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The Nebraska Medical Association is excited to announce Lindsey Hanlon as the new LifeBridge Nebraska Program Coordinator. Lindsey’s passion for health and wellness led her to complete her Masters of Science (M.S.) degree in Community Nutrition and Health Promotion from the University of Nebraska-Lincoln while also completing the Public Health certification program (CPH) through the University of Nebraska Medical Center. Lindsey previously worked with the Nebraska DHHS Division of Behavioral Health as the Prevention Administrator where she oversaw various federal grant programs targeted at substance use prevention, mental health promotion, and addressing the opioid crisis. The NMA is fortunate to have a team comprised of results-driven individuals, and we look forward to the energy and experience Lindsey brings to the LifeBridge Nebraska program. Welcome, Lindsey!

LifeBridge Nebraska is a free, confidential peer-to-peer physician wellness program developed to help support the wellbeing of physicians by engagement and being proactive to take care of themselves throughout their lives. Stress and burnout can lead to negative work-life balance, disengagement, and loss of job fulfillment. The coaching program through LifeBridge addresses individual strategies to manage stress and enhance resilience through self-care along with a focus on preventative measures. To find out more, please visit our website at nebmed.org/lifebridge.

The Governor of the State of Nebraska announced that the COVID 19 State of Emergency expires 6/30/2021 (midnight). License types that were deferred per Executive Order 20-10 will have their expiration dates extended to 10/31/2021 and must be renewed by that date. 

What about deferred renewals?
Renewal was deferred for some professions, including Physicians, Physician Assistants, Acupuncturists, Perfusionists and Surgical First Assistants. Those licensees that have deferred their renewal during the state of emergency will now be required to renew by 10/31/2021. If they choose not to renew, their credential will expire and they will need to cease practicing in Nebraska.

What about CE waivers for renewals and reinstatements?
The continuing education waiver for circumstances beyond a licensees control will remain an option after the expiration of the COVID-19 State of Emergency. As it was during the emergency, if a licensee selects this waiver, they must provide documentation to the Department which outlines the circumstances beyond the licensees control that prohibited them from obtaining continuing education.

Visit https://dhhs.ne.gov/licensure/Pages/Licensing-Home-Page.aspx for more information.

By William Padmore, Host/Reporter Nebraska Public Media

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Reggae music plays softly in the background of CBD Remedies’ South Lincoln location, as its employees keep busy with a steady stream of customers. Workers direct the curious to various shelves and glass cabinets, almost all stocked with products infused with cannabinoids, naturally occurring chemicals found in hemp. From smokable flowers, to vape cartridges, gummies and dog treats, the selection is seemingly limitless.

Adam Brewer is co-owner and founded CBD Remedies four years ago. He says while his business still carries plenty of products containing the popular hemp derivative known as CBD, business has picked up since the introduction of one of the newest derivatives, Delta-8 THC.

“People who wouldn't have come in to get CBD are coming in to ask for Delta,” says Brewer, “There's also some existing CBD customers who are now integrating Delta into their supplements as well. Yes, it definitely has been a good thing.”

Delta-8 THC has been at the center of an apparent upswing in hemp related business in Lincoln and Omaha as it has taken root in smoke shops and specialty stores.

But what is Delta-8 THC?

Dr. Andrea Holmes is the Director of Cannabis Studies at Doane University and works with CBD Remedies as a science consultant. She says Delta-8 is a cannabinoid extracted in trace amounts from hemp during processing. It is also the weaker chemical cousin to Delta THC-9, the psychoactive chemical prominent in marijuana that gives a person the feeling of being “high.”

“Because of the structure just being slightly different, it doesn't have that same capacity to bind on that CB one reactor the same way, how Delta 9 does,” says Holmes, “so it binds much more weakly.”

When absorbed, the Delta-8 THC does produce a psychotropic effect like that of marijuana’s Delta-9 THC, just not as intense. Holmes says people commonly purchase Delta-8 THC for anxiety, sleep and pain management.

Dr. John Massey is an interventional pain physician in Lincoln and says patients ask him about hemp derivatives like Delta-8 THC regularly. He says there is some research that shows some cannabinoids have been shown to be helpful for people with certain medical conditions, but he warns there are still a lot of unknowns surrounding long-term implications.

“If there is an individual who may be prone to problems with substance use disorders or they have a mental health/ mood disorder or something like that, I’d be very cautious. If individuals have limitations that make their options more difficult, I might be less cautious,” says Massey, “but it's never fun as a physician to be without enough information to counsel a patient correctly or confidently.”’

Dr. Kenneth Zoucha is an associate professor of psychiatry at the University of Nebraska Medical Center and a program director for Addiction Medicine Fellowship. He says that while he is optimistic about the future of medical cannabinoids, he hasn’t seen enough evidence at this point.

He also has concerns about the potential development of substance abuse disorders, especially in children.

“We know that they're definitely more at risk for developing a substance use disorder if they use a substance that has euphoric potential with it,” says Zoucha.

Lorelle Mueting is the Prevention Director for Heartland Family Service, a social service agency in Omaha and Council Bluffs. She says THC-8, THC-9 and other psychoactive drugs may be OK for strict medical use, but says if any such compound is free to spread unregulated, it is bound to cause some societal ills.

“You know, a lot of times people will say to me, Well, it's no big deal. It's my choice to get high, but my choice to get high doesn't just affect me,” says Meuting.

Andrea Holmes is the first to admit that more research needs to be done on Delta-8 and other hemp derivatives. Still, for her, what data is available is enough to convince her that byproducts of hemp do more good than harm.

“Our reputation is on the line,” says Holmes. “We're not going to recommend a product to somebody that we don't fully believe is of quality.”

Delta-8 THC and other hemp derivatives are technically legal to sell, carry and consume in Nebraska. The 2018 Farm Bill only regulates Delta-9 THC and the 2019 Nebraska Hemp Farming Act promotes the sale of hemp extracts. The FDA is fine with the sale of hemp byproducts so long as sellers don’t make unsubstantiated claims about their medical properties.

Regulated or not, Delta-8 and other hemp derivatives have become big business in Nebraska and across the nation. Chad Frey is the Executive Director of the Nebraska Hemp Industry Association and said since the implementation of the 2018 Farm Bill, the hemp industry has grown from a $500-700 million industry in 2018 to a $1.8 billion industry last year.

Still, he warns there is a significant amount of risk as the industry gets more attention, especially in a conservative state like Nebraska where many lawmakers continue to oppose medical marijuana efforts.

“It Is really writing on the wall for any entrepreneur in the state of Nebraska, considering the stringent views towards cannabis,” says Frey, “It's very difficult not to think that Nebraska will not begin to create legislation banning all THC forms, including Delta-8."

State Senator Robert Clements voted against the 2019 Nebraska Hemp and Farming Act. When contacted for this story, he said he has not heard of any legislation being considered to regulate or ban Delta-8 THC yet but would support such a bill.

Meanwhile, Attorney General Doug Peterson is looking into the issue after a request from Governor Pete Ricketts.

“We’re not done with our evaluation,” says Peterson, “but we will be and will be making you aware.”

Andre Holmes of CBD Remedies says such a crackdown in Nebraska would be devastating for those who have come to depend on it.

“It's absolutely critical for us to have Delta-8 THC,” says Holmes. “I am worried that somebody is going to put the kabash on this because it's a very effective cannabinoid that can help people, and to shut that down would be a travesty in my opinion.”

CBD Remedies' Adam Brewer is well-aware of the risk and understands concerns about regulation. To stave off criticism, he has imposed a series of self-regulatory measures, many like those at dispensaries in states where marijuana is legal.

“All of the products that we sell in store have obviously been tested by a third-party facility before we purchased them, and then oftentimes after we receive the products we'll select a random sample out of the shipment and we'll have it retested ourselves,” said Brewer.

His business also won’t sell to anyone who’s not at least 21. He hopes by being a responsible business owner he can convince detractors that the hemp derivative business is legitimate and avoid burdensome regulations.

“It's always possible for that to happen,” said Brewer, “But I do have a positive outlook on it and I think that I think that the state of Nebraska is going to look at this as, you know, this is our form of medical marijuana.”

At that, Brewer laughs somewhat nervously.

“Maybe, but we’ll see.”

Nebraska Medical Association member physicians invite you to join their physician-lead campaign to raise funds to help restore the Dr. Susan La Flesche Picotte Center in Walthill, Nebraska.

In 1889, Susan La Flesche Picotte, MD was the nation’s first Native American woman in the United States to receive a medical degree. In her remarkable career she served more than 1,300 people over 450 square miles, providing medical care at all hours of the day and night on horse and buggy. In 1913, she saw her life's dream fulfilled when she opened a hospital in the reservation town of Walthill, Nebraska, eliminating the arduous journeys patients endured to Omaha or Sioux City for care. It was the first hospital built on a reservation without federal funding, and had a 12-bed general ward, 5 private wards, maternity ward, and an operating room. 

Today, this historic building is at risk of being lost after years of neglect. Nebraska physicians have answered the call to help restore the original hospital into a community center – following in the footsteps of Dr. Susan’s trailblazing legacy to bring hope and health to the Omaha tribe and surrounding community. In 2017, the Nebraska Commission on Indian Affairs formed a Susan La Flesche Memorial Advisory Committee comprised of Dr. Picotte’s descendants, community leaders, architects, museum professionals, stakeholders, and Omaha Tribe elders. The restored building will serve the needs of today’s local community and provide medical services, behavioral health services, substance use disorder services, youth programming, Native arts and culture, and a Dr. Susan historical exhibit.

To find out more about the physician campaign, please visit nebmed.org/drsusan.

When Alena Balasanova, MD, started the addiction psychiatry consultation-liaison service at the University of Nebraska Medical Center with a colleague two years ago, even she didn’t realize how much it would become part of the culture of her hospital. From developing protocols and processes for patients with substance use disorders getting surgery to routine consults with her internal medicine and surgical colleagues, Dr. Balasanova says she’s most proud of the team-based culture she’s been able to help create.

“With the past year and COVID, while hospital occupancy generally went down, our census on the addiction consult service increased exponentially,” said Dr. Balasanova. “As alcohol and drug use have sharply risen, there’s been an even greater need to ensure evidence-based care across multiple settings.”

For medically and surgically hospitalized patients, there is now a multidisciplinary team....READ MORE 

Thank You Tuesday is a joint venture with the Lincoln Saltdogs and the Nebraska Medical Association to honor various frontline heroes who have helped navigate the ongoing COVID-19 pandemic over the past year. This will be done for every Tuesday home game throughout the 2021 season.

Nominations are now open for every #ThankYouTuesday at Haymarket Park.

Family members, friends and co-workers can nominate workers they know for a chance to be one of four selected during a Tuesday home game. Those selected will receive four club-level tickets to the game and will be honored with on-field recognition during the game.

“We look forward to recognizing heroes in our community throughout the summer here at Haymarket Park,” Saltdogs President/GM Charlie Meyer said. “We would also like to thank the Nebraska Medical Association for partnering with us.”

Those eligible for nomination include nurses, respiratory therapists, physicians, hospital workers, clinic staff personnel, teachers, school staffers and first responders. These Tuesdays provide a chance to celebrate all frontline heroes in Lincoln and the surrounding communities, working to keep residents safe, cared for, healthy and fed.

Nominations can be sent in throughout the year, and the first #ThankYouTuesday will be the ‘Dogs home opener — May 25th at home against Cleburne.

Click here to nominate someone you know!