keyNOTES with Dr. Dave
4:20 is Annual Weed Day. Smokers celebrate this day by gathering and smoking in public places. This year it’s difficult to avoid the shift in attitude about the Marijuana plant with many States in the USA now allowing its use for medical purposes. Many people still don’t seem to understand what this means so we asked Dr. Dave Hepburn, Canadian Author and Canada's leading expert on the topic of medical Marijuana to explain what is driving this momentum and to educate us on the topic.
KSC: What is your belief about natural medicine in general?
Dr. Dave: Aspirin comes from the bark of the willow tree. Digoxin from the foxglove plant. The saliva of the Gila monster is the template for a commonly used treatment of diabetes. These are but a few of the medications that we use having been guided by nature. Medical science constantly strives to, safely and effectively, harness the best of what nature offers for disease prevention and treatment. This includes our own natural endocannabinoid system (ECS), discovered in 1992 by medical scientists in Israel. It behooves every health care provider to understand the basics of the ECS.
Would you say medical marijuana is on the same level as naturopathy and homeopathy?
Dr. Dave: No, not at all. It only serves to distract and saboutage the promise and potential of cannabis by trying to force it into divergent categories or labelling it for the benefit of one “opathy” or another.
KSC: Why do you think most traditional doctors refuse the idea of medical marijuana?
Dr. Dave: In the past, a cultural and political bias as well as fear of legal ramifications have interfered with the ability to carry out the necessary studies that doctors rely on. Now, however, fewer and fewer doctors are closing their minds or ignoring patients who they know and trust and who definitely benefit from cannabis for a myriad of illnesses and/or symptoms. They see patient after patient who want to get help, not high. Patients are teaching doctors and those doctors who are honest enough to listen and humble enough to be teachable are far ahead of the curve.
Doctors are recognizing the importance of the role that key receptors, ligands and transmitters play in disease and health. They note that key opinion leaders in medicine, including many who were previously opposed to the use of cannabis as medicine, have not only embraced its use but are actively engaged in learning more or using it as part of their armamentarium. The fact that for 70 years it has been labelled a Schedule 1 Drug, a designation which will change sooner than most think, has prevented the kind of press that doctors would like to have.
KSC: What would you say are the top 3 myths about medical marijuana?
Dr. Dave: Myth 1: Cannabis is THC. There are still those who think that the two are synonymous, so it boggles my mind that they must therefore think “Wow. Kids with seizure disorders are getting high when they’re put on THC.” There is cannabis and then there is cannabis. There are 107 different cannabinoids in the cannabis plant of which only four are psychoactive, THC being the most well known. CBD, not at all psychoactive, is now becoming as well known given its success in treating many conditions and symptoms. The combinations of assorted cannabinoids (and terpenoids) that can be engineered and used to treat assorted illnesses is staggering.
Myth 2: It has to be smoked. Health Canada has recently approved the use of oils that can be ingested and will undoubtedly be available in capsule forms.
Myth 3: It is a dangerous narcotic. First of all it is not an opiate in any way shape or form. In addition there are virtually no cannabinoid receptors in the brainstem, an area vital for breathing, heartbeat ie living, so nobody dies of cannabis. While the rise in death and damage from prescription tranquilizers, sedatives and narcotics in particular have been quite alarming, cannabis offers, for many, a safe alternative.
KSC: In your opinion, do you believe medical marijuana could become a bigger market than traditional medicine? If so, how would this affect pharmaceutical companies and the way they do business?
Dr. Dave: The many kinds and combinations of cannabinoids will become part of traditional medicine. It will be both adjunctive therapy and even primary treatment for many people and many conditions. Pharmaceutical firms have had an enormous interest in researching all aspects of the ECS and determining how best to treat both deficiencies and abnormalities of the ECS. Some of these abnormalities may well be responsible for a plethora of common malaises ranging from migraines to insomnia to pain of various sorts.
KSC: If legalization happens in Canada, what would that mean to those who use medical marijuana and their relationship with their doctors?
Dr. Dave: Personally, I am more interested in the science, so I don’t get too involved in the politics. However legalization happens, patients will want to be more involved and responsible for their own health. The will want access to medical grade treatment and guidance on the appropriate use of which cannabinoid or combinations of cannabinoids is most useful for them. The real patient will probably prefer to have a prescription that can be claimed on their taxes (as it can be now) and distributed by a source such as a pharmacy with guaranteed consistency of dose and quality.
KSC: Is there a concern about medical marijuana patients developing a dependency on marijuana after treatment?
Dr. Dave: The risk of dependency on cannabis is no greater that the risk of dependency on coffee. There is far greater concern of those who become dependent on opiates, sleeping pills and benzos.
KSC: What is the most successful medical marijuana case you have seen?
Dr. Dave: Too many cases to enumerate. The faces of medical cannabis range from two year olds with a seizure disorder to a 75 year old law-abiding female with insomnia caused by chronic pain, and everyone in between who battles a host of chronic conditions. One 91 year old, waiting for a hip replacement, was on Fentanyl patches and breakthrough morphine. After going on cannabis she went completely off the morphine and was on her way off of the Fentanyl. “Doctor, I know my hip is bad and I need surgery, but it just doesn’t bother me anymore.” She then stood up and looked me in the eye and said “I wouldn’t have believed it... but this stuff really does work."
KSC: Where can the public go to learn more about medical marijuana?
Dr. Dave: Start with learning about the ECS, easily done courtesy of Dr. Google. In addition, the extremely well referenced book "Smoke Signals" by Martin Lee gives a well researched base of knowledge and should be read by anyone interested in this topic.
Featured Speaker Dr. Dave Hepburn just released his first book, The Doctor is In(sane): Indispensable Advice from Dr. Dave. Dr. Dave is entertaining and tackles a variety of health issues, from smoking (“the nicotine patch works best when placed directly over the mouth”) to the body mass index (“useless, corrupt, and irrelevant”) and provides sensible, up-to-date advice. The GP and popular columnist proves the adage about laughter and medicine.