Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disease that leads to motor neurons death. There are two types of this disease including: fALS and sALS. Lateral sclerosis refers to the hardening of the spinal cord. The disease is characterized by muscle weakness. Since the ALS is progressive degeneration of the neurons in the brain and spinal cord, the patient slowly lose the function of all muscle. This is the most fatal feature of the disease because of loss of function of muscle associated with respiratory, cardiac, digestive, speech and other systems. Currently, there is not cure for ALS, except a drug called Riluzole, which decrease the symptoms of the disease. Glutamate is an important neurotransmitter in the central nervous system. Glutamate plays a significant role in the onset of ALS disease. The concentration of glutamate is higher in the cells as well as in the fluid outside of the cells (extracellular fluid) in the ALS patients. This leads to neural dysfunction and degeneration, which is process resulting in death of the neurons. Riluzole regulates the level of glutamate in and outside of the neurons.
Discussion about ALS in our neurochemistry class did bring up other important topics such as sensitive conversations and decisions to be made by ALS patients and their family members. We spoke about whether or not consulting and being tested if one has a family member with ALS. It is a very important matter in one’s life because it might determine future decisions such as marriage, having children and other personal decisions. There are people who love to become parent; it becomes complicated and very difficult decision to make if genetic testing indicates a potential to develop ALS in the future. I am not sure if I can ignore my hope to become a mother some day and at the same time knowing that my child will suffer and die from ALS. It really made think about what I would want to do if I get diagnosed by ALS.
There is not a treat for ALS and at the same time there is not enough funding to get significant studies done about the possible treatments. As we discussed in our group, raising awareness and educating people on the disease might help to raise funds toward the research on the disease. For example Ice Bucket Challenge was a great step which has enabled the ALS Association to have a significant fund raising. Ice Bucket Challenge has caused awareness and also initiated research projects. I hope our society grow as a whole by helping and educating one another on fatal disease that can be cured by doing more research. If we always come up with creative ways like Ice Bucket Challenge to increase public awareness, then in return the society would help by donations toward research funding and emotional support to the patients and family members. If we know about the symptoms of a particular disease, then we would not act or say something offensive by seeing a patient having the disease.
I am so grateful for taking neurochemistry course at Concordia College. It has definitely helped me to learn about different disease, importance of public awareness on different topics related to our health, and function of the brain in cellular level. I know that there is a lot more topics to come and I will be appreciated by learning them. I feel very happy when I am writing on this website because I feel like I am contributing to social awareness and this is a way to help our society.
https://moodle.cord.edu/pluginfile.php/468373/mod_resource/content/1/NMDA%20receptors%20and%20ALS.pdf
What we know about concussion?
I have learned great amount of information on concussion after reading the article of “The young brain and concussion: Imaging as a biomarker for diagnosis and prognosis” and had group discussions in our neurochemistry class. I had almost no information on concussion and its consequences. This article is a great source to obtain general information of what is concussion, and impacts of concussion on the brain in short and long term.
Changes in the brain after concussion, diagnosis, treatment, and current science on concussion: 
Concussion causes alterations in the regions of the brain which in return impacts our behavior and perceptions of events happening in our body and in our environment. When concussion happens, it causes parts of the brain cells (neurons) to get injured and my die off. This is when the long term effects of concussion occurs. There is not a very in depth and well known scientific knowledge on pathophysiology (the functional changes associated with or resulting form) of concussion. This makes the treatment and diagnostic processes difficult. The techniques of imaging concussion’s effects on the brain are costly and most people might not afford it. Based on our group discussion on the topic, the insurance agencies do not cover the cost of these diagnostic measures. Some of the techniques also uses radiation which is not safe for us to use it often, in case of having second or third concussion especially for people who play sports like football. Since there is no well understanding of how and why the functional changes in the brain after concussion occurs, the treatment of concussion is not very well developed either. Treatment options might even make further functional changes in the brain.
Increasing awareness about concussion and its consequences to the best of our knowledge is the best method to approach concussion: Football is very important in American culture and the “hitting” part of it is what people enjoy. This is what causes concussion. As we discussed in our class, it is not easy to change a culture, but it is very crucial to raise awareness and educate public on concussion. We spoke about whether to change some rules in sports like football which might lead to less head injuries or develop more protective equipment. Since football has a very deep root in American culture, it would be difficult to convince people to make football safer by changing some rules. At the same time, it might cause players to hit harder if they wear protective equipment. The best conclusion we came up with was the fact that people do not know a lot about concussion, and educating them, and raising awareness would be the best possible solution at this time. It is very important to increase information of people on concussion so they take better care of their children or themselves who are playing some sports like football. This is because the impact of concussion is not the same for everyone, and its “healing” process also varies person to person. This is not for football, any sport or activity in which we hurt our head can cause concussion. I think it is important to increase public awareness because this is the secret to make informed and responsible decisions.
Why knowing about marijuana is important?
Marijuana is a preparation of a plant called Cannabis sativa. During the history, in different cultures, this plant has been used for different reasons. But the question is what it contains that has such impact on the person who uses it? According to the article of “Endogenous cannabinoids revisited: A biochemistry perspective”, Cannabis has at least 400 chemical components, 60 of them to cannabinoid class.
Why our body naturally produces cannabinoids:
We have cannabinoid system in our body, which is called endogenous cannabinoid system. It has protein molecules that are functioning as receptors for the cannabinoids that are naturally produced in our body. These are called endocannabinoids. They are naturally produced in the body. Different endocannabinoids in the body are produced when they are needed; they are not stored in the cells. They have important roles, for example, Anandamide, an endocannabinoid that is able control motor activities (movements), stimulates appetite, and so many other impacts. Another example is Oleamide, which is a sleep inducing substance. Endocannabinoids are involved in the pathway that leads to cell death. This characteristic and so many other benefits of endocannabinoids make scientists more willing to research and discover possible benefits of different compounds in Cannabis sativa plant. This is important because of possible production of new drugs to treat many diseases.
Potential benefits of cannabinoids in Cannabis sativa:
This is the molecular structure of tetrahydrocannabinol (THC), which is a cannabinoid isolated form Cannabis sativa plant. Extensive research has been done on the characteristics and structure of this compound. The results of scientific researches on this cannabinoid, as a treatment for cancer, have indicated its important role in apoptosis of cancer cells. This is death of cancer cells. THC kills cancer cells by binding to the cannabinoid receptors and causing changes in the cell which leads to the death of the cell. Marijuana, a schedule I classified drug, needs to be thoroughly explored through scientific studies. This is because of its compounds’ possible potential for development of drugs, which can help with treatment of diseases. Having marijuana as a schedule I drug disables scientific studies about it. There are thousands of cancer patients who have used marijuana and reported satisfying results. The link to a video, which contains interviews with doctors, researchers and cancer patients. The video provides a helpful summary about potential benefits of this plant.
http://www.bing.com/videos/search?q=THC+and+cancer+treatment&FORM=HDRSC3#view=detail&mid=FE8E4717191445E6C3FEFE8E4717191445E6C3FE
Why should general public care about this topic:
I have learned helpful information during one week of discussion on topic of cannabinoids, endocannabinoids, endogenous cannabinoids system in the body, the role of endocannabinoids, and possible helpful characteristics of cannabinoids derived from marijuana. I shared what I have learned in the first three paragraphs. I would like to share my knowledge on the topic, even if it is not very completed, because I think it is very critical for general public to know about a matter before making any decision. We do know that marijuana can have potential to treat disease, but abuse of the drug is also associated with unwanted consequences. I found the adverse impacts of abusing THC on an online article, which the link is provided for. According to the article, some possible risks of consuming THC include: impaired motor skills, decrease in IQ, memory and cognition [in younger people]. The same article on this website explains, “THC before birth, soon after birth or during adolescence have shown problems with specific learning and memory tasks later in life”. Having enough information about risks and medical benefits of marijuana can help people to make informed decisions.
http://www.livescience.com/24553-what-is-thc.html
ALS: Put your Money Where the Ice is
Imagine if a close family member or friend was diagnosed with amyotrophic lateral sclerosis. The statistics flocking into your mind would include the debilitating symptoms, the understanding of knowing they may only have three to five years left to live, and the realization that the person you love will never be the same.
Amyotrophic lateral sclerosis (ALS or Lou Gehrig’s Disease) is a neurodegenerative disease that affects roughly 30,000 individuals in the United States every year. The disease is “characterized by the massive loss of motor neurons in the spinal cord, brain stem and cerebral cortex.” This loss in function of motor neurons leads to stiffness, weakness, muscle cramps, decreased reflexes and eventually the inability to breath, leading to the tragic cause of death: suffocation. The eventual dysfunction of the motor neurons can be contributed to a neurotransmitter toxicity, (glutamate toxicity), with the major dysfunction involving excitotoxicity (too much calcium being released in the cell, leading to cell death) in the AMPA and NMDA receptors.
The AMPA receptors found in the cell membrane seem to be impacted due to the fact that when the channel for calcium to influx into the cell stays open, or “unedited”, the channel doesn’t have the ability to control the amount of calcium let into the cell, as mentioned before, leading to excitotoxicity and death of the motor neuron.
What has recently been reviewed is the impact the NMDA receptors (the main receptor for the excitatory neurotransmitter glutamate) may play in regards ALS. Similar to AMPA receptors, calcium may enter the cell at a rate that leads to excitotoxicity. This excitotoxicity results in calcium release from the endoplasmic reticulum (ER), eventually leading to misfolded proteins. The structure of a protein is the entire basis of the function to the protein. With misfolded proteins, the function is compromised, giving rise for the cell’s inability to carry out its function, eventually leading to cell death.
Even if all of this information was known, the news of the diagnosis would probably leave you with one statistic looming over all the rest.
There is no cure.
Even with certain treatments, such as Riluzole and Memantine, by inhibiting NMDA receptors, the symptoms of the disease are only prolonged by two to three months. If this were the case, what would you do? Research is heavily funded dependent on the number of individual’s impacted. Some diseases most impacted by people include lung and heart disease, breast cancer, and Alzheimer’s disease. ALS is not amongst the top in the list. So what to do?
Raise awareness.
The ice bucket challenge has that connotation for that exact purpose. Dumping buckets of ice water over the head has swept through nations of bringing awareness to the neurodegenerative disease of ALS. The challenge went viral on social media just last year. The challenge is to film proof of ice water actually being dumped on the head, posting the video to social media, and then nominating friends and family to participate within 24 hours or forfeit by donating money to research funding of ALS.
But even if ALS is not among the top diseases to impact people in the world, I don’t believe that should make it any less important in finding a cure. ALS, as with any major disease, impacts more than just the individual. Entire families, friend circles and communities are impacted by the horrific and debilitating symptoms associated with these neurodegenerative diseases. Regardless of how many are affected, I still believe ALS should receive research funding in order to find a cure. Donate regardless of if you complete the Ice Bucket Challenge or not. If that means put your money where the ice is, do that!
ALS: More is still to come…
This week in NeuroChem we discussed amyotrophic lateral sclerosis, ALS, or Lou Gehrig’s disease, which is a progressive neurodegenerative disease that causes degeneration of motor neurons in the brain and spinal cord. When the motor neurons degenerate scarring occurs, which causes sclerosis, hardening of the spinal cord. Since these neurons can no longer function properly, the brain is unable to initiate and control muscle movement. Individuals with ALS eventually lose the ability to breath, eat, speak, or move, and eventually die from this disease since there is no cure.
If you had a history of ALS in your family, would you want to be tested to see whether you had the gene and could potentially develop ALS? Personally, I would not want to know, because I wouldn’t want that knowledge to consume my life and spend my time waiting around for the disease to kill me. But the issue also arises, if you knew you could potentially develop ALS, would you want to have children and risk passing it on to them? I know I would feel like a horrible parent for passing ALS onto my child.
Currently, not a lot of money is being spent on ALS research compared to cancer research, so the question remains, even though there is not a large portion of the population suffering from ALS should more money be allocated to ALS research in order to find a cure? There is an estimated 30,000 people suffering from ALS in the United States, so even though there is not a lot of people suffering from ALS compared to an estimated 14.5 million people currently suffering from cancer, that doesn’t make it any less important. With this being said, I think that ALS should be made a higher priority in the field of research.
It is important that we, as a society, promote ALS research. The ALS Ice Bucket Challenge is currently the most successful promotional campaign for ALS research. The Ice Bucket Challenge has allowed the ALS Association to double their annual budget, which has helped them to fund more research projects. Hopefully, through increased awareness of ALS and monetary donations, there will be a cure found for ALS in the near future!
References
http://www.alsa.org/
http://www.cancer.org/acs/groups/content/@editorial/documents/document/acspc-044552.pdf
Death and Dying: Advanced Care Planning
“Thinking about death clarifies your life.” -Candy Chang
Amyotrophic Lateral Sclerosis (ALS), commonly known as Lou Gehrig’s disease is a neurodegenerative disease that is characterized by loss of motor control and eventual death. ALS involves the death of motor neurons and the progressive loss of motor function. Patients with ALS slowly lose control of their limbs, their body systems and finally speech. ALS patients however never lose their cognitive function; while their body is declining, their mind is fully functional. ALS eventually leads to loss of respiratory function and patients spend their last months or days on a ventilator. As time progresses, quality of life declines for those suffering from ALS. This progressive loss is characteristic of many degenerative or terminal diseases: multiple sclerosis, Parkinson’s, Huntington’s, and some cancers. Our class discussion on ALS and its effect on quality on life led to a discussion on creating an end of life plan.
Advanced Care Planning (ACP) is the process of communication between the individual, family, and healthcare professional to understand, discuss, and plan for future healthcare decisions for a time when the individual is unable to make their own healthcare decisions. The process typically results in the designation of a healthcare proxy and a written care plan referred to an advanced directive. An advanced directive or living will lays out the individual’s wishes when it comes to ventilation and being resuscitated. Living wills are typically created for patients suffering from a chronic or terminal condition. 7 out of 10 Americans die from a chronic disease and over 90 million Americans live with at least one chronic condition. In theory, 70% of Americans should have an advanced directive, however only 20-30% of Americans report having a living will. This means that some 40% of individuals who know they have a shortened time to live, do not have a written end of life plan. This discrepancy leads to difficulties for the family of such individuals. Without a written directive, family members are often reluctant to follow the wishes of the patient.
When my maternal and paternal grandparents were reaching the end of their life my aunts and uncles along with my parents had trouble making the decision to ‘pull the plug.’ My grandparents had rarely discussed their wishes with their children so that when it came time to make that decision everyone was divided. Because of their experience, my parents have already discussed their wishes with me and have written a living will. As a 21 year old I know that my parents do not want to be kept alive on a machine. If and when I have to make that decision regarding my parents’ lives, I can say ‘pull the plug’ without a guilty conscience because I am following their wishes.
If more individuals discussed their end of life wishes the family could be saved the heartache associated with being forced to make that decision for a loved one. Who is responsible for starting the conversation regarding advanced care planning? Is it the role of the physician to ask the patients suffering from a terminal disease their end of life plan? Currently there is a disconnect between patient and physician regarding advanced directives. A large-scale study found that only 25% of physicians knew that their patients had a living will. I believe it is important that we have these conversations with our loved ones so that future healthcare decisions are easier to make. If all patients diagnosed with ALS or similar conditions had a written living will, the end of life transition would be less difficult as those decisions would not need to be made last minute or without the individual’s input. Facing the end of your life is hard for both you and your family, but by developing a living will, you can ensure the end is how you want it to be.
Advanced Care Planning: http://www.acpelsociety.com
Statistics: http://www.pbs.org/wgbh/pages/frontline/facing-death/facts-and-figures/
Images: http://conversationsofalifetime.org/; pinterest.com
Annual ALS Ice Bucket Challenge Until We Find a Cure!
I must admit, at this time last year I perused social media with a hatred for video after video of people dumping ice water on their heads in the name of ALS fundraising and research. It was not that I lacked support for the ALS Association or its goals. In fact, I have high respect for the association and the strides they have made in ALS research. I simply struggled to believe that the hype about the challenge was truly making a difference in the name of ALS.
After learning about ALS, or amyotrophic lateral sclerosis, in neurochemistry class this week I decided to check back in on the ALS Association and the results of last year’s viral Ice Bucket Challenge. The results pleasantly surprised me. In the summer of 2014, more than 17 million people uploaded Ice Bucket Challenge videos to Facebook; the videos were watched by 440 million people, and they were watched more than 10 billion times. The monetary donations gathered from the challenge were all donated to the ALS Association, which provides care to people with ALS, endorses political policies that respond to the needs of those with ALS, and researches ALS to find a treatment and cure for the disease. During the six official weeks of the 2014 challenge, 115 million dollars was raised for the ALS Association. This has energized the research community and accelerated research projects. It also allowed for additional resources to pursue new programs and research ideas.
Due to the major success of the Ice Bucket Challenge last year, the ALS Association declared that the challenge will take place every August until they find a cure. And the ALS community is urging for a cure to the devastating disease. ALS is a progressive neurodegenerative disease that affects the nerve cells in the brain and spinal cord that innervate the voluntary muscles in the body. As the motor neurons degrade during the progression of ALS, control over voluntary muscles is lost. The symptoms of ALS begin subtly. Muscle fatigue, weakness, increased tripping while walking, or dropping things are the most common symptoms noticed initially. Changes in the voice or trouble swallowing may also occur.
These symptoms progress slowly, escalating into severe muscle twitching and paralysis throughout the body. While it begins as either upper or lower motor neuron degeneration, it will eventually affect both systems, leaving those with the disease unable to walk, move, eat, or breathe. During late stage ALS a ventilator and a feeding tube is needed for respiration and nourishment, respectively. However, senses such as sight, smell, taste, and hearing go unimpaired. The brain and the ability to think remain intact as well.
It does not take much to paint a stark picture of the devastation ALS has on the human body. The urgency of finding a cure is felt by simply understanding the course of the disease, and campaigns like the Ice Bucket Challenge are a way awareness is spread and money is raised. Simply making the disease known to the public, which is what the challenge achieved, is an accomplishment in itself, and I am happy share the news of the ALS Ice Bucket Challenge success, along with its plans for future challenges with you. Here’s to hoping the challenge will continue to make a strong impact within the ALS Association as they desperately search for a cure.
Basics of Endocannabinoids and the Developing Brain
As our country slowly shifts its stigma on marijuana, there are many issues that need to be discussed. Some of these issues include its medicinal properties, if research should be funded and conducted on marijuana, if it should remain a schedule I drug, and if it is safe among other questions. Many people only have a small idea of how marijuana actually affects the body, as we have been told since we were younger that pot is bad for you and smoking it causes the person to be high. With the broad scope and many issues surrounding this topic, I wanted to give a short background on the body’s natural endocannabinoid system (i.e. the system that marijuana is working on) and why studies have shown it to have damaging effects on the developing brain with extensive use. Other than the actual effects of smoke in a person’s lungs, studies on the effects of marijuana on the developing brain are the reasons we hear that “pot is bad.” Under medical circumstances, without smoke, and in moderation – medical marijuana actually has some useful qualities that need to be further researched. So let’s start by looking into some of the science behind marijuana.
To begin, our bodies have many different substances, like hormones or neurotransmitters, that are released from cells and that bind to other cells on a receptor that is generally specific to that substance. This is how our body communicates with itself and responds to the environment around us. Our bodies naturally have substances called endocannabinoids (endo meaning produced in the body). These endocannabinoids have receptors in the body, CB1 and CB2 that they bind with to cause reactions. They are involved in a variety of physiological processes including appetite, pain-sensation, mood, and memory, and they mediate the psychoactive effects of cannabis. The active drug in cannabis is THC, which binds to that receptor and causes an abnormal effect – resulting in the high that people feel. During development, the endocannabinoid system helps the brain to create and refine neural connections. Heavy marijuana use during development has been shown to alter the growth of neural connections.
According to the National Institute on Drug Abuse (NIDA), THC exposure during development can cause long-term notable problems with learning and memory tasks later in life. The THC is binding to the CB receptors in the hippocampus, the main area of the brain associated with memory. In studies on rats, they found that THC exposure during development caused structural and functional changes in the hippocampus. Fully developed adult brains did not show this effect. Image studies in humans revealed impaired neural connectivity in areas affecting memory, learning, and impulse control as it was altering how information was processed in the hippocampus.
As people age, they lose neurons in the hippocampus which decreases their ability to learn new information. Chronic THC exposure during development may speed up that process. This is how researchers are explaining the memory issues found in younger adults who used THC chronically when they were developing their brains as teenagers. There is a great need for more studies involving the actual pathways that cannabis takes in our bodies so we can understand its full effects and use them to our advantage without damaging our brains.
Endocannabinoids: is There Marijuana Inside our Brains?
While current legislation considers marijuana/cannabinoids to have no medical uses, the discovery of an endocannabinoid system in the body, specifically in the central nervous system (brain and spinal cord), gives significant evidence to the contrary. This endocannabinoid system is made up of receptors that bind to THC as well as natural molecules similar to THC (endocannabinoids). The specific receptor that produces the most well-known effects of THC is called CB1 and is most prominently found in the brain.
Other than its psychoactive effects, there is an abundance of anecdotal evidence and much less scientific evidence that cannabis provides relief from symptoms of ailments as wide reaching as pain, to tumor growth management, to seizures. This, coupled with the legalization of medical marijuana in many states including Minnesota, has created an increased interest in the medical possibilities of cannabis. However, the legal standing of marijuana as an illicit drug makes it hard for researchers to study. The presence of the endocannabinoid system is a handy-dandy (and legal) alternative.
The study of endocannabinoids (a type of molecule or chemical) that are naturally found in the brain allows researchers to see the effects THC has by binding to the same receptors. One of these is called anandamide or abbreviated AEA. This chemical has been shown to decrease pain (analgesia), increase appetite, control inflammation, and decrease cell division (important in controlling tumors…for example, in cancer), all activities that many individuals claim cannabis also demonstrates. So, the answer is no, there is not marijuana in our brains, although there are similar molecules that seem to have positive effects naturally that could be duplicated using cannabinoids such as those found in marijuana.
However, the psychological effects of cannabis are often a barrier for acceptability by the general public when it comes to medical legalization of marijuana. In this instance, some available solutions have been to extract the best known active ingredient out of the plant form of the drug, THC. However, more recent research as shown that a chemical from the marijuana plant called cannabindiol. This chemical may be able to have a wider range of medial effects than THC without inducing any kind of psychological changes, thus reducing abuse potential and the “high” that accompanies intake of the cannabis plant itself. In addition, these extracts are often available medically in a less stigmatized administration than smoking, such as oils, edibles, or pills.
Perhaps in a few generations, there will be over-the-counter pills and syrups with drugs derived or extracted from cannabis for pain or to help increase appetite in the seriously ill. Perhaps the stigma will be gone to allow for medical use of THC or cannabindiol and it will join the ranks of the opioids (serious pain relievers) as a therapeutic drug, instead of with heroin and meth as an illicit drug.
Miracles and Medical Marijuana
Is it our right to deny someone the medication they need in order for them to be free of pain and illness? No its not and yes, I’m talking about medical marijuana. We’ve all heard stories of the miracles of medical marijuana, especially the story of the little girl, Charlotte Figi, who was suffering from epilepsy but was immediately relieved of her seizures when she was administered a high dose of medical marijuana in the form of cannabidiol oil. There are a lot of misconceptions and negative stereotypes relating to cannabis because of the psychotropic effects, but in the case of cannabidiol, CBD, there are no psychotropic effects.
First and foremost, marijuana should be removed from the schedule I list of drugs and should be placed in the schedule II category, because research has shown that marijuana does in fact have medicinal uses. In order for more research to be done on the medicinal benefits of marijuana, changing it to a schedule II drug is necessary because it will make it more easily accessible for research labs.
There continues to be a lot of controversy around this subject because there is not a lot known about the short-term and long-term symptoms of cannabis and research has shown that cannabis can have effects on the developing brain. But ultimately, if medical marijuana can help other people like Charlotte enjoy life, then this is all for a great cause.
To avoid stereotypes and regulations on marijuana, alternatives to using cannabis as a medical treatment have been a “hot topic” in recent research. This past week in our Neurochemistry course we talked about endocannabinoids, which are molecules made in our bodies that bind the same receptors as cannabis. The two forms of endocannabinoids synthesized by our bodies are 2-AG and AEA, which are fatty acids formed from the plasma membranes of our cells.
Cannabis has been shown to help relieve symptoms of nausea and vomiting due to cancer treatments, stop seizures, decrease the growth of tumors, increase or suppress appetite, and reduce chronic pain. With this knowledge, we can target the endocannabinoid system and develop medications to treat these symptoms with decreased toxicity and without the psychotropic effects of cannabis. In the case of decreasing tumor growth, endocannabinoids can induce cell death by binding CB1 or CB2 receptors on the surface of cells and as a result induce modulatory events within the cell.
Ultimately my message is, let’s educate America and break down the stereotypes surrounding marijuana, so we can help more people like Charlotte!
Sources:
http://www.alternet.org/drugs/8-miraculous-medical-marijuana-survival-stories