during VWAP break.
BDS – Bid Stack Absorption
Large resting bids absorb aggressive sellers, often preceding upside reversal or continuation.
Example: Repeated hits into bid at VWAP, price holds firm.
BRR – Break-Retest-Run
Break level, controlled pullback, renewed expansion confirming continuation.
Example: Break PDH → shallow pullback → bullish engulfing → scale 50c.
CBR – Continuation Breakout Re-entry
Secondary entry after breakout when pullback holds structure and momentum resumes.
Example: Pullback to breakout level with strong CLV → re-enter.
CD – Cumulative Delta
Running total of aggressive buying versus selling; confirms imbalance or divergence.
Example: Price flat, delta rising → bullish breakout pending.
CLV – Closing Location Value
Where candle closes within range; high close signals directional conviction.
Example: Marubozu close at high → continuation bias.
DLR – Deep Liquidity Raid
Stop sweep beyond obvious highs/lows before reversal or acceleration.
Example: Spike above ONH, immediate rejection wick.
DVP – Delta Volume Pulse
Sudden surge in aggressive order flow confirming expansion.
Example: +5,000 delta spike on breakout candle.
ELR – Extreme Liquidity Reversal
High-velocity reversal immediately after liquidity sweep.
Example: Stop purge above PDH → 80-point bearish impulse.
FBO – Failed Breakout
Break lacking follow-through, leading to sharp opposite move.
Example: Break high stalls, inside bar forms → short trigger.
FLS – First Liquidity Sweep
Initial stop run before structural move develops.
Example: Sweep range low, reclaim, build long.
HTF-A – Higher Timeframe Alignment
Lower timeframe entries aligned with 5m/15m/hourly structure bias.
Example: 1m breakout long with 15m bullish trend.
IMP – Impulse Leg
Strong directional displacement with minimal overlap, large bodies, strong volume.
Example: Three consecutive Marubozu, 100-point YM move.
LQZ – Liquidity Zone
Area containing clustered stops, equal highs/lows, visible resting liquidity.
Example: Equal highs above range attract breakout sweep.
LRR – Liquidity Reclaim & Run
Reclaim after sweep with sustained acceptance above/below level.
Example: Sweep PDL, reclaim VWAP, hold → expansion.
MEX – Momentum Exhaustion
Velocity decreases, wicks expand, delta diverges; trend fatigue signals exit.
Example: Higher highs with weakening volume.
MSS-X – Market Structure Shift with Expansion
Break in prior swing structure confirmed by displacement candle.
Example: Lower high breaks with volume expansion → trend shift.
OFI – Order Flow Imbalance
Significant disparity between aggressive buyers and sellers.
Example: 4:1 buy imbalance during breakout.
PVA – Price-Volume Acceleration
Simultaneous increase in price velocity and traded volume.
Example: Rapid 30-point move with doubled volume.
RLP – Reversal Liquidity Pocket
Tight consolidation after stop purge before reversal expansion.
Example: 3-candle base forms after sweep → long trigger.
SFA – Size Flow Acceleration
Increase in large-lot transactions supporting move.
Example: Block trades repeatedly lifting offer.
SPR – Stop-Purge Reversal
Aggressive stop sweep followed by immediate opposite expansion.
Example: Flush below range → bullish engulfing reversal.
TFX – Timeframe Expansion
Higher timeframe breakout aligns with lower timeframe trigger.
Example: 1m break aligns with 15m range break.
VEX – Volatility Expansion
Compression transitions into high-range breakout.
Example: Three narrow candles → explosive expansion bar.
VW-Dev – VWAP Deviation Extension
Significant stretch beyond VWAP deviation bands signaling continuation or exhaustion.
Example: +2 SD extension with divergence.
II. $50K+ Structured Execution Model (YM/NQ)
II. $50K+ Structured Execution Model (YM/NQ)
Capital Assumption
Capital Assumption
$50,000 account
Aggressive sizing model: 20–100 contracts (YM or NQ)
Target: 80–200+ points in expansion phase
Phase 1: Pre-Trade Qualification (All Must Align)
Phase 1: Pre-Trade Qualification (All Must Align)
HTF-A + TFX present
Liquidity event confirmed (FLS / DLR / LQZ interaction)
IMP or ATRX triggered
OFI + DVP confirmation
CLV strong in breakout direction
If 4/5 present → proceed.
Phase 2: Entry Protocol
Phase 2: Entry Protocol
Primary triggers:
• BRR
• MSS-X
• ABR
Execution:
Initial entry 25c
Add via AAR or CBR
Scale to 50c–100c only during VEX + SFA conditions
Phase 3: Risk Architecture
Phase 3: Risk Architecture
Initial stop: below structural reclaim (not fixed tick)
Max per-trade risk: 3–5% capital during expansion phase
Move to BE+ only after second impulse confirmation
Phase 4: Profit Model
Phase 4: Profit Model
YM example:
100 contracts × 100 points = 10,000 points
$5 per point = $50,000
NQ example:
50 contracts × 100 points
$20 per point = $100,000
Scaling logic:
Partial at 1R
Trail via TS under impulse lows
Final exit on MEX or VW-Dev divergence
Phase 5: Exit Triggers
Phase 5: Exit Triggers
• MEX
• Delta divergence
• Failure to hold reclaim
• Opposing SPR
• A TERELS-integrated version
• Or a statistical probability model for $50K setups
Page updated
Google Sites
Report abuse